Interview | News & Analysis
Interview with Chi-Chao Chan
Chi-Chao Chan, an American board certified ophthalmologist, is the Chief of Immunopathology Section, Laboratory of Immunology and the Head of Histology Core at the National Eye Institute at National Institutes of Health (USA). In 1967, Dr Chan graduated from Chungzhan Medical College in Guangzhou, China and then earned her AB (1972), as well as MD (1975) at Johns Hopkins University (USA). Currently, her research is focusing on primary intraocular (vitreoretinal) lymphoma; uveitis (intraocular inflammatory diseases); and the molecular pathology, animal models, and genetic epidemiology of age-related macular degeneration. Dr Chan spoke to Future Medicinal Chemistry, about the challenges ophthalmic research faces and how the aging population could lead to better drugs. Interview conducted by Isaac Bruce, Commissioning Editor.
QQ In
your opinion, how do you think the area of ophthalmic therapeutics changed over the past few years? I became interested in ophthalmic therapeutics during my ophthalmology residency at Stanford Medical Center (1976–1979) and have seen some changes and major breakthroughs over my career. Over the past few years, several novel therapies based on translation research have been developed; for example, topical cyclosporin (Restasis®) for keratoconjunctivitis sicca (dry eye disorder), a prostaglandin analogue (Xalatan®) for glaucoma (an eye disease that damages the optic nerve in a unique pattern mostly due to increased intraocular pressure) and anti-VEGF agents (Lucentis® and Avastin®) for neovascular age-related macular degeneration (AMD; an eye disease that affects elderly and results in a loss of central vision due to damage to the center of the retina – the maculae). QQ Please
can you update us on some of the research activities that your group is currently engaged in? We have been testing different molecules for their effects on AMD-like retinal lesions in our mouse model. Novel drug-delivery systems (e.g., long-term sustained-release implant), gene therapy and stem cell therapy are the key areas that show the most promise and our group will investigate these further in our ongoing research efforts.
Chi-Chao Chan National Eye Institute at National Institutes of Health, 10 Center Drive, 10/10N103, Bethesda, MD 20892-1857, USA E-mail:
[email protected]
QQ How
do you believe the pharmaceutical industry will change with respect to ocular drugs for eye disorders among aging populations? I feel that the pharmaceutical industry will generate large revenues with respect to ocular drugs in the next decades for the prevention and treatment of aging eye diseases such as AMD, glaucoma, diabetic retinopathy (retinal damage associated with diabetes) and keraoconjunctivitis sicca. With an aging population, these diseases will become more prevalent and I anticipate that the pharmaceutical industry will invest in R&D for novel therapies and will benefit from drugs currently on the market as well as those in development. QQ The
use of angiogenesis inhibitors, such as those that target the VEGF signaling pathway, are becoming an emerging trend in treating certain forms of eye-related disorders. What current therapies are available for ocular angiogenesis? Current therapies for ocular angiogenesis include a range of VEGF inhibitors including antibodies and antisense oligonucleotides/siRNA. Other angiogenesis inhibitors target PEDF over expression and matrix metalloproteinases. Angiostatic steroids are also available for treatment of ocular diseases. With regards to the future of angiogenesis inhibition, I believe that gene therapy may be featured in years to come and diseases such as neovascular AMD will greatly benefit from the use of this therapy type as well as sustained-release ocular implants and RNA interference technology. 10.4155/FMC.12.171
Future Med. Chem. (2012) 4(17), 2139–2140
ISSN 1756-8919
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News & Analysis | Interview Of course, the use of the drug bevacizumab (an angiogenesis inhibitor) was revoked in 2011 by the US FDA in the treatment of breast cancer due in insufficient evidence for safe and effective use. Large-scale clinical trials and long term follow-up are required in order to see if it is possible to use such therapy for ophthalmic conditions. QQ What
words of encouragement would you give young scientists who might be envisioning a career in the field of ophthalmology with respect to therapeutics? And what are the main obstacles that research in this field of will face in the next 5–10 years? To become a physician scientist in this field, you should have an interest in translational research, and conducting and, most importantly, learning from clinical trials. For young scientists in basic eye research, the mechanisms for major ocular diseases are still unclear. A mindset on disease mechanism and therapeutics will greatly propel the field of ophthalmology. One of the main obstacles is research funding. There are many ways in which this issue can be resolved and of the best steps to overcome this would include greater cooperation among government and the private sectors of pharmaceutical companies and private foundations. Acknowledgements XK Chu provided assistance with English editing of the article.
Financial & competing interests disclosure C-C Chan is Chief of Immunopathology Section, Laboratory of Immunology and the Head of Histology Core at the National Eye Institute at National Institutes of Health. The author has no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. No writing assistance was utilized in the production of this manuscript.
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Future Med. Chem. (2012) 4(17)
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