Pre-menopausal
women who took the combined oral contraceptive pill were less likely to develop
COVID-19 and had a lower rate of admission into hospital. However, this was not
the case for post-menopausal women taking hormone replacement therapy (HRT).
On
the one hand, the team identified that the use of hormone replacement therapy was
linked to an increased rate of predicted COVID-19. On the other hand, the HRT results
need be considered with caution due to the lack of information about HRT type,
route of administration and duration of treatment.
Over the COVID-19 pandemic,
widespread research has detected that adult men of all ages have higher chances
of developing serious complications compared with women. In addition,
post-menopausal women who contract COVID-19 have been shown to have more severe
complications.
The
team analysed the link between COVID-19 and its severity in women taking oestrogen
in the form of the combined contraceptive pill and in menopausal women undergoing
hormone replacement therapy.
The researchers analysed information supplied by hundreds of thousands of women logging their symptoms on the Zoe COVID Symptom Study app between May and June 2020, including members from the TwinsUK cohort. The team also used further health information collected through TwinsUK in their analysis.
Joint first author Dr Karla Lee explained:
“We hypothesised that pre-menopausal women with higher oestrogen levels would have less severe COVID-19 when compared to women of the same age and BMI who had been through the menopause, and our findings supported this. Additionally, when we compared a younger group of women on the combined oral contraceptive pill (COCP) with a similar group not taking the COCP we saw less severe COVID amongst those taking the COCP, suggesting hormones in the COCP may offer some protection against COVID-19. More research is certainly needed to further our knowledge.”
Joint
first author Dr Ricardo Costeira said:
“Thanks to women of the COVID Symptom Study app we were able to show, with relatively large numbers, the significance of studying the sex hormone oestrogen in relation to COVID-19. We hope that results from our study can help inform ongoing biomedical research and clinical trials in the field.”
Senior
author Dr Jordana Bell said:
“We would like to thank all of the women who participated in the COVID Symptom Study app and our TwinsUK members for their contributions towards this study, and would encourage everyone to keep logging on the app.”
The government has announced that the country will be moving to the “delay” stage of the plan to fight coronavirus in the UK.
We have taken the decision to cancel twin visits for the next month, in order to protect our twins and our staff alike. Our other research studies that require sending samples in the post will also be put on hold, and our staff will be working from home.
Please be aware that we are unable to take calls to our usual number, so please contact us over email at twinsuk@kcl.ac.uk if you need to reach us.
We are sending to you and your families and friends our very best wishes at this time, to keep yourself and others safe and strong. Of course, now is a good time to make plans to ensure you, your family and your friends will be ready and able to support each other should the need arise to self-isolate for an extended period of time. We know it is particularly important that older individuals have support networks in place, not forgetting that tools like Skype and Facetime can keep us all connected while minimising close contact.
Please keep an eye on the NHS webpage for the most accurate information, and use the NHS 111 online service or call the 111 helpline if any coronavirus symptoms you experience worsen and you need additional support
This means
that women may not benefit from technologies that predict health risks based on
genes on the X chromosome.
The team,
led by researchers from the Department of Twin Research & Genetic
Epidemiology, also found that age affects the patterns of X chromosomes,
through a process known as “X inactivation”.
Further
research is needed to understand the impact of different patterns of X
inactivation on healthy ageing in women and how it can be taken into account
when developing genetic tools that predict health risks.
What is X
inactivation?
Chromosomes
are lengths of DNA that contain genes on them.
Males have
both an X and a Y chromosome, and females have two X chromosomes (XX). Humans
only need one dose of the genes on the X chromosome however, so in females one
of the X chromosomes in every cell is “switched off” so they don’t get double
the dose. This process is known as X inactivation.
Which of the
two X chromosomes is switched off is random, leading to roughly equal levels of
each in the body.
Evidence
suggests however that in some body parts in women, one X chromosome is much
more likely to be inactivated than the other, leading to skewed patterns of X inactivation
across different body parts.
What did
they do?
The team, led by Dr Kerrin Small and Antonino Zito, studied whether the skew of X chromosome inactivation is linked to genetics, age, smoking and autoimmune diseases.
