Europe PMC Team

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[[Image Source:
[Serial/Trash](http://www.serialtrash.com/){target="_blank"
rel="noopener"}]{style="font-size: xx-small;"}]{style="font-family: \"arial\" , sans-serif; line-height: 150%;"}
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[There is good news  
for rheumatoid arthritis sufferers: scientists are a step closer to
predicting which  
patients will benefit the most from a particular type of drug using just
a  
urine
sample.]{style="font-family: \"arial\" , sans-serif; font-size: 11pt; line-height: 150%;"}
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[Imagine being in pain  
whilst carrying out routine, daily tasks such as opening a door,
reaching for  
something in the cupboard, or writing. On top of this, imagine that this
pain  
often comes on quickly and intensively, but not being able to predict
when this  
will happen. This is what thousands of people with rheumatoid arthritis
have to  
cope with every day. ]{lang="EN-US"
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[Usually, the cells of  
your immune system protect your body from invasion by harmful viruses
and  
bacteria, acting as your body's army. Rheumatoid arthritis occurs when
some of  
these immune cells start to attack your own cells, specifically in the
healthy  
tissue around your joints. This results in the affected joint and
surrounding  
area becoming swollen, painful and stiff. These symptoms often intensify
very  
quickly and without warning, resulting in severe discomfort for the
person  
concerned. What causes these sudden 'flares' and the onset of the
disease in  
general is still largely a mystery. ]{lang="EN-US"
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[There are currently  
several different types of drugs available to treat the symptoms of
rheumatoid  
arthritis. Unfortunately, it can take a period of trial and error to
find out  
which drug works the best to reduce symptoms in each patient. Doctors
and  
scientists are currently trying to find out why some drugs work very
well in  
some people, but not in others. This research is important as it will
ensure  
that in the future, patients are more likely to be given a drug that
works the  
best for them; wasting less time than trying treatments by trial and
error.]{lang="EN-US"
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[TNF-alpha inhibitors  
are a group of drugs currently used to treat moderate to severe
rheumatoid  
arthritis. TNF-alpha is one of the proteins responsible for creating
the  
swelling and pain in joints affected by rheumatoid arthritis. These
drugs block  
the TNF-alpha protein, and so in turn reduce the symptoms associated
with  
rheumatoid arthritis. They work very well in reducing symptoms in some  
patients, but do not work for many others. This latest research reveals
a potential  
way to identify which people with rheumatoid arthritis are most likely
to  
respond well to the TNF-alpha inhibitor drugs, by looking at their
urine.]{lang="EN-US"
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[[Image Source: Shutterstock Copyright: MILA
Zed ]{style="font-size: xx-small;"}]{lang="EN-US"
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[The researchers  
decided to see if they could find any differences in the amounts of
certain  
molecules in the urine of rheumatoid arthritis patients who responded
well to  
the TNF-alpha inhibitors, compared to the urine of those who did not
respond well.  
They chose to look at the patients' urine as a similar approach has
already  
been successful with other diseases. Obtaining a urine sample is also
very  
quick, easy and not intrusive to the patient. ]{lang="EN-US"
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[Sixteen rheumatoid  
arthritis patients were chosen to participate in the study. They each
gave a  
urine sample before commencing treatment with one of two TNF-alpha
inhibitor  
drugs, which continued for one year. After this time, a doctor assessed
the  
patients and decided, based on their symptoms, who had responded well
and who  
had not. At the same time, scientists analysed the urine samples the
patients had  
given at the beginning of the study. They did this using a technique
called  
nuclear magnetic resonance spectroscopy. This takes advantage of the
notion  
that different molecules behave differently when they come into contact
with a  
magnetic field. When a magnetic field was applied to the urine samples,
all the  
different molecules in the urine separated and a machine identified
exactly  
which molecules were present, and in what amounts. ]{lang="EN-US"
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[Three different computer  
programs analysed the results to make sure the final conclusions were
accurate.  
In the patients who responded well to the TNF-alpha inhibitor drugs, all
three  
computer programs agreed that these patients had more histamine,
glutamine and  
xanthurenic acid molecules in their urine, but less ethanolamine
molecules,  
compared to those who did not respond well. These findings mean that, if
this  
test was used in the future, a doctor could take a urine sample from a  
rheumatoid arthritis patient to help him or her decide if the TNF-alpha
inhibitor  
drugs are likely to ease the symptoms of the patient. ]{lang="EN-US"
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[This study was small,  
so the next step is to test these findings on a larger group of
rheumatoid  
arthritis patients. These initial findings are exciting though, and not
just  
for those patients who are most likely to benefit from the TNF-alpha  
inhibitors. For patients where the drugs are not likely to work, this
will be  
known quickly, and an alternative can be suggested instead. This means
that  
each patient is more likely to receive a treatment that helps his or
her  
symptoms as quickly as possible; something which is
invaluable.]{lang="EN-US"
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*[  
]{style="font-family: \"arial\";"}*  
*[This summary by Elizabeth McAdam was shortlisted for Access to
Understanding 2014 and was awarded second prize. It describes research
published in the following
articl]{style="font-family: \"arial\";"}[e, ]{style="font-family: \"helvetica neue\" , \"arial\" , \"helvetica\" , sans-serif;"}*[*selected
for inclusion in the competition by the Arthritis Research
UK*]{style="background-color: white; color: #5a595e; font-family: \"helvetica neue\" , \"arial\" , \"helvetica\" , sans-serif; line-height: 20px;"}*:*
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[[Metabolic profiling predicts response to anti-tumor necrosis factor α
therapy in patients with rheumatoid
arthritis](http://europepmc.org/articles/PMC3715109){target="_blank"
rel="noopener"}]{style="font-family: \"arial\" , sans-serif; line-height: 19px;"}
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[PMCID: PMC3715109]{style="font-family: \"arial\" , sans-serif;"}
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[[S.R. Kapoor, A. Filer, M.A. Fitzpatrick, B.A. Fisher, P.C. Taylor,
C.D. Buckley, I.B. McInnes, K. Raza & S.P.
Young.]{style="font-size: xx-small;"}]{style="font-family: \"arial\" , sans-serif;"}
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[[*Arthritis & Rheumatism* (2013) 65(6),
1448-1456.]{style="font-size: xx-small;"}]{style="font-family: \"arial\" , sans-serif;"}
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[  
]{style="font-family: \"arial\" , sans-serif;"}
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<div>

