Impact Magazine Issue 63 | Wesley Medical Research

IMPACT

WMR RESEARCH UPDATE ISSUE 63 SUMMER 2018

TOP STORY

IN THIS ISSUE

03

Understanding the Role of Bacteria in Breast Cancer

04

Muscle, Confidence & Motivation for Parkinson’s Patients

05

On the Cusp of Real Change in Coeliac Disease

06

Finding Answers for Total Knee Replacement Patient Outcomes

THE ROLE OF BACTERIA IN BREAST CANCER Associate Professor Ian Bennett has been investigating changes in bacterial communities in the breast tissue of patients diagnosed with breast cancer.

This two-year project has just concluded and is showing promising insight that could lead to the prevention of breast cancer through targeting of healthy bacteria....

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A MESSAGE FROM THE CHAIRMAN – PETER ALLEN As the end of the year is fast approaching, I wanted to thank everyone who has donated to Wesley Medical Research.

Without this support, we would be unable to continue important research, such as the work from Professor Ian Bennett on breast cancer. On behalf of the patients who will benefit from the research made possible with your support, thank you.

I wanted to acknowledge three significant supporters, Lyn and Bobbie Brazil AO, The Thorsen Foundation and Rosalie Russell. We are truly

appreciative of your confidence and belief in our work.

Finally, I would like to thank Associate Professor John Allan for his voluntary service as Acting CEO for the past year. John will continue his service as director and for 12 months, as Chief Research Advisor.

As you will read in this research update, a focus area at WMR is our work in coeliac disease lead by Dr James Daveson. Those who attended our recent Advocates Event: A Coeliac Revolution, received a glimpse into exciting developments in coeliac disease diagnosis, treatment and management.

Dr Daveson, who is internationally

renowned for his work in coeliac disease, is conducting clinical trials and research projects at WMR. Knowledge gained from these projects will contribute to a better understanding of the condition, and give insight into the complex immune system.

With some exciting research planned for 2019, we look forward to keeping you updated. Our advantage at WMR is that we have access to incredible doctors, nurses and allied health professionals who are passionate about improving patient outcomes through research. Thank you again for your commitment to supporting WMR and enabling this important work to happen.

ASSOCIATE PROFESSOR JOHN ALLAN APPOINTED CHIEF RESEARCH ADVISOR AT WESLEY MEDICAL RESEARCH Experienced researcher and medical specialist, Associate Professor John Allan, has been appointed to the newly created role, Chief Research Advisor at Wesley Medical Research.

He will commence in this new position in October 2018.

A long-standing Director of the WMR Board, A/Prof John Allan was appointed as Acting CEO in October 2017, working in an honorary capacity. He has spent the last twelve months implementing WMR’s new strategic direction and restructuring WMR to maximise the impact of donations towards practical outcomes for patients.

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Mr Peter Allen, Chairman of the WMR Board of Directors, praised John for his achievements during his tenure as CEO and for his willingness to continue to serve WMR in this new role. “The realignment of the role of A/Prof John Allan will allow him to focus on his key strengths and knowledge in medical research.”

“I’m thrilled to be continuing my involvement in WMR’s research operations, as we have the vision and infrastructure to undertake some internationally competitive clinical research,” said A/Prof John Allan.

“We have been fortunate to have retained the services of such a respected researcher and clinician.

We are very grateful for his contribution as CEO and pleased he has accepted this critical new role,” Mr Peter Allen said.

Associate Professor John Allan will continue as a Director on the WMR Board.

UNDERSTANDING THE ROLE OF BACTERIA IN BREAST CANCER Breast cancer is perhaps the most extensively studied human cancer of all. Genome and transcript sequence from several thousand patients are now publically available.

Despite the progress made in curing breast cancer, we still do not know what causes it.

Professor Ian Bennett has been investigating changes in bacterial communities in breast tissue and the development of the changes of these communities in patients with breast cancer. This two-year project has just concluded and is showing promising insight that could lead to the prevention of breast cancer through targeting of healthy bacteria.

Whilst there have been recent reports suggesting that viruses might be implicated in breast cancer development, in an earlier study Professor Bennett’s group

demonstrated using genome deep sequencing techniques that viral genomes were not actually incorporated into the tumour genome, thus essentially showing that is was unlikely that viruses were playing a significant role in breast cancer aetiology. This work was published in Scientific Reports.

