University of Surrey

Forskolin, a plant-derived compound, shows surprising potential against one of the most aggressive forms of leukemia. Researchers discovered that it not only stops cancer cells from growing but also makes them far more vulnerable to chemotherapy by preventing them from pumping out the drugs meant to kill them. Experts say this dual action could help create safer, more powerful AML treatments with fewer harsh side effects.Forskolin, a plant-derived compound, may offer a meaningful improvement in therapies for a highly aggressive leukemia known as KMT2A-rearranged Acute Myeloid Leukemia (KMT2A-r AML). Researchers at the University of Surrey report that this natural molecule could play a valuable role in enhancing patient outcomes. According to findings published in the British Journal of Pharmacology, forskolin not only slows the growth of leukemia cells but also increases how well chemotherapy drugs work. The Surrey team discovered that forskolin activates Protein Phosphatase 2A (PP2A) and reduces the activity of several cancer-linked genes (MYC, HOXA9 and HOXA10). Natural Compound Greatly Improves Chemo Sensitivity The study also identified a notable and unexpected effect. Forskolin made KMT2A-r AML cells far more responsive to daunorubicin, which is a standard chemotherapy option. This improvement did not rely on PP2A activation. Instead, forskolin appeared to interfere with P-glycoprotein 1, a protein that cancer cells use to remove chemotherapy drugs. By limiting the function of P-glycoprotein 1, more daunorubicin remained inside the leukemia cells, increasing the strength of the treatment. Dr. Maria Teresa Esposito, Senior Lecturer in Biochemistry at the University of Surrey, said: "Our findings have highlighted an exciting dual mechanism of action for forskolin. Not only does it have direct anti-leukemic effects, but it also acts as a powerful enhancer to conventional chemotherapy. Combining forskolin with daunorubicin could lead to a more effective treatment strategy, potentially allowing for lower doses of chemotherapy and reducing the severe side effects often associated with AML treatments." Dr. Simon Ridley, Director of Research and Advocacy at Leukemia UK, says: "We are committed to funding innovative research and are proud to have supported Dr. Esposito's work. AML is one of the most aggressive and deadly cancer types, and this study not only deepens our understanding of KMT2A-rearranged AML but also opens the door to kinder, more effective treatments. Work like this is essential if we are to achieve our goal of doubling the five-year survival rate for AML within the next decade." Large Research Collaboration Supports Findings The work was funded by Leukaemia UK and carried out through a broad collaboration involving scientists at the University of Surrey, University of Roehampton, Barts Cancer Institute-Queen Mary University of London, Great Ormond Street Institute of Child Health London- UCL and the Genomic Regulation, CRG Barcelona (Spain).

Researchers at the University of Surrey developed an AI that predicts what a person’s knee X-ray will look like in a year, helping track osteoarthritis progression. The tool provides both a visual forecast and a risk score, offering doctors and patients a clearer understanding of the disease. Faster and more interpretable than earlier systems, it could soon expand to predict other conditions like lung or heart disease. A new artificial intelligence system developed by researchers at the University of Surrey can forecast what a patient's knee X-ray might look like one year in the future. This breakthrough could reshape how millions of people living with osteoarthritis understand and manage their condition. The research, presented at the International Conference on Medical Image Computing and Computer Assisted Intervention (MICCAI 2025), describes a powerful AI model capable of generating realistic "future" X-rays along with a personalized risk score that estimates disease progression. Together, these outputs give doctors and patients a visual roadmap of how osteoarthritis may evolve over time. A Major Step Forward in Predicting Osteoarthritis Progression Osteoarthritis, a degenerative joint disorder that affects more than 500 million people globally, is the leading cause of disability among older adults. The Surrey system was trained on nearly 50,000 knee X-rays from about 5,000 patients, making it one of the largest datasets of its kind. It can predict disease progression roughly nine times faster than similar AI tools and operates with greater efficiency and accuracy. Researchers believe this combination of speed and precision could help integrate the technology into clinical practice more quickly. David Butler, the study's lead author from the University of Surrey's Centre for Vision, Speech and Signal Processing (CVSSP) and the Institute for People-Centred AI, explained: "We're used to medical AI tools that give a number or a prediction, but not much explanation. Our system not only predicts the likelihood of your knee getting worse -- it actually shows you a realistic image of what that future knee could look like. Seeing the two X-rays side by side -- one from today and one for next year -- is a powerful motivator. It helps doctors act sooner and gives patients a clearer picture of why sticking to their treatment plan or making lifestyle changes really matters. We think this can be a turning point in how we communicate risk and improve osteoarthritic knee care and other related conditions." How the System Visualizes Change At the core of the new system is an advanced generative model known as a diffusion model. It creates a "future" version of a patient's X-ray and identifies 16 key points in the joint to highlight areas being tracked for potential changes. This feature enhances transparency by showing clinicians exactly which parts of the knee the AI is monitoring, helping build confidence and understanding in its predictions. The Surrey team believes their approach could be adapted for other chronic diseases. Similar AI tools might one day predict lung damage in smokers or track the progression of heart disease, providing the same kind of visual insights and early warning that this system offers for osteoarthritis. Researchers are now seeking collaborations to bring the technology into hospitals and everyday healthcare use. Greater Transparency and Early Intervention Gustavo Carneiro, Professor of AI and Machine Learning at Surrey's Centre for Vision, Speech and Signal Processing (CVSSP), said: "Earlier AI systems could estimate the risk of osteoarthritis progression, but they were often slow, opaque and limited to numbers rather than clear images. Our approach takes a big step forward by generating realistic future X-rays quickly and by pinpointing the areas of the joint most likely to change. That extra visibility helps clinicians identify high-risk patients sooner and personalize their care in ways that were not previously practical."

