MICA: Development of PEGylated Domain I of beta-2-glycoprotein I as a new therapeutic agent for the antiphospholipid syndrome
Lead Research Organisation:
University College London
Department Name: Medicine
Abstract
Antiphospholipid syndrome (APS) is an autoimmune disease. This means that it is a disease in which the immune system of the body, which is designed to protect us against infections, instead starts to attack parts of the body itself causing the disease process. Different autoimmune diseases attack different parts of the body and have different symptoms. In APS, the problem is that the immune system makes antibodies called antiphospholipid antibodies (aPL) which interact with various different types of cells. The main cells affected are in blood vessels or in the womb, so the main effects of APS are to cause clots in blood vessels, strokes in the brain and/or recurrent miscarriages. APS is one of the main causes of these problems; for example it is one of the most important causes of stroke in people under 50.
The only treatments currently available to prevent clots, strokes or miscarriages in patients with APS are drugs that thin the blood and stop it from clotting. These drugs are called anticoagulants, and include warfarin and heparin. However, they have side-effects, notably a risk of bleeding, because they oppose all clotting - even the helpful clotting that occurs after an injury to stop bleeding from a wound. We seek to develop an entirely new form of treatment for APS, which does not thin the blood but which directly targets the aPL themselves.
The main way in which aPL cause their harmful effects in APS is to attach themselves to a protein in the blood called beta-2-glycoprotein I (beta2GPI). Beta2GPI is present in everyone and is harmless in the absence of aPL. When aPL combine with beta2GPI, however, this combination can bind to the surfaces of cells in the blood vessels or womb, change the behaviour of these cells and thus promote clotting or miscarriage. We are developing a drug that will be designed to stop aPL binding to beta2GPI to prevent this harmful process from occurring.
Beta2GPI is composed of five parts, called domains, arranged end to end like beads on a string. We know that aPL primarily attach to the end domain (Domain I or DI). Over the last 10 years our research group has developed the only system in the world for making DI in bacteria. We are now able to grow these bacteria in large quantities and purify DI from the bacterial cultures. This can be done in high-yield with the DI at over 95% purity. We have shown that this purified DI can be used to block binding of aPL from patients with APS to human beta2GPI on plastic plates and also to stop human aPL from causing clots in mice.
However, DI is a small molecule, which makes it unsuitable for use as a drug because it would only be retained in the body for a few hours. To circumvent this problem we need to modify our DI to make it larger. We are doing this by a process called PEGylation, in which large polyethylene glycol (PEG) molecules are joined to smaller molecules. We have been working with a biotechnology company called PolyTherics to achieve this. PolyTherics have developed technology to PEGylate small molecules at precisely determined points on their surface. We have achieved production of three different variants of PEGylated DI, which have PEG of different sizes. Larger PEGs could be good to make the DI last longer in the body after injection but could also block the effects of DI on aPL. Therefore we need to do tests comparing all three variants to see which is best. We have already proved that our PEG-DI blocks effects of aPL from patients with APS on binding to beta2GPI, on clotting in a test tube and on formation of clots in mice.
In this project we will carry out further tests to find out which form of PEG-DI is best at blocking effects of aPL then take that form forward to tests in animals. These tests will determine how long it is retained in the body and whether it has any toxic side-effects. Assuming no toxicity is found we will develop production of this PEG-DI at large scale in a form pure enough for human trials.
The only treatments currently available to prevent clots, strokes or miscarriages in patients with APS are drugs that thin the blood and stop it from clotting. These drugs are called anticoagulants, and include warfarin and heparin. However, they have side-effects, notably a risk of bleeding, because they oppose all clotting - even the helpful clotting that occurs after an injury to stop bleeding from a wound. We seek to develop an entirely new form of treatment for APS, which does not thin the blood but which directly targets the aPL themselves.
The main way in which aPL cause their harmful effects in APS is to attach themselves to a protein in the blood called beta-2-glycoprotein I (beta2GPI). Beta2GPI is present in everyone and is harmless in the absence of aPL. When aPL combine with beta2GPI, however, this combination can bind to the surfaces of cells in the blood vessels or womb, change the behaviour of these cells and thus promote clotting or miscarriage. We are developing a drug that will be designed to stop aPL binding to beta2GPI to prevent this harmful process from occurring.
