00:00 – Dr. Malcolm Starkey: The urinary bladder potentially has very different types of responses
00:04 – or it’s evolved to use these responses in different ways because it’s a different organ. It’s an exit organ.
00:09 – So the immune response there has to kind of balance all these different things.
00:26 – Melissa Kramer: Before we jump into immunotherapy itself, can you give us
00:29 – a description of how the immune system responds to a UTI?
00:34 – Dr. Starkey: Yes, it’s interesting, particularly in the urinary bladder.
00:39 – So of course, a urinary tract infection is an infection by bacteria of any part of the urinary tract,
00:45 – which is the urethra, the urinary bladder, the ureters, which is the tube that connects the bladder to the kidneys.
00:52 – And of course, the kidneys. The kidneys being the filtration device,
00:55 – you know, comes through the ureter to the bladder for excretion through the urethra.
00:59 – So it can be an infection in any part of that tissue.
01:03 – Now, it behaves a little bit differently depending on where it is in that urinary tract.
01:07 – But for the urinary bladder, it’s a bit of a bizarre sight compared to the kidney.
01:13 – So what happens in the urinary bladder? We get this very good initial immune response.
01:17 – So the first responders, the cavalry comes in, it’s called the innate immune response.
01:22 – And these have cells in there, kind of white blood cells or immune cells called nitrophils and macrophages.
01:29 – And their job is to behave like little pac-man. They sort of come in and they sort of eat up the bacteria.
01:34 – And as part of that, you also get in the epithelium as we talked about before shedding into the urine.
01:39 – And of course, because the bladder is an excretory organ, you can excrete through the urine.
01:45 – So we can get rid of some of the bacteria through that process. So that works really well.
01:49 – What the bladder doesn’t do well is develop what we call immune memory.
01:55 – So if we think about vaccination, for example, we have a vaccine so that
01:59 – our immune system can recognize the pathogen where we get infected with it.
02:04 – So that might be influenza when we get the flu jab or it might be COVID when we get our latest COVID booster.
02:10 – However, for bacteria that cause infection in the bladder, the immune system doesn’t seem to really do that.
02:17 – And I think part of that might be that it’s favoring repairing that bladder wall over a really effective immune response long term.
02:26 – And the reason, if you think about it, it makes evolutionary sense because the bladder is full of urine. Urine is highly toxic.
02:34 – You don’t want that urine coming back through the wall and causing damage.
02:37 – You know, that could cause some really serious issues.
02:40 – So evolutionary, we had to sort of decide on what’s the better of the two evils.
02:46 – And obviously we’ve evolved to decide, well, we really don’t want those toxins coming back in all the time.
02:50 – So we have to preference repair over antibacterial immunity.
02:55 – So we still deal with the infection, but we don’t deal with it when we have recurrent infections.
03:01 – Now, when the infection gets to the kidney, it’s a different story in the kidney.
03:04 – The kidneys decided, okay, we’re not a barrier site.
03:09 – We are basically the inside of the castle where the king and queen hidden up at the top tower.
03:15 – We’re really important and we can’t have anything here. This is bad.
03:19 – If it gets here, it’s going to get into a bloodstream.
03:21 – So now the immune systems decided, okay, in this organ, we have to do something about it.
03:26 – So now it develops a memory response. So next time you get infection in the kidney, it knows what to do.
03:33 – And so for those people that have had really serious infections that get to their kidney,
03:37 – when they have a subsequent infection of the bladder, they’re more likely to be able to clear it.
03:42 – But for the people that have these infections that just keep happening in the bladder,
03:45 – for whatever reason, our immune system doesn’t generate that memory.
03:49 – So when we see it again and patients, as you know, they get infected with exactly the same strain of bacteria.
03:55 – So something they’ve seen before.
03:57 – And our immune system just doesn’t recognize it, which doesn’t make sense when we think about all these other things
04:03 – we can be vaccinated against. So that’s something we need to understand. We need to understand why is that not happening?
04:09 – Is that different between males and females?
04:12 – Is that a reason why females are more susceptible to these infections, these recurrent infections?
04:17 – And then how do we manipulate that part of the host response for new treatments?
