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Doctors plead for Lotto funds to build biobank in war against disease

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Battle: Professor Tim Lynch from the Dublin Neurological Institute at the Mater Hospital. Photo: Steve Humphreys

Battle: Professor Tim Lynch from the Dublin Neurological Institute at the Mater Hospital. Photo: Steve Humphreys

Battle: Professor Tim Lynch from the Dublin Neurological Institute at the Mater Hospital. Photo: Steve Humphreys

Medical academics on the frontline of the Covid-19 battle want National Lottery funding for a national biobank, hosting a database of patient samples that would help tailor future treatment and prevention of the disease.

UCD professor Tim Lynch, a neurologist and chief academic officer for the Ireland East Hospitals Group (IEHG), has raised the issue with the Department of Finance.

Some €16m of unclaimed Lotto prize money was recently handed over to the Exchequer to support the health sector response to Covid-19, and Prof Lynch now wants it to go a step further.

A biobank is a collection of samples, such as blood or tissue, as well as healthcare data, which can be explored to throw light on the causes and progression of a disease.

In countries such as the UK and Germany, where they have been in place for years, they are being used to gain insights into the coronavirus.

Prof Lynch said it would allow for the collection, and storage, of samples from patients with and without Covid-19, which would be helpful in determining how different people were going to respond to the virus and how best to treat them, as well as supporting antibody testing for the Irish population.

"You might be able to target particular anti-viral agents for a certain patient who is going to get into trouble or anticipate a clotting tendency and use anti-coagulants early rather than late.

"It would mean a more personalised, precision approach, but to do that, you need the science, the biobank. So you put this national resource in place to test different hypotheses, to test what the virus does to different patients."

Ireland has single-user or disease-specific databanks - including one on infectious disease patients built up by Professor Paddy Mallon of UCD and Dublin's St Vincent's Hospital, but there is added value in a national repository with samples from multiple sources, providing a pool into which researchers can dip.

The idea of an All-Ireland biobank was investigated in 2004. It was considered feasible and to hold real potential to advance research into the genetic basis of health and disease on the island, but it never materialised.

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The new impetus has sprung from the heightened level of engagement and collaboration between medicine, academia and industry in response to the coronavirus.

"We have seen how we can achieve a lot in a pretty short period of time," said Prof Lynch, adding that they wanted to build on the gains that have derived from the response to the coronavirus.

For one, Covid-19 prompted a stepping up in contacts between the IEHG and the hospital networks linked to the six universities, and Prof Lynch said their now "weekly meetings clearly identified a need for national biobank".

For his part, Prof Lynch also wants the Government to retain use of the Citywest Hotel, off the N7 motorway on the fringes of Dublin, which came under the wing of the HSE for Covid-related purposes, as a permanent facility for the health service.

Work across UCD and its 11-hospital IEHG partner over the past three months, provides a snapshot of what universities and hospital groups have contributed to the fight against Covid-19.

Extensive support to the HSE from academia has ranged from the provision of facilities including labs, contact-tracing hubs, accommodation and field hospitals/clinics to research, and the supply of medical and personal protective equipment.

One project, led by Prof Alistair Nichol, UCD chair of critical care medicine and an intensive care consultant at St Vincent's Hospital, is an example of the sort of joined-up thinking that Prof Lynch and his colleagues want to see more of in the system.

As the pandemic's arrival spread panic, Prof Nichol was ready and waiting for the research opportunity it presented. He is the Irish lead on a ground-breaking global research network, called REMAP-CAP, which is evaluating different drug combinations on more than 500 Covid-19 patients around the world, including 20 in Ireland.

In April, an Irish patient was the first on whom the drug interferon was used for the purposes of this trial.

The story of the network's readiness for the novel coronavirus goes back to 2009 when bird flu (H1N1) hit and it was unprepared for a trial that would deliver statistically-reliable, real-time results.

"We tried to do trials but we couldn't get it up on time for the first pandemic wave and by the time we were ready, it was finished," he said. Only 100 patients globally were involved in that evaluation.

"We came up with this because we got it wrong before," he said.

The innovative REMAP CAP design means that the necessary protocols, such as ethics approval, are in place in advance.

REMAP-CAP aims to improve outcomes for critically ill patients with community-acquired pneumonia, but can adapt rapidly in the event of a pandemic.

"We are looking at people every winter with pneumonia and the idea is that for a new pandemic flu or coronavirus, the increase in pneumonia in the intensive care unit is the canary in the coalmine. We had our armoury ready. We were waiting for pandemic flu, not pandemic coronavirus, but when it came we were able to pivot immediately. We had some treatments going within two days," said Prof Nichol.


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