Beta2GPI is composed of five parts, called domains, arranged end to end like beads on a string. We know that aPL primarily attach to the end domain (Domain I or DI). Over the last 10 years our research group has developed the only system in the world for making DI in bacteria. We are now able to grow these bacteria in large quantities and purify DI from the bacterial cultures. This can be done in high-yield with the DI at over 95% purity. We have shown that this purified DI can be used to block binding of aPL from patients with APS to human beta2GPI on plastic plates and also to stop human aPL from causing clots in mice.
However, DI is a small molecule, which makes it unsuitable for use as a drug because it would only be retained in the body for a few hours. To circumvent this problem we need to modify our DI to make it larger. We are doing this by a process called PEGylation, in which large polyethylene glycol (PEG) molecules are joined to smaller molecules. We have been working with a biotechnology company called PolyTherics to achieve this. PolyTherics have developed technology to PEGylate small molecules at precisely determined points on their surface. We have achieved production of three different variants of PEGylated DI, which have PEG of different sizes. Larger PEGs could be good to make the DI last longer in the body after injection but could also block the effects of DI on aPL. Therefore we need to do tests comparing all three variants to see which is best. We have already proved that our PEG-DI blocks effects of aPL from patients with APS on binding to beta2GPI, on clotting in a test tube and on formation of clots in mice.
In this project we will carry out further tests to find out which form of PEG-DI is best at blocking effects of aPL then take that form forward to tests in animals. These tests will determine how long it is retained in the body and whether it has any toxic side-effects. Assuming no toxicity is found we will develop production of this PEG-DI at large scale in a form pure enough for human trials.
Technical Summary
The antiphospholipid syndrome (APS) is an autoimmune disease in which autoantibodies interact with phospholipid-binding proteins, particularly beta-2-glycoprotein I (beta2GPI), leading to thrombosis, strokes and/or pregnancy morbidity. The only evidence-based treatment currently available is long-term non-specific anticoagulation with agents such as warfarin, carrying a significant risk of haemorrhage. No biologic targeted therapies exist.
We, and others, have shown that the key autoantibody-antigen interaction in the pathogenesis of APS is with the N-terminal domain (Domain I or DI) of beta2GPI. Recombinant DI, expressed from bacteria, blocks binding of IgG purified from APS patients (APS-IgG) to beta2GPI in-vitro and inhibits thrombosis caused by these patient-derived APS-IgG in a mouse model. Our proposed therapeutic for APS is a PEGylated form of DI. PEGylation of small molecules improves half-life in-vivo, allowing feasible dosing regimens in patients, and two PEGylated agents are already in clinical use for other rheumatological diseases.
We are collaborating with PolyTherics, a biopharmaceutical company with an innovative proprietary method of PEGylating proteins on disulphide bonds. A shared UCL/PolyTherics MRC CASE PhD student has established high-yield, high-purity expression of PEGylated DI, including three different PEG sizes, which retained the ability to inhibit the activity of IgG from patients with APS in assays of binding and clotting.
In this project we will work with a CMO to optimise and scale-up the manufacture of PEG-DI and produce material to GLP standards. Pharmacokinetics and efficacy studies will show which PEG-DI variant has the optimal balance of half-life and retained activity. Toxicology studies in appropriately selected species will be carried out. The aim is to select a lead PEG-DI candidate for a first-in-man study and to determine from preclinical safety, efficacy and pharmacokinetic studies the dose range for such a study
We, and others, have shown that the key autoantibody-antigen interaction in the pathogenesis of APS is with the N-terminal domain (Domain I or DI) of beta2GPI. Recombinant DI, expressed from bacteria, blocks binding of IgG purified from APS patients (APS-IgG) to beta2GPI in-vitro and inhibits thrombosis caused by these patient-derived APS-IgG in a mouse model. Our proposed therapeutic for APS is a PEGylated form of DI. PEGylation of small molecules improves half-life in-vivo, allowing feasible dosing regimens in patients, and two PEGylated agents are already in clinical use for other rheumatological diseases.