04:24 – And of course, that is immunotherapy, which I think is your next question.
04:29 – Melissa: There was one sub question about the epithelial cell shedding.
04:32 – Is there any visible evidence of this in the urine? Can you actually see the tissue or anything? Or is it microscopic only?
04:38 – Dr. Starkey: It could be. You could have like clusters of them.
04:40 – So you might see, you know, some float around the urine, but you wouldn’t be able to tell what they are.
04:45 – Will you see something? Yes, probably. Can you say that that is actually epithelial cells?
04:51 – You’d have to look under the microscope to know what they are. But are they seen, shedded epithelial cells? Probably.
04:59 – Melissa: Okay, fair enough. That’s good to know.
05:01 – So you’ve mentioned the immune cells that are resident in the bladder, in the urinary tract.
05:07 – Are some people’s immune systems just inherently stronger or weaker than others?
05:10 – And could that explain why some people are more susceptible to recurrent UTI than others?
05:17 – Dr. Starkey: I mean, this is something that we’ve got to work out, but that would be the hypothesis, right?
05:21 – And even between male or female differences.
05:24 – So we know that there are very distinct differences in other organs and systems between males and females.
05:30 – And we know that the immune system behaves differently, even in healthy individuals,
05:35 – just based on sex or whether you’re male or female. And this could be driven by male sex hormones,
05:41 – but also just, you know, the way in which the immune system is sort of set up.
05:45 – And of course, that makes evolutionary sense as well. You know, women are, you know, child bearing. Men aren’t.
05:53 – And so our immune systems need to be, you know, viewed a little differently for those sorts of reasons.
06:00 – And so there’s some logic behind that. So indeed, there’s some rationale there.
06:04 – I mean, look, there could well be genetic causes underlying this. There could be factors from early life that affect this.
06:11 – You know, there was a study that just came out earlier this week about a virus called BK virus,
06:16 – which is a virus that I actually have as that’s reactivated because of my immunosuppression with kidney transplant.
06:21 – Now, about 95% of us will get this infection early in life.
06:26 – And then this virus sort of embeds itself in the urinary tract, in the urinary bladder and in the kidneys.
06:31 – And then it can become reactivated in some people because of immunosuppression or other illness
06:37 – or whatever the case might be. And then this virus is now sort of seen as a predictor for bladder cancer.
06:43 – But, you know, one of the things that I was thinking about is, okay, well, perhaps just these sort of viruses that we all have
06:49 – and hanging around as a result of early childhood infections that we all have.
06:54 – What’s the consequence of those sort of infections that we think are benign in different individuals?
06:58 – Are they kind of changing the landscape to the immune response in the background?
07:03 – Have you had lots of illnesses when you’re young that changed how you set up?
07:07 – And we know again from respiratory disease that if you have lots of respiratory infections when you’re very young,
07:13 – you’re much more likely to get diseases like asthma and COPD.
07:17 – So emphysema, for example, which we normally think is because of smokers.
07:21 – But even in non smokers, these early life infections are a massive consequence for decline in lung function in later life.
07:28 – And so it could also be that some of these early life challenges that we’ve had changes the landscape of our urinary bladder,
07:35 – both the immune system and structural cells, so that over time we become more susceptible to infections.
07:41 – And so perhaps these are the individuals that then go on to have these recurrent infections.
07:45 – I mean, look, there is never ending interesting questions for us to pursue.
07:49 – Yeah, but there’s a whole bunch of things that could be going on going on there.
07:53 – But the short answer is yes, there could well be differences and there probably are.
07:58 – But what’s causing that could be any number of things and again requires a lot of investment for us to understand.
08:04 – Melissa: And all of these questions don’t point to it being the patient’s fault in any way.
08:08 – It’s not about how they wipe or any of their hygiene habits. It’s just things that we don’t understand yet.
08:12 – And I think it’s really good to highlight those.
08:15 – Dr. Starkey: Yeah, I totally agree with that.
08:17 – I mean, even with things like hydration, you know, one of the things I really want to look at if we can get the funding for it.
08:23 – You know, people say, you know, you increase hydration and you know, you dilute out the bacteria.
