Team:Slovenia/SocietyMedicalDoctors
From 2012.igem.org
Strazkosann (Talk | contribs) |
Strazkosann (Talk | contribs) |
||
Line 416: | Line 416: | ||
<tr class="inliner"><td class="inliner"><b>Figure 1.</b> <b> Medical team at the Division of Internal Medicine of the University Medical Centre Ljubljana, Slovenia.</b> | <tr class="inliner"><td class="inliner"><b>Figure 1.</b> <b> Medical team at the Division of Internal Medicine of the University Medical Centre Ljubljana, Slovenia.</b> | ||
From the left: Petra Zupan, a registered nurse, Miran Brvar, MD, PhD, Assist. Prof., a specialist in internal medicine, Hikmer Badnjević, a nurse. | From the left: Petra Zupan, a registered nurse, Miran Brvar, MD, PhD, Assist. Prof., a specialist in internal medicine, Hikmer Badnjević, a nurse. | ||
- | + | </td></tr> | |
</tbody> | </tbody> | ||
</table> | </table> |
Revision as of 12:45, 26 September 2012
Physicians
Figure 1. Medical team at the Division of Internal Medicine of the University Medical Centre Ljubljana, Slovenia. From the left: Petra Zupan, a registered nurse, Miran Brvar, MD, PhD, Assist. Prof., a specialist in internal medicine, Hikmer Badnjević, a nurse. |
We felt that the potential use of our inovation should be disscused with medical professionals and patients as they are the target population which could directly benefit from our idea. All physicians to whom we spoke expressed enthusiasm for this application of synthetic biology and assessed that the devised therapy would be attractive for many different diseases.
We held discussion panels about our project with Prof. Dragica Smrke, MD, PhD, a surgeon, Prof. Mojca Matičič, MD, PhD, an infectologist specializing in hepatitis, Prof. Zlatko Fras, MD, PhD, a cardiologist and Peter Popovič, MD, Msc, an interventional radiologist (all from the University Medical Centre Ljubljana and Medical Faculty, University of Ljubljana). Each of them contributed their opinion from the different medical viewpoint. |
Figure 2. Meeting with Prof. Dragica Smrke (first from the right) at the Department of Traumatology of the University Medical Centre Ljubljana. |
We presented the basic idea of our project and were interested if she thought that it was applicable to her area of specialty. There were two possible cases where we imagined it could be used, one is a bone fractures that are not healing properly and the other is a chronic skin wound. For the purpose of bone healing,microcapsules with therapeutic cells could be delivered at the site of the fracture and could support the formation of new bone tissue. Students of medicine from the team proposed to use bone morphogenetic protein factors(BMPs), to which she was sceptical. She informed us that although these biological drugs are effective they are not in general use in clinical medicine, mainly because of extremely high price. If our delivery system solved this problem this could represent a therapeutic application with great potential in the future. Prof. Smrke thought we could put our system to a much better use in the healing chronic skin wounds which are extremely common in her everyday medical practice. An advantage to this approach is the ease of applying the microcapsules to the wounded tissue and proposed collaboration on in vivo testing. The conclusion of our meeting was that this application could be a good way to improve chronic wound healing.
Figure 3. Meeting with Prof. Mojca Matičič (first from the left) at the Clinic for Infectious Diseases and Febrile Illnesses, University Medical Centre Ljubljana. |
We introduced the idea of our project to Prof. Matičič and wanted to know if it could be applicable for the treatment of chronic hepatitis C. We proposed the idea of treating this disease with a combination of the standard therapeutics consisting of interferon-alpha and hepatocyte growth factor that would potentially reverse the long term effects of infection on progression to life threatening conditions such as liver cirrhosis and liver cancer that happen in up to 40% of untreated or unsuccessfully treated with currently recommended standard of care medications. Her consideration was that something like this has never been done before and so it would be a complete novelty in treating hepatitis C and in her opinion it holds much promise for the future. She also wanted to know about the route of administration of the microcapsules. We considered two possibilities. The first would be direct application to the liver. She told us this might be possible and that she could organize a meeting with an intervention radiologist, specialising in liver procedures, with whom we made arrangements to discuss this matter further. The other possibility which we considered for administration was to inject the microcapsules into the peritoneal cavity, which could accommodate larger volume of microcapsules as a mimic of an artificial organ. It turns out intraperitoneal application might be suboptimal because concentration of therapeutic in the liver would probably be lower. Since we were interested in the perception of this type of therapy by patients, we composed a questionnaire on our project which she reviewed and distributed among her patients during her outpatient clinic duties.
Figure 4. Meeting with Prof. Zlatko Fras (second from the right) at the Division of internal medicine, University Medical Centre Ljubljana |
We were interested in the application of our idea to the field of expertise of Prof. Fras. Treating cardiac ischemia was first on our list of possible applications. Prof. Fras suggested it could be especially effective in treating patients after miocardial infarction in whom the narrow time window of opportunity was missed. This includes patients who did not receive the proper treatment in less than 90 minutes after the myocardial infarction. Microcapsules could be applied simultaneously with percutaneous coronary intervention via the catheter applied into the coronary artery, thus minimizing the need for any additional procedures. Another possibility of administration of microcapsules in miocardial muscle would be through pericardiocentesis. Prof. Fras also suggested another way of using our therapeutic system. He daily encounters patients with peripheral arterial obstructive disease in his clinical practice. The prevalence of this disease in the adult population is 3% (20.000-30.000 patients with this disease are treated per year in the University Medical Centre Ljubljana). He considered that it would be possible to deliver microcapsules to the occluded vessel where they would produce antiinflammatory and revascularizing therapeutics. The route of administration is much easier in the limb than in the heart.
During the course of our project we often asked ourselves what would be the best way to introduce microcapsules with engineered synthetic devices into the body.
The ideal type of administration would have to be:
- as minimally invasive as possible,
- deliver the capsules throughout the whole affected tissue and
- ensure that the capsules will remain in this location.
Figure 5. Peter Popovič from the Institute of Radiology, University Medical Centre Ljubljana. |
Therefore in summary all physicians we contacted though that the proposed approach offers many advantages and that it would be definitely worthwhile to test it in vivo.
Next: Ethics, safety and regulations >>