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Straits Times
2 days ago
- Health
- Straits Times
S'pore researchers to study stem cell transplants in brain for Parkinson's disease in novel trial
Researchers involved in the project include (from left) Professor Lim Kah Leong, President's Chair in Translational Neuroscience at the Lee Kong Chian School of Medicine; Associate Professor Prakash Kumar, head and senior consultant at the department of neurology at the National Neuroscience Institute (NNI); Professor Louis Tan, NNI's director of research; and Professor Tan Eng King, NNI's deputy chief executive officer for academic affairs. ST PHOTO: NG SOR LUAN S'pore researchers to study stem cell transplants in brain for Parkinson's disease in novel trial SINGAPORE - Researchers from the National Neuroscience Institute (NNI) are embarking on a ground-breaking project to transplant stem cells into the brains of those with early Parkinson's disease, in a bid to stop the disease in its tracks. Planning for the first-of-its-kind trial in Singapore is still under way, pending regulatory and ethical approvals. Researchers are hopeful that the phase one trial for the novel approach can begin in late 2026, with five to eight patients who are younger and facing complications with their current treatments. The project is being funded under a $25 million research grant awarded on May 28 to the institute by the National Medical Research Council for five years to study Parkinson's disease. The programme is called Singapore Parkinson's Disease Programme, or Sparkle. An estimated 8,000 people in Singapore live with Parkinson's disease, which happens when dopamine-producing cells in the brain progressively die. As dopamine levels fall, patients present symptoms such as tremors and stiffness, and slowed movement appears. There is no known cure for the neurodegenerative disease, which leads to difficulty with walking, balance, coordination and even speech. The idea of replacing brain cells killed off by Parkinson's with stem cells has been around for about four decades. The hope is that the transplanted cells, which have the ability to evolve into different types of specialised cells, can then start producing dopamine, reversing the condition. But progress was held back by ethical considerations and technical hurdles. Professor Tan Eng King, principal investigator for Sparkle and NNI's deputy chief executive officer for academic affairs, said that in the past, stem cells from embryos and foetuses were used, raising ethical concerns . There were also mixed results, as some transplanted cells did not end up producing dopamine, and led to adverse side effects like involuntary limb movements. With advancements in cell therapies in recent years, scientists are now able to convert a patient's own normal body cells, such as skin or blood cells, into stem cells. Using a patient's own cells is a better approach as it reduces the risk of the body's immune system rejecting the transplanted cells. Prof Tan said NNI has collaborated with Duke-NUS Medical School, Lee Kong Chian School of Medicine and A*Star to develop a proprietary method of converting a person's normal cells into stem cells. The therapy is currently undergoing final approval by the US Food and Drug Administration before it can be used for the trial. He added that researchers from other countries are also studying similar stem cell approaches for Parkinson's disease. The most successful group will be the one 'that is able to create a stem cell source from using a patient's own cells that contains almost 100 per cent dopamine-producing cells and nothing else', said Prof Tan. 'This is a very challenging endeavour and it is not something that anybody can do. We have developed the expertise, and we think that potentially, we can be one of the pioneers,' he added. After the stem cells are transplanted, patients on the trial will likely be monitored for about two years to evaluate the safety and effectiveness of the approach. Other than the stem cell trial, another initiative under Sparkle is an early screening programme in the community to identify those at high risk of developing Parkinson's disease. Prof Tan said he is optimistic that the screening programme can be rolled out by the end of 2025, and reach 10,000 people over the age of 55 in the next three to five years. Currently, in Singapore, there is no screening available to detect those at risk of developing Parkinson's disease. But Prof Tan said that based on previous research done by NNI, those who suffer from a loss of sense of smell, have rapid eye movement sleep disorder (where people act out their dreams) and a particular gene variant have a higher chance of developing the disease. The screening will involve a questionnaire, after which those whose results warrant a closer look will be invited to go for more detailed examinations like brain scans. Those who are identified as having a high risk of developing the disease will be introduced to interventions, including making lifestyle changes in areas such as exercise and diet. Prof Tan pointed out that Singapore has one of the highest life expectancies in the world. 'If you can reduce the risk of developing a neurodegenerative condition, then you can increase the amount of years that you can spend in healthier living,' he said. Join ST's WhatsApp Channel and get the latest news and must-reads.