More recently, it has emerged that bacteria may be implicated in the causation of human cancers and through a mechanism which involves changing the environment surrounding tissue cells.

Bacterial communities are found in almost all human tissue and are generally considered to be required for good health. However, changes in the composition of bacterial communities are known to cause disease such as inflammatory bowel disease, even diabetes. Whilst Prof.

Bennett’s preliminary data indicated that more than 70% of normal breast tissue contained a bacterial community, breast cancer tissue had low levels of bacteria.

Further research using PCR and gene sequencing techniques compared normal breast tissue with cancerous

...normal healthy breast tissue has a small healthy bacterial community, whereas breast cancer tissue has little if any.

tissue from the same breast of patients.

Using this approach, they consistently found that normal breast tissue had a population of bacteria. However, significantly, it was discovered that the cancer tissue itself had almost undetectable levels of bacteria.

This suggests that the normal healthy breast tissue has a small healthy bacterial community, whereas breast cancer tissue has little if any. It may be that we need bacteria to maintain breast health and that loss of these “healthy” bacteria may contribute to the formation of breast cancer.

Professor Ian Bennett

“Because our study shows that breast cancer tissue has a greatly reduced bacterial burden, this might suggest that the loss of ‘good bacteria’ may alter the breast tissue biochemical milieu and potentially incite inflammatory changes which predispose to breast cancer development. If we can show that this is the case, then it suggests that tests of bacterial burden may be helpful in diagnosing those at risk of breast cancer. More importantly, it may suggest that treatments or diets that maintain ‘good bacterial’ communities within breast tissue may prevent breast cancer development,” said Professor Ian Bennett.

These findings will be pursued in a future study to understand what preventative mechanisms could be introduced to maintain the healthy bacterial composition of breast parenchyma.

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ISSUE 63 | SUMMER 2018 3

BUILDING MUSCLE, CONFIDENCE AND MOTIVATION THE TRIAL CHANGING LIVES FOR PARKINSON’S PATIENTS

Every day, 37 people in Australia are diagnosed with Parkinson’s disease.

Despite best medical intervention, Parkinson’s patients still have a steady decline in physical function and activity.

Research shows that exercisebased programs are beneficial to Parkinson’s patients, however long-term behaviour change is difficult to achieve. Wesley Medical Research, in conjunction with The University of Queensland, is working to find a solution.

Professor Sandra Brauer (Physiotherapist) and Associate Professor John O’Sullivan (Neurologist) are determined to give patients the best opportunity to slow progression of the disease by trialling a new intervention that combines exercise, self-monitoring devices and education.

“As a Physiotherapist, I have seen benefits from exercise sessions including improving patients’ walking ability and quality of life. This trial aims to address participants physical fitness, confidence and motivation to get going, and keep going with exercise” said Professor Brauer.

The clinical trial involves 96 patients, randomised to either usual care or the intervention group.

This intervention extends previous research by using this training to

explicitly improve patient’s belief they can exercise safely, while providing tools and strategies to change their activity levels permanently.

The usual care group will be monitored via questionnaires and patient interviews in combination with standard follow-up from their Neurologist and General Practitioner.

The intervention participants are required to attend group exercise sessions at The Wesley Hospital over a 4-week period. Each participant will be given a Garmin VivoSmart monitoring device, enabling participants to measure their own performance via a mobile application, while providing physiotherapists with accurate data to track activity outside training sessions. A portion of each exercise session will involve training in motivational coaching, guiding participants through the process of setting short- and long-term goals, as well as formulating action plans and coping strategies.

Specifically, the intervention has been designed to enhance participants’ motivation for engaging in physical activity by satisfying their needs for competence, autonomy and relatedness.

If successful, this novel approach could easily be translated into clinical practice. The outcome will equip patients with the skills needed to improve their physical activity and functional ability and importantly, the ability to maintain it.

This Clinical Trial was made possible through the generosity of Lyn and Bobbie Brazil AO.

Want to support our Parkinson’s research?

Please call us on 3721 1774 or donate online: wesleyresearch.org.au/donate

Patient Michael Fitzgerald has just completed the four-week program and has seen great benefits both physically and emotionally. “I have seen a significant improvement in my symptoms including a reduction in the tremor in my left hand. I found that since the trial, I can comfortably hold a glass and engage in social conversation.”

I have seen real benefit from this program.

It should available to everyone as part of mainstream treatment.

