Newsletter No. 475

8 475 • 4.4.2016 ’ 口谈实录 Viva Voce 本刊由香港中文大学资讯处出版,每月出版两期。截稿日期及稿例载于 www.iso.cuhk.edu.hk/chinese/newsletter/ 。 The CUHK Newsletter is published by the Information Services Office, CUHK, on a fortnightly basis. Submission guidelines and deadlines can be found at www.iso.cuhk.edu.hk/english/newsletter/ . 蓝辉耀教授 Prof. Lan Hui-yao • 卓敏生物医学讲座教授 • 以「慢性肾脏病进展的机制及临床防治研究」 获颁2015年中华医学科技奖一等奖 • Choh-Ming Li Professor of Biomedical Sciences • Awarded First Prize in Chinese Medical Science and Technology Award for his project entitled ‘Research into the Mechanism and Control of Clinical Progression of Chronic Kidney Diseases’ 请简介你得奖的研究。 当人体组织纤维化,即有伤疤,会令组织结构受损,逐步丧失 功能,继而器官衰竭,如心、肺、肝及肾衰竭。我经多年研究, 发现TGF-β1/Smad信号传递在形成伤疤组织起了关键作 用。是次研究是与南方医科大学、东南大学、山东大学、中国 科学院昆明植物研究所及复旦大学合作,深入而系统化找出 导致肾纤维化的机制,期能对症下药。 研究确定在TGF-β1/Smad信号传递中一个名为Smad3蛋白分 子过多,是引致纤维化的原因,而本用以抵抗纤维化的Smad7 蛋白分子则丢失了。套用中医理论来说,是阳(Smad3)盛 阴(Smad7)衰所致。我们又发现存于常见柑橘类果皮的柚 皮素能有效抑制Smad3,常用的陈皮就含有柚皮素;而积雪 草酸则可刺激Smad7的产生,中医就以积雪草来活血消肿。 把两者结合入药,可望成为治疗慢性肾病的新法。 怎样想到应用中医理论来治疗? 根据我从事病理学研究多年的心得,「失衡」是致病主因。 中医理论基础是强调阴阳平衡,五脏六腑和谐协调,最切合 用于治疗「失衡」上。 相关研究去年也获国家教育部颁发高等学校科学研究优 秀成果奖,再次获奖,有什么感想? 研究既无止境,也无捷径。愈是研究,愈发现更多问题。获奖 不过是代表研究工作一个阶段的总结,而非终点,反倒是一 股动力,鞭策我开展下一阶段的研究。去年获得的优秀成果 奖,是校内团队的研究。今年获中华医学科技奖,则结合了中 大和内地多间大学研究团队的努力。 那么下一步的工作是什么? 我们计划把研究成果转为临床应用,研发抗纤维化的药物和 疗法,主力研究柚皮素和积雪草复方。研究过程中,我们亦发 现了TGF-β1/Smad信号传递的失衡是导致丧失抗肿瘤能力 的主因,揭示一个新研究方向─TGF-β1/Smad信号传递在 肿瘤微环境中的作用和机制。 什么原因促使你专注肾脏疾病的研究? 我在广州中山医学院毕业之时,肾脏科在内地还未发展为专 科,我应邀参与建立和发展肾脏科,由此从事肾脏病病理研 究。再说,肾病是威胁人类健康的主要疾病之一,晚期患者更 需要血液透析(俗称洗肾)或肾移植以延续生命,不容轻视。 念医科的你,为何不行医而以研究和教育为志业? 我在临床实践中,发现慢性疾病总是带有伤疤组织,可是,这 些伤疤如何形成,却仍然是一个谜。是以,我转战研究工作, 矢志要破解个中奥秘,以期研发有效的疗法。毕业后便开始 教书,深深了解到通过教学,才能把想法和理念传承下去,发 扬光大。故我定下「重研重教」为人生宗旨。我的研究团队成 员以研究生为主,从澳洲、美国至香港,二十多年来,已培育了 八十多位博士生及博士后研究生,当中不少已在世界各地的 专科领域中担任领导者角色。过往的研究取得佳绩,都是要 归功他们。看到他们的卓越成长,令我倍感欣慰,也是人生的 最大乐趣。 Please briefly introduce your award-winning research project. When fibrosis occurs in human tissues, the scarring that ensues can damage the tissues, causing them to gradually lose their functions. This is followed by organ failure, such as that of the heart, lungs, liver and kidneys. Through my years of research, I have found that TGF- β 1/Smad signalling pathway plays a critical role in tissues scar formation. This research project marks our collaboration with Southern Medical University, Southeast University, Shandong University, Kunming Institute of Botany of the Chinese Academy of Sciences and Fudan University. Together, we conducted an in-depth and systematic study to find out the mechanism of renal fibrosis, with the aim of finding the right treatment. Our research discovered that the cause of fibrosis is due to excessive Smad3 molecules in the TGF- β 1/Smad signalling pathway, while Smad7 molecules, a protector from fibrosis, are missing. From a traditional Chinese medicine (TCM) perspective, the cause can be attributed to an imbalance of a strong yang (Smad3) and a weak yin (Smad7). We also found that Smad3 can be inhibited by naringenin, commonly found in citrus peel. Asiatic acid, used by TCM practitioners to facilitate blood circulation and reduce inflammation, can stimulate Smad7 production. Combining these two in medicine can be expected to offer a new