Vaccination begins for TwinsUK staff in healthcare roles

15th December 2020 – by Paz García

Dr Claire Steves receiving the Covid-19 vaccination from a nurse.

Dr Claire Steves receiving the first dose of the COVID-19 vaccine

TwinsUK staff working in high-priority healthcare roles have now started to receive the COVID-19 vaccine.

The aim of the vaccine is to train your immune system to build protection against the virus that causes COVID-19. This helps to protect the person receiving the vaccine, as well as their community.

Dr Claire Steves is a Consultant Geriatrician at Guy’s and St Thomas’ Trust and Deputy Director (Clinical) of TwinsUK. She has been leading the TwinsUK Covid-19 research programme.

Dr Steves received her first dose of the vaccine earlier today. She said:

“For me, it’s clear that the risk of Covid and its effects on us economically and socially are huge. The risks of the vaccine in the short term are negligible and in the long term, honestly are not fully known, but likely to be small.

I work with vulnerable older people, so I feel it’s my honour to get the vaccine to protect them.”

Dr Rose Penfold receiving her first vaccine dose

Dr Rose Penfold is also a Geriatrician and is a researcher at TwinsUK. She received her first vaccine on the 18th December:

“A healthy dose of optimism to end a tough year! I received my first dose of the Pfizer vaccine on Friday. The whole experience was painless and other than a slightly heavy arm the following day, I didn’t notice any adverse effects.


I encourage all of you to take the opportunity to get vaccinated when you are able to, to protect yourself, friends and family and take a step on the journey towards restoring normality”

For more information on the COVID-19 vaccine, visit the NHS website here.

Professor Frances Williams to start new project to predict who will develop tinnitus

4th December 2020

The British Tinnitus Association (BTA) have announced today the first recipient of £125,000 through their 2020/21 large research grant funding programme – and it’s none other than our very own Professor Frances Williams.

The study aims to identify tinnitus biomarkers, using the health and genetics data of TwinsUK members.

The two-year research project will be led by Prof Frances Williams, Professor of Genomic Epidemiology at King’s College London, and Dr Christopher Cedderoth, Associate Professor in Hearing Sciences at the University of Nottingham.

Using data from TwinsUK and the Karolinska Institutet’s Swedish Tinnitus Outreach Project, they will be looking for biomarkers – or special molecules – in the blood that can help to objectively diagnose and/or predict who will develop tinnitus.

Professor Willams said:

“We’re really pleased to have been awarded a grant from the BTA, to allow us to take this significant project forward. We hope that using the large sample from TwinsUK will help us identify a blood molecule which will provide an objective, reliable indicator of tinnitus. This would allow the development of a blood test for tinnitus, leading to it being defined as a “disorder” rather than symptom, and providing an objective measure of a subjective condition.” 

This project is an important study and could provide essential information that will propel new research towards a cure for tinnitus.

The British Tinnitus Association are committed to funding, supporting and lobbying for what’s needed to silence tinnitus once and for all.

Addicted to the sun? It’s in your genes

10th September 2020 – by Paz García

Sun-seeking behaviour is linked to genes involved in addiction, behavioural and personality traits and brain function, according to a study of more than 260,000 people led by TwinsUK researchers.

This means that people’s behaviour towards seeking sun is affected by a genetic predisposition, and this needs to be taken into account when designing skin cancer awareness campaigns.

The researchers studied detailed health information of 2,500 twins from TwinsUK, including their sun-seeking behaviour and genetics. Identical twins in a pair were more likely to have a similar sun-seeking behaviour than non-identical twins, indicating that genetics play a key role.

The team then identified five key genes involved in sun-seeking behaviour from a further analysis of 260,000 participants from other cohorts. Some of these genes have been linked to behavioural traits associated with risk-taking and addiction, including smoking, cannabis and alcohol consumption and number of sexual partners.

First author Marianna Sanna said:

“When we look at the genes involved in sun-seeking behaviour, we see a clear link with genes previously associated with addiction and various risky behaviours. It would be interesting to investigate the connections between sun-seeking and other addictions and the genetic regulation and biology behind them.”

Senior author Dr Mario Falchi said:

“Our results suggest that tackling excessive sun exposure or use of tanning beds might be more challenging than expected, as it is influenced by genetic factors. It is important for the public to be aware of this predisposition, as it could make people more mindful of their behaviour and the potential harms of excessive sun exposure.”

