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02 January 2024 | Story Leonie Bolleurs
UFS scientists contribute to the battle against cancer
From top left, moving clockwise: Dr Nerina van der Merwe, Dr Osayande Evbuomwan, Prof Alicia Sherriff, Profs Andreas Roodt and Alice Brink.

Cancer stands as a prominent contributor to deaths worldwide, with a big impact on families and communities. Prostate cancer is one of the leading causes of mortality in the world. The recent diagnoses of cervical cancer are 10 702 annually, with 5 870 patients passing away. Female breast cancer surpassed lung cancer as the most commonly diagnosed cancer in 2020 (American Cancer Society), representing 11,7% of all cancer cases, making it the fifth leading cause of cancer mortality worldwide. Researchers at the university are doing their part in the fight against cancer.

Treating prostate cancer

In July 2021, Dr Osayande Evbuomwan, Senior Lecturer and Medical Specialist in the Department of Nuclear Medicine, along with a team of university doctors, initiated patient treatment using radioligand therapy (RLT). This targeted nuclear medicine therapy delivers high radiation levels precisely to cancer cells, minimising damage to normal organs and tissue, a benefit not typically provided by conventional therapies.

It was the first time that Lutetium 177 PSMA – a type of PRRT – has been used to treat patients with metastatic castrateresistant prostate cancer (MCRPC) in the Free State, providing hope when standard treatments and conventional therapy are not an option. This treatment generally enhances quality of life, slows disease progression, and extends overall survival, with minimal side effects.

All three patients treated with Lu 177 PSMA so far have completed at least four therapy cycles and tolerated it well. The first two patients, while initially responding well, sadly passed away due to unrelated causes. The third case stands out as the most successful, responding excellently to seven treatment cycle and remaining in good health.

Dr Evbuomwan recently also obtained a license for a more effective therapy, AC 225 PSMA, as an alternative to Lu 177 PSMA.

Precise cervical cancer therapy

Medical personnel at the Universitas Academic Hospital also became the first in Southern Africa to use interstitial brachytherapy as a method for treating cervical cancer. Prof Alicia Sherriff, Head of the Department of Oncology, explains that brachytherapy – a form of internal radiation therapy – places the radiation source near or inside the cancer. “Precise delivery of curative doses to the cancer protects surrounding organs such as the bladder, rectum, and small bowel,” she explains.

Three to five weekly brachytherapy sessions under conscious sedation usually begins after two weeks of daily external beam radiation. On brachytherapy days, external beam radiation is not administered. “The intracavitary brachytherapy applicators are placed within the cervix and uterus and deliver high doses locally, but for surrounding tissue infiltration, additional needles are inserted via the Venezia applicator, delivering high-dose radiation while sparing organs,” says Prof Sherriff.

Their work aligns with the broader goals of the university and its commitment to advancing health care in the region by ensuring the continued growth of their skills and technology, while applying these skills to improve the possibility of disease control, cure or palliation with quality of life.

Familial breast and ovarian cancer testing

Dr Nerina van der Merwe, a principal medical scientist in the Division of Human Genetics, and colleagues are engaged in breast cancer research. They are involved in translational research using new technologies that, once validated as a first-tier diagnostic test, could revolutionise genetic testing for familial breast and ovarian cancer in South Africa when used in conjunction with genetic counselling. This parallel application is ideally suited for primary hospitals and rural clinics, as it will dramatically increase accessibility and uptake of genetic testing in rural areas.

By performing first-tier genetic testing at a community clinic, patients no longer have to be transported to tertiary hospitals for testing, and more patients and related family members who are unaware of a familial predisposition will be reached. “By warning unaffected related individuals about their potential increased risk, we can play a part in the earlier detection or diagnosis of patients, improving their cancer survival rate,” states Dr Van der Merwe.

Patenting cancer research

Prof Andreas Roodt, a retired Distinguished Professor in the Department of Chemistry, and colleagues – particularly Prof Alice Brink and co-worker Prof Roger Alberto from the University of Zurich – have published widely on the chemistry of radiopharmaceutical models. Since the 2000s, the world has introduced the concept of ‘theranostics,’ which involves the use of a single compound for both cancer detection and therapy. “These compounds contain a radioisotope that provides internal radiation for cancer detection (diagnostic) and a second part for treatment,” explains Prof Roodt.

Their research enables the high-yield preparation of compounds containing multiple isotopes often present in very low concentrations. “This allows combining diagnostic isotopes such as technetium-99m (used in >80% of diagnostic patient studies worldwide) with therapeutic radioisotopes, such as rhenium-186 (used for bone cancer therapy), with ease. Many therapeutic radioisotopes do not have good diagnostic radiation; thus, by combining the two types of radioisotopes in one medicine, the oncologist can now clearly see where the therapeutic part is going and apply more effective treatment,” he says.

News Archive

Inaugural lecture: Prof Robert Bragg, Dept. of Microbial, Biochemical and Food Biotechnology
2006-05-17



Attending the inaugural lecture were in front from the left Prof Robert Bragg (lecturer at the Department of Microbial, Biochemical and Food Biotechnology) and Frederick Fourie (Rector and Vice-Chancellor).  At the back from the left were Prof James du Preez (Departmental Chairperson:  Department of Microbial, Biochemical and Food Biotechnology) and Prof Herman van Schalkwyk (Dean: Faculty of Natural and Agricultural Sciences). Photo: Stephen Collett
 

A summary of an inaugural lecture delivered by Prof Robert Bragg at the University of the Free State:

CONTROL OF INFECTIOUS AVIAN DISEASES – LESSONS FOR MAN?