[*[Access to
Understanding](http://www.access2understanding.org/competition/){target="_blank"
rel="noopener"}* entrants are asked to write a plain English summary of
a research article. For *Access to Understanding* 2014 there were 10
articles to choose from, selected by the [Europe PMC
funders](http://europepmc.org/Funders/){target="_blank"
rel="noopener"}. **The articles are all available from Europe PMC, are
free to read and download, and were supported by one or more of the
Europe PMC
funders.**]{style="font-family: \"arial\" , sans-serif; line-height: 24px;"}

</div>

<div>

[  
]{style="font-family: \"arial\" , sans-serif; line-height: 24px;"}

</div>

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[]{lang="EN-US"
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<div>

[Look out here and on
Twitter [@EuropePMC_news](https://twitter.com/EuropePMC_news){target="_blank"
rel="noopener"} for further competition news and other Europe PMC
announcements.  ]{style="font-family: \"arial\" , sans-serif; line-height: 24px;"}[ ]{style="font-family: \"arial\" , sans-serif; line-height: 24px;"}

</div>
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[Image Source: Serial/Trash]{style=“font-family: "arial" , sans-serif; line-height: 150%;”}  [There is good news for rheumatoid arthritis sufferers: scientists are a step closer to predicting which patients will benefit the most from a particular type of drug using just a urine sample.]{style=“font-family: "arial" , sans-serif; font-size: 11pt;

