Spring Issue 2014
For information about the AMRF
T: 09 923 1701
E: [email protected]
www.medicalresearch.org.nz
Arthritis
Colin’s personal story
My name is Colin and I am
74 years young!
My brush with gout started when
I was about 45 years old. Up
to that time I was reasonably fit
with activities such as golf, rugby
refereeing, jogging and squash.
My first indication of gout was a
swollen and painful big toe. Over
the next 5 years I had a number
of flares in my toe, elbow, ankle
and knee joints. I developed a
tophus (gouty lump) on my left
elbow and it became infected
on several occasions. I tried diet
control and to identify my food
triggers with little success.
Eventually my GP suggested
allopurinol and I agreed to try this
treatment. By this stage I had a
lot of flares which occurred very quickly. For example I was playing golf and on the
16th hole my right ankle became sore and by the 18th hole it was so painful I could
hardly walk. I have continued on the allopurinol and my latest uric acid level is below
0.36. Over the last 2 to 3 years I have only had a few minor flares and the tophus on
my elbow has all but disappeared.
Living with Arthritis is challenging, but with education and most importantly research,
new knowledge and treatments will emerge.
AMRF Free Public Lecture
The Auckland Medical Research Foundation invites you to attend our free public lecture
Arthritis in New Zealand: Progress and challenges
Dr Nicola Dalbeth
Consultant Rheumatologist and Associate Professor of Medicine
at the University of Auckland Monday 20 October, 7pm
Arthritis is the single greatest cause of disability in New Zealand.
Dr Nicola Dalbeth is a specialist rheumatologist who leads an
arthritis research programme at the University of Auckland. In
this public lecture she will describe the impact and treatment
of arthritis, focusing on the most common forms of arthritis;
osteoarthritis, rheumatoid arthritis and gout.
“We make a living by
what we get, we make
a life by what we give”
Winston Churchill’s words above bring to mind
the recent death of our Patron, Dr William
Douglas Goodfellow. He was an inspirational
man who channelled his success into a life of
services to humanity through his charitable
and philanthropic initiatives, particularly in the
areas of health and education. Indeed the
Goodfellow family has been the driving force
behind the establishment of our Foundation from
Dr Goodfellow’s father Sir William, leading our
incorporation in 1955. On behalf of the Board of
Trustees and all our stakeholders, I pay tribute
to this remarkable man and acknowledge his
legacy, which will endure forever.
Next year the Auckland Medical Research
Foundation will mark 60 years, and we will
get close to $60 million in the distribution of
medical research grants since 1955. We will be
working hard to gather interesting and significant
highlights of these 60 years of medical research,
to present to you our supporters.
Please join us for our upcoming free public
lecture this month, Monday 20th October
at 7pm. It is another topic that affects many
New Zealanders - Arthritis. An AMRF Medical
Committee member, grant holder and expert
researcher in this area, Dr Nicola Dalbeth will
share her clinical experience and latest research.
This is a chance to ask questions and gain
knowledge.
Thanks again for investing in health.
AMRF Auditorium - Faculty of Medical & Health Sciences,
University of Auckland, 85 Park Road, Grafton, Auckland
To register phone 09 923 1701 or
visit our website www.medicalreserch.org.nz
Kim McWilliams - Executive Director
TOP GRANTS FROM
LAST GRANT ROUND
June 2014 Grant Round Awards
$1,054,611
The Auckland Medical Reserch Foundation’s
latest grant round continued to see a record
number of grants received by the Medical
Committee for consideration where funding
was distributed over a variety of biomedical and
clinical research areas including Biomedical
Imaging, Reproduction, Maternal and Newborn
Health, Cardiovascular Science, Cancer,
Infection and Immunity and Musculo-skeletal
Science. Awards included 9 research projects,
2 Gavin and Ann Kellaway Medical Research
Fellowships, 2 Sir Harcourt Caughey Awards,
36 travel grants for researchers to present their
research overseas and 2 Kelliher CharitableTrust
Emerging Research start-up awards.
