Professor Jill J F Belch

Professor of Vascular Medicine and Tayside R&D Director

Address:

Division of Cardiovascular and Diabetes Medicine
Medical Research Institute
Mailbox 1
Ninewells Hospital and Medical School
Dundee
DD1 9SY

Phone Number:

+(44) 01382 632457

Email Address:

J.J.F.Belch@Dundee.ac.uk

Biography

Professor Belch graduated as a Doctor from the University of Glasgow (MBChB), becoming a Lecturer within the University Department of Medicine, where she completed her Research MD degree (Honours, winner of Belahouston Gold Medal) in 1987. She was appointed Senior Lecturer with Honorary Consultant status at the University Department of Medicine in Ninewells Hospital, Dundee, also in 1987, and became Professor of Vascular Medicine in 1995. She was Director of the Tayside Clinical Trails Centre before becoming the Director of the Tayside Medical Science Centre (TASC) and the Tayside R&D Director. She is a founder Fellow of the Academy of Medical Science, and a Fellow of the Royal Society, Edinburgh. She is Deputy Dean in the Medical School as Co-Director of the Medical Research Institute.

Research

Summary:

Professor Belch’s research area is Cardiovascular Disease prevention and management, with focus on two areas: microvascular disease (Systemic sclerosis, Raynaud's, chronic fatigue syndrome) and macrovascular disease, (peripheral arterial disease). She heads the Vascular Diseases Research Unit, with 23 multidisciplinary staff whose expertise covers lab to clinical research, all grant-funded. Our Laboratory develops assays (biochemical, and microvascular imaging) and is the core Biomarker lab for a number of international trials. Our research programme has been awarded significant grant support =£25,372,804, [of which ~£5m was in the last 5yrs] - £19,683,040 peer-reviewed, £5,689,764 Industry. This includes 17 Medical Research Council awards totaling over £4.5m.

Professor Belch research interests include:

  1. Vascular Medicine especially Peripheral Arterial Disease
  2. Vascular Risk especially inflammatory aspects
  3. Connective tissue disease with a focus on Systemic Sclerosis

This work was key in the discovery of the contribution of inflammation to cardiovascular disease (CVD), and she was first to report oxidative stress and impaired endothelial function in many CVDs through her biomarker laboratory. She has developed, with her team, state of-the-art equipment microvascular imaging, and the laboratory is among the best-equipped in the UK, facilitating the original research into small vessel disease in the connective tissue disorders (CTDs). This microvascular imaging is further enhanced by the collaborative development of vascular MRI scanning (she obtained funds for a dedicated MRI scanner), allowing her work access to state of the art MRI and CT measures of blood flow, perfusion, arterial stenoses in relation to peripheral arterial disease (PAD).

There are 2 further inter-related study areas within her research portfolio: In the first she has explored and developed novel surrogate markers for vascular risk (biomarkers) within a normal or at risk population. This work is then translated into clinical trials to validate hypotheses or develop interventions. 

These two areas cover major trials within the normal population such as the MRC funded Dundee Infant Feeding Study (Howie/Forsyth) where she detected vascular risk in 20% of normal children throughout  Tayside, and TASCFORCE (funded by Chest Heart and Stroke, Scotland), a 10,000 population screening study for novel risk factors using MRI in 3,300 subjects within a specified sub-group. This complements the earlier work of 20,000 volunteers (Scottish Heart and Arterial Risk Prevention, SHARP) which has documented CV risk in a cross section of the Scottish workforce through a 10 year follow up. This latter risk factor study provided data for novel MAFF/FSA funded dietary studies in essential fatty acids, and in saturated fats, the results of which contributed to FSA recommendations regarding fat in diet for the UK population.

In peripheral arterial disease (PAD) she was first to link adhesion molecules & restenosis in diabetes (CHS/CSO funded), facilitating an 8 year CV endpoint study of patients with diabetes and asymptomatic PAD (7,900 in screening and 1,300 in therapy) (POPADAD, MRC funded clinical trial programme grant). This trial of eight years duration, published in the British Medical Journal (2008;337:a1840),has been cited by 155 subsequent scientific papers. It has changed clinical practise world-wide. 

