TwinsUK seeks genetic answers

Following an announcement from King’s College London - TwinsUK won of a multi-million-pound award for resilience research - Paz García tells us more about the most clinically detailed adult twin registry in the world.  

Can you tell us about your role within King’s Health Partners. 

My name is Paz García and I am Programme Manager at TwinsUK, which is a study run through the Department of Twin Research & Genetic Epidemiology at King’s College London. Our offices and clinic are based in St Thomas’ Hospital. My role at TwinsUK includes setting up and running studies, overseeing communications and engagement, and chairing the TwinsUK Volunteer Advisory Panel to ensure our twins’ views are reflected in the work that we do. 

What work is TwinsUK involved in? 

TwinsUK is the UK’s largest adult twin registry and the most clinically detailed in the world. Since setting up the cohort in 1992, we now have 16,000 identical and non-identical twins from across the UK, with ages between 18 and 100.  

TwinsUK aims to investigate the genetic and environmental basis of a range of complex diseases and conditions. Twins can help us with this because identical twins share 100% of their genes and non-identical twins share 50% of their genes, and so we can make comparisons to unpick the role of genetics. 

Current research includes the genetics of metabolic syndrome, cardiovascular disease, the musculoskeletal system, ageing, sight, nutrition and the microbiome. We also completed a number of studies during the pandemic to understand COVID-19 infection, antibodies and mental health & wellbeing. 

TwinsUK data has enabled multiple collaborations with research groups worldwide and the publication of over 1,000 research papers.

Why is it important that we learn more about how genetic variation relates to human health and disease? 

Understanding how genetic variation relates to human health and disease is important right from discovery research through to clinical applications and population health: 

Precision Research: Genetic research provides valuable insights into the molecular mechanisms underlying diseases. This knowledge is essential for advancing scientific understanding and for designing better experiments and studies to uncover new therapeutic targets. 

Disease Prevention: Identifying genetic variations associated with diseases allows for early detection and prevention strategies. By analysing genetic risk factors, individuals can make informed lifestyle choices and undergo appropriate screenings to mitigate their risk of developing certain diseases. 

Personalised Medicine: Genetic variation plays a role in how individuals respond to medications and treatments. By uncovering these genetic links, in future we can tailor medical interventions to an individual's unique genetic makeup, leading to more effective and safer treatments. This approach, known as personalised medicine, could significantly improve patient outcomes. 

Public Health: Understanding genetic variation can inform public health policies and strategies. It helps identify populations that may be at higher risk for certain diseases, allowing for targeted public health interventions, such as vaccination campaigns. 

Scientific Advancement: Genetic research not only enhances our understanding of human biology but also contributes to advancements in fields such as genomics, bioinformatics, and data science. These advancements have broad implications beyond healthcare. 

You worked very closely with the ZOE app during the pandemic, how did that happen?  

With Tim (Spector) leading both TwinsUK and ZOE, we were already used to working closely with ZOE on research projects. When Tim and the team came up with an idea for an app to help twins log their symptoms, it quickly morphed into a bigger project to reach the whole of the UK (and eventually, beyond). Thus, the COVID Symptom Study app was born within days of the first lockdown announcement.  

Scientific and clinical input from TwinsUK researchers coupled with the engineering abilities of ZOE led to the iterative development of the app, which was regularly updated as we learnt more about COVID-19. A strong communications and engagement effort from ZOE and King’s College London also ensured that the app’s work was picked up by national media and policymakers, and encouraged interaction between app users and the research team. 

It was a huge team effort, and our joint work on the app demonstrated the power of collective action, data-driven research and community engagement in addressing global health challenges. We are immensely proud of the role TwinsUK played in this endeavour. 

2022 marked 30 years since the start of TwinsUK, can you highlight any main challenges and successes over the years? 

Looking back on 30 years of TwinsUK, it's clear that the journey has been marked by both challenges and successes. 

One main challenge has been securing ongoing funding and resources. Always a challenge in research, we have relied on a combination of grants and collaborations to ensure the longevity of TwinsUK. 

Another challenge common to all longitudinal studies is the long-term retention and engagement of participants. Maintaining this over three decades has required continuous effort and innovative strategies to ensure our members remain happy to take part, and that our cohort and data remain as representative and informative as possible. 

In terms of successes, TwinsUK has made important contributions to advancing our understanding of the heritability of complex traits and diseases. One study that analysed 3,000 GWAS (genome wide association studies) found that TwinsUK data was the seventh most used resource world-wide. 

By studying identical and non-identical twins, the study has contributed to identifying genes associated with a wide range of conditions, from heart disease and diabetes to osteoporosis. One of TwinsUK's strengths is its longitudinal nature, through the long-term follow-up of twins. This has allowed researchers to study how genetic and environmental factors interact over time and how they influence the ageing process. Insights gained from these studies have implications for healthy ageing and longevity. 

Another success is our work on data accessibility: TwinsUK has made its data available to the scientific community, promoting open science and enabling other researchers to build on its findings. This managed-access approach has facilitated further discoveries and advancements in the field. 

Lastly, I want to mention influence on health policy, especially during the COVID-19 pandemic. Findings from the COVID Symptom Study app but also other TwinsUK studies investigating COVID-19 influenced health policies and guidelines. By providing evidence on the factors influencing health, the study has contributed to shaping public health strategies. 

We remain committed to advancing scientific knowledge, improving health outcomes, and continuing our mission to unravel the complexities of genetics and human health for many more years to come. 

How can colleagues collaborate further with you? 

Thanks to the generosity and commitment of our TwinsUK members, we have collected so much data over the 30 years that we couldn’t possibly analyse it all ourselves. We therefore strongly encourage researchers to request data from us for their health research, in order to get the most scientific benefit out of our twins’ health data and samples. More information about this is available here.  

If you have ideas on how we could work together, please do get in touch. We often carry out work in collaboration with researchers outside of the department. Similarly, if you would like to find out more about how we operate, we are happy to share our ways of working and best practice. 

Lastly, if you’re a twin – do consider joining TwinsUK! We are always open to new members. More information about joining is available here.