Professor Catherine Williamson
When and where did you do your medical training and what did you train as?
I trained at Manchester University. I didn’t do 3 sciences at A level so I had to do an additional year at university to learn science to A level standard, and then I joined the medical course. I did a BSc in Medical Biochemistry in the middle of my training and this was where I learned to love research. From that stage of my undergraduate career I knew that I would like to combine clinical work with research when I qualified.
I trained to be a specialist in General Internal Medicine, Diabetes and Endocrinology, and during my training saw several pregnant women with medical disorders. I became very interested in Obstetric Medicine at an early stage of my specialist training and made an effort to attend as many clinics that allowed me to look after pregnant women as I could. Soon afterwards I was awarded a research fellowship to work at the Hammersmith Hospital. This allowed me to meet Michael de Swiet, the most eminent obstetric physician in the UK at that time. I was privileged to train with him in Obstetric Medicine for the remainder of my time as a registrar.
What made you change your speciality?
I find it a pleasure to work with pregnant women, a group who are usually very motivated with regard to improving their health. Also I enjoy being part of a small specialty. I think it is essential for a small number of doctors to specialise in disorders of pregnancy as most obstetricians have limited experience of looking after women with medical diseases and most medical specialists haven’t trained in how to manage women with diseases they usually manage when they are pregnant.
What made you focus on OC?
One of the first patients I saw when I trained with Michael de Swiet had OC and also had a family history of the disease. She was also very articulate about her concerns about the risk of stillbirth and other fetal risks. I realised that there was very little known about what causes the condition, and also had a strong suspicion that genetic factors played a role. As I had previously spent 3 years doing genetic research I thought that my experience could be important in understanding this important disease. Soon after this I met Jenny Chambers when we were both speaking at a conference. I heard Jenny’s moving story and we spent a long time talking about the importance of studying OC in detail. Soon after that I was funded to study OC by the Wellcome Trust. Jenny helped with recruitment from the start of that study and we have continued to work together since that time.
What has the research group found out about OC so far?
We are studying what causes OC and the ways that the fetal complications can occur. In addition we are trying to establish what the best treatments are.
With regard to the causes of OC, we have made several genetic findings. We have identified mutations in a small number of genes, all of which influence the way the liver handles bile acids. Other groups have made similar findings and we are now trying to establish the extent to which genetic changes in all of these genes influence the risk of getting OC in a large number of women who have had the disease. We are also studying the ways that female hormones (e.g. oestrogen, progesterone and hormones from the placenta) cause symptoms of OC. In particular we have extended studies by Swedish scientists that show that metabolites of progesterone cause OC, and have shown that they are likely to cause cholestasis through a variety of pathways in the liver.
We have studied heart cells and our data suggest that raised bile acids in the blood may affect the way the babies heart works. To date we have only studied this in laboratory studies of heart cells and hope that the work will be extended to include ECG studies of fetal hearts. We are also trying to find out how bile acids harm placental tissues and influence transport of bile acids across the placenta. In parallel we are studying how UDCA protects heart cells and the placenta in laboratory experiments, human placental samples and in patients with OC.
Where do you see the research group in ten years?
I hope we will have a much better understanding of what causes OC and that we will be working on better ways to predict, prevent and treat cholestasis. If we develop a better understanding of what causes stillbirth in OC we will aim to also apply this knowledge to preventing other causes of stillbirth.
Do you ever find time to relax?!
I have 2 young children and make it a priority to spend time with them most evenings and at weekends. We have a lot of fun playing in the park, swimming, seeing family and friends. My husband and I also enjoy keeping fit and going to (occasional) concerts.