Reforming rheumatoid arthritis treatment: a step in the right direction

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[By Elizabeth McAdam, a postdoctoral researcher at the Cancer Research
UK London Research Institute,
UK]{style="font-family: \"helvetica neue\" , \"arial\" , \"helvetica\" , sans-serif;"}  
[  
]{style="font-family: \"helvetica neue\" , \"arial\" , \"helvetica\" , sans-serif;"}[[Note:
Elizabeth ]{style="font-family: \"helvetica neue\" , \"arial\" , \"helvetica\" , sans-serif;"}[was
awarded second place in this year's *[Access to
Understa](http://europepmc.org/sciencewritingcompetition){target="_blank"
rel="noopener"}*]{style="background-color: white; font-family: \"helvetica neue\" , \"arial\" , \"helvetica\" , sans-serif; line-height: 20px;"}*[nding](http://europepmc.org/sciencewritingcompetition){target="_blank"
rel="noopener"}*[ competition. Check back tomorrow to read her winning
entry. Congratulations
Elizabeth!]{style="background-color: white; font-family: \"helvetica neue\" , \"arial\" , \"helvetica\" , sans-serif; line-height: 20px;"}]{style="font-size: x-small;"}  
[  
]{style="font-family: \"helvetica neue\" , \"arial\" , \"helvetica\" , sans-serif;"}  
[Writing always terrified me. Growing up, I didn't enjoy English at
school; I positively hated it. It all seemed to be about big words and
complex detail. But I didn't really care; I was going to be a scientist!
And who needs to worry about being good at writing when you're a
scientist?]{style="font-family: \"helvetica neue\" , \"arial\" , \"helvetica\" , sans-serif;"}  
[  
]{style="font-family: \"helvetica neue\" , \"arial\" , \"helvetica\" , sans-serif;"}  

|                                                                                                                                                                                                                                                                                                                               |
|:-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------:|
| [![](https://3.bp.blogspot.com/-01MUcwQPC3g/U2i2x6NlR6I/AAAAAAAAATQ/ipgfP9T20G0/s1600/240314_0115.jpg){decoding="async" loading="lazy" border="0" height="400" width="266"}](http://3.bp.blogspot.com/-01MUcwQPC3g/U2i2x6NlR6I/AAAAAAAAATQ/ipgfP9T20G0/s1600/240314_0115.jpg){style="margin-left: auto; margin-right: auto;"} |
|              [Elizabeth receiving her award from Sir Mark Walport ]{style="font-family: \"helvetica neue\" , \"arial\" , \"helvetica\" , sans-serif; font-size: xx-small;"}[©The British Library Board]{style="font-family: \"helvetica neue\" , \"arial\" , \"helvetica\" , sans-serif; font-size: xx-small;"}               |