08:28 – It’s an assumption. Nothing’s actually being shown.
08:30 – I mean, I would actually think that, you know, hydration is changing the way in which the host, the bladder is responding.
08:40 – And not just by diluting out the bacteria, but I would imagine that you’re changing the way that the structural cells behave,
08:46 – the signals that they send to immune cells and then what your immune cells are actually doing.
08:50 – So, I wouldn’t be surprised if something as simple as hydration is actually changing the immune response.
08:56 – And we see that in the gastrointestinal tract, for example. Time of feeding is really important.
09:01 – So, you know, relative to your circadian rhythm. So we eat at times of the day.
09:06 – If we sort of disrupt that and travel and eat at weird times of the day,
09:10 – our gut will start to produce an inflammatory response from our immune system that it wouldn’t normally do,
09:16 – which can then cause damage to the gastrointestinal tract. So same sort of thing with drinking.
09:21 – It’s got to be causing some kind of physiological and immunological response.
09:25 – So often we just – there’s a lot of assumption with UTI.
09:28 – Melissa: There really is.
09:29 – Dr. Starkey: People think, oh, we just do this or do that – it has to be that. But none of it’s actually really been proven.
09:34 – So I wouldn’t be surprised if something as simple as increase in hydration
09:38 – is actually having an effect on us, the host, not just diluting the bug.
09:43 – You know, so we really need to just understand what we’re doing. But 100 percent, it’s not our fault.
09:48 – I get really angry when people say it’s because of your anatomical setup or, you know, your unhygienic.
09:55 – Because I mean, everybody that suffers from this condition knows it’s not true.
09:58 – Every time I teach this to undergrads, you know, all the female students are just horrified to think
10:03 – that people are being treated this way.
10:06 – Melissa: It is horrifying.
10:06 – Dr. Starkey: It makes no sense. Yeah.
10:07 – Melissa: Yeah. And a lot of things that end up being researched end
10:10 – up being things that patients have been saying all the time, even the hydration thing.
10:14 – They – a lot of patients say when they drink, their symptoms are relieved before it even gets to the point
10:19 – where they might urinate again. So there could be something else going on.
10:22 – But that’s just put down to the assumption that it’s in their head, that it’s psychological, that it makes them feel better.
10:28 – And there’s so many things like that, but we don’t really understand the mechanisms.
10:32 – Dr. Starkey: This is where we need to work with patients as well. And this is the power of consumer involvement in research.
10:38 – And in Australia, that’s a really critical component of our research design now.
10:43 – Because by understanding the things that patients are experiencing and what’s the priorities to them,
10:48 – it can actually help us develop scientific questions.
10:51 – And also to develop processes and approaches that best meet the need of the community.
10:56 – And I must say that Chronic UTI Australia and others and the initiatives that you’re driving,
11:00 – Melissa, is really great in this space because it helps to educate us as scientists
11:05 – who I like to think this next generation is very open-minded.
11:08 – We want to know these things so that we can try to look at how that information
11:13 – fits into what we’re seeing scientifically. So we need to do it in collaboration.
11:16 – We shouldn’t be treating them as separate baskets.
11:18 – It shouldn’t be patients over here, medical doctors over here, scientists over here.
11:23 – We need to bring everyone together to talk about these things and their experiences
11:28 – and increase everybody’s understanding to really drive innovation.
11:31 – Melissa: So back on the immunotherapy side of things, can you explain in patient-friendly terms what type two immunity is
11:37 – and why these immune cells might be important for preventing chronic UTI?
11:41 – Dr. Starkey: Sure. So type two immunity is just a way that we label a particular arm of the immune system.
11:47 – So our host immune response. Type two immunity evolved to deal with worms, so helminth infections.
11:56 – And so really it’s an arm of the immune system that’s there to fight off worms.
12:01 – Now we also know that this type two immune response is really important in things like driving allergy and asthma.
12:08 – And so it does also drive when it’s dysregulated, diseases that are pathologic, right, like asthma.
12:17 – And so in the urinary bladder, what’s happened is this type two immune response has evolved to,
12:23 – as we talked about before, repair the urinary bladder. But as a consequence, it’s potentially, you know,
12:32 – at the consequence of not having effective antibacterial immunity or immune memory.
