For this issue of the QUOD newsletter, we spoke to James Shaw, Professor of Regenerative Medicine for Diabetes and Honorary Consultant Physician at Newcastle University, Lead of the QUOD Whole Organ Programme in Newcastle, and QUOD Steering Committee Chair.
As a diabetologist, James is hugely active with both clinical and research work, and divides his time equally between both. In the clinic, his main focus is patients with type 1 diabetes, particularly those who struggle to control their glucose levels. His responsibilities include patient education, mentorship of patients’ skills, keeping up to date with the latest technologies, and transplantation (islets and whole organ pancreases). James says it is an amazing time for diabetes as the field is rapidly evolving. He describes the ultimate goal as helping people to not need insulin and maintain good blood glucose levels without episodes of low blood glucose (known as hypos). “Diabetes isn’t a disease, it is a hormone deficiency, and it’s important to believe in the patients and support them.”
When he is not with patients, the rest of James’s time is spent researching diabetes, looking to better understand beta cells (cells within the pancreatic islets that produce insulin) and signalling from the pancreas to try to dissect out how stress signalling can lead to loss of function of these cells. In some patients, it may be possible to use other approaches to help their beta cells to work again, ultimately avoiding transplantation, and this is one of James’s areas of interest currently.
While James always knew he wanted to be a hospital doctor, he had imagined he would be a gastroenterologist or hepatologist. However, early in his career the opportunity arose to work with a fantastic mentor and endocrinologist, John Bevan, in Aberdeen. His venture into the field of diabetes and endocrinology coincided with the arrival of Kevin Docherty, whom he admired, who moved his group to Aberdeen, and it was then he undertook an MRC-funded PhD.
Following his specialist training and PhD in Aberdeen, James was awarded a senior fellowship from Glaxo Wellcome and moved to Newcastle. While he was a consultant at that time, his drive to move was partly motivated by the opportunity to continue to carry out basic science research. This gave him the flexibility to shape his clinical practice, setting up a pump service and working with the transplant team in Newcastle, who were beginning to transplant pancreases and introduce islet transplantation. James feels really lucky to have played a role bringing together the first UK islet transplantation centres and he still chairs the UK Islet Transplant Consortium. He considers it a privilege to have been a part of establishing the first adopted integrated pancreas and islet transplant service worldwide. James loves having the flexibility to support clinical programmes as well as everyone in the multidisciplinary team, allowing them freedom to learn by their own experience and support biomedical scientists. James describes his work as really rewarding, as his roles enable him to see the research from bench to bedside and back again. He has the advantage of being able to see both clinical and research angles, which can often be the hardest link to make. He is proud of his research team and takes great joy in being part of a team as a doctor and seeing the trials that have have come out of the scientific discoveries from his group.
James’s involvement with QUOD first began with a conversation with Prof Rutger Ploeg, over the phone while James was rattling around on a train and struggling with signal. Despite conditions, he fondly recalled this as an “inspiring chat” about the opportunity to enhance the quality and scope of QUOD biobank. The pair communicated well, brought their different approaches to the challenge and worked to collectively bring together a successful MRC grant application. Their concept was to take untransplanted whole organs (starting with the pancreas) to build a wider, deeper tissue bank. This involved taking the whole organ to Newcastle and looking at its anatomy from the outside, then cutting sections and taking biopsies all throughout the organ. To date, QUOD has analysed 145 whole pancreases from carefully selected donors, and the programme is now accepting organs from donors with diabetes. The goal of this project is to begin to move away from exclusively transplantation related research, towards understanding ageing and chronic disease, such as diabetes. QUOD has collected these tissues “for the common good”, enabling access for researchers around the world.
James is proud of the initiative and believes that “QUOD is so successful because it is done by transplanters for transplanters” and there is a real investment from teams all across the UK. He is particularly impressed by how quality-oriented QUOD is, including the quality of the samples, as well as all the governance and the data, which he attributes to the “fantastic” hub and team in Oxford led by Dr Sarah Cross. Moving forward, he sees it as QUOD’s mission to make the non-transplant community aware of how successful this quality bioresource is and help them to tap into what he describes as this “marriage made in heaven”. He believes there is a lot of work still to do to disseminate the resource to the wider research community and go beyond simple transplant solutions.
James’s role as Chair of the QUOD Steering Committee is to ensure there is transparency and clarity in terms of how the management group is working and what QUOD are up to and that this is disseminated, discussed, partnered, and coproduced by the stakeholders, comprising the teams at the QUOD regional centres, charities, experts by experience, lay stakeholders, and NHSBT. His role is to coordinate what he sees as an interactive discussion between all of these partners so that the core management group have oversight and everyone can have input and reflect. He assures that the QUOD team works hard to make sure everything is well run and everyone has a voice.
In March, QUOD held its 8th National Symposium, at which James chaired the final session and delivered the closing remarks. He has attended many QUOD Symposia over the years and feels it is an excellent stage to showcase the exciting developments coming from QUOD, especially for the people on the ground who are doing all the hard work collecting samples and consenting donor families. He describes it as the crossover between bringing together transplant science and clinical care and wider tissue-based clinical care and research. When asked about the future, James’s enthusiasm was clear as he revealed there are big opportunities in terms of larger datasets, exciting new science, the prospect of a national recipient bioresource, developments in organ perfusion and preservation, the introduction of organ ARCs (assessment and repair centres), and the role of QUOD within all of this. He envisages QUOD maximising the value of the resource rather than just turning the wheel. “The science is taking leaps and bounds and tissue-based research may lead to huge changes in donor and recipient management.” As Chair of the Steering Committee, he is excited to see that unfold and ensure that ideas are seen and shared. He also stressed the importance of hearing what the QUOD community would like to see happen in the future.
When he does get time away from his busy work life, James enjoys “simple things”, such as spending time with family and walking in the countryside (sometimes with a golf club in hand, although not recently). James also enjoys music and plays the guitar and sings, both as a hobby and as a member of a band. He describes his music taste as mostly 70s (Americana, Neil Young, folk music). What he enjoys most about being in a band is being more than the sum of the parts, and while he modestly describes his own performances as not the highest quality he also views that as part of the enjoyment!