We are collaborating with PolyTherics, a biopharmaceutical company with an innovative proprietary method of PEGylating proteins on disulphide bonds. A shared UCL/PolyTherics MRC CASE PhD student has established high-yield, high-purity expression of PEGylated DI, including three different PEG sizes, which retained the ability to inhibit the activity of IgG from patients with APS in assays of binding and clotting.
In this project we will work with a CMO to optimise and scale-up the manufacture of PEG-DI and produce material to GLP standards. Pharmacokinetics and efficacy studies will show which PEG-DI variant has the optimal balance of half-life and retained activity. Toxicology studies in appropriately selected species will be carried out. The aim is to select a lead PEG-DI candidate for a first-in-man study and to determine from preclinical safety, efficacy and pharmacokinetic studies the dose range for such a study
Planned Impact
The main beneficiaries from this research would be people with the antiphospholipid syndrome (APS). The main effects of the syndrome are development of clots in blood vessels, strokes and recurrent miscarriages.
Currently, this research is targeted primarily at the prevention of clots and strokes. Although our proposed therapeutic agent may subsequently play a role in prevention of pregnancy loss in patients with APS this is not one of the current objectives.
APS is one of the commonest causes of strokes in people under 50. A stroke in a young person may have a devastating effect on their capabilities and quality of life as well as ability to work and look after others. Clots may be life-threatening, particularly in the pulmonary circulation. Thus, patients with APS need to take long-term drug treatment in order to prevent clots or strokes.
At present, the treatment of choice for prevention of clots and strokes in patients with APS is long-term anticoagulation with warfarin. This is difficult and inconvenient for patients. Warfarin and similar agents act by blocking all clotting, including the helpful forms of clotting that stop people bleeding when they cut or injure themselves. This means that patients who take these drugs are at risk of bleeding, which may be serious. Regular blood tests to monitor the effects of warfarin on clotting are necessary. In addition, warfarin may interact with a number of other drugs.
Our proposed biologic agent, being specific for the antibody-DI interaction, is designed not to interfere with any other form of clotting apart from that caused by antiphospholipid antibodies and therefore should not increase the risk of bleeding. Our aim is to provide a new form of therapy that can be taken long-term to prevent clotting in APS without causing side-effects. It is important to note that the development of either our biologic agent or any other novel therapeutic agent for APS will ultimately depend on the willingness of patients to enter into clinical trials comparing new agents with warfarin (the current standard-of-care agent). Thus it is crucial to engage patient groups in this research and to elicit their opinions about what sort of new therapies they would wish to see. We work closely with the Hughes Syndrome Foundation (HSF), the UK's leading patient group for APS. Professor Anisur Rahman, the Principal Investigator of this research project, is a Trustee of the HSF and speaks every year at their annual Patients' Day. Over the last few years, he has spoken about the Domain I research project and the challenges of developing new therapies and carrying out clinical trials. A letter of support from HSF has been uploaded as an Attachment.
There are possible economic and industrial benefits as the idea of developing a PEGylated agent to block binding of antigen to antibody in a chronic autoimmune disease is novel. We have used bacterial expression followed by site-specific PEGylation to make our agent. The bacterial expression system allows for high-yield production with relatively low cost compared to eukaryotic systems. If we can establish proof of concept for the utility of our PEGylated antigen as a therapeutic agent in the clinic, this could provide impetus for academics, companies and investors to explore similar drug development strategies in other diseases that are characterised by an identifiable key antigen-antibody interaction. Autoimmune diseases in which such interactions play an important role are systemic lupus erythematosus and rheumatoid arthritis.
Currently, this research is targeted primarily at the prevention of clots and strokes. Although our proposed therapeutic agent may subsequently play a role in prevention of pregnancy loss in patients with APS this is not one of the current objectives.
APS is one of the commonest causes of strokes in people under 50. A stroke in a young person may have a devastating effect on their capabilities and quality of life as well as ability to work and look after others. Clots may be life-threatening, particularly in the pulmonary circulation. Thus, patients with APS need to take long-term drug treatment in order to prevent clots or strokes.
