When we initially try to arrange an interview, Tamas Szakmany is about to head to Egypt for a 10 day diving trip. Szakmany, a keen diver, is also Senior Lecturer in the Department of Anaesthetics, Intense Care and Pain Medicine. The contrast between those two activities might seem profound but this balance of work and life seems to be integral to Tamas’ lifestyle.
“Originally I come from Hungary and I’ve done my PhD back home in critical care. I’ve always been attracted to the Science and research part of the job. I came to the UK to learn new things and learn a new system and I kind of stuck here. Once I finished the training, I got a job as a consultant in Cwm Taf. I didn’t feel that my life was full because I really missed the research element,” he says, “and that’s when Judith came along when she was looking for someone who can lead of the intensive care research, which was pretty much lacking at that point in Cardiff University.”
Four years ago, a partnership was set up. This has flourished into multiple studies and looks set to continue.
“What we have done is we teamed up with scientists within Cardiff University, mostly within the Infection and Immunity Institute and also with the School of Pharmacy. We started small and now we are becoming bigger and participating in multi centre trials and leading multi centre trials with both pure academics and with industry and governmental agencies like Public Health England.”
One of the projects that Tamas has been working on is a multi centre clinical trial called the ANEMONES (Analysis of gene expression and biomarkers fOr point-of-care decision support in Sepsis) study which looked at multiple genetic and proteomic markers of sepsis.
“There is another trial which is going on which has already produced some exciting results which is in conjunction with the scientists in Infection and Immunity, with Dr Mario Labeta and Dr Matthias Eberl,” he explains excitedly. “We looked at the immunology of early sepsis, looked at different populations in the immune system and how we can predict the response of those patients. That has produced some really interesting results already and that work is ongoing. On top of that, I’m writing plans to further the research we are doing.”
These two pieces of research have two aims. The first uses data analysis of biomarkers in order to work out the best course of action to take, the second analyses the immunology of early sepsis which could have huge impact on the prevention and treatment of the disease.
“I’m looking at stratifying patients who are in the intensive care unit and may or may not have an infection, because it will give us very distinct opportunities to change the therapy and as a result change the outcome for these patients,” Tamas explains. “The other aim is that we’d like to understand what is going on in the human body during critical illness.”
But hasn’t there already been a large research effort in this area? Well, yes. But Tamas is aware that although the history of research in this area is long, it is not nearly comprehensive:
“There has been more than 50 years worth of research looking at this but we’ve actually just scraped the surface and we start to understand that much of what we were looking at 20 years ago is probably not as it looked,” he explains. “We have more advanced techniques now and also care has advanced so we have got a new patient population that didn’t exist before, a patient population who are on the intensive care unit for a relatively prolonged amount of time and we still are not sure how their body is reacting to the infection, to the drugs and to the general care we are giving to these patients.”
While the work that has already been done is undoubtedly great, Tamas is not keen to stop there. As for what comes next in his research agenda, he has a few ideas.
“We are really excited about what we’ve got now, but as I said the next step will be we need to confirm that what’ve we found is really there and is working in the way we think it’s working,” he explains. “At the moment in the ANEMONES study, we are looking at biomarkers which have already been described as potential prognostic factors. We developed a very complex data set and we hope that we might be able to get new biomarkers, which probably, when we put them together, will be even better than the current ones. So there are two further steps – one is to validate what we’ve already found and then to look for new biomarkers which could be maybe, easier to measure and maybe even better in their discriminating power.”
Additionally, Tamas is interested in researching the immune system in the early phase of critical illness.
“We have gathered evidence that the immune system is not just hyper-active but it’s actually very significantly suppressed in the early phase of critical illness. What we’re aiming to do is to try and tease out how does it happen and whether there is any way which we can change that for the benefit of the patient,” he continues.
Dr Tamas Szakmany is looking forward to what comes next. Much like when we tried to arrange this first interview, he was looking forward to diving into unknown waters, you get the feeling that he’s always diving into unknown waters – whether those are physical or metaphorical seems to matter little:
“I’m absolutely certain that we can continue with what we’ve started because this work has spread the news that there is something exciting happening in Cardiff and that made it possible for us to look at the epidemiology of sepsis,” he says in closing. “We are looking at different ways of working within the hospital to try and tackle this problem. And it made the news so even that medical students are excited about that. We’ve got a healthy collaboration with the Cardiff University medical student research society, which is very important, because if you can engage the future doctors in this type of thinking, then you can make sure that we can drive forward”