12:38 – Now, we don’t even think it’s necessarily that simple and we’ve just got new major funding from
12:43 – the Australian government to explore type two immunity and UTI.
12:48 – And so we think that, and we’ve talked about this before, Melissa, so there’s sex differences.
12:52 – So we know that there’s large sex differences in type two immunity between males and females,
12:57 – with females having much stronger type two immune responses than males,
13:01 – with testosterone suppressing these type two immune responses.
13:04 – And so we think it could also be a biological reason as to why women are more susceptible.
13:09 – And we’re also discovering some really interesting things, not just about what type two immunity
13:14 – is doing in immune cells, but also what type two immunity is doing within structural cells within the bladder lining.
13:21 – And so these are non-typical processes that we understand as scientists.
13:27 – And so we’re really interested to understand what’s happened in the urinary bladder,
13:31 – because generally the urinary bladder gets ignored.
13:34 – If you look at studies where they say they’ve looked at multiple organs, it’s never the urinary bladder.
13:40 – They’ll look at the lung and the eye and the brain and the gut and maybe the kidney,
13:44 – but the urinary bladder is never, ever, ever, ever, ever part of that process.
13:49 – And so the urinary bladder potentially has very different types of responses,
13:53 – or it’s evolved to use these responses in different ways, because it’s a different organ. It’s an exit organ.
14:00 – It’s still exposed to the external environment, as we talked about before,
14:04 – it has to protect against these toxic chemicals within the urine. It’s the waste product, right?
14:09 – It’s the garbage truck of our body, right? And so the immune response there has to balance all these different things.
14:19 – So we’re trying to understand what that is.
14:20 – But our overall goal and hypothesis is that there’s dysregulated type two immunity
14:26 – that we can then target with immunotherapies.
14:29 – And we think that this is very achievable, because there’s already type two immunotherapies that are available for asthma.
14:35 – So our key idea is to repurpose the existing immunotherapies that have already been developed
14:40 – and already gone through clinical trial for asthma, and to repurpose them after having the
14:46 – evidence that we need to show that they’re important to repurpose
14:49 – those drugs for these recurrent or chronic urinary tract infections.
14:55 – Melissa: And what kind of advantages would immunotherapy have over antibiotics?
15:02 – Dr. Starkey: Well, exactly what we’re just talking about, right? So all
15:02 – the way through, we’ve been talking about this bug drug dogma.
15:05 – Antibiotics focus on targeting the bug. But immunotherapies target on restoring balance in the host response.
15:14 – And when you think about it, we know that healthy individuals that see the bug don’t really get unwell.
15:20 – So it’s not the bug necessarily that’s the problem.
15:24 – It’s the way that we respond to the bug that’s the problem.
15:27 – So if we always focus on the bug, we’re sort of forgetting that part of us that’s really the responder, right?
15:34 – So really what immunotherapy does is try to restore back to baseline, back to normality,
15:40 – back to homeostasis, so that we no longer respond to those bacteria the way that we were in the past.
15:47 – Now that’s advantageous because we’ve always evolved with bacteria over a millennia, right? But we only evolve slowly.
15:55 – So getting us back to normal is important, whereas the bugs can evolve very, very, very, very quickly.
16:02 – So no matter what we do, they’re always going to evolve resistance to antibiotics.
16:06 – And these bugs are so clever, they can even switch off their cell wall so that they,
16:10 – when there’s antibiotics present, so the antibiotics can’t kill them.
16:13 – And then when your antibiotics course finishes, they’ll turn back on their cell wall again, so they can go back on and infect.
16:18 – So the bugs are that smart. They can evolve that quickly.
16:21 – We can’t, we take millennia and millennia and millennia to evolve these new mechanisms.
16:26 – And so I think by targeting the host response, we can kind of hopefully allow us to get back
16:31 – to a point where it’s a bit more of an even playing field, and our bodies have a chance
16:35 – of defending itself against these infections without having to rely on antibiotics.