Michael Fitzgerald Clinical Trial Patient Clinical Trial particpant Michael Fitzgerald in action.

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ON THE CUSP OF REAL CHANGE IN COELIAC DISEASE Coeliac disease is recognised as the most common of the autoimmune conditions, affecting one in 70 Australians.

With 80% of cases undiagnosed, finding less invasive diagnostic testing and understanding the triggers for its development, are crucial to managing the condition ongoing.

The reality of a potential treatment for coeliac disease beyond a gluten-free diet could be on the horizon with several therapies in differing stages of clinical trials.

Hearing the status of global research

Wesley Medical Research held a special Advocates event on Thursday 30th August to explore the exciting clinical trials that are happening on-site and across the globe in Coeliac Disease.

‘A Coeliac Revolution: On the Cusp of Real Change’ showcased Gastroenterologist and expert in coeliac disease, Dr James Daveson.

Peter Ciereszko, Nat Hutton & A/Prof John Allan.

The Point-of-Care test, is a quick pin-prick method currently being explored at Wesley Medical Research.

Dr Daveson is actively involved in global research and provided an update on new diagnostic testing and novel management therapies that could transform a coeliac diagnosis.

One diagnostic study currently being explored is the Point-of-Care test; a quick pin-prick method. The impact of this testing could lead to a simpler, faster diagnosis at the GP practice – an important step in preventing further complications from the auto-immune disease which is triggered by gluten.

The Point-of-Care Study is possible through the generosity of The Thorsen Foundation.

Missed the event?

The full video presentation is available on our website wesleyresearch.org.au/watch

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Living with Coeliac disease - Yvette Lynch

Virginia Gehrke, Joanne Richards & Guest

SEEKING DEFINITIVE ANSWERS FOR TOTAL KNEE ARTHROPLASTY PATIENT OUTCOMES

A new clinical trial has commenced at the Wesley Hospital, investigating the use of Tranexamic Acid in total knee replacements with the goal of improving recovery times and reducing blood loss during and after the procedure.

Total joint arthroplasty can be associated with major blood loss and require subsequent blood transfusions for postoperative anaemia. It is important to research and understand ways to effectively and safely decrease blood loss and reduce the need for blood transfusions. The result of which would help improve patient outcomes and lower health care costs.

Tranexamic acid (TXA) is a medication used to treat or prevent excessive blood loss from major trauma, surgery, tooth removal, and a myriad of other procedures and applications. In this trial, we are investigating a newly developed dosage algorithm for TXA. Anaesthetist Dr Sue Clark, the Principal Investigator of the study explains, “We do currently understand that with the use of this drug, patients can experience less pain and less bleeding after a total knee replacement surgery, however, there has been no definitive data that shows the ideal dosage and for how long patients should be receiving this drug to optimise their recovery.”

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To deliver conclusive data on the use of Tranexamic Acid throughout a patient’s care is an exercise in collaboration.

“We’ve brought the whole team on this journey.” stated Dr Sue Clark. “From the preadmission nurses, through to the theatre nurses, surgeons, recovery staff, ward nurses, as well as the physiotherapists and allied health professionals. Because of this collaboration, we’ll get an answer that will give our patients the very best outcome from their surgery.”

At the conclusion of this study, this new algorithm will help to define exactly the right way to use Tranexamic Acid to ensure patients undergoing a Total Knee Arthroplasty have the best outcomes. These patients will have less pain, less bleeding, and get back to work and life much faster.

This study was made possible through the generosity of The Thorsen Foundation.

Want to support our Investigator Initiated research? Please call us on 3721 1500 or donate online: wesleyresearch.org.au/donate.

Dr Sue Clark after her first trial patient

Patients required

Patients recruited

36

58%

Estimated completion

May 2019

LIST OF MAJOR SUPPORTERS IN 2017/2018 Wesley Medical Research acknowledges the support of its donors. It is only through their generosity that we are able to invest in research that will bring immediate and lasting improvements for patients.

We are grateful to our donors, friends, corporations and foundations for their support this year.