The
researchers studied blood, fat and skin samples from almost 800 twins,
including 8 pairs where one twin had rheumatoid arthritis – an autoimmune
condition – and the other twin did not.
What did
they find?
Blood, fat
and skin have different X chromosome inactivation patterns. These patterns
become more skewed with age and smoking. In addition, genetics affect the
skewed patterns in the blood, but not in fat or skin.
The team
also found that twins who have autoimmune conditions have more skewed patterns
of X chromosome inactivation in the blood than their co-twins without the
condition.
What does
this mean?
Researchers
will need to take into account the differences in X inactivation throughout the
body in females.
First author
Antonino Zito explained:
“It’s important to note that X inactivation patterns in the blood are not a reliable indicator of X inactivation in other parts of the body. We need to take this into account when designing genetic tools to predict health risks, which often rely on specialised blood tests. Otherwise, it may be that future genetic health tests are less reliable for older women, as the dose of X chromosome genes in the blood sample is different to that found elsewhere in the body.”
Senior
author Dr Kerrin Small added:
“Our results indicate an association between X inactivation patterns and genetics, age, smoking and autoimmune conditions. We will need to carry out further research to understand the relationship between these features, and the implications of skewed X inactivation for healthy ageing in women.”
Every four years since 2000, identical twins Tracey and Julia make a
trip to St Thomas’ Hospital in London. But they don’t go for treatment – they
go to meet researchers who are working to make new treatments possible for
others.
Tracey and Julia are two out of more than 14,000 twins who take part in TwinsUK, a study which follows twins throughout adulthood to understand how various health conditions develop and the genetics behind them.
They signed
up to TwinsUK after a former colleague mentioned it to them, as Julia
explained:
“My sister Tracey convinced me to sign up to TwinsUK. One of Tracey’s work colleagues mentioned the study to her as she’d signed up with her twin. After reading an article in Woman’s Own magazine, we both joined TwinsUK 6 months after the initial launch.”
Julia and Tracey
Studying twins
How can we tell
whether a particular condition is due to genetics and/or our environment and
lifestyle? The answer of course is twins.
Professor Tim Spector is the Director of TwinsUK. What started as an arthritis study with a few hundred twins in 1992 turned into what we now know as TwinsUK – a long-term study of 14,000 twins.
Professor
Spector explained the reasoning behind studying twins:
“Twins are the perfect experiment. Identical twins have identical genes. Non-identical twins, or “fraternal” twins, only share half their genes with each other. We can make comparisons to work out to what extent nature or nurture cause different conditions and diseases.”
When both
twins in a pair have the same condition, researchers say they are ‘concordant’.
If only one twin in a pair has the condition and the other doesn’t, they are
‘discordant’. Researchers can then design studies which take advantage of
twins’ unique set-up.
For example,
if more identical twin pairs are concordant for a particular condition than
non-identical twins, then that condition is likely influenced to a greater
extent by genes than by the environment.
Conversely,
if identical twin pairs are discordant for a particular condition, then
researchers can investigate whether other aspects such as their environment or
lifestyle may have a stronger influence on the development of the condition.
That’s not all twins can do. TwinsUK is uniquely placed to identify the molecular systems underpinning health and development of disease. The sheer volume of data TwinsUK collects means that their twins are amongst the most studied in the world. TwinsUK holds hundreds of thousands of pieces of information. Genetics, age, weight, blood pressure, bone density, gut bacteria, blood cell counts – you name it, they have it. As if that wasn’t enough, TwinsUK now wants to ramp up data collection and explore personal, social and ambient environmental influences in more detail. This includes studying the impact of things such as physical lifestyle, pollution, pesticides and inequality.
The
researchers are not trying to answer one big question with all this data. They’re
working in a wide range of areas such as ageing, type 2 diabetes, back pain and
sensory impairment, to answer lots of different questions about health and how
conditions develop throughout the life course of an adult. All of the work brings
us closer to understanding how the human body works – in sickness and in
health.
Sharing is caring
TwinsUK
doesn’t carry out their work alone. Considering the enormous amount of data
collected, it wouldn’t be possible, and there are lots of other researchers and
specialists who want to take a closer look at the data as part of their own
research.
