understanding
the development of
renal failure
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In the body, hormones and hormone-like agents pass messages between cells and organs. These messages can either maintain health or, in disease states, aggravate the disease.

The hormones and hormone-like agents act on the outside of cells. The cells interpret the messages and react by producing complex networks of signal pathways inside the cell.

Because a single hormone or agent can induce a wide variety of outcomes, it is important that we identify the different signals inside the cell that regulate the different outcomes.

To this end, Lecturer Dr Mark Dockrell is supervising the work of Research Fellows Dr Magalakumar Veerasamy, Dr Reza Motazed and James Browne into the causes of Renal Interstitial Fibrosis(scarring of the kidneys) and collaborating with the work of Dr Mysore Phanish.

We know that continued scarring will eventually lead to chronic kidney disease.

Therefore, the research is aimed at finding out not only what causes the scarring but a way to safely stop, or considerably slow down, the formation of this damaging scar tissue.

 

Dr Mysore Phanish performed his PhD studies at SWTIRR under the supervision of Dr Dockrell and Professor Bruce Hendry of King’s College London from 2002-2005. He gained his medical degree from Jawaharlal Nehru Medical College, Karnataka University, Dharwar, India. He was awarded gold medals for first rank to the University in his 2nd and final year MBBS and for obtaining first rank to the University in General Medicine. He was awarded the Pfizer Postgraduate Medical Award & Medal by Pfizer Pharmaceuticals Ltd for the year 1991 and the Dr R R Joshi Gold Medal for best outgoing medical student of Karnataka University, India, awarded by the Indian Medical Association for the year 1992.

After obtaining his medical degree (MBBS) in 1992, he obtained an MD degree in General Medicine from one of the premier medical institutions of India, the Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh in 1996. He trained in Nephrology at the University Hospital of Wales, Cardiff, Bangor District General Hospital, St Helier Hospital and Guy’s Hospital, London. Dr Phanish is currently a consultant nephrologist at the St Helier Hospital, Epsom and St Helier University Hospitals NHS trust and Mayday University Hospital NHS Trust and Honorary Senior Research Fellow at SWTIRR.

Connective Tissue Growth Factor (CTGF CCN2) is a more recently identified protein that promotes scarring within the kidney. It is both a marker and mediator of kidney scarring. During his work at SWTIRR Dr Phanish was the first to identify CTGF production from human proximal tubule epithelial cells (PTECs). He later went on to dissect various cell signalling pathways that regulate the production of CTGF. He also studied cell signalling pathways regulating transition of tubule epithelial cells to scar producing myo-fibroblasts. The results from this work were published in peer-reviewed journals (Nephron-experimental nephrology and Biochemical Journal). He has also presented his work in several national and international renal meetings.

Dr. Phanish’s current work aims to investigate the effects of CTGF on human proximal tubule epithelial cells. He intends to investigate the mechanisms of pro-fibrotic effects of CTGF on human PTECs. In addition, he has recently obtained a grant from Johnson and Johnson (as a co-applicant with Dr. Dockrell) to study urinary markers in diabetic kidney disease.

 

Dr Mangalakumar Veerasamy did his medical training in Chenai, India at Madurai Medical College where he gained his medical degree (MBBS) in 1996 acquiring gold medals in medicine en route. He completed his MD at Madras Medical College in 2000 where he was 'Best Outgoing Student' of his class.

Dr Veerasamy will be joining Dr Dockrell working on the Genzyme Research Initiative Program (GRIP) funded project studying the role of Id proteins in determining renal epithelial cell fate. In other cell typed Id proteins have been demonstrated to have a pivotal role in regulating the behaviour of cells. Dr Veerasamy will be studying what regulates the expression of Id proteins in human renal epithelial cells, particularly after treatment with TGF-beta and BMP-7.

 

Dr Reza Motazed gained his BSc from St Mary’s Hospital Medical School in 1995 and his medical degree (MBBS) from St George’s the following year. Dr Motazed has an established association with St Helier hospital having worked as an SpR in the Renal Unit prior to coming to SWTIRR.

BMP-7 is locally acting growth factor which is very important for the correct development of the embryonic kidney and recently it has been identified as a possible treatment for kidney disease. The kidney is one of the few organs where BMP-7 is expressed in adults, but its function is not understood. Dr Motazed’s key area of research is the cellular effects of BMP-7 in the adult human kidney.

Among the areas he will be addressing are the potential for BMP-7 to regulate MAP kinase activation in the human proximal tubule cells and whether this relates to its ability to inhibit TGF-beta-induced fibrotic responses

 

James Browne completed his BSc at the University of Surrey in 2004 and his MSc in 2005. Previously, James had worked at SWTIRR in his sandwich year during his degree. James returned in October 2005 as the Epsom & St. Helier University Hospitals NHS Trust Research and Development Research Fellow to work with Dr Dockrell studying Erk5 activation in human proximal tubule cells.

Previously Dr Dockrell’s team were among the first groups to show the signalling molecule Erk5 existed in human proximal tubule epithelial cells and that it could be activated by the pro-fibrotic growth factor TGF-beta. This project expands that work to investigate whether Erk5 may have a role in the development in renal fibrosis and will also examine a potential role for Erk5 in diabetic nephropathy.

 

 
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