The countdown for the 2015 World Congress of Dermatology (WCD) in Vancouver continues—only one week to go. The meeting, scheduled for Vancouver starting June 8, will offer presentations by Canadian and international experts in dermatology and other related clinical fields. Following are highlights from the five keynote lecturers that delegates will be able to attend.
How the data revolution will change the scientific method
Data scientist and physician Dr. Atul Butte, is scheduled to discuss his work and research that makes use of the “data driven revolution” during a plenary session on Tuesday, June 9.
Dr. Butte, chief of the Division of Systems Medicine and associate professor in pediatrics, medicine, and by courtesy computer science at Stanford University and Lucile Packard Children’s Hospital in Palo Alto, Calif., told The Chronicle of Skin & Allergy that his primary goal is to communicate that this is an exciting time to be in science and research because there is so much information available online. Dr. Buttee added that medicine in the future is going to require doctors to have a much greater understanding of DNA sequencing and data analysis—or precision medicine.
“The DNA and analysis are there and today we would never expect a radiologist to interpret radiology images by just looking at ones and zeros on a computer file. We give them tools to analyse this data, and it is the same thing with precision medicine,” Dr. Butte said.
“In dermatology, whether it is apps to look at moles, whether it is genome analysis to try to figure out someone’s risk for psoriasis, we are not expecting physicians of the future to do this all by themselves, but to be ready for the world with tools and to learn how to use those tools to help patients.”
In 2012, Dr. Butte gave a TEDMED talk where he discussed his work using an online marketplace for scientific and pharmaceutical research services (assaydepot.com) to determine new uses for already available drugs (i.e., drug repositioning) such as an anticonvulsant (topiramate) as a therapy for Crohn’s disease.
“Finding new uses for drugs, especially connecting a rare disease to a commonly treated disease makes me feel good about the future of how we can suggest therapies in the future for our patients. But the idea is that we as scientists now have to share our data to get to predictions and drug uses like this,” said Dr. Butte during his TEDMED talk.
Treatment as Prevention: Building on the HIV experience to promote healthcare sustainability
Dr. Julio Montaner, the director of the BC-Centre for Excellence in HIV/AIDS, a professor and head of the Division of AIDS at the University of British Columbia in Vancouver, will be giving a plenary session on Wednesday, June 10, on his Treatment as Prevention (TasP) strategy.
“Since 1996, when we discovered [highly active antiretroviral therapy or HAART as a therapy for HIV], we were able to deploy that in the community and we saw significant decreases in morbidity and mortality, but then unexpectedly we also saw that the treatment was uniquely able to decrease the likelihood of transmission of an HIV-infected person to his or her peers,” Dr. Montaner told DERM.city. “We became interested in [HAART] HIV treatment as prevention approach.”
Dr. Montaner said the TasP’s “seek and treat” approach calls for proactive testing of the community at large and proactive engagement of people on treatment through support. The method involves a slight increase of investment upfront with a long term “dramatic return on investment.” He has been sharing TasP with his colleagues in other fields for the goal of it becoming the cornerstone for a disease elimination strategy.
“I welcome the opportunity to discuss this with our dermatology colleagues, first because it is an interesting story . . . and there were multiple . . . skin related complications of HIV that unfortunately my colleagues saw and hopefully they do not see anymore because our strategy has been so successful. So I suspect that they would be interested in knowing about this from that perspective. But beyond that, we would like them to start thinking, ‘is there anything in the repertoire of the diseases that we will deal with that would be amenable to this type of treatment?’”
In Dec. 2014, Dr. Montaner was appointed an Officer of the Order of Canada. “Being a foreign graduate who has been here for about 30 years, this kind of recognition from my adopted country really means twice as much to me,” he said.
Autoinflammatory Syndromes and the Skin
On Thursday, June 11, Dr. Daniel Kastner of the Division of Intramural Research at the National Human Genome Research Institute in Bethesda, Md., will be presenting a talk on a group of related genetic disorders that impact the innate immune system and can produce cutaneous manifestations, as well as other issues, and can potentially be fatal.
“The autoinflammatory diseases are a group of disorders in which people have seemingly unprovoked inflammation that can be either systemic or localized without the high titre antibodies or antigen-specific T-cells that we would usually see in the more classic autoimmune diseases,” says Dr. Kastner.
Dr. Kastner and his colleagues proposed the concept of autoinflammatory disease in 1999 after they discovered a new disease they called TRAPS: TNF Receptor-Associated Periodic Syndrome. TRAPS, as well as other autoinflammatory diseases, such as the recently-described DADA2 (Deficiency of ADA2) are associated with a recurrent fever, migratory skin rashes, severe abdominal pain, severe chest pain, arthritis, as well as other manifestations. “Some of the patients go on to develop kidney failure from a build-up of some inflammatory proteins of the kidney,” says Dr. Kastner.