Dr Veronique Bataille, Consultant Dermatologist involved in the research said:

“It is clear that we see individuals who have unhealthy sun behaviour and are fully aware of it. They will continue to expose themselves excessively even if they have clear skin cancer risk factors. Our research shows that genes regulating addiction and other risky behaviour are important and may explain some of the reticence in changing behaviours in the sun.”

Sanna, M et al. Looking for sunshine: genetic predisposition to sun-seeking in 265,000 individuals of European ancestry. Journal of Investigative Dermatology, 2020.

Could fat tissue hold the key to why some people experience more severe COVID-19?

17th August 2020

Lower levels of a key molecule in fat tissue are linked with health conditions that are risk factors for severe COVID-19, according to new research from TwinsUK.

ACE2 is a molecule our body’s cells use to regulate processes in our blood vessels, such as blood pressure, wound healing and inflammation. It also plays a key role in managing our heart and kidney functions to keep us healthy.

We know from recent research however that the coronavirus that causes COVID-19 also uses ACE2 molecules in the body as a gateway to infect our cells.

Faced with these two counteracting roles for ACE2, the TwinsUK team wanted to understand the link between ACE2 and the severity of COVID-19 experienced by individuals,  particularly as conditions such as obesity and type 2 diabetes, as well as heart and kidney conditions, put people at greater risk of severe COVID-19.

The body makes ACE2 molecules using instructions provided by the ACE2 gene. The researchers analysed ACE2 gene expression levels in fat tissue from over 760 TwinsUK participants and a further approximately 700 participants from the METSIM and FUSION studies. The team studied how ACE2 gene expression levels in fat tissue were linked with participants’ known pre-existing conditions, and measures of health such as cholesterol levels.

Lead authors Dr Julia El-Sayed Moustafa and Dr Kerrin Small explained:

“Doctors and researchers quickly realised that reactions to SARS-CoV-2 (coronavirus) infection vary widely between people, and that obesity and type 2 diabetes, as well as other factors, increase the risk of suffering from severe COVID-19. Through this research, we show that people living with these conditions often have lower gene expression levels of ACE2 in their fat tissue compared to the general population.”

Drs El-Sayed Moustafa and Small continued:

“Fat tissue is important not only for energy storage, but also for signalling in the body. Further studies will be needed to establish whether lower starting levels of ACE2 gene expression in this important tissue then contribute to COVID-19 severity.”

El-Sayed Moustafa et al. ACE2 expression in adipose tissue is associated with COVID-19 cardio-metabolic risk factors and cell type composition. medRxiv, 2020.

Cycling for COVID-19 – Professor Tim Spector’s fundraising challenge

10th August 2020 – by Paz García

It’s time to limber up for Professor Tim Spector, as he will be cycling 100 kilometres and swimming 1.5 km this weekend in order to raise money for the COVID Symptom Study.

The COVID Symptom Study app has more than 4 million users in the UK and the regular logs by participants have enabled researchers to make key discoveries about COVID-19.

For example, the widespread use of the app provided crucial data for understanding the spread and progression of the virus, such as confirming that loss of taste and smell – anosmia – was a bizarre yet distinct symptom of COVID-19.

Professor Spector said:

“To our supporters, those who’ve donated and those who have diligently reported their symptoms on the CV-19 app, the COVID Symptom Study team are extremely grateful for your contributions.

“Thank you, and stay safe and well.”

To donate, visit Tim’s fundraising page available here.

Researchers identify three nutrients with major effects on blood pressure

10th August 2020 – by Paz García

Going to work on an egg may be a good idea after all, as new research from TwinsUK has found that key nutrients in certain foods – including eggs – are linked with lower blood pressure.

High blood pressure, also known as hypertension, can lead to increased risk of heart disease and stroke. An estimated 1.5 billion people will be affected by hypertension by 2025, and so researchers want to understand how we can reduce high blood pressure back to a healthy level.

Many previous studies have shown that certain foods can affect blood pressure, and the TwinsUK team wanted to explore this further and understand specifically which nutrients in foods are linked with blood pressure.

