Four researchers from the School of Medicine at Trinity College Dublin have secured funding for innovative health research projects under the latest round of the Health Research Board Investigator-Led Projects scheme.
The awards form part of a national €12 million investment by the HRB to support 29 new investigator-led research projects addressing pressing challenges in health and social care. The scheme supports innovative and internationally competitive research across patient-oriented research, population health research and health services research. By placing public and patient involvement at the heart of project design and execution, the scheme ensures that scientific innovation addresses real-world healthcare challenges that matter most to patients, families, and communities.
The Trinity School of Medicine awardees, Professor Ursula Fearon, Dr Viviana Marzaioli, Dr Mikel Egana, and Dr Gerry Hughes, are leading innovative investigations in inflammatory arthritis, psoriatic bone disease, exercise safety in diabetes, and hospital antimicrobial prescribing.
Unravelling cellular crosstalk in inflammatory arthritis
Professor Ursula Fearon, Professor of Molecular Rheumatology has received Patient-Oriented Research funding for her project entitled 'Distinct Cellular Crosstalk defines RA and PsA pathotypes' .
Inflammatory arthritis, including Rheumatoid Arthritis (RA) and Psoriatic Arthritis (PsA), affects up to 1% of the Irish population and represents a major cause of disability and chronic pain. Professor Fearon’s project investigates the single-cell molecular mechanisms and cell-to-cell communication (crosstalk) between synovial tissue cells—specifically fibroblasts and T-cells—that drive joint inflammation and cartilage/bone destruction. Utilising advanced flow-cytometry, single-cell RNA sequencing, and spatial transcriptomics on patient-derived tissue samples, the research aims to identify distinct disease pathotypes, uncover novel therapeutic targets, and establish biomarkers to tailor treatments for patients. The project embeds public and patient involvement throughout, partnering with Arthritis Ireland and patient advocate partners.
Speaking about the award, Professor Fearon said: “This funding allows us to delve deep into the cellular crosstalk driving Rheumatoid and Psoriatic Arthritis. By identifying unique disease pathotypes, we hope to unlock novel therapeutic targets and establish biomarkers that ensure the right patient gets the right treatment at the right time.”
Evaluating exercise safety and brain blood flow in Type 2 Diabetes
Dr Mikel Egana, Associate Professor in Physiology at Trinity College Dublin, has been awarded Patient-Oriented Research funding for his project, 'Is the exercising diabetic brain at risk? Elucidating the impact and safety of acute exercise modalities on cerebrovascular function in type 2 diabetes'.
Type 2 Diabetes (T2D) is a recognised risk factor for mild cognitive impairment, vascular dementia, and Alzheimer's disease. While physical activity is a vital lifestyle intervention, rapid fluctuations in blood pressure and ventilation during high-intensity interval training or resistance exercise may carry cerebrovascular risks that remain unexplored in T2D. Dr Egana’s study will evaluate how acute bouts of six distinct, time-matched exercise modalities—ranging from moderate continuous aerobic exercise to high-intensity interval training, sprint intervals, and resistance exercise—affect brain blood flow, cerebrovascular reactivity, and cerebral autoregulation in men and women with T2D. The project also explores the modulating influence of biological sex to establish safe, personalised exercise guidelines that protect long-term brain health and cognitive function.
Speaking about the award, Dr. Egana said: “Type 2 Diabetes significantly increases the risk of cognitive decline, making it critical to understand how exercise affects brain blood flow. This project will evaluate the safety and physiological impact of various exercise intensities across biological sex, ensuring we can prescribe physical activity that safely protects long-term brain health.”
Optimising hospital infection management through pharmacist prescribing
Dr Gerry Hughes, Research Synergies Manager at the Wellcome-HRB Clinical Research Facility at St James’s Hospital and clinical pharmacist within the School of Medicine, Trinity College Dublin, has received a Health Services Research award for his project, 'Making Every Dose Count: Positioning Pharmacists as Prescribers of Optimal, Evidence-Based Therapy for InfeCtion in HoSpital (POETICS)' .
Antimicrobial resistance (AMR) represents an escalating global health crisis. Dr Hughes’s research programme will evaluate the safety, effectiveness, and implementation potential of expanding pharmacist roles to include antimicrobial prescribing in acute hospital settings, with a primary focus on timely intravenous-to-oral antimicrobial switching. Combining evidence synthesis. international comparative case studies, and a hospital-based proof-of-concept trial, the project seeks to explore such clinical pharmacist activity to potentially reduce healthcare-associated line infections, lower drug waste, and improve patient comfort and mobility. Co-designed with patient representatives, the study findings will generate robust evidence to guide national health policy and antimicrobial stewardship practice.
Speaking about the award, Dr Hughes said: “This is an important study that seeks to support the delivery of excellent patient care through the evidence-based use of antimicrobials by optimising hospital pharmacist practice. Timely intravenous-to-oral antimicrobial switching has the potential to be a high-impact intervention, improving patient outcomes by enhancing the quality and efficacy of care. I am delighted to lead this research programme and generate evidence that can help inform future antimicrobial stewardship policy and practice.”
Targeting osteoimmunity and bone remodelling in Psoriatic Arthritis
Dr Viviana Marzaioli, Research Assistant Professor and group leader within the Molecular Rheumatology Group at Trinity College Dublin, has secured Patient-Oriented Research funding for her project, 'Osteoimmunity in Psoriatic Arthritis: circulating monocytes as drivers of pathological bone remodelling'.
Psoriatic Arthritis (PsA) is a chronic autoimmune condition affecting approximately 1% of the Irish population, characterised by systemic inflammation and dysregulated bone remodelling. In PsA, bone erosion and abnormal new bone formation can occur simultaneously, contributing to progressive joint damage and disability. Dr Marzaioli’s research focuses on circulating monocytes, immune cells in the bloodstream, which are dysregulated in PsA patients and may have an increased capacity to differentiate into bone-resorbing osteoclasts. By combining multi-dimensional flow cytometry, RNA sequencing, and functional bone assays, the study aims to uncover the environmental and molecular signals driving this destructive process. The ultimate goal is to identify selective therapeutic targets to halt pathological bone damage and support personalised treatment strategies. The project has been developed in close partnership with patient representatives, Arthritis Ireland, and national and international collaborators.
Speaking about the award, Dr Marzaioli said: “Psoriatic Arthritis presents a unique clinical challenge where bone breakdown and abnormal new bone growth co-exist, often leaving patients trapped in a costly trial-and-error treatment cycle. This HRB award enables us to decode the precise molecular signals that push blood monocytes to become destructive bone-resorbing cells. Uncovering these pathways will allow us to establish disease signatures and lay the groundwork for personalised combination therapies tailored to each patient's specific bone pathology.”