PhD interview, 04/01/2017, by Shreeya
Last year saw the opening of Tommy's National Centre for Miscarriage Research which enables 24,000 women per year to access treatment and support.
Miscarriage is by far the biggest cause of pregnancy loss in the UK, but it is also the least understood.
Our centre boasts some of the most skilled PHD students in the country who are working to find the answers and discover ways of preventing this heartbreak, currently affecting 1 in 4 UK parents.
Shreeya Tewary is a 30 year old PhD student who has been working at University Hospital Coventry since August 2015. The year after Shreeya began, the hospital became part of our National Centre for Miscarriage Research which opened in April 2016.
She told us;
'I am genuinely thrilled that in my time here we have become Tommy’s National Centre for Miscarriage Research. It is a wonderful opportunity to be part of projects that are ultimately going to create new knowledge.'
Shreeya is focusing on new concepts in recurrent miscarriage and endometrial mesenchymal stem cell deficiency (the endometrium is the lining of the womb).
Currently in the fifth year of her PHD, Shreeya is currently an MD student at the University of Warwick.
How long you have been working on this body of research and how did you come to be working on it?
I have been working on setting up a clinical trial of medication, which I have named SIMPLANT (Sitagliptin for IMPLANTation) for just over a year. The trial is based on new evidence from work done here at the University of Warwick showing that patients with recurrent miscarriage have low levels of endometrial mesenchymal stem cells (eMSCs) at the endometrium.
We have established a randomised, double-blind placebo-controlled pilot study aimed at improving the endometrial mesenchymal stem cell count in those with recurrent miscarriage. We will be repurposing a medication called sitagliptin that is routinely used for patients with diabetes. It is a DPP4 inhibitor known to enhance endometrial stem cell recruitment via an enhancement of the CXCL12-CXCR4 axis.
Why does this research appeal to you specifically?
Despite many randomised controlled trials there are still no effective treatments to prevent recurrent miscarriage in the majority of sufferers. Seeing such patients in my day-to-day work and being unable to give them answers has driven me to help conduct the trials we are running. I am looking forward to finding positive results from the SIMPLANT trial.
What is the long term aim of the work you are currently doing and when do you expect to have reached these results?
If the trial shows positive results I would hope it goes on to become a large multicentre randomised controlled trial. If we are able to show that sitagliptin improves the eMSC count in those with recurrent miscarriage, we will conduct further research to explore whether it also results in better pregnancy outcomes.
How long has Tommy’s been involved with the work you’re doing and what impact does the charity have on what you’re able to do?
The SIMPLANT trial is being funded by Tommy’s. Without Tommy’s support I would not have been able to run this clinical trial.
How much interaction do you have with women and parents and how much is based in the laboratory?
In my role as a clinical research fellow I am involved in caring for the participants in many research trials. I help with recruitment, consent and ongoing treatment once the participants have been recruited. I feel this role has given me a broad understanding about how research trials are conducted.
I am also involved in specialist research clinics every week including an implantation clinic, a preterm prevention clinic and a recurrent miscarriage clinic. These clinics have given me lots of patient contact in the way of consultations, follow up appointments, pelvic ultrasound scans and endometrial biopsies.
I am lucky to be based in the clinical sciences research laboratory of University Hospital Coventry and the University of Warwick. I am learning how to conduct clonogenic assays to assess the stem cell count of the endometrium as part of my research project.
What does the Tommy’s funding enable you to do that you wouldn’t otherwise have been in a position to?
The SIMPLANT medication, the matching placebo and the regulatory database required for all such clinical trials have been supported by Tommy’s funding. Without Tommy’s support we would not have been able to conduct this trial. The costs of the medication, the placebo and the database alone would be prohibitively expensive. Tommy’s support has provided a platform onto which the study can grow.
Let’s end on a cheesy one! What’s your proudest achievement to date?
Becoming a member of the Royal College of Obstetricians and Gynaecologists before turning 30 has to be my proudest achievement to date, as it is a notoriously difficult exam. I look forward to the completion of SIMPLANT being my next proudest achievement.
If you want to take part in one of our current miscarriage research trials you can find out which trials are currently looking for participants here.