The Biology of Dying

The Biology of Dying

A shot of science: sniffing out death? : here is my 2 minutes laypersons description of this project, which I gave as a part of a "shot of science", at a "Pint of science" on 16th May 2018.

From January 2018 - April 2020, I was employed as a Postdoctoral Research Associate funded by a Wellcome Trust seed award in science. I worked alongside palliative care consultant Dr. Seamus Coyle (Honorary Clinical Fellow), Prof. Chris Probert and Prof. Mark Boyd.

We believe there is a physiological process to dying. Recognising when someone is in the last weeks or days of life is difficult. No diagnostic test is available and little is known about how people die from disease. This knowledge is crucial for providing the best care possible. Predicting the last days of life will change clinical practice [Chapman, E., & Coyle, S. (n.d.). Predicting the last days of life will change clinical practice. BMJ Supportive and Palliative Care. doi:10.1136/bmjspcare-2020-002187].

A previous study by Dr. Coyle established it was feasible to collect urine samples from patients in the last weeks and days of life (http://bmjopen.bmj.com/content/6/11/e011763).

Whilst there are common themes shared amongst advanced cancer patients, indicative of a common biological process to dying, there is no one clear biomarker of prognosis (http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0175123).

During my time on the project, the pilot study identified volatile organic compounds (VOCs) from urine, using gas chromatography-mass spectrometry analysis as potential prognosticators for dying patients with advanced cancer.  I optimised conditions in which the urine was run on the GC-MS. This  work was published in September 2020, entitled: "Optimisation of Urine Sample Preparation for Headspace-Solid Phase Microextraction Gas Chromatography-Mass Spectrometry: Altering Sample pH, Sulphuric Acid Concentration and Phase Ratio" .

We created a model with these VOCs to predict the dying process. This work has the potential to have a profound impact on the understanding of human biology and on patient care. In January 2023, I published significant findings in the article: "GC-MS Techniques Investigating Potential Biomarkers of Dying in the Last Weeks with Lung Cancer".

In addition to VOCs, I began investigating metabolites in urine of patients dying with lung cancer using  liquid chromatography-mass spectrometry (LC-MS). We have a pre-print of our LC-MS data available here: https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4453379

This work has the potential to have a profound impact on the understanding of human biology and on patient care. I maintain an active interest in this topic.

This work was being undertaken with Dr Seamus Coyle (Honorary Clinical Fellow), Prof. Chris Probert and Prof. Mark Boyd, University of Liverpool. I was funded by a Wellcome Trust seed award in science to investigate the biology of dying (https://wellcome.ac.uk/what-we-do/directories/seed-awards-science-people-funded).

Additional funding was received from North West Cancer Research in a Short Impact Grant:  Method optimisation of urine GC-MS analysis to predict dying in lung cancer patients https://nwcr.org/what-we-do/research/merseyside-cheshire/