Lifetime Donors and Supporters

Donors: $10,000–$99,999

These donors are recognised a supporting Wesley Medical Research at transformational level, donating over $100,000 or more cumulatively during their lifetime:

¡¡ Mr Martin Albrecht AC and Mrs Fran Albrecht ¡¡ Mr T Hogg ¡¡ Mrs Maureen Stevenson ¡¡ Neumann Benevolent Foundation ¡¡ The Honda Foundation ¡¡ Tour de Cure Limited ¡¡ Vidyajey Foundation

¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡

Brazil Family Foundation Aurizon Operations Limited Australia Pacific LNG Pty Limited Katharina Elizabeth Foundation The Thorsen Foundation Justin Cameron Cancer Care Foundation Xstrata Limited The Wesley Hospital Auxiliary JJ Richards & Sons P/L Mitchell & Partners Pty Ltd Mitsubishi Development Pty Ltd The Atlantic Philanthropies Devine Limited Queensland Government Mr Martin Albrecht AC and Mrs Fran Albrecht Mr Adrian Axelsen Mr Trevor and Mrs Donna Bailey Mr Paul Darrouzet Dr Jon Douglas AM and Mrs Kay Douglas Gary Kleinschmidt Mr John Martin Mrs Diana McCamley Mr Arnold and Mrs Nancy Sinnamon

Bequests in 2017/2018 These donors have kindly left a gift in their will in the past 12 months. ¡¡ Estate of the Late Betty Davies

Donors $100,000–$999,999 ¡¡ JJ Richards & Sons P/L ¡¡ Katharina Elizabeth Foundation ¡¡ The Thorsen Foundation

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Donors: $1,000–$9,999 ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡

Alex Gow Funerals Borgert Family Endowment Dr Cathryn Mittelheuser AM Dr John Chippendale Dr Jon Douglas AM and Mrs Kay Douglas Heart Support Australia Ltd – Caboolture & Districts Branch Inner Wheel Club of Brisbane West McGarry Partners Morgans Financial Mr Alexander Dixon Mr Alexander Peden and Mrs Mary Peden OAM Mr Christopher and Dianne Morton Mr David and Mrs Vivien McGarry Mr David Sartor Mr Don Murray Mr Eddie and Mrs Katherine Codd Mr John Allpass Mr John and Mrs Patrice Foote Mr John Coman Mr Peter and Mrs Anne Allen Mr Richard Hughes Mr Rodney Wylie OBE Mr Tom McKerrell Mrs Daphne Dunn Mrs Dorothy Singer Mrs Lorretta and Mr Bill Whitmore Mrs Lynette Barnett Mrs Viti Packer Ms Marie Isackson

¡¡ Prof Russell Stitz AM and Mrs Anne Stitz ¡¡ Rachael Shetty ¡¡ The Edward Bullock Endowment ¡¡ The Greatorex Foundation Pty Ltd

Donors: $500–$999 ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡ ¡¡

A/Prof Jim and Mrs Jill Nicklin Dr Alan and Mrs Lois Porter Dr Ben Fitzgerald Dr Donald Reiman Dr Joan M Lawrence AM Dr John and Mrs Patsy Quayle Dr Marie Jameson Dr Stephen Yelland Mr Craig Cardinal Mr Hunter Gottschalk Mr Ian and Mrs Jan Broadfoot Mr Ian and Mrs Patricia Munro Mr Ian and Mrs Penny Moysey Mr Johannes and Mrs Diana Pronk Mr John Clark Mr Michel Holmes Mr Peter Billingham Mr Peter Cranna Mr Phillip and Mrs Pam Whittaker Mr Rob and Mrs Sheryl Ross Mrs Betty Vandeleur Mrs J Boughen Mrs Janelle Miller Mrs Jocelyn and Mr Ted Ranson Mrs Julie Gastrell Mrs Pam Tate Mrs Raelene and Mr Geoff Cranna Mrs Wendy and Mr Alan Grummitt Ms Jill McGhie Mrs Marian and Ken Gibney Ms Valmai Pidgeon AM Prof David and Mrs Nicoletta Coman Prof Emeritus Roy Webb AO and Mrs Heather Webb ¡¡ Queensland Community Foundation

We hope you have been inspired by the research in this magazine.

Below are some ways you can get involved and make a big impact.

Donate to fund research Online Visit wesleyresearch.org.au/donate

Phone Contact our fundraising staff on (07) 3721 1774.

Mail Complete and return the included donation slip using the enclosed reply-paid envelope.

PO BOX 466 Toowong DC QLD 4066

Help us raise awareness www.wesleyresearch.org.au

Register for a clinical trial www.wesleyresearch.org.au/clinical-trials

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