Dr Claire
Steves, Deputy Clinical Director for TwinsUK explained:
“It’s important that we share our data with other health researchers so that we can make the best use of it. It’s only fair to the twins – after all, it would be unethical not to get the most value out of the samples and health measures they so generously provide.”
To this end,
the TwinsUK Resource Executive Committee has approved more than 800 data
sharing requests, covering 150,000 samples shared with 100 collaborators. This
means that even years after it was collected, the twins’ data and samples
continue to be used to advance health research for everyone.
That’s not
where the sharing ends either. TwinsUK has contributed to more than 850
scientific publications as well, ensuring that the results of health research carried
out using the twins’ data and samples are made available to other researchers
around the world.
Looking
ahead, TwinsUK has ambitions to work more closely with other cohort studies,
particularly other twin studies. This will encourage more cross-cohort work,
and researchers will be able to learn from each other – which can only be a
good thing for health research.
The twin experience
Sharing data
and publishing the results of research however are the end products of a
research process that starts with the twins. Central to TwinsUK are the twin
visits, where pairs of twins come into St Thomas’ Hospital for a full day of mental
and physical health checks and tests. In addition, twins may be offered the chance
to take part in specific studies that TwinsUK is carrying out at that time.
“The visits up to St Thomas’ have been interesting and revealing. It’s great that you have the opportunity to help with research, from taking vitamin supplements, which helped with research into eye problems, to having MRI scans to check the brain,” mused Tracey.
Some of the
tests may be unusual, but that doesn’t deter Julia:
“The studies and tests are also very safe. The fact that any procedures and studies are carefully and intricately explained makes me feel relaxed about what’s going to happen. It’s always interesting and sometimes fascinating or even surprising to hear the results of the studies.”
Tracey added:
“Finding out we were tone-deaf was surprising, but answered a few questions as to why music always sounded perfect!”
The twins do
receive some health test results, but most take part to help with research,
like Julia:
“Personally, I feel honoured to be a part of TwinsUK and if the studies my twin and I take part in can help make a difference to other people’s health then that has got to be a good thing.”
Looking ahead
The TwinsUK team has no intention of slowing down. TwinsUK
wants to remain at the cutting edge of scientific cohort studies, and so the
team are looking to expand: their connections, their data collection, and most
importantly, their registry.
Whereas up
until now TwinsUK has only studied adults, they recently received permission to
recruit and study twins all the way from birth. This adds another dimension to
the research programme, and will help researchers understand how diseases
develop throughout the whole life course of a person.
Dr Deborah
Hart, Executive Director:
“We’re really excited to be opening up TwinsUK to more people. Like Tracey’s work colleague, if you’re a twin and know some twins who would be interested, do point them towards us.”
And for
anyone thinking about signing up, Tracey has a few words of encouragement:
“The staff and twins that you meet have been amazing. I can honestly say it’s been lovely taking in part with the research, and I’ve made lovely friends and memories along the way.”
–
TwinsUK is currently recruiting same-sex identical and non-identical twins over the age of 18. We will soon begin to recruit under 18s. Find out more on twinsuk.ac.uk/twinzone or call the team on 020 7188 5555.
TwinsUK
is funded by the Wellcome Trust, Medical Research Council, European Union, the
National Institute for Health Research (NIHR)-funded BioResource, Clinical
Research Facility and Biomedical Research Centre based at Guy’s and St Thomas’
NHS Foundation Trust in partnership with King’s College London.
White wine
had a similar although much smaller effect, while researchers found no
association between other types of alcohol and gut bacteria variety.
In addition,
twins who drank more red wine than their co-twin had more diverse gut bacteria.
Previous
research suggests that a more varied community of bacteria in your gut leads to
a healthier gut.
First author
Dr Caroline Le Roy, from the Department of Twin Research, King’s College
London, explained:
“We’ve known for some time that red wine has some health benefits, which likely come from certain molecules called polyphenols.
“Our research shows how red wine is associated with an increase in gut bacteria diversity.
“At this time however we cannot say that drinking red wine directly causes an increase in gut bacteria diversity – we need more research first.”
What did
the researchers do?