The team analysed blood pressure data and food frequency questionnaires of over 3,800 TwinsUK participants who don’t use blood pressure medication. The researchers also studied an additional group of identical twin pairs with large differences in blood pressure.

The team found 15 nutrients were associated with blood pressure, even after taking into account other factors such as age, sex and body mass index (BMI).

Three key nutrients however were linked with the largest effect on blood pressure:

1. Alcohol: This had the worst effect on blood pressure, and the more you drink, the higher your blood pressure.

2. Riboflavin: Also known as vitamin B2, this nutrient is found in milk and egg products and can reduce blood pressure.

3. Tryptophan: This nutrient is found in meat products and soybeans and can reduce blood pressure.

First author Panayiotis Louca explained the next steps for this research:

“Our results are further evidence that diet is closely linked with blood pressure. We now need clinical trials to test how different people respond to a modified diet and how it impacts blood pressure. ”

Senior author Cristina Menni said:

“Before we can encourage people to eat more of a certain food to reduce blood pressure, we need to understand how exactly different nutrients affect our blood vessels and blood pressure. Our work supports the need for further research to understand how we could use diet as a tool for preventing and treating hypertension. ”

Louca, P. et al. Dietary influence on systolic and diastolic blood pressure in the TwinsUK cohort. Nutrients, 2020.

There are microbes in your urine – and now we know why

23rd July 2020 – Paz García

You have microbes in your urine and that’s completely normal, according to the latest TwinsUK research.

Contrary to popular belief, urine is not sterile but rather home to a variety of microbes – and not just when you have a urinary tract infection (UTI).

The study of the microbiome in the urine, known as the “urobiome”, is relatively new. We know from previous research that certain microbes are responsible for infections, including UTIs. In the first large-scale study of its kind, TwinsUK researchers wanted to understand what microbes are typically present in the urobiomes of healthy adults and why.

The researchers analysed urine samples from 1,600 healthy female TwinsUK participants who were on average 66 years old.

The team found that microbes in urine varied greatly from person to person, with only 2.2% of bacteria present found in at least 5% of samples, and diversity increasing with age.

The community of microbes in the urine was also distinct from microbes found in stool samples, showing that the urinary tract has its own, unique microbiome.

The team found that age, menopausal status, previous UTIs and genetics were the top factors defining the urobiome. Diet and use of antibiotics however had a smaller effect on the diversity of microbes present.

In addition, the researchers found a strong connection between a person’s genetics and key bacteria linked to urinary tract infections.

First author Dr Adewale Adebayo explained:

“This is the first large-scale study to look at the microbes present in the urinary tracts of healthy adult females. Further research will need to focus on the differences between males and females and how this may affect susceptibility to infections.”

Senior author Dr Claire Steves said:

“Thank you to our twin participants for donating a urine sample – it may not be a glamorous task, but it has allowed us to get the first real sense of what a healthy urobiome looks like and what factors affect it. This is invaluable for future studies of the urobiome.”

Adebayo, A.S. et al. The urinary tract microbiome in older women exhibits host genetic and environmental influences. Cell Host & Microbe, 2020.

What does tap water mean for our gut bacteria? Dr Ruth Bowyer explains in this blog

17th July 2020 – Dr Ruth Bowyer

The global improvement to tap water quality worldwide has been a public health success, with access to clean water for drinking, food preparation and cleaning being essential for health.

It’s understood that where there are contamination events – for example, pollutants entering water bodies that feed into tap water treatment works – drinking water can affect human health. How badly this might affect an individual might in part be due to their microbiome.

Microbiome and health

Whilst diet is frequently researched, drinking water, and its ability to alter gut bacteria, has been surprisingly overlooked. So that’s what we set out to do.

We asked 90 of our amazing twins who have lived in the same house since they donated their microbiome samples to supply a much easier to acquire sample – tap water! We then looked for any associations between the tap water and the microbiota.

Because drinking water in the UK is extremely regulated, we were not looking to see if there was a health effect of the water. Unless there are very old pipes, it is not only safe to drink but indeed essential to drink tap water regularly.

What we found instead was that molecules that are commonly found in water (for example, minerals that are dissolved in the water), but differ from tap to tap and region to region, did associate with microbiome composition.

This was a small, preliminary study, and further work and experiments are needed to confirm our findings, but it does suggest that tap water could influence the microbiome.