A selection of project grants are summarised
below:
MRI AS BIOMARKER FOR
RHEUMATOID ARTHRITIS
($159,560 – 2 years)
Prof Fiona McQueen, Dr Peter
Chapman, A/Prof Nicola Dalbeth, A/
Prof Anthony Doyle, Dr Karen Lindsay
Dept of Molecular Medicine and Pathology,
University of Auckland
Elevated urate levels in the blood are present
in approximately 20% of the adult population.
Recent observational studies have reported
that high urate levels are protective in the
development of thin bones (osteoporosis)
and fractures. This laboratory study aims to
understand how urate exerts this protective
effect. We will study the effects of urate on the
function of bone-forming cells (osteoblasts)
and cells that control the breakdown of bone
(osteoclasts). We will also study the effects of
medications that reduce urate levels on bone
structure. If urate does indeed directly act
on bone cells to increase bone density and
reduce fracture risk, these observations may
have important clinical implications in guiding
blood urate targets in people treated for gout
(the most common form of inflammatory
arthritis), understanding patterns of bone
disease in people with gout, and, in the longterm, identifying new therapeutic strategies for
prevention of osteoporosis.
A NON-INVASIVE TEST OF EMBRYO
QUALITY ($120,285 - 2 years)
Dr Lynsey Cree, Prof Larry Chamley,
Prof Peter Stone, Dr Matthew VerMilyea
Dept of Obstetrics and Gynaecology,
University of Auckland
In vitro Fertilisation (IVF) is a commonly used
technique for infertility and its use is rising due
to women delaying child bearing. Annually
350,000 babies are born using this technique,
however success rates are still low. Developing
techniques to select the best embryo for transfer
in order to maximise the likelihood of a healthy
live baby represents one of the major challenges
in reproductive medicine. Recent data suggests
that embryos expel genetic material into the
media in which they are cultured. This is a
novel finding that has the potential to provide
a non-invasive way to look at the genetic
complement of the embryo. Current techniques
used to do this are invasive and some may harm
the embryo. Our research aims to investigate
whether this genetic material, located within
the media, can give meaningful data of embryo
quality and whether it can be used to select only
those embryos with the correct chromosomal
makeup. This is particularly important for older
women whose embryos are more likely to have
an incorrect chromosomal makeup. Selecting
embryos with the correct chromosomal makeup
will increase IVF success rates. This novel
research project has the potential to change the
future of embryo screening in New Zealand and
internationally.
EFFECTIVENESS OF FOOTWEAR IN
PEOPLE WITH GOUT
($106,553 – 2 years)
Prof Keith Rome, A/Prof Nicola
Dalbeth, Prof Peter Gow, Prof Peter
McNair, A/Prof Alain Vandal
Dept of Podiatry, Auckland University of
Technology
Gout is a major cause of musculoskeletal
disability in Aotearoa New Zealand. Foot pain
occurs in most people with gout. There is strong
evidence that many people with gout wear
inappropriate or poor quality footwear, and that
ill-fitting footwear may contribute to further foot
problems. We have shown in a recent feasibility
study that footwear with good cushioning,
motion control and adequate width reduces
foot pain and disability in the short term. We
propose a long-term randomised controlled
trial examining the effects of a footwear
intervention on foot pain and disability. The
trial will assess the effect of standard podiatric
care and a relevant footwear intervention
against standard podiatric care only. The
study findings will be used to make evidencebased recommendations regarding footwear
intervention for people with gout.
