Dr Paidamoyo Gwiti
Dr Paidamoyo Gwiti
Pathological Society Bursary
January 2018
Conference Report:
It was a great honor to be awarded a travel grant to attend the Joint Meeting with the Royal Society of Medicine 209th Scientific Meeting of the Pathological Society of Great Britain & Ireland on January 25th-26th where I was presenting as a poster and oral “rapid fire presentation” on the work we are doing on investigative the value of elevated betahydroxybutyrate at autopsy.
I arrived on the eve of the conference and was comfortably accommodated in central London. The conference kicked off at 0830hrs on the 25th of January with registration. I then picked up my poster “Significant Ketoacidosis At Autopsy: A Single Centre Systematic Review.
Professor AM Flanagan, who I had the privilege to meet during the meeting opened the meeting and introduced the first keynote speaker, Prof YMD Lo from Hong Kong who introduced the basis of epigenetics of disease dating back to groundbreaking work done on observing the methylation of foetal DNA in maternal circulation and updated the audience on the applications in ecclampsia, the napsin gene, RASSF1A gene hypermethylation, discovering unexpected results e.g. occult malignancies.
This was followed by Prof D Capper (InstitutfürNeuropathologie, Charité-Universitätsmedizin, Berlin, Germany) who presented on the epigenetic testing for brain tumour diagnosis especially in cases with similar, usually undifferentiated morphology where immunohistochemistry alone may not be useful. It was enlightening to learn of how methylation profiling is now subclassifying neoplasms such as medulloblastomas and preliminary data seems to explain the differences in biological behaviour.
Following this, Professor C Bock (CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria) whose talk on the use of bioinformatics for personalised medicine was excellently delivered. He spoke on the use of mathematics remodelling to predict the site of origin of a cell using epigenetic signatures and how this could be used in investigating metastatic neoplasms of unknown origin. He also expanded on the potential role of epigenetic to identify resistance early and perhaps switch chemotherapy before tumours have developed complex mechanisms of evading therapy, as has been used in HIV antiretroviral therapy.
The plenary oral presentations included outstanding talks including molecular pathology of infant gliomas, clonal evolution of colonic adenomas and carcinomas, scientific evaluation and redefining of what an “expert pathologist” is, using “Features Predictive of Diagnostic Concordance at Expert Level Amongst a Large International Sample of Pathologists Diagnosing Barrett’s Dysplasia”.
I got the chance to present my poster during the lunch period and met Prof S Fleming, Dundee and Dr A Freeman, London.
After lunch, Prof Stephen Baylin gave a keynote presentation on “Overview – The Role of Epigenetics in Cancers”. He highlighted the significance of epigenetic on the initiation and progression of cancer. His work on CHD4 epigenetic abnormalities in wild type and knock out mice and the biological behaviour of colorectal carcinoma was instructive. He also touched on the potential of regulating the epigenome and potentially reversing aberrant epigenetic methylation using PARP inhibitors. This was followed by Prof Manon van Engeland, Netherlands who explored the potential of using methylation markers in the clinic.
The afternoon symposium was concluded by Dr Amy Webster who discussed the discussed the work they are doing with volunteers on personalising the epigenome and using this to predict risk.
This was followed by the “rapid fire presentations”, where I was one of the 6 presenters. The talks were wide ranging and included work on genomic and epigenetic studies in malignant bone neoplasms, use of galetin 7 in studying DCIS and in-situ mutation detection maps in the clonal architecture of colorectal neoplasms.
I attended the Path Society conference dinner where I interacted with high quality researchers, including people working in her group at UCL.
The highlights of the second day included the update on the "The lung TRACERx" study that aims to track the evolution of non-small cell lung cancer from diagnosis to relapse and to determine the relationship between intratumour heterogeneity and clinical outcome. This groundbreaking work also aims to identifying patterns of metastatic disease, potential mechanisms of drug resistance and exploring in greater detail the process of tumour evolution.
Dr David Adams demonstrated, in his talk that great progress has been made in understanding the somatic genetics of melanoma and in explaining why some people are more likely to develop the disease including the latest technology for analysing cancer genomes and the use of gene-editing to study melanoma in human cells and mice.
From a microbiological point, Prof Judith Breuer, UCL presented how they are using metagenomic-sequencing technologies to pathogen detection and discovery in brain biopsies obtained from cases of encephalitis for which conventional methods have not yielded a diagnosis.
The main highlight was from the last speaker, Prof Tim Spector, King College London, who presented his work on microbiomes, emphasising that this, indeed is and organ is key to our digestion, appetite, mood, metabolism, and control of our immune system. He wowed the audience with his groundbreaking work on twins, microbiome, metagenomes and metabolomics and massive potential application. The take home message was that every medical professional needed to know about maintaining a healthy microbiome from birth to death.
Overall, this was an extremely well planned scientific conference, full of high quality research and leading speakers in the application of epigenetics in understanding diseases and treatments. Once again, I am very grateful to the Pathological Society for their generous travel grant. I look forward to attending and presenting at future meetings.
Dr Paidamoyo Gwiti.
Histopathology ST4
North Bristol NHS Trust.