Guest Blog: Creating and developing peptides to treat bacterial corneal infections
It’s a great honour to write a blog for Fight for Sight as one of the first recipients of the jointly funded Fight for Sight / John Lee, RCOphth Primer Fellowship Award. I’m a final year ophthalmology specialist registrar from the North East, with a clinical and research interest in the cornea – the transparent front window of the eye. Here’s a short story about a medical student discovering his vocation as an ophthalmologist.
I was born in Malaysia and I started my undergraduate medical degree at the age of 16 in International Medical University (IMU). After completing 2.5 years of education in IMU, I had the opportunity to complete my remaining 3 years of study at the University of Edinburgh. As with all medical students, I was exploring each medical and surgical specialty. It wasn’t until my 4th year that I found my vocation in ophthalmology. It’s a highly rewarding specialty where you are given the privilege to improve or even restore the patients’ sight – one of the most important senses. I still remember the first time watching an awe-inspiring corneal transplant surgery where the ophthalmologist removed the diseased cornea and replaced it with a healthy donor one to restore the sight of the patient. Ophthalmology is also one of the very few specialties that offers the best of both worlds, in which one could practice both medicine and surgery. I decided to pursue ophthalmology as my lifelong career and I’ve not looked back!
In a day-to-day clinical practice, the eye conditions that I mainly deal with range from common conditions like dry eye disease, blepharitis, keratoconus to sight threatening conditions such as corneal infection. In some cases of refractory corneal infection, patients may end up losing their vision and potentially the entire eye. And this is the main reason why I have developed my corneal research interest, especially in corneal infection, because I feel as though there is still a lot of research that needs to be done to help these patients and to improve their vision and quality of life.
Why have I chosen the clinical academic path?
Being a clinical academic allows me to enjoy the best of both worlds. As a clinician, I enjoy chatting with my patients, as I have the opportunity to treat and manage them directly. However, it can be frustrating for the clinicians when, despite medical and surgical efforts, the patients continue to lose their sight. This is when research comes into play. Being a clinician allows me to identify the pressing clinical issues or unmet needs for treatment in a particular medical area and, as a researcher, I could help advance the medical knowledge – be it developing a new diagnostic test or a new drug – ultimately helping thousands more patients in the real-world setting.
I discovered my interest in research when I was a final year medical student working on my first research project. It was on a review paper looking at visual neglect following stroke. It was through that project I learnt how research has advanced our understanding of the human body, and improved the management and outcome of the disease. I’ve also learnt that there are still a lot of unknowns in medicine. After one year of hard work and reading through almost 200 papers, I have finally managed to publish my first paper in the Survey of Ophthalmology as a Foundation Year 1 doctor. I was thrilled when the paper was accepted for publication and it was that early experience that has motivated me to become a clinical academic. Since then, I have proactively participated and led many research projects during my ophthalmology training years, and recently I led the ophthalmology trainees in the region in publishing the first two peer-reviewed papers under the umbrella of our trainee-led research network.
Use of antimicrobial peptide for ocular surface infection
Corneal infection is the most common cause for corneal blindness in the world and recently there has been a growing concern about antimicrobial resistance in eyes and other parts of the body. Our work aims to create and develop novel antimicrobial peptides for treating bacterial corneal infection. Antimicrobial peptides are important components of our immune system and they have recently shown promise as a potential antimicrobial treatment due to their unique antimicrobial ability against a wide range of organisms with low risk of resistance.
Therefore the successful development of these drugs will open up an exciting therapeutic avenue for infection because they could be potentially be used in other types of infection, such as fungal and acanthamoeba infection, for which the treatments are currently limited. Development of these drugs may also offer a potential solution to antimicrobial resistance, which is currently an emerging global threat to human health.
Primer Fellowship Award
As a clinical specialist trainee like myself, the two main barriers for conducting research are the lack of time and funding. Clinical trainees often do not have much protected time for doing research and, so far, most of my research work is carried out in the evening after work, weekends or even during my holidays. In addition, funding is usually a main issue and funders are always looking for researchers who have an established track record to ensure that they can deliver. So to secure funding as a junior clinical researcher is always challenging.
This Primer Fellowship award is an important stepping-stone in my research career because for the very first time, I will have a ring-fenced time to focus on research and to work with an established group of researchers. I would like to take this opportunity to thank my supervisors, Professor Harminder Dua and Dr. Imran Mohammed in Nottingham, for guiding me through this research fellowship proposal, and Fight for Sight and the Royal College of Ophthalmologist for giving me this amazing opportunity to realise my ambition as a clinical academic.