National University Health System NUS Yong Loo Lin School of Medicine NUS Faculty of Dentistry Saw Swee Hock School of Public Health Alice Lee Center for Nursing Studies National University Hospital Governing Board Chief Executive (Lead) Deputy Chief Executive
How Health Sciences Would Love To Work With Computer Science!
John E.L. Wong, MBBS, FAMS, FRCP, FACPIsabel Chan Professor of Medical SciencesVice Provost (Academic Medicine), National University of SingaporeDeputy Chief Executive, National University Health System Director, National University Cancer Institute, Singapore
NUS SoC Faculty Retreat13 September 2013, 12-1pm, Rasa Shangri La, Sentosa
2. Divider•Introducing new topic NUHS Research Strategy
6 diseases interrogated by
8 platforms in a matrix fashion
NUHS Research Strategy
2. Divider•Introducing new topic Key Disease Research Areas• Cancer• Cardiovascular• Metabolic Medicine• Infectious Diseases• Neuroscience• Eye Diseases
Research Themes
1. Early Phase Drug Development
2. Developmental Therapeutics in Endemic Cancers
3. Immunotherapy in Cancer
4. Childhood Malignancies
5. Translating Epithelial-Mesenchymal Transition for Cancer Prognostics and Therapeutics
Cancer
National University Cancer Institute, Singapore
Research Directors: Phillip Koeffler, Soo-Chin LeeDevelopment of Novel Therapeutics and Biomarker-Directed Strategies in Refractory Solid Tumors and Haematological Malignancies
Phillip KOEFFLER Soo-Chin LEE
Cancer
Cancer Science Institute, Singapore•Present: 17 PIs and 200 scientific staff•At steady state: up to 25 PIs and approx 350 staff & students
Daniel TENEN
GOH Boon Cher
CHNG Wee Joo Phillip KOEFFLER
LEE Soo-Chin
Basic programs – experimental models
Translational programs – human studies
Cancers Affecting Singaporeans
GastricLungLiver
Leukemia
Nasopharyngeal
CancerBiology
ExperimentalTherapeutics
GenomicOncology
Breast
CancerStem Cells
Personalised Medicine for Asian population
Finding Cancers Early to Enable Cure
IMPACT:
Gastric Cancer
Note: Data for Univ Cambridge retrieved on 3 July 13 (27 May for all others).
• To understand the biological processes leading to cardiovascular disease• Target parts of those disease pathways with new treatments in order to prevent or
ameliorate the disease
• Heart Failure– new candidate biomarkers for diagnosis and prognosis– Establishing specific improved therapies for subtypes of heart failure.
• Cardiac Valve Disease– Assess value of plasma biomarker measurements in predicting progression of
valve disease– and in optimising timing of interventions such as valve replacement or repair.
• Acute Coronary Syndrome– Exploration of novel candidate peptide biomarker tests for detection of
cardiac ischaemia or heart failure
• Ventricular Repair– Pre-clinical studies devoted to the development of bioengineered tissue
constructs seeded with progenitor cells to be used in the repair of post-infarction left ventricular scar.
• Cardiovascular Epigenomics and Epigenetics
Mark RICHARDS
TAN Huay
Cheem
Roger FOO
CarolynLAM
MarkCHAN
Cardiovascular Diseases
Singapore Heart Failure Outcomes and Phenotypes (SHOP) study:
•SG Heart Failure (HF) cases average 8 yrs younger than in NZ
•Diabetes in SG HF cases > NZ (55% versus 27%)
•Diabetes may be a more important underlying substrate for HF in SG than in western populations
IMPACT:1.Development of new clinical practice guidelines for heart failure and coronary artery disease in Asian patients
2.Improve the ability to predict the onset of HF, anticipate what kind of HF will occur and the course of its progression
3.New treatment approaches to HF
National University Heart Centre Spore (NUHCS)Cardiovascular Research Institute (CVRI)
Mark RICHARDS
TAN Huay
Cheem
Cardiovascular Diseases Roger
FOOCarolyn
LAMMark
CHAN
Note: Data for Univ Cambridge retrieved on 3 July 13 (27 May for all others).
Cardiovascular Diseases
Diabetes, Obesity and Metabolism
• Address the rising incidence of metabolic diseases in Singapore, where diabetes now affects 11.3% of Singaporeans (nearly 7% rise within 2 decades)
• Asian features of the metabolic diseases – Singapore comprises 3 major Ethnic differences in the prevalence rates and pathogenesis of metabolic diseases
• We have:– built up capacity for epidemiology, physiology and metabolic imaging to
facilitate target identification and validation– established in-vitro models for all three ethnic groups
• We have active programs:
Our Research Focus 14
2. Nutrient metabolism and insulin resistance•Role of protein intake, amino acid metabolism & fat intake/metabolism in pathogenesis of insulin resistance•Role of carbohydrate quality on glycemic control & appetite regulation•Role of altered nutrient handling in the ability of bariatric surgery to ameliorate diabetes
3. Burden of diabetes mellitus & novel models of health care delivery for chronic disease •Unique features of type 2 diabetes in Asia and designing of stratified medicine•Designing of programs for prevention of type 2 diabetes mellitus•Efficacy of patient-centered medical home in reducing hospitalization and improving outcomes
1. Pathogenesis of type 2 diabetes•Mechanistic basis in genetic variants with unique effects in populations of Asian ancestry•Ethnic differences in insulin resistance
CHONGYap Seng
TAI E Shyong
LEEYung Seng
Sue-Anne TOH
Implications for Clinical Practice
Higher incidence of gestational diabetes (GDM) than previously suspected & higher glucose levels in mothers - even in the absence of GDM – can still affect infant adiposity. Obesity has a major role to play in the risk of diabetes in Chinese and Malays. However, Indians are at high risk of diabetes, but obesity has a smaller impact.
