Today The Washington Post mentioned Bournemouth University’s research into kidney disease in migrant workers from Nepal. Our research was highlighted in an article with the title ‘The world’s torrid future is etched in the crippled kidneys of Nepali workers‘ written by journalist Gerry Shih. Dr. Pramod Regmi and Dr. Nirmal Aryal, both in the Faculty of Health & Social Sciences, are leading on a research project on kidney health and migrant workers. The paper mentioned in The Washington Post is titled: ‘Risk of kidney health among returnee Nepali migrant workers: A survey of nephrologists’ . This survey paper was published just over a year ago, in late 2021, and it was preceded by other papers on this issue [2-3].
Dr. Pramod Regmi is Senior Lecturer in International Health and, Dr. Nirmal Aryal recently returned to BU as researcher on a study into kidney disease among Nepalese migrant workers (funded by the Colt Foundation).
Prof. Edwin van Teijlingen
- Aryal, N., Sedhain, A., Regmi, P.R., KC, R.K.,& van Teijlingen, E. (2021). Risk of kidney health among returnee Nepali migrant workers: A survey of nephrologists. Asian Journal of Medical Sciences, 12(12), 126–132.
- Aryal, N., Regmi, P.R., Faller, E.M,, van Teijlingen, E., Khoon, C.C., Pereira, A., Simkhada, P. (2019) Sudden cardiac death and kidney health related problems among Nepali migrant workers in Malaysia, Nepal Journal of Epidemiology 9(3): 755-758.
- Simkhada, P.P., Regmi, PR., van Teijlingen, E., Aryal, N. (2017) Identifying the gaps in Nepalese migrant workers’ health & well-being: A review of literature, Journal of Travel Medicine 24(4): 1-9.
Whether its in you, a blue whale or a tiny insect, circulating fluids bathe and nourish organs, tissues and cells. To avoid compromising organ function, these ‘bloods’ are filtered and kept free of unwanted molecules. Studying these clearance mechanisms informs us about normal physiology, as well as disease across a vast array of organisms, from flies to humans.
In a new paper led by BU, it has been established that a mechanism common to flies and humans involving a protein called Amnionless, relies on a cell’s calcium level being controlled by genes known as Stim and Orai. Using powerful fruit fly genetics and dynamic cellular imaging techniques, the researchers found that as calcium levels change, Amnionless is turned-over at the cell surface where is helps to remove unwanted molecules. This new information is important because of its relevance to the human kidney’s role in blood filtration. Additionally, research is showing that the mechanism can be targeted by environmental toxins and this may explain why some insect species are struggling in the wild.
It is sobering to think that aspects of human cardiovascular disease and the ‘insect apocalypse’ may actually have common origins. Understanding these biological systems therefore has a dual purpose by informing medical, biomedical and ecological research fields.
(The image shows insect filtration cells in blue, adjacent to the heart, coloured magenta).
Research at BU has helped establish a cause of childhood kidney failure. The work, accepted for publication the journal Paediatric Nephrology, was a combined effort, including inputs from academic and clinical teams at the universities of Oxford, Bristol and Bournemouth. It focused on Steroid Resistant Nephrotic Syndrome (SRNS), a life-threatening form of kidney disease seen in young children, which may require dialysis and eventually a kidney transplant.
It is increasingly understood that genetic mutations play a critical role in SRNS but proving cause and effect is problematic. A patient’s family may have evidence of mutations in key ‘kidney genes’ but establishing if these actually combine in the patient to cause SRNS needs experimental evidence. Bournemouth’s contribution to this work involved disrupting a gene called Nucleoporin 93 (NUP93) in the kidney-like cells (nephrocytes) of fruit flies (Drosophila). When NUP93 function was lost in nephrocytes, failed to do their kidney filtration job and then died; providing strong evidence that mutations in the human gene do indeed lead to SRNS.
NUP93 is part of a protein complex that allows communication between a cell’s ‘head quarters’, the nucleus, and the rest of the cell. Perplexingly, NUP93 is found in all cells raising questions as to why mutations specifically affect the kidney. This work facilitates the search for a cure in the long term and, in the shorter term, allows for a definitive diagnosis when clinicians and families are confronted by this potentially devastating disease.
Paul Hartley (Life and Environmental Sciences).
Congratulations to Dr. Pramod Regmi and Dr. Nirmal Aryal on the acceptance of their paper ‘Risk of kidney health among returnee Nepali migrant workers: A survey of nephrologists’ . This paper has been accepted by the Asian Journal of Medical Sciences, after having been rejected previous by another scientific journal . The reason for rejection was the small sample size of 38 nephrologists (=medical specialists in kidney disease). We think one of the reasons for acceptance of this research by the Asian Journal of Medical Sciences is the high proportion (74.5%) of all Nepal’s nephrologists who participated in this national study. Although the absolute number of participants is low there are only 51 kidney experts in the whole country and three-quarters took part in this study!
