Dr. Phil Halloran is using gene chip technology to improve the lives of transplant patients
Dr. Phil Halloran is very, very busy. He corrects that statement and says, "Add two more verys to that." He is a very, very, very, very busy man. He just returned from a conference in Chicago and his summer vacation this year is non-existent. His current research is hopping with momentum and it's no wonder—Halloran is on the verge of making a revolutionary advance in the field of transplant medicine.
By harnessing the power of technology to understand the way genes behave when transplants are rejected, his current research project has the potential to improve the quality of life for organ transplant patients. Building on a tradition of pioneering research in the field, his research will further establish Edmonton and the Alberta Transplant Institute as an international leader in transplant research.
In the Capital Health region, over 200 organ transplants were performed last year alone, the second highest number in Canada. These transplants include kidney, liver, lung, heart, pancreas, bowel and islet (for diabetic patients).
After a transplant, patients are subject to a variety of toxic anti-rejection drugs to help ensure their bodies don't reject the new organ. These drugs do not guarantee the organ won't be rejected and have to be taken for the rest of a patient's life. The anti-rejection drugs make patients susceptible to infection and have serious side-effects such as high blood pressure and an increased risk of glaucoma and cancer.
Halloran explains that by understanding what is taking place in the genes when a transplanted organ is being rejected, physicians will be able to make more timely diagnoses and prescribe more effective treatments. Pharmaceutical companies testing new products will be able to measure the impact of new drugs by seeing how gene expression changes when drugs are introduced in the body. Ultimately, this information could prevent transplants from failing altogether and minimize the number of anti-rejection drugs patients have to take.
The project harnesses potent new technology that takes the form of a microarray or gene chip, a hand-held device which records the expression of up to 30,000 genes in a tissue sample. The microarray allows researchers to measure and track changes in the genes when an organ is being rejected. Halloran further explains, "This project bridges the gap between new technology and sick people - and shows how gene expressions change with different disease states." Instead of just being able to treat a patient after an organ is rejected, doctors will be able begin treatment before organs become damaged. Halloran likens it to monitoring a patient's cholesterol levels to help prevent a heart attack. "We don't wait for the heart attack to happen before we treat the disease," he explains. The same principles will be applied to organ transplantation patients.
Halloran carefully describes the project while he sits in his office surrounded by plaques, degrees and genetic textbooks. He has his own array of titles, including professor of medicine in both the Division of Nephrology and Immunology and Department of Medical Microbiology and Immunology at the U of A. As the director of the Alberta Transplant Institute, he oversees a new organization that is in a unique position to advance both organ transplant research and patient care. By amalgamating all transplant activity at the U of A Hospital, the Institute encourages new ideas and collaboration through its combination of clinical practice and research. Recently he was appointed as an Officer to the Order of Canada for lifetime achievement in the health care field. He is also the editor-in-chief of the American Journal of Transplantation. This is tall order for one man, but Halloran says he feels "privileged to be working on something that counts, something this important."
On his desk sits a powerful computer, and this computer contains what Halloran terms "marvelous technology" on a massive Excel spreadsheet. The spreadsheet lists all 30,000 genes in the body, and contains data on what happens to these genes when certain disease mechanisms hit. This data was scanned from a portable microarray device, which is no bigger than the palm of one's hand. The information comes from lab mice who are the recipients of kidney transplants.
The current phase involves research on mice and also clinical trials on patients' biopsies. (Despite their different biology, mice and humans have surprisingly similar genes). The tissue from both the mice and patients is then examined and the data about their genes is collected on a microarray.
The chip is then scanned, anomalies are highlighted, and this information is transferred to an elaborate spreadsheet which can track changes as individuals (and mice) undergo treatment. The project has a consortium of health care facilities eager to participate in this groundbreaking work. The next phase includes more extensive clinical trials involving patients from facilities all over North America. The final phase of the project is to develop software that will share the findings with physicians who can then use the knowledge in the diagnosis and treatment of their patients.
Halloran himself is surprised by the magnitude of the work he's undertaken. "We are just scratching the surface. We had no idea this information even existed, and we have no idea what we are going to find. This is a great age of discovery." He speaks highly of the dedicated team working on the project in the Heritage Medical Research Building on the University of Alberta campus. From "technological geniuses" working in the lab with supercom-puters, to co-investigators and clinicians, a group of skilled researchers is working hard to guide the project through its phases.
- Sue Robins
Your Health Magazine - September - October, 2004 Issue
Disclaimer
Reviewed by Alberta clinical experts. Brought to you by HealthLink Alberta. Copyright.
This material is designed for information purposes only. It should not be used in place of medical advice, instruction and/or treatment. For more health advice call Capital Health Link at 780-408-LINK (5465) 24 hours a day, seven days a week. In Alberta, call Toll-free: 1-866-408-LINK (5465)
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