At present, the treatment of choice for prevention of clots and strokes in patients with APS is long-term anticoagulation with warfarin. This is difficult and inconvenient for patients. Warfarin and similar agents act by blocking all clotting, including the helpful forms of clotting that stop people bleeding when they cut or injure themselves. This means that patients who take these drugs are at risk of bleeding, which may be serious. Regular blood tests to monitor the effects of warfarin on clotting are necessary. In addition, warfarin may interact with a number of other drugs.
Our proposed biologic agent, being specific for the antibody-DI interaction, is designed not to interfere with any other form of clotting apart from that caused by antiphospholipid antibodies and therefore should not increase the risk of bleeding. Our aim is to provide a new form of therapy that can be taken long-term to prevent clotting in APS without causing side-effects. It is important to note that the development of either our biologic agent or any other novel therapeutic agent for APS will ultimately depend on the willingness of patients to enter into clinical trials comparing new agents with warfarin (the current standard-of-care agent). Thus it is crucial to engage patient groups in this research and to elicit their opinions about what sort of new therapies they would wish to see. We work closely with the Hughes Syndrome Foundation (HSF), the UK's leading patient group for APS. Professor Anisur Rahman, the Principal Investigator of this research project, is a Trustee of the HSF and speaks every year at their annual Patients' Day. Over the last few years, he has spoken about the Domain I research project and the challenges of developing new therapies and carrying out clinical trials. A letter of support from HSF has been uploaded as an Attachment.
There are possible economic and industrial benefits as the idea of developing a PEGylated agent to block binding of antigen to antibody in a chronic autoimmune disease is novel. We have used bacterial expression followed by site-specific PEGylation to make our agent. The bacterial expression system allows for high-yield production with relatively low cost compared to eukaryotic systems. If we can establish proof of concept for the utility of our PEGylated antigen as a therapeutic agent in the clinic, this could provide impetus for academics, companies and investors to explore similar drug development strategies in other diseases that are characterised by an identifiable key antigen-antibody interaction. Autoimmune diseases in which such interactions play an important role are systemic lupus erythematosus and rheumatoid arthritis.
Organisations
- University College London (Lead Research Organisation)
- Polytherics (Collaboration)
- University of Greifswald (Collaboration)
- The University of Texas at San Antonio (Collaboration)
- University of Milan (Project Partner)
- Abzena (United Kingdom) (Project Partner)
- Imperial College London (Project Partner)
- The University of Texas Medical Branch at Galveston (Project Partner)
Publications
Buchholz I
(2021)
Specific domain V reduction of beta-2-glycoprotein I induces protein flexibility and alters pathogenic antibody binding.
in Scientific reports
Farinha F
(2020)
Outcomes of membranous and proliferative lupus nephritis - analysis of a single-centre cohort with more than 30 years of follow-up.
in Rheumatology (Oxford, England)
McDonnell T
(2022)
Antibodies to FXa and thrombin in patients with SLE differentially regulate C3 and C5 cleavage.
in Lupus science & medicine
McDonnell T
(2018)
Antiphospholipid Antibodies to Domain I of Beta-2-Glycoprotein I Show Different Subclass Predominance in Comparison to Antibodies to Whole Beta-2-glycoprotein I.
in Frontiers in immunology
McDonnell T
(2020)
The role of beta-2-glycoprotein I in health and disease associating structure with function: More than just APS.
in Blood reviews
McDonnell TCR
(2018)
Going viral in rheumatology: using social media to show that mechanistic research is relevant to patients with lupus and antiphospholipid syndrome.
in Rheumatology advances in practice
McDonnell TCR
(2018)
PEGylated Domain I of Beta-2-Glycoprotein I Inhibits the Binding, Coagulopathic, and Thrombogenic Properties of IgG From Patients With the Antiphospholipid Syndrome.
in Frontiers in immunology
Pericleous C
(2020)
Antiphospholipid antibody levels in early systemic lupus erythematosus: are they associated with subsequent mortality and vascular events?