Straits Times
5 days ago
- Health
- Straits Times
NNI, Lien Foundation roll out early palliative care for patients with neurological conditions
Palliative care patient Chia Shyh Shen (bottom) practising on a communication device with Tan Tock Seng Hospital staff on May 29. ST PHOTO: KUA CHEE SIONG SINGAPORE – The first time Mr Chia Shyh Shen experienced weakness in his right arm, he thought little of it. It was 2021, and the now-71-year-old was trying to change a ceiling light bulb at home. He could not hold his arm raised. At the time , he and his wife, Madam Tam Fee Chin, 70, attributed what they thought was temporary weakness to old age. But soon, M r Chia, who along with his wife was employed at a relative's gold jewellery shop in Johor Bahru, could not even lift a tray at work. Mr Chia was diagnosed in October 2021 with amyotrophic lateral sclerosis (ALS), t he most common type of motor neurone disease, which affects how nerve cells communicate with the muscles . In 2022, the Malaysian couple sought help in Singapore. There is no cure for ALS, which was formerly known as Lou Gehrig's disease. There are around 300 to 400 people living with ALS in Singapore. The condition is more common to individuals older than 50, and afflicts more men than women. Mr Chia is becoming weaker as his motor neurons – the nerve cells sending signals from the brain and spinal cord to the muscles, enabling movement – degenerate and die. He now has minimal mobility below the neck. And as his disease progresses, he will lose the ability to speak, eat and , finally, breathe. Mr Chia, however, remains cheerful, and is looking forward to future trips. His doctor at the National Neuroscience Institute@Tan Tock Seng Hospital, where Mr Chia is a patient, is helping to make sure this stays the case for as long as possible. While this may not sound like much , it reflects the transformation of care that is taking place there, particularly after NNI and the Lien Foundation rolled out in April 2024 a $6.8m five-year initiative to provide palliative care from diagnosis onwards. They call it NeuroPal, which stands for Neuropalliative Ecosystem of care. Prior to 2024, patients were referred to palliative care after experiencing advanced symptoms, said Dr Ang Kexin, a senior consultant at NNI, who has undergone training in palliative care. 'They came to me when they were bed bound or could not talk. Now they come earlier and can express their needs,' she said. 'We ask them about their hobbies... We anticipate their needs. We journey with them.' NNI and the Lien Foundation held a press conference on May 29 to announce NeuroPal and its aim of integrating palliative care into standard neurological care. It will go some way to help alleviate the suffering of patients living with ALS , dementia, Parkinson's disease and other complex brain, spine, nerve and muscle conditions. Palliative care patient Chia Shyh Shen (bottom) was diagnosed in October 2021 with amyotrophic lateral sclerosis, the most common type of motor neurone disease, which affects how nerve cells communicate with the muscles. ST PHOTO: KUA CHEE SIONG NeuroPal has screened nearly 2000 NNI patients with neurological conditions, of which 370 patients are given palliative care. NNI@SGH started the programme at one clinic in 2024. By the time NeuroPal ends in five years' time , it should have supported more than 3,600 NNI patients annually at TTSH and SGH, said NNI and the Lien Foundation. The hope is to expand it to other hospitals, and more community care partners. NNI specialists treat patients at seven hospitals across Singapore. With NeuroPal, patients are routinely screened for psychosocial issues and support can then be tailored for them, based on their distress levels. Associate Professor Adeline Ng, Senior Consultant, Neurology, NNI and NeuroPal co-lead, said they use a self-reported short questionnaire called the Distress Thermometer to understand what matters most to the patients. The initiative pumps funding into training and hiring more palliative care staff, including two psychologists, three medical social workers, four nurses and others. Palliative care patient Chia Shyh Shen (bottom) with Tan Tock Seng hospital staff (from centre-left) National Neuroscience Institute Senior Consultant Dr Ang Kexin, Principal Occupational Therapist Huang Huixin and Senior Speech Therapist Yong Xing Tong at the Centre for Geriatric Medicine, in Tan Tock Seng Hospital, on May 29. ST PHOTO: KUA CHEE SIONG Lien Foundation's CEO Lee Poh Wah said during the press conference that with the initiative, they want to dismantle the misconception that palliative care is only for the end of life. 'It's naive to frame neurological diseases as a battle to be fought at all costs... I think we need a more humane and humble approach to healthcare, one that acknowledges the complexities of living with serious illness.' Palliative care aims to help relieve the symptoms and stress of serious illness and support caregivers, and it can help to reduce unnecessary suffering when it is given early in the disease trajectory, he said. Neurological conditions often unfold as a long journey of progressive decline, where a patient suffers emotional distress and is gradually robbed of his or her independence. Among those who receive palliative care, 60 per cent are cancer patients, but cancer only accounts for 26 per cent of all deaths, he said. The hope is to train more healthcare professionals to deliver general palliative care, he added. Associate Professor David Low, Deputy CEO (Clinical), NNI, told the media that people often think of palliative care as something that is given at the terminal stages of life. But for neurological conditions, the care can start early, for instance, when a person is diagnosed with motor neuron disease. ALS patients typically live for around 3 to 5 years, but there are a lot of outliers, and Mr Chia is one of them, said Dr Ang. To help improve his quality of life, the NeuroPal team at NNI@TTSH regularly monitor him and recommend solutions to help him cope with the inevitable changes that the disease brings. They recently let him try out an eye-tracking device called Tobii, which will enable him to communicate with others or pick out videos to watch, and a tilted wheelchair that can support his neck. 'We are future-proofing him. With Tobii, he can learn it faster now because he can still communicate verbally,' Dr Ang said. With that wheelchair, should he opt to buy it, he can travel in greater comfort, she added. Join ST's WhatsApp Channel and get the latest news and must-reads.