For more than thirty years, Denise Whitby, Ph.D., has devoted her career to studying Kaposi’s sarcoma herpesvirus (KSHV) and KSHV-associated diseases, including Kaposi’s sarcoma (KS). From the early days of the AIDS epidemic to her current leadership of the Viral Oncology Section within the AIDS and Cancer Virus Program (ACVP) at the Frederick National Laboratory, Whitby has become a recognized global leader in the KSHV community. Whitby graduated with her Bachelor of Science in microbiology from the University of Surrey UK in 1984 as the world became aware of what would become the HIV/AIDS epidemic. For a young scientist interested in virology, this outbreak gave her a compelling purpose to contribute to HIV science. “It was the biggest thing,” she recalls. “What else would you want to work on?” At the time, HIV transmission routes were poorly understood, and fear and stigma shaped both public perception and the research community. “People were very frightened,” she explains. “I had colleagues who wouldn’t ride in the lift with us if we were carrying an ice box, and who refused to sit with us at lunch.” Whitby said she was fortunate early in her career to be mentored by Robert Weiss, a noted United Kingdom retrovirology expert. One of the earliest clues linking HIV to KS, a rare cancer previously seen mainly in elderly men of European, East European or Italian origin, was its sudden appearance in otherwise healthy young men who had sex with men. “That suggested KS might have an infectious origin,” she says. “It led me to start looking for such an infectious agent.” By 1994, when Yuan Chang and Patrick Moore, professors at the University of Pittsburgh Cancer Institute, identified KSHV for the first time, Whitby was uniquely prepared. “I had a freezer full of samples from men who had sex with men with and without Kaposi’s sarcoma,” she recalls. Using the PCR assays she developed, she demonstrated that men with detectable KSHV DNA were significantly more likely to develop KS than those without it. This was one of the first confirmations that the virus was the cause of the disease. “That was the first thing that got me into KS research,” she says. “And I’ve worked on it ever since.” Within the ACVP, Whitby heads the Viral Oncology Section (VOS), internationally recognized for developing and applying state of the art methods for quantifying levels of the virus and both antibody and cell-mediated immune responses to the KSHV virus, as well as obtaining genetic sequences of different variants. This unique combined expertise in the study of KSHV, including in the setting of HIV coinfection, includes performing CLIA-certified tests that can help guide clinical decision making in clinical care or research studies involving individuals with KSHV-associated diseases. The VOS works closely with Dr. Robert Yarchoan and colleagues in the National Cancer Institute Center for Cancer Research HIV and AIDS Malignancy Branch, and consistent with the national laboratory mission of the Frederick National Laboratory and the ACVP, also collaborates with numerous other investigators in the United States and internationally. One of the main ways to measure productivity and contributions in science is through publications and citations. In a recent bibliometric analysis of global research on HIV and KS published in Frontiers in Microbiology, Dr. Whitby was identified as the most prolific author in the field from 2011 to 2024. Over her career, she has authored more than 250 scientific papers, cited more than 14,000 times. “This recognition is a gratifying, objective documentation of the importance and impact of her work and of the contributions made by the ACVP and FNL toward advancing both scientific understanding and the care of individuals living with KSHV infection,” says Jeffrey Lifson, M.D., director of ACVP at the Frederick National Laboratory. While HIV treatment has advanced substantially, KS remains a major public health concern. “People think KS has gone away, but it hasn’t,” Whitby cautions. “It’s just moved.” Once concentrated in New York and San Francisco, cases now occur more often in the South, particularly among young black men with HIV. Another emerging concern is KS among organ transplant recipients. KS can be transmitted via the transplant, or if the recipient is KSHV infected, and the immunosuppressive treatments in conjunction with the transplant compromise the ability of the immune system to control the virus. The CDC has turned to Whitby’s laboratory for assistance. “We’re working with them to develop testing for KSHV in donors,” she explains. “It’s become a bit of a crisis.” Looking back, Whitby reflects on the choices that defined her career. “In the early days, people avoided HIV research out of fear. But for me, as a virologist, it was the big thing. There was no question that’s what I wanted to do.” Mary Ellen Hackett Manager, Communications Office 301-401-8670