Research on the horizon

Congratulations to our 2016 SSMRF researchers, we are honoured to fundraise to support your work, and look forward to sharing more details of your research soon.

Ordered from left to right (pictured above), keep reading to discover what our researchers had to say about their research plans & what they are working to achieve in 2016 and beyond.

Dr Bill Giannakopoulos

Seed Grant: “Beta 2-glycoprotein I: An important modulator of Gram-negative sepsis.”

Septicaemia is multi-organ failure due to overwhelming infection. It is an important cause of death and morbidity in patients in intensive care units. Lipopolysaccharide which is released by the gram negative organisms stimulates the immune system and contributes to hemodynamic instability and organ damage. So it’s important to understand how the body regulates lipopolysaccharide that is released into the bloodstream during infection. What we have found upon analysis of our preliminary data is that beta 2-glycoprotein (β2GPI), which is also contained in the bloodstream, can modulate the lipopolysaccharide response, specifically it down regulates inflammatory cytokine release by white blood cells. My group wants to understand exactly how beta 2 glycoprotein I does this, as it will provide important mechanistic insights into the body’s natural defences against lipopolysaccharide induced hyper-stimulation, with the ultimate aim of perhaps generating peptides which mimic certain segments of beta 2-glycoprotein I. We might be able to use such mimeto-peptides in the future therapeutically to protect against septicaemia, in conjunction with antibiotics and other measures.

Dr Freda Passam

Seed Grant: “Functional disulphides of the platelet receptor alpha IIb beta 3 in health and disease.”

For over 10 years I’ve been involved in basic blood clot research, and when colleagues and friends asked “What sort of research have you been doing?” I said “Well, studying the disulphide bond patterns of clotting proteins in vitro and in vivo animal models. And there is really good technology which is new, that is here, developed with our curators which have different isotopes of carbon.” I would never get engagement. But now, I am very happy with this funding, that I’m taking it back to the patients – with more understanding. This is my first attempt at a translation of a research project that will use the methodology I’ve developed for the disulphide bond patterns in the major platelet receptor alpha IIb beta 3. I will see how those patterns go for patients with clots, or high risk of clots, to identify a signature, and if that is found, the disulphide bond signature will be important in knowing which patients are at risk. I’m very optimistic that some of these bonds will be effectively transferred into prophylaxis for clotting disease.

Professor John Myburgh AO

Capacity Building Grant: “St. George and Sutherland Critical Care Research Program: thermoregulation in acute brain injury (ABI) program.”

Capacity building is very key to maintaining research outcomes – to make research enticing to our students, trainees and registrars, to our young consultants and in the office. The program here at St George is targeted primarily to encourage and sustain capacity building in our department and also to attract young doctors while at the same time integrating high quality, internationally focused collaboration.

One of the most topical areas of neurology currently is the measurement of temperature in acute brain injury, stroke and brain injury – with this grant we could really put St George on the map. Central to this program, which is to be based here at the hospital, is a series of studies and clinical trials in determining the best temperature for measurement in brain injury. We were also fortunate enough to receive last year two major grants from the university on holistic health, to set up a high-level, multi modal monitoring program, which will be unique to the hospital, and the only ICU in the country that is doing this. We will then enter into collaborations with all the leading centres in neurology and neurosurgery in Cambridge, Edinburgh and the USA. So, hopefully by the end of this program in three years time, our unit in the hospital through collaboration with our neurosurgical colleagues and friends and neurologists, will be able to put a high-quality neuro-monitoring program in place that will lead the way for international and hospital controlled trials, while defining the temperature in a range of patients. I’m sure this will build capacity at the lower end, in our department, our hospitals and across the board – backed by the hospital and the university.

SSMRF and their grants are a wonderful initiative and will continue to grow in the hospital, and become a leading light in the future.

Dr Peter Iung-Chiang Wu

Scholarship Grant: “Pharyngeal and oesophageal compliance – the clinical utility of Endolumenal Functional Lumen Imaging Probe in managing dysphagia.”

My thesis is based on the role of biomechanical measurement in the management of pharyngeal and oesophageal disorders causing dysphagia. When we swallow, ingested food and liquids encounter potential resistive force at a number of key sites between the mouth and the stomach. Disorders involving these sites could cause dysphagia through various mechanisms. A common end result of which is a reduced gut wall compliance, meaning a reduced luminal calibre and an increased gut wall stiffness. Typical examples of such disorders include scarring at upper oesophageal sphincter following head and neck cancer therapies, eosinophilic oesophagitis, and oesophageal achalasia. There are currently no effective methods to measure such resistive force. In this research proposal, we aim to explore the previously unrecognised potential for direct gut wall compliance measurement to guide the management of these conditions. The potential clinical applications will include (but are not limited to) provision for a complimentary tool to improve diagnostic accuracy, monitoring of disease activity during therapies, and prognostication of patients’ long-term outcomes. We anticipate that the results of our studies will favourably impact on the current management algorithms for these conditions.

Dr Fernando Roncolato

Clinician Researcher Grant: “A pilot study of a randomised control trial assessing the impact of a supervised exercise program on the quality of life of lymphoma patients treated with chemotherapy – the EXEL study.”

EXEL is a trial looking at the impact of a structured exercise program in patients who have lymphoma who are receiving chemotherapy and radiotherapy. The idea is that we use aerobic and strengthening exercises to improve psychological and physical quality of life. In contrast to a lot of other studies in this area, we’re attempting to employ the exercise component concurrently with chemotherapy. We’re hoping that by proving benefit, we will allow patients to promote their own health away from the clinic and hospital environment.

Professor Marissa Lassere

Seed Grant: “A comparative effectiveness randomised placebo controlled pilot trial of the management of acute lumbar radicular pain: evaluate route versus pharmacology of intervention, and feasibility in public hospital and community practice settings.”

Essentially, the funding is to undertake a pilot randomised control trial of patients who present to St George Hospital and also to community rheumatologists predominantly, but also to General Practitioners and others, with acute sciatica. This is sciatica of less than four weeks duration. The current practice of treatment of acute sciatica – something that we’ve been managing for about 10 years at St George Hospital – has been with an injection of steroids. These are selective transcribable lumbar epidural steroids with an anaesthetic, but there’s actually no data supporting that treatment. There are no Cochrane reviews of acute sciatica. All the trials have been of chronic sciatica. These are trials where you’ve actually had to fail six weeks of conceptive therapy. So, what we’ve been doing, and what a lot of rheumatologists and orthopaedic surgeons and possibly neurosurgeons have been doing – there’s no evidence base for it. So, I thought this is an opportunity to do a randomised control trial, because it may well be effective in the short-term – giving people relief, getting them out of hospital, getting them back to work – and it may well be that treating acute sciatica may prevent the development of chronic sciatic symptoms.

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