Straits Times
10-05-2025
- Health
- Straits Times
Pompe disease took this musician's breath away
Mr Yeo Wee Chong, 36, plays the bass clarinet in a concert band but his late onset of Pompe disease had affected his breathing and hence his performance. PHOTO: RARE DISEASE FUND Medical Mysteries Pompe disease took this musician's breath away Medical Mysteries is a series that spotlights rare diseases or unusual conditions. SINGAPORE – Mr Yeo Wee Chong, 36, used to play the bass clarinet full-time in a concert band. His career as a musician was abruptly cut short, however, when he was diagnosed with Pompe disease at the age of 29. Pompe disease is a rare genetic disorder that can result in respiratory failure, a significant complication due to progressive respiratory muscle weakness, especially affecting the diaphragm. 'I became extremely drowsy and unable to focus properly. On the advice of my family doctor, I went to the emergency department. I was admitted to the ICU (intensive care unit) and subsequently intubated while the doctors figured out the root cause of my feeling poorly,' said Mr Yeo , who is currently between jobs. It took doctors another two to three weeks before they diagnosed his condition. Dr Yong Ming Hui, a consultant from the Department of Neurology at the National Neuroscience Institute at the Singapore General Hospital (SGH), told The Straits Times that affected patients lack the acid alpha-glucosidase (GAA) enzyme needed to break down glycogen. Glucose, the fuel used by the body's cells for energy, is normally stored as glycogen in the liver and muscles. In Pompe disease, glycogen builds up in the cells of certain organs and muscles, impairing their normal function. This leads to progressive muscle weakness, mobility problems and affected breathing. Mr Yeo was told he could not continue playing the bass clarinet because of the weakness of his diaphragm. 'This was a particular sore point for me as I was active in performing with bandmates and that was a big part of my social life and identity,' he said. 'But I accepted and recognised the situation, and just try to do my best with what I have on hand,' he added. Reported incidence of Pompe disease is around 1 in 40,000, with some literature citing it as 1 in 17,000 to 37,000 in Asia. Doctors said when Pompe disease starts at infancy, it usually progresses faster and with greater severity, compared to later onset when the patient is an adult. '(Infant patients) develop severe symptoms in the first few months of life. They classically have generalised weakness and loss of muscle tone, feeding difficulties, and continue to develop respiratory failure and require ventilator support. Important organs are also affected, leading to enlarged heart and liver,' Dr Yong said. Dr Yong Ming Hui (right), a consultant in neurology at the National Neuroscience Institute, was instrumental in diagnosing and treating Mr Yeo Wee Chong. PHOTO: RARE DISEASE FUND According to medical literature, some cases even develop enlarged tongues. 'If left untreated, the disease is fatal by aged one to two years,' she added. Adult patients with Pompe disease, on the other hand, have a less severe form that progresses gradually. 'The ages at which the symptoms start can even be when they are in their 60s, and the severity depends on the degree of the deficiency (of the enzymes). These symptoms can include difficulty in walking, the inability to perform sit-ups, exercise intolerance and fatigue, shortness of breath, and sometimes difficulty in swallowing,' Dr Yong said. Such adults generally do not develop heart failure or liver enlargement, but abnormalities of blood vessels in the brain have been diagnosed in a small number of patients, she added. On rare occasion, the latter can lead to a stroke. The life expectancy for adult patients with late onset Pompe disease varies with age of symptom onset and disease severity but it decreases in patients with respiratory failure. To diagnose the condition, Dr Yong said once when Pompe disease is suspected in a patient, a dried blood spot (DBS) test is performed to confirm abnormally low GAA enzyme activity in the patient. Then the diagnosis is confirmed with genetic testing. Adults get a diagnostic test called electromyography, where a small needle electrode checks muscle activity to confirm if there's a muscle damage. Sometimes, a muscle biopsy is used to diagnose Pompe disease, Dr Yong added. Mr Yeo's condition is currently managed by a team of doctors, nurses and allied health professionals from SGH including a team of neurology pharmacists who 'regularly communicate with me if there are any changes to my medication as well as preparing my bi-weekly infusions'. As his breathing was affected by the condition, he uses a bilevel positive airway pressure (Bi-PAP) machine at night, in case his airway gets blocked or he cannot breathe deeply when he sleeps. The Bi-PAP device pushes air into his lungs, to keep his airways open. He said the initial weeks in the ICU were the hardest. His condition had to improve so he could get off the ventilator. 