Exploring "junk DNA" to help heart patients

Costanza Emanueli, the newest BHF Professor

Costanza Emanueli, our new BHF Professor, talks to Sarah Brealey about using junk DNA to help heart patients recover and how travelling the world has furthered her research.

Junk DNA might not sound like a promising topic for scientific study, but BHF Professor Costanza Emanueli is revealing how it could help patients recover after heart surgery.

Junk DNA explained

The newly appointed BHF Professor of Cardiovascular Medicine is studying microRNA, tiny molecules found within DNA. MicroRNA is known as non-coding DNA, or ‘junk DNA’. DNA contains instructions that tell the body how to make proteins, which are then used to make cells. Junk DNA does not give the body such instructions.

When the human genome was sequenced in 2000, it was found that only two per cent of DNA makes proteins. The rest was written off as ‘junk’. But scientists are coming to understand that much of it may play a role in how our bodies work.

MicroRNAs were first discovered in worms in 1993 and then in humans in 2000. They are thought to control the activity of some protein-coding genes and have a role in conditions such as cardiovascular disease (CVD), cancer and some immune diseases.

Helping heart patients after surgery

Professor Emanueli wants to use her knowledge of microRNAs to develop new solutions for heart surgery patients. For example, acute kidney injury (AKI) is a common complication of heart surgery.

Between eight and 30 per cent of patients go on to develop AKI. It leads to kidney failure and need for dialysis in about one per cent of cases. Professor Emanueli’s team took blood samples from patients before and immediately after surgery.

“In a preliminary analysis, we found we could match the patients who developed AKI based on the measurements of microRNA not just after surgery but before surgery,” she says.

microRNA stats “If this is true – and we need to do more work with larger numbers of patients – this could have great potential. It is very exciting to identify the patients who might develop this complication, because they could be monitored and treated in a different way  to improve clinical outcomes.”

This area of work came about from conversations with BHF Professor Gianni Angelini at Bristol University, where both professors work. As a surgeon, he was able to give Professor Emanueli an insight into clinical problems she wasn’t aware of as a lab-based scientist.

“The frequency and severity of AKI and other acute complications after cardiac surgery are things I didn’t know about before,” she says. “Everyone knows about heart attacks, but there are these neglected areas.

It is really important to build relationships with clinicians – to really understand each other’s fields. If you want to do something that will add to clinical practice, then this kind of dialogue is vital.

“Bristol is an exceptional place for this. We work on the same floor as the clinicians, and we share staff and common goals with them. We can just go over and have  a conversation.”

International adventures for Professor Emanueli

Moving to Bristol in 2005 was the latest adventure for Professor Emanueli, whose career has taken her around the world. She grew up in Florence, where she did her PhD in pharmacology. Her supervisor sent her on a lab placement to San Francisco.

“At the beginning I was frightened,” she says. “I was crying on the plane to San Francisco; I thought I was not good enough to work in such a prestigious institution. Then I did very well and I loved it. I kept on moving after that.”

Having also worked in Rome, Sardinia, Ferrara and Boston, Professor Emanueli believes researchers benefit from travelling to learn from different places. “I think we should really encourage it,” she says.

The BHF promotes networking between different universities

“Your career can progress more quickly and you can be influenced by different environments. You can be scared to go away and be confronted by different cultures, but this is something we should all do.”

Collaboration and networking between institutions is vital for the best science. Professor Emanueli is honorary professor at Imperial College London and collaborates with colleagues at other institutions.

“The BHF promotes networking between universities through its three Centres of Regenerative Medicine. This is very important,” she says. “You can re-energise with other people and make results stronger.”

The BHF has played a huge role in her career, too. “BHF support has been fundamental,” Professor Emanueli says, “even though many of my grant applications have been rejected! It is not easy, but you get good advice on how to improve. Jeremy Pearson [BHF Associate Medical Director]  has given me so much support. Every time I have had a doubt or concern, Jeremy has given me advice.

“Also, you can speak to BHF Professors at other universities. People have been very encouraging, very generous with their time, not being possessive and saying ‘but this is my field’. You feel part of the family.”

Women in science

Professor Emanueli is one of the newest BHF Professors and one of four women holding this post, alongside 28 men. Women are still in a small minority when it comes to the top level of science. Why does she think this is?

“Other women feel differently, but I have never felt discriminated against in the workplace. Although, I certainly don’t approve of the gender pay gap,” she says. “The major barriers, I think, are outside of work. There are many problems, like the kind of education we receive and the family context. Growing up in an Italian family, I was treated differently from my brother; there were different expectations of me.

Having reached this position, I have a duty. Now I need to give back

“Then there are relationships. Often, because you work long hours in a lab, people have relationships with other scientists. It might be that it benefits one person’s career to move somewhere but not the other, and one person makes sacrifices.

“Some women accept being overshadowed by their partner. From what I have seen and experienced, when one person has to downsize their career, it is nearly always the woman.”

She may have reached a top role, but Professor Emanueli is not complacent. “I never feel I have ‘arrived’. I challenge myself,” she says. “I compete – not with other people but with myself – and I often feel I am not good enough for the standards I want to achieve and that I have to do better. I think this is a typical attitude of women in high-profile jobs.”

She sees her role as a team player and “someone who can see the bigger picture and involve others in a common project”. She says: “The BHF has given me an opportunity to do excellent work that can benefit patients, but I also want to sponsor junior scientists and support my colleagues.

“Having reached this position, I have a duty. I have been supported by the BHF, my university, my colleagues and by those who donate money to fund research. Now I need to give back.”

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