16:40 – And of course, that’s also important for antimicrobial stewardship, which is one of the issues that
16:45 – patients would face when they see their clinicians is because clinicians are really worried about
16:50 – antibiotic use and these antibiotics not being available for really severe life-threatening infections.
16:55 – And many people see UTI as one of the major causes of antibiotic prescription.
17:01 – And so if we have a way of being able to complement that therapy so we can reduce the
17:05 – antibiotic load in patients so that we can restore the host response, but we’re also
17:10 – being responsible with the antibiotics that we have. I think it’s a win-win scenario in that sense.
17:16 – Melissa: So one of the grants that you have is for your work on therapeutic targeting of cytokines for
17:20 – the complicated urinary tract infection. Can you talk about how that might impact the patient experience in the future?
17:27 – Dr. Starkey: Yeah, so it’s similar to what I was just describing with type 2 immunity.
17:31 – So the other grant was really a similar sort of thing. In this case, rather than something
17:35 – being up and us wanting to use inhibitors to bring it back down, this was something that was missing that we need to restore.
17:42 – So immunotherapy isn’t just about inhibiting something.
17:46 – When we think about drugs or therapies, we normally think about trying to get rid of something that’s bad.
17:51 – Sometimes it’s also replacing something that’s potentially good that’s missing.
17:55 – And so what we found here was that there was a particular immune protein that following an
18:01 – infection doesn’t seem to be there. And again, in females, this is lower compared to males, so it’s missing.
18:08 – And it’s one of these things that you can replace. And of course, again, similar sort of strategy.
18:14 – Other companies have developed this immunoreplacement therapy for other conditions.
18:20 – In this case, it was really for psoriasis, so a skin type condition.
18:25 – And so again, these drugs can be repurposed to try to restore balance in the immune system.
18:30 – So again, this personalized medicine comes in.
18:33 – So for some individuals, they might be lacking this factor and we need to restore it.
18:37 – For others, they might have very strong dysregulation of this factor, so we need to inhibit it.
18:42 – For other people, they might need that combined with antibiotics.
18:45 – So I don’t think it’s just going to be a new magic therapy that’s going to solve it for everyone.
18:50 – I think we really do need to understand what’s happened in each individual patient
18:54 – and then have multiple weapons in our armory to be able to deal with each of these different scenarios.
19:02 – Melissa: Do we already have the tools to investigate what’s going on in each patient in that way
19:06 – so that we can tailor these drugs to their experience?
19:10 – Dr. Starkey: Do we have the tools? Yes. Have we proven how to do that in these patients?
19:15 – No. So the technology’s there. We just need the urgency. So if you imagine a hypothetical scenario where we had a
19:23 – uropathogen that caused the kind of worldwide spread disease that COVID did,
19:29 – we would have a solution to all of these problems in six months.
19:32 – Melissa: Yeah.
19:33 – Dr. Starkey: It just comes down to simply investment and awareness.
19:37 – And because COVID was perceived internationally by all governments to be such a significant problem,
19:42 – huge amount of investment, breaking down of all the regulatory red tape and all the collaborative
19:49 – barriers, everybody could just jump on this and we had great solutions, which happened very,
19:55 – very, very quickly. We would say exactly the same thing if we saw a life threatening,
19:59 – highly resistant strain of uropathogenic bacteria that spread around everyone around the world
20:06 – would see the same response. So do we have the tools and the technology?
20:10 – 100%. Do we have other technology that we didn’t know about?
20:13 – Like most of the community didn’t know about mRNA technology.
20:16 – That’s been there for 30 years. It’s just we’re able to take advantage of that technology when the time was right.
20:23 – So is the technology there 100%? Is the capability there 100%? But do we know what we need to be looking for?
20:30 – No, because there hasn’t been the investment in being able to understand what this looks like in
20:35 – patients. And that’s where we need to lobby governments, increase funding and be able to
20:41 – work together collaboratively to really work out what these would be.
20:46 – Melissa: What do you think a realistic timeline is for this type of therapy to become available for patients?
20:52 – Dr. Starkey: I mean, look, people always, these things always take a minimum of 10, 15 years in the
20:56 – normal pipeline. And that’s when you have something really hit.