[Fast forward ten years to my doctoral studies. I found myself becoming
increasingly frustrated reading poorly written research articles.
Scientists were desperately trying to look impressive by using long
complex paragraphs of words to explain work that could easily be
summarised in a sentence. I would spend hours reading and re-reading a
single article trying to get my head around the unnecessary (and often
wrong) use of words, all the while wondering how an interested member of
the public might fare. Someone newly diagnosed with a particular disease
may be curious as to what the latest research means for them, or maybe a
scientific documentary inspired another to read on further. Whatever the
reason, these people would find the jargon filled, over complicated,
research articles impossible to
understand. ]{style="font-family: \"helvetica neue\" , \"arial\" , \"helvetica\" , sans-serif;"}  
[  
]{style="font-family: \"helvetica neue\" , \"arial\" , \"helvetica\" , sans-serif;"}  
[Often, the media is the messenger between scientist and non-scientist,
and is usually fairly accurate in its reporting. Unfortunately however,
many newspaper articles describing current scientific findings are
headed by misleading, sensationalised titles and content, particularly
when it comes to medical research. 'Food X causes cancer!' or 'Food Y
prevents cancer!' can be weekly occurrences in some heavily read
tabloids, at best misleading the public; at worst outright scaring
them. ]{style="font-family: \"helvetica neue\" , \"arial\" , \"helvetica\" , sans-serif;"}  
[  
]{style="font-family: \"helvetica neue\" , \"arial\" , \"helvetica\" , sans-serif;"}  
[That's the beauty of *Access to Understanding*. It promotes simple, yet
accurate scientific writing intended for interested members of the
public often bewildered by the science which directly impacts upon their
daily lives. The competition requires entrants to summarise a research
article in plain English, which is then checked for its scientific
accuracy and judged. I chose an article from Dr Stephen Young's research
group at Birmingham University, which detailed some exciting
possibilities for alleviating rheumatoid arthritis, something I knew
almost nothing about beforehand. This was actually beneficial, as I
needed to simplify the information to understand it
myself. ]{style="font-family: \"helvetica neue\" , \"arial\" , \"helvetica\" , sans-serif;"}  
[  
]{style="font-family: \"helvetica neue\" , \"arial\" , \"helvetica\" , sans-serif;"}  
[The competition has raised an important issue, and hopefully in the not
too distant future, scientists will be asked to provide a lay summary
when they publish their work, to help make research accessible to anyone
who is interested in it. Encouraging the next generation of scientists
to write in plain English will help immensely, which, I was pleased to
hear, is already happening at Dr Young's University.
 ]{style="font-family: \"helvetica neue\" , \"arial\" , \"helvetica\" , sans-serif;"}  
[  
]{style="font-family: \"helvetica neue\" , \"arial\" , \"helvetica\" , sans-serif;"}  
[Writing no longer terrifies me quite as much as it used to. *Access to
Understanding* has helped me to realise that a good piece of writing
doesn't always involve fancy words and in-depth descriptions. Sometimes,
keeping it simple is best. After all, what's the point of writing
something if most people can't understand
it?]{style="font-family: \"helvetica neue\" , \"arial\" , \"helvetica\" , sans-serif;"}  
[  
]{style="font-family: \"helvetica neue\" , \"arial\" , \"helvetica\" , sans-serif;"}  
[Look out here and on
Twitter [@EuropePMC_news](https://twitter.com/EuropePMC_news){target="_blank"
rel="noopener"} for further competition news and other Europe PMC
announcements.]{style="font-family: \"arial\" , sans-serif; line-height: 24px;"}
:::


[By Elizabeth McAdam, a postdoctoral researcher at the Cancer Research UK London Research Institute, UK]{style=“font-family: "helvetica neue" , "arial" , "helvetica" , sans-serif;”} [ ]{style=“font-family: "helvetica neue" , "arial" , "helvetica" , sans-serif;”}[Note: Elizabeth ]{style=“font-family: "helvetica neue" , "arial" , "helvetica" , sans-serif;”}[was awarded second place in this year’s
<em>
 Access to
</em>

Simplicity is sometimes best

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[By
]{style="font-family: \"helvetica neue\" , \"arial\" , \"helvetica\" , sans-serif;"}[Emma
Pewsey,  
Department of Materials Science, University of
Cambridge.]{style="font-family: \"helvetica neue\" , \"arial\" , \"helvetica\" , sans-serif;"}

  