THE ROLE OF INTRACELLULAR AGES
IN THE DIABETIC HEART
($159,335 – 2 years)
Dr Kimberley Mellor, Prof Margaret
Brimble, Prof Lea Delbridge
Dept of Physiology, University of Auckland
In New Zealand, more than 200,000 people
are currently diagnosed with diabetes and the
burden falls disproportionately on the Maori and
Pacific Island populations, with the prevalence
and death rates approaching double those
of Pakeha. Diabetic patients have 2.5-fold
increased risk of heart failure. The prevalence
of diastolic dysfunction in type 1 and type 2
diabetes is estimated to be as high as 40-75%
without overt coronary artery disease. The
myocardial origins of this vulnerability are poorly
understood and effective treatment strategies
are lacking. This study aims to establish that in
diabetes – glycation of intracellular proteins in
the heart is a pathology to target therapeutically.
In characterising intracellular glycation as a
novel component of diabetic cardiomyopathy,
this project has potential to contribute a
highly significant advance in knowledge in this
field – and to prompt an innovative paradigm
shift in thinking about causation of diabetic
cardiopathology. It is anticipated that this
research will translate into specific fundamental
outcomes relating to the science and the
treatment of heart failure in diabetic patients.
TARGETING THE MECHANISM OF
HOST RECOGNITION TO PREVENT
BACTERIAL INFECTIONS
($53,580 – 1 year)
Dr Xue-Xian Zhang, A/Prof John
Harrison, Dist. Prof Paul Rainey, Dr
Stephen Ritchie
Institute of Natural and Mathematical
Sciences, Massey University
With the widespread increase of bacterial
resistance to antibiotics, new strategies to
prevent and treat healthcare-associated infection
are urgently required. This proposal addresses
a crucial gap in our current understanding of
how bacteria cause disease - namely, how
pathogenic bacteria recognise vulnerable
hosts for successful colonisation and immune
evasion. To date, our research has focused on
Pseudomonas aeruginosa, an environmental
pathogen that causes a wide range of
healthcare-associated infections and pulmonary
infections in people with chronic lung diseases,
particularly cystic fibrosis. Recent progress has
led us to a novel hypothesis that P. aeruginosa
recognises urocanate in human tissues and
use it as a trigger for bacterial invasion. To test
this hypothesis, we will develop the analytic
techniques that are essentially required for the
detection of urocanate in chemically complex
human samples (e.g., sputum, urine and wound
fluid). Next, we will screen ~200 specimens from
patients with various diseases (including asthma,
diabetes and cystic fibrosis) in order to identify
the urocanate-containing tissues for further
investigation into the association between
urocanate concentration and predisposition to
bacterial infection. The data will form the basis
for the development of new strategies to prevent
bacterial infection through interrupting the
urocanate-mediated host recognition.
WHY ARE KNEE LIGAMENT
SURGERIES FAILING IN YOUNG
PEOPLE?
($159,171 – 2 years)
Dr David Musson, Mr Brendan
Coleman, Prof Jillian Cornish, Dr Dorit
Naot, Dr Matthew Street
Dept of Medicine, University of Auckland
Tears of the anterior cruciate ligament, an
important stabiliser of the knee joint, are a
significant clinical problem in active, young
individuals, with surgeries costing over $18
million per year in New Zealand. Recent data
has highlighted that patients under the age of
20 undergoing surgical reconstruction of their
anterior cruciate ligament are more prone to
re-tearing. This study aims to understand the
biological mechanisms behind this phenomenon
by comparing the mechanical strength, structure
and gene expression profile of biopsies from
patients under the age of 20 and biopsies from
those over the age of 20 undergoing anterior
cruciate ligament reconstruction.
Obituary
Dr William Douglas Goodfellow OBE - Patron AMRF
Dr Douglas Goodfellow was a major benefactor and figure behind
the journey of the Auckland Medical Research Foundation (AMRF)
following in the footsteps of his father, Sir William Goodfellow, who
was instrumental alongside other business and medical figures in
the establishment of the Foundation in 1955. Dr Goodfellow was
a Trustee from 1978, Chair of the Board’s Finance Committee
from 1984 – 2007, and on his retirement in 2007 was made the
first Patron of the Foundation in honour of his commitment to, and
support of, AMRF.