Dr. Nirmal Aryal was until recently based in the Department of Midwifery and Health Sciences and he will be starting later this month as a Research Associate at Greater Manchester Mental Health NHS Trust. Dr. Pramod Regmi is Senior Lecturer in International Health in the Department of Nursing Sciences. This paper was also co-authored with a nephrologist Dr. Arun Sedhai based in Chitwan (Nepal) and a public health expert based at the UN organisation, International Organization for Migration (IOM).
This paper which will be Open Access and hence freely available for any reader across the globe adds to the growing research evidence published by Bournemouth University’s researchers on migration and health, especially of migrants from Nepal [2-21].
Prof. Edwin van Teijlingen
Centre for Midwifery, Maternal & Perinatal Health (CMMPH)
- Aryal, N., Sedhain, A., Regmi, P.R., KC, R.K., van Teijlingen, E. (2021) ‘Risk of kidney health among returnee Nepali migrant workers: A survey of nephrologists’, Asian Journal of Medical Sciences (accepted).
- Simkhada, B., Vahdaninia, M., van Teijlingen, E., Blunt, H. (2021) Cultural issues on accessing mental health services in Nepali and Iranian migrants communities in the UK, International Journal of Mental Health Nursing (accepted). https://doi.org/10.1111/inm.12913
- Adhikary, P., Aryal, N., Dhungana, R.R., KC, R.K., Regmi, P.R., Wickramage, K.P., Duigan, P., Inkochasan, M., Sharma, G.N., Devkota, B., van Teijlingen, E., Simkhada, P. (2020) Accessing health services in India: experiences of seasonal migrants returning to Nepal. BMC Health Services Research 20, 992. https://doi.org/10.1186/s12913-020-05846-7
- IOM [International Organization for Migration]. (2019) Health vulnerabilities of cross-border migrants from Nepal. Kathmandu: International Organization for Migration.
- Aryal, N., Regmi, P.R., van Teijlingen, E., Trenoweth, S., Adhikary, P., Simkhada, P. (2020) The Impact of Spousal Migration on the Mental Health of Nepali Women: A Cross-Sectional Study, International Journal of Environmental Research & Public Health 17(4), 1292; https://doi.org/10.3390/ijerph1704129
- Regmi, P., Aryal, N., van Teijlingen, E., Adhikary, P. (2020) Nepali migrant workers and the need for pre-departure training on mental health: a qualitative study, Journal of Immigrant & Minority Health 22, 973–981.
- Adhikary, P. van Teijlingen, E. (2020) Support networks in the Middle East & Malaysia: A qualitative study of Nepali returnee migrants’ experiences, International Journal of Occupational Safety & Health (IJOSH), 9(2): 31-35.
- Simkhada, B., Sah, R.K., Mercel-Sanca, A., van Teijlingen, E., Bhurtyal, Y.M., Regmi, P. (2020) Health and Wellbeing of the Nepali population in the UK: Perceptions and experiences of health and social care utilisation, Journal of Immigrant & Minority Health (accepted).
- Regmi, P., van Teijlingen, E., Mahato, P., Aryal, N., Jadhav, N., Simkhada, P., Syed Zahiruddin, Q., Gaidhane, A., (2019) The health of Nepali migrants in India: A qualitative study of lifestyles and risks, Journal of Environmental Research & Public Health 16(19), 3655; doi:10.3390/ijerph16193655.
- Dhungana, R.R., Aryal, N, Adhikary, P., KC, R., Regmi, P.R., Devkota, B., Sharma, G.N., Wickramage, K., van Teijlingen, E., Simkhada, P. (2019) Psychological morbidity in Nepali cross-border migrants in India: A community-based cross-sectional, BMC Public Health 19:1534 https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-019-7881-z
- Aryal, N., Regmi, P.R., van Teijlingen, E., Simkhada, P., Mahato, P. (2019) Adolescents left behind by migrant workers: a call for community-based mental health interventions in Nepal. WHO South East Asia Journal of Public Health 8(1): 38-41.
- Aryal, N., Regmi, P.R., Faller, E.M,, van Teijlingen, E., Khoon, C.C., Pereira, A., Simkhada, P. (2019) ‘Sudden cardiac death and kidney health related problems among Nepali migrant workers in Malaysia’ Nepal Journal of Epidemiology 9(3): 755-758. https://www.nepjol.info/index.php/NJE/article/view/25805
- Adhikary P, van Teijlingen E., Keen S. (2019) Workplace accidents among Nepali male workers in the Middle East and Malaysia: A qualitative study, Journal of Immigrant & Minority Health 21(5): 1115–1122. https://link.springer.com/article/10.1007/s10903-018-0801-y
- Simkhada, P.P., van Teijlingen, E.R., Gurung, M., Wasti, S. (2018) A survey of health problems of Nepalese female migrants workers in the Middle-East & Malaysia, BMC International Health & Human Rights 18(4): 1-7. http://rdcu.be/E3Ro
- Adhikary P, Sheppard, Z., Keen S., van Teijlingen E. (2018) Health and well-being of Nepalese migrant workers abroad, International Journal of Migration, Health & Social Care 14(1): 96-105. https://doi.org/10.1108/IJMHSC-12-2015-0052
- Adhikary, P, Sheppard, Z., Keen, S., van Teijlingen, E. (2017) Risky work: accidents among Nepalese migrant workers in Malaysia, Qatar & Saudi Arabia, Health Prospect 16(2): 3-10.
