Professor Mark Slevin is Chief Scientific Officer at The Regenerative Clinic and Professor of Cell Pathology at Manchester Metropolitan University.
He is also Professor of Pathology at Targu Mures University of Medicine and Pharmacy (Romania) and Weifang University (China). Prof. Slevin is a Fellow of the Royal College of Pathologists (2008-). He was also a consultant for Smith and Nephew pharmaceuticals (2012-1017) and LIPOGEMS incorporated (2017-2020).
With 293 articles listed in Google Scholar, his research interests are focused on cell and tissue regeneration, stem cell biology and vascular development during healing. He works with scientists and clinicians around the world creating novel therapies to improve the clinical outcome of patients suffering from degenerative disease.
OPN: What drove you to choose your career in pathology – cell pathology in particular?
MS: I suppose several factors played a part, firstly, my fascination of disease and the causes of major disease, hence the interest in the individual cells and the micro-environments where the tissue damage precipitates. Secondly, I also have always been passionate about chemistry and indeed astronomy and the physics of matter. Hence the interactions of components within the cell that determine its behaviour and ultimately its fate and eventually the outcome of the disease.
Only by understanding the pathology in detail can we retrospectively reflect upon the series of events leading up to the cellular, tissue, organ or bodily dysfunction and use this information in our attempt to create novel therapeutics and protective treatments covering prevention, earlier diagnosis and more effective stratified treatment.
OPN: It is clear that the healthcare industry has been greatly impacted by the pandemic, what has been the greatest impact for you within your research and the industry as a whole?
MS: Clinical research involved pre-clinical proof-of-concept studies usually followed by clinical trials. In our work this always involves the contribution of scientists and doctors from several or more centres around Europe and often beyond.
During the pandemic, with severe travel restrictions, these collaborations were effectively broken and this has affected and significantly slowed down the development of potentially new therapeutics and medical devices for regenerative medicine and in particular for the treatment of osteoarthritis and related joint dysfunction injury and disease. For the industry in general, the waiting lists for joint treatments, particularly arthroplasty, have increased enormously due to the increased burden placed upon the NHS during this period [through 2021, over 160,000 UK residents had significant delays for hip or knee replacements due to COVID-19].
Whilst biological treatments such as administration of micro-fragmented adipose tissue, have shown great promise in what is now a significant number of clinical studies, [reducing pain and increasing mobility over extended periods – sometimes years for O/A] many of the orthopaedic clinical community remain unwilling to consider it as part of their therapeutic treatment armoury, and none of the major insurance companies have these treatments included in healthcare packages. This I find disappointing since both the safety and the efficacy of the procedure(s) are now fully biologically characterised and medically/clinically proven.
OPN: What’s the best part of your job?
MS: Two things stand out and their origin would have been a study of pathological findings together with a characterisation of the mechanisms involved in disease development, these are:
- the pleasure in successfully creating a protocol for a clinical study or trial knowing that people/patients will hopefully enjoy a better quality of life from the treatment that will represent a state-of-the-art or near-future advancement in medicine and secondly
- from a personal perspective, the absolute and sheer variety of engagements from basic research in pathology, through clinical studies, engagement with collaborations around the World, working with industry and pharma and even the involvement with government, legislation and regulatory bodies and law firms in cases of litigation—its amazing!
OPN: … and the worst?
MS: I suppose this being a career or even a combination of careers, that can be very time consuming and certainly sometimes limits the time remaining available to spend with family and friends
OPN: What has been the highlight of your career so far?
MS: I think it was probably being lucky enough to spend a 2-year sabbatical at the National Centre for Cardiovascular research at St Pau Hospital in Barcelona (CSIC-ICCC) under the director Prof. Lina Badimon. The place was stunning and the organisation and quality of work undertaken to pre-clinical studies was world-leading.
OPN: You recently analysed eighteen separate peer-reviewed and published global studies, looking at the effects of orthobiologics. Could you tell us more about your findings and what it could mean for osteoarthritis sufferers?
MS: As part of my work at The Regenerative Clinic we investigated a number of important elements from understanding and characterising the biological properties of the injectable, then conducting medium to long term assessment of the outcomes [1-2 years +], and studying AI algorythms using clinical and other data to stratify treatment and identify likely ‘super responders’ along with non-responders in order to maximise the treatment effectiveness within the population.
OPN: What could this mean for the patient experience, management strategies and surgical outcomes looking forward?
MS: So standardising of preparatory protocols comes out as being absolutely essential and there still remains a need to conduct large multi-centre focussed trials in order to reach the point of understanding suggested in my previous answer. Products based around MFAT still look to be extremely promising but can be improved further by optimisation and a little manipulation for content. For example, MFAT is able to absorb drugs and release them over a period of weeks and this could be highly advantageous in novel targeted therapies as well as maximising the known therapeutic effects in osteoarthritis and other joint injury repair. All of this should certainly stream line and improve the patient experience as well as management strategies with a wider range of options available and the probability of delaying (or avoiding) joint replacement until very late in life.
OPN: Are you currently involved in any further research? If so, could you tell us more about it?
MS: As below, yes we are conducting pre-clinical and clinical studies looking at novel tissue regenerative strategies primarily stem cell or exosome-based for a variety of degenerative conditions; as well as a particularly exciting study where the indications are already that treatment produces a significant reversal of aging in dogs.
OPN: Are you planning to attend any orthopaedic events this year?
MS: I participated in the Stem Cell and Tissue Engineering LLC Conference in London in October and don’t plan to travel further until after the Christmas holiday. Meantime we are setting up three clinical trials here in CCAMF, at the George Emil Palade-UMFST, Targu Mures, Romania where I direct the Research Centre.
OPN: If you didn’t work in pathology what would you be?
MS: My passion has always been astronomy so I would have really liked to be an astrophysicist.
OPN: What would you tell your 21-year-old self?
MS: To understand and accept that life will never turn out like you expect it to but that the most important things are to follow your passion and remain modest and respectful without ego.
OPN: If you were Health Minister for the day what changes would you implement?
MS: I would remove the incentivisation for corruption, arrogance and greed – these are things which have slowed down progression and advancement in medicine and healthcare throughout the last few decades. Seriously though, there needs to be a common patient pathway and patients need to be aware of all the options—currently many patients who do not need joint replacement are being offered this whilst others who do need one are not. The system needs an overhaul and better regulatory management.
OPN: Away from the clinic and your research – what do you do to relax?
MS: So I have a telescope and observatory at my mother’s house in Northern Ireland –whenever I get a chance I go there and ‘star gaze’ contemplating the universe and its purpose. Also, I always participated in sport and continue to do so daily cycling, running and rowing mostly.
OPN: How do you think the future looks in the field of orthopaedic surgery and what are your predictions for 2023 and the next decade?
MS: I predict change although not necessarily as early as 2023. As younger surgeons develop their clinical practices they are more likely to integrate and understand the latest advances in the field including the potential of orthobiologicals either used alone or as an adjunct to surgical procedures supporting repair and prevention, slowing down the disease process in O/A and thereby reducing the yearly number of arthroplasty cases. I estimate within a decade common practice will be to stratify individuals and focus on early and effective treatment that will include orthobiologicals and significantly reduce the risk of development of degenerative disease.