20:59 – The problem is, is that are you going to be able to convince pharmaceutical companies that
21:03 – there’s a market here to make money? Because if you’re being realistic about these things,
21:08 – pharmaceutical companies want drugs that they can give people for a very long period of time.
21:13 – There isn’t much investment from pharma in new antibiotics.
21:17 – It’s not something that they’re particularly interested in.
21:19 – GSK’s just come out with a new antibiotic, which is now being tested for UTI, which is great.
21:25 – Gepotidacin. And that could buy us some time and it could also create a new treatment option.
21:31 – But ultimately, the bacteria will find a way of becoming resistant to this.
21:36 – It’s a very different type of antibiotic. It works in a very different way.
21:39 – It’s a new class, which is great. But that’s one of the first new antibiotics for UTI in
21:45 – decades. So it’s not like there’s investment even in antimicrobials.
21:49 – So there is investment in immunotherapies. Hence why we’re thinking about how can we
21:53 – repurpose them? Because companies are going to be very interested in repurposing and
21:57 – reusing drugs they’re already making if they can make more money.
22:01 – But if they have to create a whole new drug and if they have to spend two billion dollars to
22:05 – develop a whole new drug for a disease that they don’t see as marketable, then we’re not
22:11 – going to get very far. So that’s why we’re taking the approach of and we’re being realistic of what
22:16 – can we do? What’s important? What do we need to solve? We know patients need new diagnostics
22:22 – and we need new non-antibiotic treatments. So as a group, we’re going after it from the
22:26 – perspective of what’s the immune system doing? And then when we look at that, what makes sense?
22:31 – What could actually have an impact? And then what’s available that we can repurpose?
22:36 – Because unfortunately, there’s too many people that just don’t see UTI as a problem in the
22:41 – community. So business people and pharma aren’t going to want to invest in what they don’t see as a
22:47 – problem. But if we can say, hey, you can reuse your drugs that you’ve already got and you can
22:52 – have this impact on quality of life, we have a chance. So in that sense, if we can prove these
22:58 – things, then prove it in humans, we could fit within that five to 10 year time frame. But if
23:04 – we have to start something from scratch, I mean, I doubt we would see it in our lifetime to be honest,
23:08 – just simply because of the investment pipeline and the way that those things work. Yeah.
23:13 – Melissa: I mean, it’s hard to feel hopeful as a patient sometimes knowing that these things are
23:16 – going to take so long. Do you think there are changes in the nearer future that might come into
23:21 – clinical practice in testing or in treatment options for patients with recurrent UTI?
23:26 – Dr. Starkey: I think we are in a unique circumstance here. Unlike things like cancer immunotherapy,
23:31 – you know, there’s a bit more urgency. You know, you’ve got people with stage four cancer and
23:36 – they’re out of hope, you know, ethically, there’s more opportunities to do things there than there
23:41 – are with people that are otherwise deemed healthy, you know, for trial in these sorts of things. So
23:46 – it’s a lot harder to get these sorts of therapies into clinical trial. So it’s challenging, Melissa.
23:55 – I think we know we have to get so much inertia. Like this has been textbook after textbook for
23:58 – generation after generation. You think about a medical training section, you know, you’ve got
24:02 – the consultant, the registrar, you know, the interns and, you know, and residents and things.
24:08 – And, you know, there’s even the senior senior consultants, you know, urine is sterile,
24:14 – you know, UTI is not a serious problem. You know, and then that filters down and they go to uni,
24:18 – they see the same thing, you know, in their community and their colleges and their guidelines,
24:22 – it’s all reinforced. We’re talking about changing generations of set dogma, you know, that
24:30 – requires very, very, very strong evidence. Whereas when you’ve got something like life threatening
24:35 – cancers, where there’s just no option, people are a lot more open to trialing things. Whereas in this
24:42 – scenario, it’s a very different circumstance. So that can be frustrating for patients and for
24:47 – researchers and for invested clinicians. But it’s the reality of what we’re up against. Like to change
24:52 – these guidelines is a big thing. And even to change diagnostic laboratories thought processes and
24:59 – guidelines is a big thing. Like they really want to see evidence. And that’s hard again, if we don’t
25:04 – have investment. But we are working here in Australia with Chronic UTI Australia. And we’ve
25:09 – got clinicians and we’re talking to the head of, you know, the clinical pathology board,
25:14 – to be able to see if we can implement some of this understanding and at least, you know, not
25:18 – exclude tests and, you know, work through those sorts of processes. And, you know, hopefully
25:23 – be able to do things like that that can have more of an immediate effect. But you know, it’s
25:29 – frustrating. It’s taboo. It’s downstairs. It’s women’s health. It gets ignored. It’s terrible,
25:34 – right? But there’s lots of us that are fighting hard and advocating for this. And we do have some
25:40 – momentum now with politicians in Australia. And when you start talking to them, you realize a lot
25:45 – of people are affected by this experience too.