The team
analysed food and drink questionnaire responses and gut bacteria diversity in
916 female TwinsUK participants. The researchers also looked at a number of
other factors such as weight and blood cholesterol levels.
The
researchers then checked their results by carrying out a similar analysis on
participants in two other studies from The Netherlands and the USA.
What did
they find?
Participants
who reported drinking red wine had greater levels of gut bacteria diversity
than non-red wine drinkers.
The team
also found that red wine consumption was linked with lower levels of obesity
and “bad” cholesterol, which was in part due to associated changes in gut
bacteria communities.
What does
this mean?
The
researchers believe the main reason for the association is due to the many
polyphenols in red wine. Polyphenols are defence chemicals naturally present in
many fruits and vegetables. They have beneficial properties and mainly act as a
fuel for our microbes.
Professor
Tim Spector, senior author on the study, explained:
“Although our results are very consistent, they are only associations and do not imply causation.
“We would need to carry out studies where humans or animals were given red wine in order to test whether red wine – or rather the polyphenols it contains – is causing an increase in gut bacteria diversity and limiting weight gain in turn.”
The
researchers stressed that it is still advised to drink alcohol in moderation, although
they have a recommendation for your tipple of choice:
“If you have to choose one alcoholic drink, then red wine is definitely the one to pick as it may have a positive effect on your gut bacteria and wider health.”
Genes have a greater influence than
previously thought not only on the number of moles you have but also where they
are on your body, according to
new research from TwinsUK.
The team found that women had more
moles on their legs than men, who previous studies have found tend to have more
moles on their head, neck and trunk. This is in line with increased melanoma
risk for men and women in these particular body sites.
The researchers found that for women,
the number of moles on their legs is 69% due to genes, compared to 26% for the
trunk.
The genes that influence mole number
and location are also linked with the development of melanoma.
Lead researcher Dr Alessia Visconti,
from the Department of Twin Research at King’s College London, explained:
“We’ve known for some time that moles are a major risk factor for melanoma skin cancer. With this research we now know that not only the number but also the location of moles on the body is in large part due to genetics.
“Our results add to previous evidence that indicates greater sun exposure alone is unlikely to be the reason why women have more moles on their legs.
“While sun exposure does contribute to mole count and skin cancer risk, policymakers, campaigners and health researchers will need to take the genetic element and sex into account when developing strategies to prevent and treat skin cancer.”
Back pain may be caused through the body or through the brain, according to the results of a new genetics study.
The international team, which included researchers from King’s College London, studied the genetic information of over 500,000 people.
They found genetic links between back pain and some of its known risk factors, such as depression, sleep disturbance, obesity and smoking.
Overall, the results highlight the complexity of the genetics behind back pain.
Why did they do this research?
Back pain is very common, and many adults will experience it during their lives. About one in ten people however go on to develop chronic back pain, which can be debilitating and affect people’s quality of life and ability to work.
Previously the team had identified genes linked to chronic back pain. The researchers therefore decided to carry out a much larger study, to get a better understanding of how genes are linked to back pain.
What did the team do?
The researchers used data from two existing research programmes.
The team analysed the genetic data of 509, 070 people who indicated they were experiencing back pain, and examined the links between back pain and known medical and social risk factors.
What did they find?
The team identified two further genes linked with back pain.
The researchers also found genetic links between back pain and depression, sleep disturbance, obesity and smoking, which are known risk factors for back pain.
Based on their findings and further analysis, the researchers proposed two key routes through which back pain may start.
One route was through the vertebrae – disks – that make up the backbone. The other route was through how people perceive and process pain.
What does this mean?
These results support what we currently understand about back pain. The findings will also help researchers and healthcare professionals develop strategies to treat and prevent back pain.
Dr Maxim Freidin, who led the study, explained:
“This study continues our ongoing efforts to identify genes underlying back pain.
“One of the most striking finding is shared genetic component of back pain with many other traits such as obesity, depression and anxiety, social and demographic factors. These traits co-occur with back pain and are considered as its risk factors.
“By identifying shared genetics for back pain and these traits, we provide evidence that this co-occurrence has strong biological ground. In turn, this finding may help identify causal links between back pain and its risk factors.”
Watch the short animation below to find out more about our back pain research.