in Rheumatology (Oxford, England)
Description | British Society for Haematology Draft Guidelines on Thrombophilia testing |
Geographic Reach | National |
Policy Influence Type | Contribution to new or Improved professional practice |
Description | APS Support UK - McDonnell |
Amount | £3,999 (GBP) |
Organisation | APS Support UK |
Sector | Charity/Non Profit |
Country | United Kingdom |
Start | 08/2019 |
End | 09/2020 |
Description | IBMS Grant |
Amount | £3,500 (GBP) |
Organisation | Institute of Biomedical Science |
Sector | Charity/Non Profit |
Country | United Kingdom |
Start | 08/2018 |
Description | MRF Fellowship Scheme (Lupus) |
Amount | £260,486 (GBP) |
Funding ID | MRF-057-0004-RG-MCDO-C0800 |
Organisation | Medical Research Council (MRC) |
Department | Medical Research Foundation |
Sector | Charity/Non Profit |
Country | United Kingdom |
Start | 01/2020 |
End | 12/2022 |
Description | Abzena |
Organisation | Polytherics |
Country | United Kingdom |
Sector | Private |
PI Contribution | This is an MRC Developmental Funding Pathway Scheme grant to develop a potential new therapeutic for the antiphospholipid syndrome (APS). Our group is leading the project and co-ordinating all the experiments to test the agent. We developed the methods for both production and testing |
Collaborator Contribution | PolyTherics/Abzena are producing the PEGylated molecules for testing and are also providing technical advice and guidance. |
Impact | The main outcome is the DPFS Grant itself. There have been a number of presentations at conferences and the paper about the development and characterisation of PEG-DI has been published in Frontiers in Immunology . |
Start Year | 2010 |
Description | Greifswald |
Organisation | University of Greifswald |
Country | Germany |
Sector | Academic/University |
PI Contribution | We have contributed our knowledge of the antiphospholipid syndrome, the structure of beta-2-glycoprotein I and methods for reducing it chemically. We also hosted a visit by Ina Buchholz, a PhD student from the Greifswald group, to learn these techniques and have sent antibody samples. More recently we have presented results from this collaboration at the International Society for Thrombosis and Haemostasis meeting in Dublin. In 2019 this collaboration was a key factor in enabling Thomas McDonnell to obtain a Medical Research Foundation Fellowship to study beta-2-glycoprotein I. |
Collaborator Contribution | Dr Mihaela Delcea's group have contributed their knowledge and expertise of techniques such as circular dichroism and atomic force microscopy. |
Impact | UCL Global Engagement Office grant to fund Ina Buchholz' visit to London in August 2016 and Dr Felix Nagel's visit in September 2019. |
Start Year | 2016 |
Description | Pierangeli |
Organisation | University of Texas |
Department | University of Texas Medical Branch |
Country | United States |
Sector | Academic/University |
PI Contribution | We have provided both monoclonal and polyclonal human antiphospholipid antobodies and a recombinant therapeutic protein for testing ine their mouse model of the antiphospholipid syndrome. |
Collaborator Contribution | They have developed the world's leading mouse model of the antiphospholipid syndrome. It is invaluable to test our antbodies and proteins in their system. |
Impact | Multiple papers including those with PMID 19342662 19220729 |
Start Year | 2006 |
Title | NOVEL POLYMER CONJUGATE |
Description | The present invention concerns a conjugate of a domain I ß2GP1 polypeptide with a water-soluble polymer, wherein the polymer is bound via two cysteine residues derived from a disulfide bridge in the domain I ß2GP1 polypeptide. |
IP Reference | US2016287718 |
Protection | Patent granted |
Year Protection Granted | 2016 |
Licensed | No |
Impact | A paper has been published describing the production and characterisation of PEG-DI. McDonnell T, Willis R, Pericleous C, Ripoll VM, Giles IP, Isenberg DA, Brasier AR, Gonzalez EB, Papalardo E, Romay-Penabad Z, Jamaluddin M. Ioannou Y and Rahman A. PEGylated Domain I of beta-2-glycoprotein I inhibits the binding, coagulopathic and thrombogenic properties of IgG from patients with the antiphospholipid syndrome. Frontiers in Immunology (in press) (2018) |
Description | 14th International Congress on SLE |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | I was invited to lecture on the subject of peptide therapies for the antiphospholipid syndrome. |
Year(s) Of Engagement Activity | 2021 |
Description | APS Support UK Patients Session |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Patients, carers and/or patient groups |
Results and Impact | At the 16th International Congress on Antiphospholipid Antibodies I was in charge of working with APS Support UK to arrange a patients' session. This consisted of talks from patients and then a Q&A session with experts. |
Year(s) Of Engagement Activity | 2019 |