25:47 – Melissa: Yeah.
25:47 – Dr. Starkey: They just don’t talk about it.
25:48 – Melissa: It’s a huge problem. Yeah. Exactly.
25:49 – Dr. Starkey: But now we get them talking about it. It really, you know, changes that. So we need champions, you know, we need
25:55 – politicians. We need famous people that suffer from these conditions to come forward and make it
26:00 – something that we can talk about. And then, you know, from there, we can really create change.
26:04 – Melissa: And I think like we’ve been talking about, we need to work together. And it’d be great to hear
26:09 – how researchers and patients can learn more about your work and maybe get in touch. And
26:13 – perhaps you could tell us a bit about the bladder and kidney health symposium, because there might
26:16 – be people interested in attending the next one.
26:19 – Dr. Starkey: Sure. So yeah, really, you know, I created the
26:22 – Bladder and Kidney Health Discovery Program really to break down this entrenched silence, you know,
26:27 – because disciplines and scientists and clinicians tend to sort of do things in their own little
26:36 – worlds. And I realized we’re now in a world of technology and communication where we just don’t
26:42 – have to do that anymore. And our collective brain trust and all of our different experiences and
26:47 – all of our different insights collectively can drive far better and faster innovation and change
26:54 – for patients. And so the whole concept of that was to break down those barriers, bring together
26:58 – people from infectious disease, microbiology, immunology, urology, nephrology, all these different
27:04 – disciplines and far more patients, you know, into a collaborative network. And so through that
27:11 – network, we’re doing funding opportunities in collaboration, student exchange, but yeah,
27:16 – one of the signature programs is the Bladder and Kidney Health Discovery Program, which we run
27:20 – every year, normally in October, November. It’s nearly always based in Melbourne. And we bring
27:27 – international experts from overseas. So this year, we had Indira visit. And we have, you know,
27:34 – interstate speakers and commercial partners, patients, patient advocacy groups, you know,
27:41 – everything from undergraduate students right through to consultant clinicians, senior scientists.
27:46 – So really sort of bringing everybody together to talk about UTI is always a big theme, but also
27:51 – other bladder and kidney conditions and sharing that knowledge and expertise to really sort of
27:56 – bring together the best minds to impact change.
28:00 – Melissa: Yeah, sounds really great. If you can share the
28:01 – link to that, I can put it in the video description so people can find out more, maybe get some
28:06 – attendees for next year. It’s been so good to hear more about your research. And I’m really
28:10 – excited to see what you’re working on in this space. I do think it will have an impact on
28:14 – patient outcomes in the future. And that’s really what we want to hear. So thank you again for
28:18 – taking the time to share your research with us.
28:22 – Dr. Starkey: Absolute pleasure. Thank you for talking to me.
28:24 – And I mean we’re really passionate about this space. And we really hope that at least, you know,
28:28 – before I retire, we have some really meaningful changes. And certainly from our perspective here
28:33 – in Australia, we’ll be pushing that as hard as we can. So thanks again for your time.
28:38 – It’s been an absolute pleasure. And I wish you all the best with this initiative moving forward.
28:44 – Melissa: Thanks so much for watching. I hope you found this expert video helpful. If you’d like to
28:48 – learn more about this or related topics, be sure to check out our other videos or head over to
28:52 – liveutifree.com for related articles. We’ll drop some links in the video description. If you like
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