The doctors who attend the plenary session can hope to “take away an understanding of the concept of autoinflammatory disease and its relationship to the different branches of the immune system,” says Dr. Kastner. “They will take away some understanding of how new genetic approaches can lead to the discovery of the genes that can cause these diseases. Thirdly, that they will have at least the familiarity with some of the cutaneous manifestations of at least some of these diseases.”
And finally Dr. Kastner says he hopes the audience will come to gain an understanding of the pathogenesis of these diseases and, in some cases, the possible treatments.
Because of the cutaneous manifestations associated with these autoinflammatory diseases, dermatologists may be the first physicians to encounter these patients, says Dr. Kastner. As a result, familiarity with these manifestations and thinking about them as part of a differential diagnosis, and knowing which genetic tests to request in the presence or absence of an autoinflammatory disease, could make a significant difference in patient outcomes.
“Some of the patients that we see with this disease DADA2 can have strokes at the age of two, so it is a serious thing,” says Dr. Kastner. “And a dermatologist who recognizes that early on and makes the diagnosis and recommends getting the patient on treatment that can make a huge difference in their lives–not only of the patients, but of their families as well.”
Role of stem cells in dermatology
Professor and investigator Elaine Fuchs, PhD, will be presenting details regarding her research relating to the role of stem cells in dermatology, during a plenary session at the WCD on Friday, June 12, 2015.
“I am excited about having the opportunity to present at the World Congress of Dermatology in Vancouver,” said Dr. Fuchs, a Rebecca Lancefield Professor in Mammalian Cell Biology and Development at The Rockefeller University and Investigator, Howard Hughes Medical Institute at Columbia University in New York, NY.
“My research for many years has been on the basic science of skin biology. For a long time now, my colleagues and I have had a strong interest in taking our work to the level where it would be of interest to dermatologists who would be able to take our work the next step and hopefully develop new and improved diagnostic and therapeutic tools with clinical applications,” Dr. Fuchs told DERM.city.
Dr. Fuchs said that much of her recent work has centered on identifying, characterizing and understanding stem cells that exist within the skin ranging from the stem cells of the epidermis, hair follicles and sweat glands.
“We have had a long standing interest in understanding the basic biology behind how stem cells function. We began to realize that stem cells play an absolutely critical role in not only maintaining the sort of wear and tear that we subject our skin to on a daily basis but also in terms of repairing wounds,” said Dr. Fuchs.
Ultimately, without functional stem cells, wounds do not repair as well, she noted.
“It turns out that this basic ability of stem cells to make and repair tissues is the very mechanism that cancers use in their malignant transformation. And so we have learned that both basal cell carcinoma and squamous cell carcinoma have hijacked certain fundamental principles that normal stem cells use to repair wounds and we must keep those mechanisms in order to repair wounds,” Dr. Fuchs added.
“We have also learned that the stem cells in cancer are very different than the stem cells in normal skin. We are now developing methods where we can hopefully come up with some avenues for new and improved methods of diagnosis and therapies for these different types of non-melanoma skin cancers.”
Skin Cancers and Viruses: Lessons from Kaposi’s sarcoma and Merkel cell carcinoma
On Saturday, June 13, Dr. Patrick S. Moore, co-discoverer with Yuan Chang of two of the seven known human cancer viruses (Kaposi’s sarcoma herpesvirus (KSHV/HHV8) and Merkel cell polyomavirus (MCPyV)), will be giving a plenary talk on the causal role of newly discovered viruses in cancers in the skin. He will also discuss a number of recently discovered viruses associated with skin diseases. Dr. Moore is a Distinguished Professor in the Department of Molecular Microbiology and Genetics at the University of Pittsburgh, and Director of the Cancer Virology Program at the Hillman Comprehensive Cancer Institute.
Attendees will hear how the advent of new technologies, such as genomic sequencing, have empowered scientists to uncover hundreds of new viruses that are resident in human skin and other tissues that the medical community had previously been unaware of, says Dr. Moore.
In the last year or two, says Dr. Moore, a large number of these viruses have been discovered to be associated with various diseases, particularly in immunocompromised patients. The identification of these pathogens “suggests there is a large number of viruses that we are continuously exposed to that may be causing some of the idiopathic diseases that occur in dermatology populations,” says Dr. Moore.
“Many of these viruses could be the causes not only of rare cancers such as the ones I’ll be talking about . . . but also may be the cause of much more common diseases which we’ll learn about in the future as we continue investigating these hundreds of viruses that have been found,” says Dr. Moore.
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