Dr Goodfellow was awarded an OBE in 1979 for services to the community
and was pleased to be made an Honorary Fellow of the Royal New Zealand
College of General Practitioners in 1983. The University of Auckland awarded
Dr Goodfellow an Honorary Doctorate in Laws in 1999. He was an inspiration
to all who knew him and a benefactor to many who did not. His low-profile
life of service to humanity through his philanthropic and charitable initiatives,
particularly in the areas of health and education, will endure forever.
Dr Goodfellow’s name is remembered through two prestigious awards –
The Douglas Goodfellow Medical Fellowship, and the Douglas Goodfellow
Repatriation Fellowship which Dr Goodfellow funded and will continue to be
funded through his charitable trust.
The AMRF would like to acknowledge a truly great man who made a profound
difference. The lives of many, many New Zealanders have been enhanced by
his sensitive and caring response to need and opportunity.
Dr Goodfellow’s legacy and support for medical education and research
continues with his sons Bruce and Peter serving as Trustees of the Foundation.
Dr Andrew Wood
Recipient of the Douglas Goodfellow Repatriation
Fellowship 2014
I am a paediatric oncologist and my research focuses on the
genetics and molecular workings of Acute Myeloid Leukaemia
(AML). It was just over a year ago today when I was sitting in a
resource rich lab in Philadelphia asking myself how I could secure
funding to start up a lab in New Zealand?
The Auckland Medical Research Foundation (AMRF) Douglas Goodfellow
Repatriation Fellowship Award provided the critical start-up funds for my
new position at the University of Auckland. The prestige of the award and the
reputation of the AMRF review process were instrumental in helping to attract
other research funding.
The goal of my AMRF funded research is to define the molecular signalling
mechanisms that drive a newly defined subtype of AML. Once we know
this information we can start to develop new treatments with the goal of
improving cure rates. For a long time choosing better chemotherapy and
increasing doses led to steadily improving survival rates, but survival for
paediatric AML has now plateaued at approximately 65%. This is because
in recent trials survival gains from decreased leukaemia deaths have been
largely offset by increased deaths from chemotherapy side effects. Molecularly
targeted therapies tend to cause fewer toxic deaths compared to traditional
chemotherapy, but the rate-limiting step is that we don’t know what targeted
therapies to give. Basic research, like this AMRF funded project, is needed to
help fill this gap in our knowledge.
HealtheX 2014
HealtheX is a student-led initiative where students
present their research findings to a wide ranging
audience of students, faculty staff, clinicians and
sponsors. For seven years now the Auckland Medical
Research Foundation (AMRF) awards the overall winner
a travel grant of $5,000 to present their research at an
international conference.
Our congratulation to this year’s overall HealtheX winner Mohanraj
Krishnan whose research focuses on early life determinants of
childhood obesity.
Childhood obesity is a major public health crisis in Western
countries, and is associated with an increased risk of cardiovascular
disease and premature mortality. The prevalence of childhood
obesity is escalating rapidly in New Zealand. Several gene variants
have been identified and have provided new insights into biological
factors that contribute to the development of obesity. We aim to
identify genetic and early life determinants of obesity in children
at 6 years of age. To achieve this we will utilise detailed clinical,
lifestyle and biomarker information from early pregnancy from
approximately 1200 participants in the Auckland Children of SCOPE
(Screening for Pregnancy Endpoints) study as well as detailed data
(particularly physical activity and diet) collected from the children at
6 years of age. This study offers a unique opportunity to advance
AMRF President Jeff Todd with Mohanraj Krishnan
understanding of the complex relationships between environmental
factors, and genetic influences in childhood obesity.
I am very grateful to the Auckland Medical Research Foundation
for this award - it is a great honour, which will help broaden my
knowledge. I will be able to meet and network with leading
researchers from around the world, and this will be an invaluable
experience.
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