treatment for chronic renal disease. What made you think of applying TCM theory for treatment? Based on my pathological research over many years, ‘ imbalance ’ is the primary cause of disease. TCM theory emphasizes a yin-yang balance. Treatment for ‘ imbalance ’ can be achieved through harmonious coordination of the body’s vital organs. This research project received the Higher Education Outstanding Scientific Research Output Awards from the Ministry of Education last year. What does winning another award mean to you? There is no end or shortcut in research. The deeper you probe, the more issues you will uncover. Winning an award doesn’t signify an end in our work but is a driving force impelling us to embark on the next stage of research. The award we received last year was a recognition of the work of our CUHK research team, whereas the award conferred to the project this year honours the combined hard work of CUHK and several universities on the mainland. What will you be working on next? We plan to use our research in clinical practices to develop anti-fibrosis medicine and treatments, with a focus on formulating naringenin and Asiatic acid compound prescriptions. In the process, we discovered that TGF- β 1/ Smad signalling imbalance leads to the loss of the body’s tumour-fighting ability. This pointed to a new research direction—the function and mechanism of TGF β 1/Smad in the tumour microenvironment. What made you specialize in renal disease research? At the time when I graduated from the Zhongshan School of Medicine in Guangzhou, nephrology had not yet developed into a medical speciality on the mainland. Upon invitation, I became involved in setting up and developing the nephrology department and from then on, started to engage in nephrology research. Furthermore, renal disease is one of the major threats to human health. End-stage patients are required to undergo peritoneal dialysis (popularly known as cleansing the abdomen) or kidney transplant to prolong their lives. So this problem merits serious medical attention. As a medical graduate, why did you not choose to practise medicine but take up research and education as your lifelong career? In my clinical practice, I found that chronic diseases are invariably linked to scarred tissues, but how the scars are formed still remains a mystery. Subsequently, I switched to research work to unravel the causes, hoping to produce effective treatments from R&D work. After graduation, I started teaching and it made me realize that through teaching, I could pass on my insights and vision and magnify their impact. This is why I have incorporated a dual emphasis on research and teaching into my lifelong goal. Over the past 20 years, I have groomed over 80 PhD students and post-doctoral fellows in Australia, the US and Hong Kong. Many of them now hold leadership roles in specialist medical disciplines in various parts of the world. They must also be credited for the outstanding research work we produced together in the past. It is gratifying to witness their professional growth and excellent accomplishments and this is the greatest joy of my life. Photo by ISO staff

RkJQdWJsaXNoZXIy NDE2NjYz