Description | BSR 2019 |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Professional Practitioners |
Results and Impact | I was invited to give a State-of-the-Art lecture on the management of antiphospholipid syndrome at the British Society for Rheumatology conference in Birmingham |
Year(s) Of Engagement Activity | 2019 |
Description | British Society for Rheumatology case-based conference |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Professional Practitioners |
Results and Impact | I was invited to lead a case-based session on management of antiphospholipid syndrome. Feedback was very good. |
Year(s) Of Engagement Activity | 2021 |
Description | International APS congress |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | At the International Congress on Antiphospholipid Antibodies in Manchester in September 2019 Professor Rahman gave lectures on the prospects for peptide therapies in APS. These were state-of-the-art talks for a wide audience. |
Year(s) Of Engagement Activity | 2019 |
Description | Lecture at Wessex Regional Rheumatology Meeting |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | Regional |
Primary Audience | Professional Practitioners |
Results and Impact | I gave a lecture on management of the antiphospholipid syndrome to a group from the West of England. |
Year(s) Of Engagement Activity | 2023 |
Description | Lecture at the 17th International Conference on Antiphospholipid Antibodies In Cordoba, Argentina in May 2022 |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | I gave a lecture via Zoom at this international congress |
Year(s) Of Engagement Activity | 2022 |
Description | Lecture on APS at East Midlands Rheumatology SpR Training Day |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | Regional |
Primary Audience | Professional Practitioners |
Results and Impact | This was a lecture updating the diagnosis and management of the antiphospholipid syndrome for East Midlands SpRs |
Year(s) Of Engagement Activity | 2024 |
Description | Lecture on APS at the Turkish Society of Rhemautology Meeting in Antalya in October 2022 |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | I gave a lecture on APS to an audience in Turkey |
Year(s) Of Engagement Activity | 2022 |
Description | Lupus Initiative Kolkata |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | Several lectures on lupus and APS in Kolkata, India |
Year(s) Of Engagement Activity | 2020 |
Description | Lupus UK Patient Day |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Patients, carers and/or patient groups |
Results and Impact | I was asked to speak at a Lupus UK patient day on the role of Complement in Lupus, I then later took part in a panel discussion in which patients raised their concerns about their illnesses. |
Year(s) Of Engagement Activity | 2019 |
Description | PAMedinterna 2021 |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | I gave a lecture on the use of Direct Oral Anticoagulants in patients with the antiphospholipid syndrome. |
Year(s) Of Engagement Activity | 2021 |
Description | Royal College of General Practitioners |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Professional Practitioners |
Results and Impact | I was invited to give a lecture on management of antiphospholipid syndrome by the Royal College of General Practitioners. |
Year(s) Of Engagement Activity | 2021 |
Description | Royal College of Physicians |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Professional Practitioners |
Results and Impact | This was a talk on managing antiphospholipid syndrome at the Royal College of Physicians Acute and General Medicine conference |
Year(s) Of Engagement Activity | 2020 |
Description | Royal Society of Medicine |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | Regional |
Primary Audience | Professional Practitioners |
Results and Impact | I gave a lecture about management of APS at the Royal Society of Medicine. The feedback was very good. |
Year(s) Of Engagement Activity | 2020 |
Description | SW Thames Regional Rheumatology Meeting |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | Regional |
Primary Audience | Professional Practitioners |
Results and Impact | After my successful lecture at the BSR, i was invited to talk to a regional rheumatology group about the management of APS |
Year(s) Of Engagement Activity | 2019 |
Description | TV with Alice Roberts |
Form Of Engagement Activity | A broadcast e.g. TV/radio/film/podcast (other than news/press) |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Public/other audiences |
Results and Impact | I was invited to take part in a programme called Royal Autopsy with Professor Alice Roberts. I was invited due to my expertise in the antiphospholipid syndrome, which is why I am associating the activity with this award. The hypothesis of the programme is that Queen Anne may have had APS. |
Year(s) Of Engagement Activity | 2024 |