This means that where there is a contamination event, one of the ways it might harm us is via the microbiome, and that in areas where this happens frequently, treatments targeted at the microbiome it might be one way of lessening its impact.

Thank you to our twins

We’d really like to thank the twins who participated in this project, who were extremely patient, engaged and a joy to speak to for the questionnaire part of the data collection. Every project is a constant reminder that all of the research we do would be impossible without our dedicated volunteers!

Bowyer et al. Associations between UK tap water and gut microbiota composition suggest the gut microbiome as a potential mediator of health differences linked to water quality. Science of The Total Environment, 2020.

Eat yourself slim? Molecules found in plants linked to reduced risk of obesity

6th July 2020 – Paz Garcia

Eating polyphenols improves your gut health and could lead to a lower risk of obesity, according to the latest research from TwinsUK.

Polyphenols are molecules found in in high quantities in foods such as fruits, nuts, tea, coffee, vegetables, olive oil and even red wine.

Previous studies have found that higher polyphenol intake is linked with improved gut bacteria diversity and reduced risk of obesity. It has not been clear however whether these associations are due to the polyphenols themselves or the fibre content of the food.

In this study, the researchers investigated whether polyphenol intake was linked with a reduced risk of obesity independently of fibre content. This builds on other recent work led by Professor Tim Spector on the health effects of polyphenols.

The team analysed gut bacteria data from stool samples and food frequency questionnaires from 1,810 female TwinsUK participants.

They found that higher polyphenol intake was linked with a 20% lower chance of obesity, after accounting for fibre content. This was in part due to increased gut bacteria diversity.

First author Olatz Mompeo explained:

“Our findings highlight the potential importance of polyphenol consumption to keep our gut bacteria happy and our bodies healthy. We now need nutrition trials to test these associations and see if they hold true across different ages in men and women.”

Senior author Dr Cristina Menni said:

“Thank you very much to our selfless twins for regularly filling in food questionnaires and donating stool samples. They may not be the most glamorous of tasks, but they make this health research possible, for everyone’s benefit.”

Mompeo et al. Consumption of stilbenes and flavonoids is linked to reduced risk of obesity independently of fibre intake. Nutrients, 2020.

Does gut bacteria play a role in rheumatoid arthritis?

26th June 2020 – Paz Garcia

Image by Alicia Harper

A group of gut bacteria is linked with high genetic risk of rheumatoid arthritis, according to new TwinsUK research published today.

These findings will help researchers understand how rheumatoid arthritis may develop in the very early stages.

Rheumatoid arthritis (RA) is a long-term condition that causes swelling and stiffness in the joints and can lead to disability. It affects around 400,000 people in the UK.

We know from previous research that certain genes can make some people are more likely to develop RA than others, and that a combination of genetic and environmental factors lead to RA. In this study, the team investigated whether high-risk genes were linked with certain types of gut bacteria.

The researchers analysed genetic and microbiome data of 1,650 TwinsUK participants with no history of RA, so that they could see if they could spot any early warning signs before the onset of symptoms. The team calculated the twins’ genetic risk for RA and then looked at the gut bacteria identified from stool samples.

The team found that bacteria from a group named Prevotella were associated with high genetic risk of RA. In addition, the researchers found bacteria from the same group were linked with early stages of RA when they analysed data from participants in another cohort study.

First author Philippa Wells explained:

“Our findings are in agreement with the gut microbiome having a role in the development of RA. Speculatively, in the future this could be a possible target for treating the condition. This is something future studies will need to explore.”

The work was funded by charity Versus Arthritis. Head of Research Engagement at Versus Arthritis Natalie Carter said:

“8 out of 10 people who experience chronic pain every day have arthritis. Despite treatments for rheumatoid arthritis improving over the years, there are still too many people who live with persistent pain because they do not respond to available therapies.

“By understanding how specific bacteria in the gut affect the development of rheumatoid arthritis we not only open the door to more targeted, effective treatments, but we can begin to tackle the disease sooner. Implementing treatment that works as early as possible will keep joint damage to a minimum, help people manage their condition and allow them to lead full and active lives.”

Wells et al. Associations between gut microbiota and genetic risk for rheumatoid arthritis in the absence of disease: a cross-sectional study. Lancet Rheumatology, 2020.

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