Kuok - Swietach Scholarship in Medical Diagnostics

Contact:
Dr P Swietach - pawel.swietach@dpag.ox.ac.uk
Dr Noemi Roy - noemi.roy@ndcls.ox.ac.uk

About the Project

Diagnostic need: Intravascular haemolysis is a serious and time-critical condition in which red blood cells (RBCs) rupture within the circulation. RBCs traverse every vascularised tissue and are exposed to mechanical, chemical, metabolic, infective, and immunological stress. With limited repair capacity, accumulated damage can lead to haemolysis, contributing to anaemia & organ dysfunction. Haemolysis also acts as an early sentinel of diverse disease processes, collectively affecting approximately 300,000 people in the UK and ~800 million people globally. Yet haemolysis is often detected too late because current diagnostics rely on blood sampling, laboratory-based assays, trained personnel, and have delayed turnaround times. These limitations are particularly problematic in acute care, neonates, chronic disease monitoring, and resource-limited settings. Thus, there is an unmet clinical need for a rapid, low-cost, non-invasive diagnostic that can be deployed at the bedside, in the community, or at home. 

Our innovation: We identified urinary excretion of carbonic anhydrase I (CA1) as a sensitive and specific biomarker of intravascular haemolysis, and developed a lateral flow, point-of-care urine test for its detection.  The biomarker and device have been tested and validated in small cohorts of newborns admitted to intensive care, malaria patients in Bangladesh, patients attending rural clinics in Peru, and a cohort of sickle cell patients in the UK. The results demonstrate benefits of our test, but further refinements, test, and documentation are required before translating our innovation into a diagnostic device.  

Research programme and training: The aim of this PhD project is to advance the technology beyond TRL-5 through a clinical feasibility study and device refinement, generating evidence to support clinical adoption and commercialisation. The student will:

• Conduct longitudinal feasibility studies in cohorts with a high propensity for haemolysis, including: patients with sickle cell disease in the UK, malaria patients in Peru and Southeast Asia, Andean highlanders with chronic mountain sickness, and elite endurance athletes;
• Benchmark lateral flow device performance against laboratory-grade CA1 assays;
• Relate urinary test readouts to paired blood-based haemolysis markers to assess concordance and temporal dynamics;
• Refine device specifications based on analytical performance and user feedback, in collaboration with our industrial partner Camtech;
• Contribute to defining clinical pathways, cost-effectiveness, and evidence for regulatory approval.

The project integrates physiology, clinical research, diagnostics, and translational science with opportunities for international collaboration and real-world patient engagement. 

Making a difference: Rapid, routine haemolysis testing could enable earlier detection of blood-related pathology, support timely therapeutic or lifestyle interventions, and guide safer use of hundreds of drugs known to precipitate haemolysis. Because haemolytic crises are often unpredictable, self-testing could better align hospital admission with clinical need, improve triage, support early discharge, and reduce healthcare costs. With non-invasive sampling, scalable diagnostics, and global relevance, this project exemplifies translational research. 

www.sciencedirect.com/science/article/pii/S3050565825000587  and http://www.medsci.ox.ac.uk/news/oxford-researchers-introduce-a-new-biomarker-of-intravascular-haemolysis-and-a-rapid-urine-based-test-for-accessible-diagnostics