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[I'm a relative newcomer to biosciences -- at school, physics  
and chemistry were more my thing. However, starting a PhD on the
corrosion of  
metal implants in the human body meant I needed to brush up on my
biology. It  
was time to hit the medical
journals.]{style="font-family: \"helvetica neue\" , \"arial\" , \"helvetica\" , sans-serif;"}
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[It was easy enough to find papers. However, it was much  
harder to determine whether they were relevant. Abstracts seemed to
compete  
with each other in squeezing the most technical terms into one sentence.
I was  
lucky -- I had plenty of time to go and learn what they meant. Most
people  
don't.]{style="font-family: \"helvetica neue\" , \"arial\" , \"helvetica\" , sans-serif;"}
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[Once I'd broken through the jargon, I found many of the  
papers really interesting. I like interesting facts, and the majority of
research  
papers are full of them. Therefore, it's a shame that they're so
inaccessible  
to most people.
]{style="font-family: \"helvetica neue\" , \"arial\" , \"helvetica\" , sans-serif;"}
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[So I love the idea behind the *Access to Understanding*  
competition. I was surprised to learn at the awards ceremony how many  
non-scientists nowadays need to access research papers -- from patient
groups to  
teachers. My own participation in science outreach events has also shown
me how  
much general interest there is in science. And making research more
accessible  
should be a priority for all researchers -- after all, who wouldn't
prefer their  
work to be read by thousands of people, rather than just a
couple?]{style="font-family: \"helvetica neue\" , \"arial\" , \"helvetica\" , sans-serif;"}
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[The competition also gave me an excuse to try some science  
writing -- something I'd been meaning to do for ages.
]{style="font-family: \"helvetica neue\" , \"arial\" , \"helvetica\" , sans-serif;"}
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[Looking down the list of articles to choose from, I saw one  
I had to write about. [Cortical thickness mapping to identify  
focal osteoporosis in patients with hip fracture? Yes
please.]{style="mso-bidi-font-family: \"Times New Roman\"; mso-fareast-font-family: \"Times New Roman\";"}]{style="font-family: \"helvetica neue\" , \"arial\" , \"helvetica\" , sans-serif;"}
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[[[You see, I have a guilty not-so-secret.  
I love bones. They are the most fantastic objects in the universe. In  
particular, I love how they adapt to the forces which we place on them
in our  
everyday lives to create a framework that supports our bodies that tries
to be  
exactly as strong as it needs
to]{style="font-family: \"helvetica neue\" , \"arial\" , \"helvetica\" , sans-serif;"}]{style="font-family: \"calibri\";"}[
be. But sometimes this goes wrong, and bones  
break. Thanks to the *Access to Understanding* competition, I got to
read a  
fascinating piece of research that investigated why this happens in
hips. If I  
hadn't entered the competition, I wouldn't have read it. I wouldn't even
have  
known it
existed.]{style="font-family: \"helvetica neue\" , \"arial\" , \"helvetica\" , sans-serif;"}]{style="mso-bidi-font-family: \"Times New Roman\"; mso-fareast-font-family: \"Times New Roman\";"}
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[[When I sent off my entry, I didn't  
expect I'd hear anything back about it. I was just happy that I had a
new set  
of interesting facts about hips to share with anyone looking for an
interesting  
fact. I am delighted that winning has brought attention on the work done
by Dr  
Poole's group at Cambridge, and the range of work funded by Arthritis
Research  
UK. And of course, I'm thrilled with the trophy that now sits in my
living  
room!]{style="font-family: \"helvetica neue\" , \"arial\" , \"helvetica\" , sans-serif;"}]{style="mso-bidi-font-family: \"Times New Roman\"; mso-fareast-font-family: \"Times New Roman\";"}
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[[My next writing challenge is completely  
different: a 60,000 word PhD thesis. I'll make sure to include a lay
summary!]{style="font-family: \"helvetica neue\" , \"arial\" , \"helvetica\" , sans-serif;"}]{style="mso-bidi-font-family: \"Times New Roman\"; mso-fareast-font-family: \"Times New Roman\";"}
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[[]{style="font-family: \"helvetica neue\" , \"arial\" , \"helvetica\" , sans-serif;"}]{style="mso-bidi-font-family: \"Times New Roman\"; mso-fareast-font-family: \"Times New Roman\";"}

Note: Emma recently won the 2013 [Access to
Understanding](http://www.access2understanding.org/competition/)
science-writing competition for her entry 'Hip, hip, hooray!' explaining
[research that investigated the causes of hip fracture in the
elderly](http://europepmc.org/articles/PMC3372523).
:::
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[By ]{style=“font-family: "helvetica neue" , "arial" , "helvetica" , sans-serif;”}[Emma Pewsey, Department of Materials Science, University of Cambridge.]{style=“font-family: "helvetica neue" , "arial" , "helvetica" , sans-serif;”}  [I’m a relative newcomer to biosciences – at school, physics and chemistry were more my thing. However, starting a PhD on the corrosion of metal implants in the human body meant I needed to brush up on my biology.

Messaggi di Rogue Scholar

Reforming rheumatoid arthritis treatment: a step in the right direction

Simplicity is sometimes best

Why I entered the Access to Understanding competition