- Simkhada, P.P., Regmi, P.R., van Teijlingen, E., Aryal, N. (2017) Identifying the gaps in Nepalese migrant workers’ health and well-being: A review of the literature, Journal of Travel Medicine 24 (4): 1-9.
- Aryal, N., Regmi, P.R., van Teijlingen, E., Simkhada, P., Adhikary, P., Bhatta, Y.K.D., Mann, S. (2016) Injury and Mortality in Young Nepalese Migrant Workers: A Call for Public Health Action. Asian-Pacific Journal of Public Health 28(8): 703-705.
- Sapkota, T., Simkhada, P., van Teijlingen, E. (2014) Nepalese health workers’ migration to United Kingdom: A qualitative study. Health Science Journal 8(1):57-74.
- Adhikary P, Keen S and van Teijlingen E (2011). Health Issues among Nepalese migrant workers in the Middle East. Health Science Journal.5 (3):169-i75 DOI: 2-s2.0-79960420128.
- Adhikary, P., Simkhada, P.P., van Teijlingen E., Raja, AE. (2008) Health & Lifestyle of Nepalese Migrants in the UK, BMC International Health & Human Rights 8(6). Web address: www.biomedcentral.com/1472-698X/8/6
Congratulations to Dr. Pramod Regmi, Lecturer in International Health & Global Engagement Lead, Department of Nursing Sciences, and Dr. Nirmal Aryal, formerly of the Centre of Midwifery, Maternal & Perinatal Health (CMMPH), whose editorial “Kidney health risk of migrant workers: An issue we can no longer overlook” has been published today in Health Prospect . Further co-authors (Arun Sedhain, Radheshyam Krishna KC, Erwin Martinez Faller, Aney Rijal, and Edwin van Teijlingen) work in India, Nepal, the Philippines and at BU. The study was funded by GCRF.
This editorial highlights that low-skilled migrant workers in the countries of the Gulf and Malaysia are at a disproportionately higher risk of kidney health problems. The working conditions are often Dirty, Dangerous and Difficult (referred at as the 3Ds) include physically demanding work, exposure to a hot environment, dehydration, chemical exposures, excessive use of pain killers, and lifestyle factors (such as restricted water intake and a high intake of alcohol/sugary drinks) which may precipitate them to acute kidney injuries and subsequent chronic kidney disease.
- Aryal, N., Regmi, P.R., Sedhain, A., KC, R.K., Martinez Faller, E., Rijal, A., van Teijlingen, E., (2021) Kidney health risk of migrant workers: An issue we can no longer overlook. Health Prospect 21(1): 15-17.
The Physiological Society is Europe’s largest network of physiologists, so it was a great privilege to be invited to give a plenary talk at the Renal physiology: Recent advances and emerging concepts satellite symposia in Aberdeen last week. This followed on from work conducted at BU using fruit flies to study human kidney function and which most recently contributed to research published in Nature Communications. We’ve been studying insect cells called nephrocytes for several years because of their tractability and genetic similarity to human kidney cells called podocytes – cells crucial to the kidney’s role in filtration and excretion. The insects cells offer us opportunities to modulate genes and infer what may happen in human diseases. The Nature Comms paper and Phys Soc talk detailed the work we collaborated on that identified a metabolic pathway in podocytes governed by a gene called GSK3, this pathway now represents a potential target for the control of kidney disease in diabetics.
BU research, (led by me, Dr Paul Hartley), was recognised at UK Kidney Week in Liverpool last week. We were invited to speak about our fruit fly model of human renal disease, work that has been variously supported by grants from the British Heart Foundation and Kidney Research UK. The conference was an excellent opportunity to showcase the model and highlight our current collaborations with consultant-scientists based at Great Ormond Street Children’s Hospital as well as a number of different groups at the University of Bristol, the University of Osnabruck in Germany, Harvard Children’s Hospital and the University of Edinburgh. The research work is based in Dorset House labs and is supported by a wide network of talented people within BU as well as our undergrad and post-grad students.
BU research will be prominent at UK Kidney Week this summer in Liverpool. The conference is led by the Renal Association with the International Society of Nephrology (ISN) and the British Transplant Society (BTS). We’re delighted to have been invited to speak at the conference, which is a great opportunity to showcase our research as well as BU’s commitment to developing biomedical research themes. We’re also contributing several abstracts, detailing collaborations with the Universities of Bristol, Oxford and Osnabruck, Germany. The work focuses on the molecular cell biology of human podocytes, cells critical for our kidney’s role in blood filtration. When podocytes ‘fail’, kidney failure ensues.
We use Drosophila (fruit fly) genetics and molecular cell biology to address intractable problems associated with podocyte aging, podocyte dysfunction in diabetic nephropathy and several rare genetic mutations affecting podocytes that cause kidney failure in the young.
The work, was primarily funded by a Kidney Research UK Innovation Award and a British Heart Foundation Fellowship.
Dr. Paul Hartley.