IMPACT:Interventions to reduce obesity and diabetes in the populationHow to advise public on healthier food choices & lifestyles
Initial Findings
Life Course Cohort:
Human Metabolic Studies:
Note: Data for Univ Cambridge retrieved on 3 July 13 (27 May for all others).
Metabolic Disease
• Provide innovative solutions to local, regional and global infectious disease challenges through a world-leading research programme
• Extensive collaborations across NUS, A*STAR Research Institutes and Industry Partners.
• We have active programs:1. Antibiotic Resistance Surveillance/Infection Control
• Methicillin-resistant Staphylococcus aureus (MRSA), multi-resistant gram-negative bacilli, hand hygiene and device-associated infections
2. Influenza• Influenza pathogenesis, pandemic influenza preparedness and business
continuity, guidance to health policies, cost-effective prevention strategies, mathematical modeling of influenza infections, novel prophylactic and therapeutic approaches
3. HIV• HIV pathogenesis and its metabolic consequences (dyslipidemia, heart
diseases, osteoporosis, diabetes mellitus and other metabolic dysfunctions), improvement of HIV treatment strategies and patient management
4. Tuberculosis• Pathogenesis, genotyping and phenotyping of the various strains, clinical and
immunological characterization, development of diagnostic tests and assays, development of cost-effective treatment strategies
5. Dengue
Naoki YAMAMOTO
Vincent CHOW
Paul TAMBYAH
Dale FISHER
NickPATON
Paul MACARY
Infectious Diseases
Infectious Diseases
• Current Neuroscience research programmes at YLLSoM focused on ischaemic stroke, dementia, and neurodegeneration:
1. Ischaemic stroke focus on intracranial stenosis or intracranial large artery disease, which is the redominant stroke subtype among AsiansAim: to understand better the mechanism of stroke, improve diagnostic and prognostic methods, improve patient care and treatment, develop new treatment modality including studying the feasibility of stem cell therapy
2. Vascular and Neurodegenerative Mechanisms in DementiaAim: to identify biomarkers for vascular and neurodegenerative mechanisms, and obtain
insights into the mechanisms of interaction may lead to potential therapeutic approaches, through study of clinical and epidemiological cohorts, neuroimaging, neurochemical and animal studies
3. Neurodegeneration focusing on role of excitotoxicity & free radicals in aging and dementia, role of glial cells and vascular factors in promoting neuroinflammation, role of metal ions and lipids in neurodegeneration, exploring neuroprotection and promoting resolution of neuronal injuryAim: to conduct in-depth analyses of factors which contribute to, or modulate, degeneration of the nervous system
NeuroscienceChristopher
CHENCarlos
IBANEZPeter
WONG
BarryHALLIWELL
SOONGTuck Wah
Dementia and Age-related Cognitive Impairment•Singapore ageing population: by 2030, 19% of the population will be aged 60 & above.•Dementia is a disease most common in the elderly•Singapore and Asia face an epidemic of dementia and cognitive impairment in the next few decades
NeuroscienceChristopher
CHEN
Prevalence of intracranial stenosis (ICS)• 40-50% in Chinese stroke patients• 8-10% in Caucasian Stroke patients
Association of ICS with cognitive impairment
NCI- Non cognitive impairment CIND- Cognitive Impairment, No Dementia
Impact of Intracranial Stenosis
CarlosIBANEZ
PeterWONG
BarryHALLIWELL
SOONGTuck Wah
AIM :Development of new screening and treatment strategies for dementia and cognitive impairment
Eye Disease
There is an epidemic of myopia in Singapore
SAWSeang Mei
WONG Tien Yin
Singapore Eye Research Institute
Glaucoma Research
Retina Research
Oculoplastics Research
Cataract Research
Cornea Research
Neuro-Opthalmology Research
Singapore* published the most papers per capita (*95% of papers SERI/NUS)
Medical EngineeringResearch & CommercializationInitiative
Core Facilities
Investigational Medicine Unit (IMU)• Services:
1. Providing clinical research support2. Providing administrative support3. Training in clinical trial management4. Storage of trial drugs and biological samples
Laboratory– Genomics Core Laboratory– Clinical Pharmacology Group
Website: http://www.imu.com.sg/
GOH Boon Cher
Clinical Imaging Research Centre (CIRC) • Partnership between NUS and A*STAR dedicated to developing
advanced imaging in humans
• Facilities: 3T MRI, the combined positron emission tomography and magnetic resonance imaging (PET-MR) system and a PET/CT, complemented by a radiochemistry suite and cyclotron that will enable in-house production of a range of clinically relevant PET tracers.
MINIMALLY INVASIVE•Navigation tool for Colonoscopy •Vascular access monitoring using Bioimpedence•Magnetic field based NG tube tracking•Gastroduodenal chute•Endoscopic raman spectrometry
