Liverpool - Officially a Paget's Centre of Excellence

The Paget’s Association Centre of Excellence Award recognises hospital and university departments which demonstrate excellence in both the management of Paget’s disease and research into the condition. Our Chairman, Professor Roger Francis, went to Liverpool to present the awards to the team.

Director: Dr Anna Daroszewska - Senior Lecturer in Musculoskeletal Biology and Honorary Consultant in Clinical Biochemistry and Metabolic Medicine, and Rheumatology.
Clinical Co-Director: Dr Eileen Marks - Consultant in Clinical Biochemistry and Metabolic Medicine.
Research Co-Director: Professor Rob van ’t Hof - Professor of Musculoskeletal Biology.

The Liverpool Paget's Association’s Centre of Excellence Award recognises the clinical work of the Department of Clinical Biochemistry and Metabolic Medicine, at the Royal Liverpool and Broadgreen University Hospitals Trust (RLBUHT), together with the research undertaken by the Bone Group, at the Institute of Ageing and Chronic Disease (IACD), University of Liverpool.

In April, professionals and patients came together at Liverpool University to see Professor Roger Francis, Chairman of the Paget’s Association, present Dr Anna Daroszewska and her colleagues, with the Centre of Excellence Award. Professor Francis commented, “The Paget’s Association is grateful for all the hard work you and your team have done in the past and wish you continued success for the future. I’m sure that your clinical and research work will continue to benefit patients with Paget’s disease, not only in the UK but also throughout the world”.

Thank you

Dr Anna Daroszewska, thanked Professor Francis and the Paget’s Association for the Award, saying, “It is a great honour to receive this prestigious award. We are humbled and proud to have been recognised by the Paget’s Association as a Centre of Excellence. I would like to acknowledge the immense contribution of my clinical colleagues, especially Dr Eileen Marks, Medical and Clinical Director, for her support, and Dr Vinita Mishra, Dr Fadil Hannan, Dr Milad Khedr and Professor Ranganath for their dedication in providing expert management to our patients and conducting clinical research. Special thanks go to the scientific team lead by Prof Rob van ‘t Hof, for furthering our understanding of the basic bone pathology underlying Paget’s disease. I would also like to acknowledge my former mentors, Professor Bill Fraser, who spent many years investigating and treating Paget’s disease in Liverpool, before moving to the University of East Anglia, and who gave me a good grounding in the understanding of metabolic bone diseases, including Paget’s disease, during my training as a Registrar, and Professor Stuart Ralston, under whose supervision I completed a PhD in Paget’s disease at the University of Aberdeen. Then as Lecturer and later Senior Lecturer I worked with him at the University of Edinburgh for a number of years. Last, but not least, my thanks go to our patients without whose support and dedication to research this achievement would not have been possible.” Dr Daroszewska also acknowledged the contribution of other members of the clinical team including registrars, nurses and administrative staff at the RLBUHT for their tireless work. Dr Daroszewska thanked Professor Eithne Comerford, Head of Department of Musculoskeletal Biology and Professor Pete Clegg, Head of the Institute of Ageing and Chronic Disease, and Tom West, Administrator of IACD, who was in the audience, for creating an excellent environment conducive to excellence in research. She also acknowledged the help of the administrative staff.

Rich History

Following the presentation, Professor Jim Gallagher, internationally renowned bone biologist and anatomist, from the University of Liverpool, discussed the rich history of bone research in Liverpool. Professor Gallagher started the talk by taking the audience back to the late 18th and 19th centuries, when Evan Thomas, also known as the ‘bone setter’ practiced and Hugh Owen Thomas laid foundations of orthopaedic surgery. A long list of achievements of clinicians and scientists from Liverpool followed. Of particular interest was the pioneering work on osteoclasts (the bone resorbing cells, abnormalities of which cause Paget’s disease), including the first motion picture of a resorbing osteoclast filmed in 1949 by N.M. Hancox. Professor Gallagher also alluded to the Liverpool team’s contribution to unravelling the causes (aetiology) of Paget’s disease, in particular the uncertainties lying behind the viral aetiology of Paget’s disease.

Current Knowledge

Dr Daroszewska gave a talk on the current knowledge of the mechanisms underlying Paget’s disease and helped the audience understand the difference between normal bone and bone affected by Paget’s disease. She also explained the current methods of diagnosis and management. Dr Daroszewska further touched upon the outcome of clinical trials into treatment of Paget’s disease and outlined the need for further research. She also reassured the audience that the condition was less severe nowadays.

Medieval Paget's

Multi-centre research is being undertaken into medieval Paget’s disease at Norton Priory Museum and Gardens in Runcorn, the largest medieval monastic archaeological site in Europe. Lynn Smith, the museum’s senior keeper, came along to discuss the progress that has been made. Universities in Liverpool (both the University of Liverpool and John Moore’s University), Norwich and Nottingham are all involved in the project and the team are looking forward to the publication of some of the research findings soon. Lynn suggested that the findings were such, that the Priory could have been the medieval equivalent of a Paget’s Centre of Excellence in the past, which is of interest in the context of the known relatively high prevalence of Paget’s disease in the area.

Research

Professor Rob van ‘t Hof, bone biologist and international expert on bone imaging, from the University of Liverpool, explained some of the current research into Paget’s disease and metabolic bone disorders. He showed the pioneering work conducted together with Dr Daroszewska into the genetic aetiology of the condition. He discussed anecdotal instances of Paget’s disease occurring in bones affected by constant mechanical loading such as a billiard player who had Paget’s disease in the fingers he constantly used during the game. Professor van ‘t Hof explained how they plan to research this further.

The Paget's Association

Our Specialist Nurse, Diana Wilkinson, introduced the audience to the Paget’s Association, explaining how the Charity works with others, including hospitals, universities and other charities, to advance research and raise awareness of Paget’s disease. Diana concluded with a short video dedicated to the late Ron Taft in which Ron explained how, when he developed Paget’s disease, he gained help from the Paget’s Association and the professionals the Charity works alongside.

Some of the audience took the opportunity to have their questions answered and all were given written information about Paget’s disease to take home.

The meeting was sponsored by the Department of Clinical Biochemistry and the Metabolic Medicine Charity Fund.