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We welcome Nicole Stoffel who has joined the Botnar Institute as a new Principal Investigator. Nicole will be establishing her group to better understand human iron metabolism, kinetics and physiology with a specific focus on the role iron plays in the immune response and the impact of iron deficiency on vaccine effectiveness.

Nicole Stoffel

Nicole recently joined the Botnar Institute as a Group Leader in Nutritional Physiology and Therapeutics where she will be collaborating with Prof. Duncan Richards and Associate Prof. James Fullerton on early experimental trials. Her research interests include optimising oral iron supplementation regimens in pregnant women, young infants and patients with chronic inflammatory disorders and thereby also improving vaccine efficacy.

From Switzerland, Nicole received her BSc and MSc degrees in Pharmaceutical Sciences from ETH Zurich. ‘I then did a PhD in Human Nutrition at ETH Zurich too,’ said Nicole. ‘The publications from my PhD contributed substantially to the design of improved oral iron supplementation regimens with high absorption and reduced side effects for women and infants. Using multiple stable iron isotopes (54Fe, 57Fe and 58Fe) to label oral iron doses I quantified iron absorption, measured by erythrocyte incorporation of the isotopic labels. I reported, for the first time, that every other day dosing of lower iron doses given in the morning are better tolerated and result in up to 50% higher absorption. Our study went on to change many international guidelines for oral iron supplementation.’ 

‘In addition to enhancing oral iron supplementation in target populations such as women of reproductive age, pregnant women, and infants, I’m also focused on optimising it for patients with chronic inflammatory diseases, who are at high risk of anaemia. The interplay between iron deficiency/anaemia and inflammation/infection in humans, particularly their respective impacts on hepcidin—the primary regulator of iron—remains unclear. This area is crucial, and I am particularly interested in optimising iron supplementation for patients suffering from inflammatory, infectious, or rheumatological diseases.’ 

Another core strand of her research is the link between iron deficiency anaemia/iron treatment and paediatric vaccine response. ‘It's well known that childhood vaccines work less well in low- and middle-income countries compared to the western world, but nobody really knew why,’ explained Nicole. ‘Our translational studies showed that iron deficiency impairs adaptive immune responses and vaccine efficacy in children. The intensified metabolism of activated lymphocytes requires high amount of iron. When infants are anaemic at the time of their vaccination, vaccines work less well but if you give them iron at the time of vaccination, the vaccine response is improved. We currently have four running controlled trials in low- and middle-income countries to assess the effects of iron repletion on vaccine response. The studies are funded by the Thrasher Research Fund, the Bill & Melinda Gates Foundation and the American Society of Hematology.

In 2021 Nicole won the Lopez-Loreta prize pour l’Excellence Académique for her work in this area, receiving one million euros to continue the research. Her main study sites are in Kenya and Thailand – chosen because iron deficiency is much more prevalent there. The sites also help Nicole with one of her passions – to support the careers of women in countries where it’s very difficult for women to pursue an academic career. ‘I find these bright and interesting students and I match them with European PhD students. The knowledge transfers from these north-south collaborations are invaluable to both sides and they each learn from the other.’

Nicole had been doing her second postdoc at the MRC Weatherall Institute of Molecular Medicine (WIMM) at Oxford, when she met Duncan and James and thoughts of collaboration started to form. ‘I'm mostly interested in doing translational research, so human studies that can help change practice and improve the lives of patients are important to me,’ she said. ‘I’m still interested in optimising oral iron supplementation, but will also be looking towards therapeutics, and exploring how iron can benefit patients before surgery or to improve post-surgical outcomes.’

Duncan Richards said: ‘Nicole’s previous work has shown how iron metabolism can have wide ranging effects on human health and the interventions we apply to try and improve it. We look forward to working with her to take this to the next stage and find practical ways to apply this knowledge for the benefit of people across the world.’

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