This approach of detecting abnormalities, linking them to outcome, then planning and expediting clinical trials has also been a feature of her rheumatological work. As a result of novel laboratory work documenting risk in these inflammatory diseases (arc funded), she has obtained funds for two further 6 year CV event and mortality studies in both Systemic Sclerosis & Rheumatoid arthritis (BHF/arc clinical trials programme grant). Both of these trials are the largest of their kind in the UK and are may change patient management when the results are available. Her work has supported 13 PhD students (3 current), 11 MD (one current), and 5 MSc (1 current). The major impact of this work has been in two areas: 1. to change attitudes and behaviour in the detection and management of vascular risk in PAD; and 2. Raise awareness of CVD in the rheumatic diseases. 

She has had a major contribution to the clinical trials summarised below:

Major National and International Multicentre Clinical Trials

  1. Scottish Heart and Arterial Risk (SHARP) 20 year study of Cardiovascular Risk. National Study. Chairman of Research Committee. 1988-current.
  2. Medical Research Council Clinical Trials Programme Grant. Prevention of Progression of Peripheral Arterial Disease (POPADAD) National Multicentre Trial. Principal Investigator. 1997-2008.
  3. Raynaud’s and Scleroderma Association, Systemic Sclerosis Trial of CV Events & Progression (SSTEP) Principal Investigator. National Multicentre Trial. 2002-current.
  4. British Heart Foundation. Mild to Moderate Intermittent Claudication and Exercise (MIMIC) National Multicentre Trial. Management Committee. 2002-2007.
  5. European Systemic Sclerosis Study Group, European DELPHI exercise. Trial Steering Committee. 1995-2006.
  6. Oral iloprost in Raynaud’s Phenomenon Study Group. Chairman of Trial Steering Committee. International Multicentre Trial (Schering Chemicals Ltd). 1995-2001.
  7. UK/Finnish PARTNER Trial. International Multicentre Trial in Critical Ischaemia. Principal Investigator and Chairman of Trial Steering Committee (Grunenthal Ltd). 1989-1994.
  8. VASOGEN. National Multicentre Trial in intermittent claudication. Chairman of Trial Steering Committee and Principal Investigator. (Vasocare Inc) 1998-2002
  9. CASPAR (Clopidogrel and aspirin in Peripheral Arterial Grafts). International Steering Committee Chairman (BMS/Sanofi Synthelabo). 2002-current.
  10. Intermittent Claudication Trial Steering Committee UK Principal Investigator and member of Trial Steering Committee (Sigma Tau). 1999-2003.
  11. Serotonin Inhibition in Claudication. International Multicentre Trial. Clinical Endpoints Committee (Mitsubishi Pharma Europe Ltd). 2003-2005.
  12. MASCOT. International Multicentre Trial. Co-Chairman (with Dr Mark Creager, USA) of Steering Committee (Bristol-Myers Squibb). 2005-2008.
  13. WALK Trial. International Multicentre Trial of Genetically modified growth factor, European Chairman of Steering Committee, Member of International Steering Committee (Genzyme Inc). 2004-current.
  14. TAMARIS. International Multicentre Trial of genetically modified growth factor in critical limb ischemia. Chairman of Trial Steering Committee (Sanofi Aventis) 2007- current.
  15. British Heart Foundation/ Arthritis and Rheumatism Council. Trial of Atorvastatin in preventing CV Events in Rheumatoid Arthritis. (TRACE RA). National Multicentre Trial. Co-Principal Investigator. 2006-current.
  16. TRACE RA Biobank. National multicentre Trial. Principal Investigator (Pfizer Inc). 2007-current.
  17. Chest Heart & Stroke (Scotland) TASCFORCE. Tayside multicentre trial (n=10,000/3500). Early detection of risk. Principal Investigator 2009-current 

The detection of CV risk in PAD has allowed both national and international recognition that risk factor management must be undertaken. She was involved in the first Royal College of Physicians, Edinburgh, PAD Guideline (Medical management of peripheral arterial diseases 1998), leading to a second one in 2007 (Management of peripheral arterial disease). Through this work she has contributed to the Quality and Outcomes Framework (QoF) process, introducing risk factor screening for PAD as local quality measure for Primary Care in the UK. Her work is contributed to the current NICE Guidelines on PAD, currently just completed its scoping phase.

Further, the POPADAD study has implications for all patients with diabetes who have not yet had a vascular event, changing practice world wide.

