Cutting-edge science harnessed to seek SA healthcare solutions

The Afrocentric Precision Approach to Control Health Epidemics (APACHE) Flagship project at UKZN is an interdisciplinary approach aimed at developing research relevant to the provision of high-quality healthcare.

The flagship project, which was recently launched at UKZN, has three focus areas, namely: precision medicine, precision public health and translational science. These focus areas have the aim of (i) delivering the right medication to the right patient, (ii) delivering the right intervention to the right population at the right time, and (iii) bringing innovations to the market that can impact disease management.

Speaking at the launch, UKZN's Deputy Vice-Chancellor for Research, Professor Deresh Ramjugernath, said: "We have broken down silos and created an environment for our researchers and academics from different fields of study to now start talking to each other about things that matter."

At present, leading investigators from different disciplines at the university are collaborating to develop trailblazing research ideas on precision medicine, precision public health, health law and ethics and translational science.

Principal investigators on the project are Dr Donrich Thaldar, Professor Manormoney Pillay, Professor Tulio De Oliveira, Dr Clinton Veale and Professor Carola Ulrike Niesler.

Gugulethu Mkhize of the KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP), a newly formed centre at UKZN, said researchers within the Centre had already raised about R30 million, hosted 12 training workshops and more than 20 seminars, with more talks planned for this year. "These outputs indicate the flagship programme is already on its way to achieving its goals," said Mkhize.

One of the research team leaders from KRISP, Dr Veron Ramsuran, who is a senior lecturer at UKZN, said their research was a collaboration with internationally recognised organisations such as the University of Oxford, the South African Medical Research Council, Harvard University, the University of Washington, and the Sanger and Broad institutes. "Their research focuses on examining the whole genomes of South African individuals infected with HIV and determining the genes that may contribute towards Aids. This is the first time South African genomes will be sequenced and analysed within the African continent," said Ramsuran.

One of the many pioneering areas of research being undertaken by the APACHE Flagship, which Thaldar will oversee, is the investigation of the ethical and legal dimensions of gene editing technologies such as CRISPR-Cas9. Thaldar questioned: "Can our ethical and legal thinking keep up with rapid scientific innovations? My answer is an optimistic 'yes'. We will not only be investigating the law as we currently find it, we will be proactive in developing model legislation for South Africa on how to regulate gene editing technologies."

Senior lecturer in Organic Chemistry Dr Veale said this flagship aimed to move away from the "current one-size-fits-all model of disease prevention and treatment, with a special focus of diseases which disproportionately affect Africa".

Dr Veale believes this innovative approach to healthcare will have a substantial impact on the lives of ordinary South Africans in the long run. "Apart from the ideas of finding solutions to healthcare issues in Africa, this project has a large focus on platform development, with a key outcome being skills and infrastructure development," said Dr Veale. "Therefore, we want to use this as a springboard to develop and retain high-end skill-sets in South Africa, particularly with an eye on transformation and economic development."

A specialist in drug discovery, Dr Veale said his role was to develop platforms that find new ways of inhibiting cancer cell growth. "We are particularly interested in using small molecular fragments to inhibit the interactions between key proteins which we have identified as potential targets," he added.

The Academic Leader of the Biotechnology Cluster (Pietermaritzburg) in the School of Life Sciences, Professor Carola Niesler, and co-PI and senior lecturer in the Discipline of Biochemistry Dr Ray Hewer, are excited about the new Zebrafish Platform they are establishing. This platform will establish relevant in vivo models for research on a range of diseases as well as the biological effects of environmental pollutants found in our river systems. The information generated has significant potential to be translated into interventions that could improve the health and well-being of South African citizens.

Prof Niesler explained the relevance of this model organism. "Zebrafish (Danio rerio) are freshwater fish, which have gained prominence over the past two decades as an increasingly relevant and powerful biological model," she said. "As they exhibit high degrees of similarity to human anatomy, gene expression and disease progression, these aquatic model organisms are used to model a range of human diseases. Zebrafish have also proven to be ideal for assessing various environmental parameters and contaminants."

This model organism is now being used at a number of universities in South Africa to assess the toxicity and developmental impact of a range of pollutants in an animal model. The proposed Zebrafish Platform at UKZN will be the first such platform in KwaZulu-Natal.

Associate Professor in Medical Microbiology and Academic Leader for Infectious Diseases Cluster in the School of Laboratory Medicine and Medical Sciences, Professor Pillay, said the team was favourably positioned to "introduce our team of young scientists to local, national and global scientific networks in the field of TB biomarkers, with a goal of becoming leading international experts in their own right.

"I will oversee the translation of our previous and current basic science research to the design/development of a rapid point of care TB diagnostic test and a novel vaccine, in collaboration with experts in this field," said Pillay.

"The diagnostics project will involve the production of monoclonal antibodies that will be immobilised in an immunochromatographic strip for the direct detection of Mycobacterium tuberculosis antigens in patients' biological samples. The vaccine project aims to develop and evaluate novel recombinant subunit TB candidate vaccines for their capacity to elicit protective humoral and T cell mediated immunity against Mycobacterium tuberculosis infection," she said.

"In parallel with this, the TB biomarker team aims to develop a bioinformatics pipeline for the mining of our big RNA Seq data sets for the continued discovery of novel host and pathogen molecular biomarker signatures."

The African Health Research Flagship aims to produce high quality research and have a significant social impact.

Words: Raylene Captain-Hasthibeer and Hlengiwe Precious Khwela