Prof Robert R Bragg
Department of Microbial, Biochemical and Food Biotechnology
University of the Free State

“Many of the lessons learnt in disease control in poultry will have application on human medicine,” said Prof Robert Bragg, lecturer at the University of the Free State’s (UFS) Department of Microbial, Biochemical and Food Biotechnology during his inaugural lecture.

Prof Bragg said the development of vaccines remains the main stay of disease control in humans as well as in avian species.  Disease control can not rely on vaccination alone and other disease-control options must be examined.  

“With the increasing problems of antibiotic resistance, the use of disinfection and bio security are becoming more important,” he said.

“Avian influenza (AI) is an example of a disease which can spread from birds to humans.  Hopefully this virus will not develop human to human transmission,” said Prof Bragg.

According to Prof Bragg, South Africa is not on the migration route of water birds, which are the main transmitters of AI.  “This makes South Africa one of the countries less likely to get the disease,” he said.

If the AI virus does develop human to human transmission, it could make the 1918 flu pandemic pale into insignificance.  During the 1918 flu pandemic, the virus had a mortality rate of only 3%, yet more than 50 million people died.

Although the AI virus has not developed human-to-human transmission, all human cases have been related to direct contact with infected birds. The mortality rate in humans who have contracted this virus is 67%.

“Apart from the obvious fears for the human population, this virus is a very serious poultry pathogen and can cause 100% mortality in poultry populations.  Poultry meat and egg production is the staple protein source in most countries around the world. The virus is currently devastating the poultry industry world-wide,” said Prof Bragg.

Prof Bragg’s research activities on avian diseases started off with the investigation of diseases in poultry.  “The average life cycle of a broiler chicken is 42 days.  After this short time, they are slaughtered.  As a result of the short generation time in poultry, one can observe changes in microbial populations as a result of the use of vaccines, antibiotics and disinfectants,” said Prof Bragg.   

“Much of my research effort has been directed towards the control of infectious coryza in layers, which is caused by the bacterium Avibacterium paragallinarum.  This disease is a type of sinusitis in the layer chickens and can cause a drop in egg product of up to 40%,” said Prof Bragg.

The vaccines used around the world in an attempt to control this disease are all inactivated vaccines. One of the most important points is the selection of the correct strains of the bacterium to use in the vaccine.

Prof Bragg established that in South Africa, there are four different serovars of the bacterium and one of these, the serovar C-3 strain, was believed to be unique to Southern Africa. He also recently discovered this serovar for the first time in Israel, thus indicating that this serovar might have a wider distribution than originally believed.

Vaccines used in this country did not contain this serovar.  Prof Bragg established that the long term use of vaccines not containing the local South African strain resulted in a shift in the population distribution of the pathogen.

Prof Bragg’s research activities also include disease control in parrots and pigeons.   “One of the main research projects in my group is on the disease in parrots caused by the circovirus Beak and Feather Disease virus. This virus causes serious problems in the parrot breeding industry in this country. This virus is also threatening the highly endangered and endemic Cape Parrot,” said Prof Bragg.

Prof Bragg’s research group is currently working on the development of a DNA vaccine which will assist in the control of the disease, not only in the parrot breeding industry, but also to help the highly endangered Cape Parrot in its battle for survival.

“Not all of our research efforts are directed towards infectious coryza or the Beak and Feather Disease virus.  One of my Masters students is currently investigating the cell receptors involved in the binding of Newcastle Disease virus to cancerous cells and normal cells of humans. This work will also eventually lead to a possible treatment of cancer in humans and will assist with the development of a recombinant vaccine for Newcastle disease virus,” said Prof Bragg.

We are also currently investigating an “unknown” virus which causes disease problems in poultry in the Western Cape,” said Prof Bragg.
 
“Although disinfection has been extensively used in the poultry industry, it has only been done at the pre-placement stage. In other words, disinfectants are used before the birds are placed into the house. Once the birds are placed, all use of disinfectants stops,” said Prof Bragg.

“Disinfection and bio security can be seen as the ‘Cinderella’ of disease control in poultry.  This is also true for human medicine. One just has to look at the high numbers of people who die from hospital-acquired infections to realise that disinfection is not a concept which is really clear in human health care,” said Prof Bragg.

Much research has been done in the control of diseases through vaccination and through the use of antibiotics. “These pillars of disease control are, however, starting to crumble and more effort is needed on disinfection and bio security,” said Prof Bragg.

Prof Bragg has been working in close co-operation with a chemical manufacturing company in Stellenbosch to develop a unique disinfectant which his highly effective yet not toxic to the birds.

As a result of this unique product, he has developed the continual disinfection program for use in poultry. In this program the disinfectant is used throughout the production cycle of the birds. It is also used to ensure that there is excellent pre-placement disinfection.

“The program is extensively used for the control of infectious diseases in the parrot-breeding industry in South Africa and the product has been registered in 15 countries around the world with registration in the USA in the final process,” said Prof Bragg.

“Although the problem of plasmid mediated resistance to disinfectants is starting to rear its ugly head, this has allowed for the opening of a new research field which my group will hopefully exploit in the near future,” he said.

 

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