In addition, within the rheumatological field, her vascular work has allowed new treatments for both microvascular and macrovascular disease, bringing change of medical practice to the benefit of these patient groups.

Finally, her work in trial design within PAD has allowed Guidelines to be developed in this area, which have been used by both EMEA, and FDA in developing regulations for drug registration in PAD (Study design options for clinical trials in PAOD patients. Transatlantic Conference on Clinical Trial Guidelines in PAOD. Basle 1997).

Publications

She has over 300 publications in peer reviewed Scientific Journals (with 4 Videos/DVDs, 2 Books, 42 Book Chapters, 40 Commissioned Reviews, 32 Editorials/Guidelines) and grant funding amounting to 23.4 million pounds over 20 years (£12M in past 5yrs). She has been cited more than 6.600 times and had a personal ‘H’ index of 43 in 2011. A selection of publications showing the breadth of work is listed below:

 

 

Teaching

Professor Belch has been involved in undergraduate teaching from SHO level and postgraduate teaching from registrar level. Current undergraduate commitment is within the CVD curriculum, with lectures on peripheral arterial disease, and teaching in the clinics. She ran a weeklong ‘work experience’ course annually for prospective medical students. Postgraduate teaching takes the form of teaching for MRCP candidates and for PhD and MD students.

PhD Supervision

Janice Rowland, PhD, 2011, Underway, The design and evaluation of a single versus multiple contact weight loss intervention in adults undertaking cardiovascular risk screening, Currently working as Research Nursing Fellow, University of Dundee

Alan Robertson, MD, 2010, Underway, Allopurinol as a possible Oxygen Sparing Agent during Exercise in Peripheral Arterial Disease, Currently working as Cardiology Registrar, Ninewells Hospital, Dundee

Naveed Akbar, PhD, 2010, Writing Up, MRC Studentship. Protein Phosphorylation and Cardiovascular Disease: A Strange Connection, Postdoctoral Research Assistant, Molecular Imaging Division of Cardiovascular Medicine Radcliffe Department of Medicine, University of Oxford

Stephen McSwiggan, PhD, 2006, Writing Up, Cardiovascular Disease in Systemic Sclerosis Disease, Senior Research Nursing Fellow / Clinical Trials Manager, University of Dundee

Bernat Gallaraga, PhD, Awarded 2009,  Effect of anti-rheumatic Therapy, folic acid supplementation and allopurinol on Surrogate Markers of Cardiovascular Disease in Rheumatoid Arthritis, Lecturer / Consultant Physician Hospital Quiron Bizkaia, Erandio, Bizkaia, Spain

Pradeep Kumar, MD, Awarded 2010, The vascular and inflammatory changes in rheumatoid arthritis - effects of rosuvastatin, Consultant Rheumatologist, NHS Grampian. Quality Imrovement Award The Rheumatology Telemedicine Team: Including Dr Pradeep Kumar

Sumantra Ray, MD, Awarded 2012, Cardiovascular Prevention, Diet and Nutrition: Current Evidence, and the Antioxidant Berries and Cardiovascular Disease (ABCD) Trials, Senior Medical Advisor/Clinician Scientist, MRC Human Nutrition Research, Elsie Widdowson Laboratory, Cambridge

Wahab Al-Allaf, MD, Awarded 2004, Microvascular Assessment in Patients with Rheumatoid Arthritis, Consultant Physician, New Cross Hospital, Wolverhampton / Nuffield Private Hospital, Wolverhampton

Jun Sun, PhD, Awarded 2002, Development and applications of a Laser Flow aggregometer: Blood cell aggregation study, Working (UK) in laser techniques for analysing the nature of blood cells

Juma Al-Kaabi, MD, Awarded 2002, The Prevalence of Macrovascular Disease in Rheumatoid Arthritis, Not Known

Khalid Elherik, PhD, Awarded 2002, Vascular Tone and Endothelial Function: Effects of Circadian, Seasonal and Dietary Variation, Not Known

Rebecca Wood, PhD, Awarded 2003,  Evaluation of the effects of dietary supplementation on individual fatty acids and vascular risk factors/in vitro effects of bosentan on platelet and white blood cell aggregation in man, Research Fellow with Prof Reid, University of Aberdeen with special interests in osteoporosis and osteoarthritis

