Team:Hong Kong HKUST/hp/interview/chan

Introduction

Professor Juliana Chan is a professor of medicine and therapeutics at the Chinese University of Hong Kong (CUHK). She is also director of the Hong Kong Institute of Diabetes and Obesity, CUHK, co-director of CUHK-Prince of Wales Hospital International Diabetes Federation Centre of Education (IDFCE), and chief executive officer of the Asia Diabetes Foundation. With extensive knowledge on diabetes, obesity and clinical practice, Prof. Chan brought to our attention practical aspects of developing treatments for medical purposes. Meeting Prof. Chan helped us to understand more about the biochemistry of diabetes. Also, by giving us information on current treatments for obesity and diabetes, she allowed us to consider our work in context. Towards the end of the interview, we also talked about the regulations for the development of new treatments in medical fields.

Main Discussion

Professor Chan thought that our project was interesting because she has been keen to solve problems related to obesity and diabetes. She mentioned that obesity is a disease that many people disregard, but that has great potential to cause complications such as diabetes and cardiovascular diseases. As more studies related to obesity are done, it seems like the cause of obesity is more than unbalanced lifestyle and diet. Professor Chan said that the underlying reason of obesity could be genetics and/or epigenetics.

In the case of diabetes, dysfunctional proteins from the deficient genes and high levels of free fatty acid could provide a stressful environment for the beta cells of the pancreas that produces insulin. Prof. Chan explained that this kind of stress on beta cells can cause insulin resistance and ultimately lead to type II diabetes. We have investigated if our project could alleviate diabetes. Prof. Chan mentioned that our project could definitely help to reduce the stress on the beta cells by decreasing the amount of free fatty acid and ultimately alleviating diabetes. She, however, acknowledged that in the long run, our project itself might not be enough to completely cure diabetes. This is because diabetes is a very complex disease that comes in different forms and is therefore very hard to cure. Professor Chan said that diabetes is a “vicious cycle” and to break this cycle different approaches such as healthy diet and insulin injection are also required. She mentioned that our project could be approached as an option to break the cycle.

We have also investigated the side effects that our project might cause. Prof. Chan specifically mentioned ketoacidosis. Ketoacidosis occurs when high concentrations of ketone bodies are formed due to the increase of fatty acid oxidation. We have explained that our inducible promoter is activated at high levels of fatty acids but shuts down before too many fatty acids are oxidized to produce fatty acid deficiency and other side effects such as ketoacidosis. Prof. Chan also worried about the increase of oxidative species caused by the increase of fatty acid oxidation. She said that because fatty acid oxidation requires oxygen, increase of fatty acid oxidation might limit the availability of oxygen for other cells and cause incomplete respiration to ultimately produce reactive oxidative species. She mentioned that to reduce this kind of possible side effect, patients that apply our product most do aerobic exercise to ensure enough oxygen is provided to the body.

In addition, we discussed the regulations on developing new treatments in medical fields. This allowed us to know more about the biosafety precautions taken in the field. It is known that technologists need to pass 4 phases of clinical research in order to bring their products to market. However, technologists are also responsible to revise and present their ideas to the public so that more people can understand the nature of the ongoing research work.

Conclusion

The interview with Professor Chan allowed us to recognize the limitations of our product in a medical context. The interview also gave us a holistic view on diabetes and brought to our attention obstacles we may need to overcome if we want to bring our work forward in applicability.

Interview Video

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Prof. Chan's Interview Script (PDF)