Tarik Elhadd, MD, Awarded 2000, Markers of endothelial dysfunction in patients with diabetes mellitus, Consultant Physician Dumfries & Galloway Royal Infirmary

Brian Ellis, PhD, Awarded 2002,  The Effect of Oxygen on Endothelial Cell Function, the Nitric Oxide Pathway and Skin Blood Flow, Academic Head of Department, Glasgow Caledonian University

Ibrahim Barouni, MD, Awarded 1999, Deep Venous Thrombosis in total Hip Replacement, Orthopaedics Consultant

Gwen Kennedy (nee Kirk) , PhD, Awarded 1997,  Cell Adhesion Molecules: Levels, Roles & Interactions, Head of Thrombosis & Haemostasis Laboratory / Manager, Biomarker Immunoassay Core Laboratory, Cardiovascular & Diabetes Medicine, Medical Research Institute, University of Dundee

Roberta Littleford (nee Brown), PhD, Awarded 1998,  Skin Microvascular Function and its relevance to Erythromelalgia, Senior Research Nursing Fellow / Clinical Trials Manager, University of Dundee

Richard Tweedie, PhD, Awarded 1995, Conception, design and development of the impulse response impedance spectroscopy, Not Known

Joanne Taylor, MD, Awarded 1993

Allan Brid, MD, Awarded 1994, Haemostatic Parameters in Cardiac Disease, Dr Allan Bridges was appointed as a consultant physician / cardiologist in 1994 and has over 20 years of clinical experience working in the NHS in Scotland. Dr Bridges has led many developments to improve cardiology services in Forth Valley and has an active national role in the setting and delivering of examinations for junior doctors.

Chak Lau, MD, Awarded 1993 (Hons),  Haemostatic Abnormalities in Raynaud’s Phenomenon and the potential for treatment with manipulation of the arachidonic acid pathway, Prof. Chak Sing Lau, Professor and Head of Division of Rheumatology and Clinical Immunology, The University of Hong Kong

Scott Wilson, PhD, Awarded 1990, Dynamic Thermographic Assessment of Human Skin Blood Flow, Assistant Project Manager, London

Faisel Khan, PhD, Awarded 1990,  The Sympathetic Control of Skin Blood Flow and its relevance to Thermoregulation in the Elderly, Reader, Cardiovascular & Diabetes Medicine, Medical Research Institute, University of Dundee

Ann O’Dowd, PhD, Awarded 1990, Not Known Glasgow University, Not Known

Ann Bancroft, MSc, Awarded 2001, The assessment of a modified Thrombocounter to assay Platelet Volume Parameters, NHS Haematology / now Retired

Rebecca Barr, MSc, Awarded 1997, In vitro Effects of Bosentan on Platelet and White Blood Cell Aggregation in Man, Research Fellow with Prof Reid, University of Aberdeen with special interests in osteoporosis and osteoarthritis

Norma Waddell, MSc, Awarded 1994, Free Radicals and Cardiovascular Disease, Not Known

Alex Collinson, MSc, Awarded 1989, Drug Effects on Granulocyte activation in Whole Blood, Not Known

Conferences

Lectures:

  • 316 Invited lectures (Named Lectures: Booth Memorial, Honeyman-Gillespie, William Walker, Ellison-Cliffe Gold Medal) in total.
  • 33 Primary Care lectures (2 in last year);
  • 23 Royal College Invited lectures;
  • 100 Post-graduate National lectures;
  • 30 Lay lectures;
  • 29 lectures to the Pharmaceutical Industry;
  • 128 International plenary or State of the Art lectures.
  • 7 International ‘Meet the Expert’ sessions at International meetings

Conferences (organised personally or been a member/chair of the organising committee):

  • 56 International meetings
  • 23 National meetings
  • 316 Invited lectures (Named Lectures: Booth Memorial, Honeyman-Gillespie, William Walker, Ellison-Cliffe Gold Medal) in total.
  • 33 Primary Care lectures (2 in last year);
  • 23 Royal College Invited lectures;
  • 100 Post-graduate National lectures;
  • 30 Lay lectures;
  • 29 lectures to the Pharmaceutical Industry;
  • 128 International plenary or State of the Art lectures.
  • 7 International ‘Meet the Expert’ sessions at International meetings