'A tracheostomy would have been need if I was unable to do so – that was the most stressful part,' said Mr Yeo. Mr Yeo Wee Chong (second from left) with the multidisciplinary team from SGH that is managing his condition (from left) Dr Leow Leong Chai, a senior consultant from the Department of Respiratory and Critical Care Medicine, Dr Yong Ming Hui, a consultant of neurology with the National Neuroscience Institute and Ms Wong Pei Shieen, a senior principal clinical pharmacist. PHOTO: RARE DISEASE FUND He needs to be on medication and enzyme replacement therapy for life, which costs $55,000 a month. 'The added financial burden of such expensive treatment is an ongoing source of stress,' he said. 'Thankfully, the Rare Disease Fund now covers the costs of most of my medication. This has been an immense relief, as I can now focus on managing my health and maintaining my quality of life, without the burden of medical expenses that would have otherwise been beyond my means,' he said. RDF, a charity fund that is managed by the KKH Health Fund (KKHHF) and supported by the Ministry of Health, provides long-term financial support for patients with rare diseases and who require treatments involving high cost medicines. KKH and SGH are both part of the Singhealth group. Receiving RDF's help 'was a big milestone and is a big source of encouragement for myself', Mr Yeo said. 'As someone living with Pompe disease, managing the condition is already physically and emotionally demanding.' On a brighter note, he had regained enough strength to perform ad-hoc with the band again since 2023. Join ST's WhatsApp Channel and get the latest news and must-reads.
South China Morning Post
19-02-2025
- Health
- South China Morning Post
Why eating more miso, kimchi and other probiotics could ease your anxiety and depression
Germs in the gut can cause anxiety and other mental health troubles, according to Singapore-based scientists, whose findings suggest that probiotics could be a solution. Advertisement Tests on mice showed a 'crucial connection between gut microbes and anxiety-related behaviour', according to researchers from Duke-NUS Medical School and Singapore's National Neuroscience Institute. Published this month in the journal EMBO Molecular Medicine, the team's findings suggest that molecules involved in metabolism – the breakdown of food, drugs or chemicals to fuel the body – called indoles, which are produced by gut microbes, 'play a direct role in regulating brain activity linked to anxiety '. Probiotics are live bacteria and yeasts that have beneficial effects on your body. These species already live in your body, along with many others. Having more probiotic foods or supplements adds to the existing supply of friendly microbes and may restore the natural balance of bacteria in your gut when it's been disrupted by illness or treatment. Kefir is a fermented milk packed with powerful probiotics. Photo: Shutterstock
Jordan News
17-02-2025
- Health
- Jordan News
Yogurt: The Hidden Player in the Battle Against Anxiety and Stress - Jordan News
A recent scientific study conducted by researchers in Singapore has revealed that gut bacteria may be responsible for anxiety and mental health disorders, suggesting that probiotics could be a potential solution to these issues. اضافة اعلان Probiotics are beneficial bacteria found in certain foods and supplements that play a crucial role in supporting gut health and maintaining microbial balance. Yogurt and fermented milk are natural sources rich in probiotics, containing beneficial bacterial strains such as Lactobacillus and Bifidobacterium, which aid digestion, improve nutrient absorption, reduce inflammation, and may also help lower anxiety and stress levels, according to Al Jazeera Net. The Link Between Gut Microbes and Anxiety According to researchers from Duke-NUS Medical School and the National Neuroscience Institute in Singapore, tests conducted on mice demonstrated a significant link between gut microbes and anxiety-related behavior. Their findings, published in the EMBO Journal of Molecular Medicine, revealed that microbial metabolites called indoles, produced by gut bacteria, play a direct role in regulating brain activity related to anxiety. The research team emphasized that these findings open new possibilities for probiotic-based treatments to improve mental health, stating that they are already conducting clinical trials to test the effectiveness of such treatments. Dr. Patrick Tan, Senior Vice Dean for Research at Duke-NUS Medical School, explained that this study highlights the connection between microbiota, nutrition, and brain function. He noted that the findings hold tremendous potential for individuals struggling with stress-related conditions, such as sleep disorders or those unable to tolerate traditional psychiatric medications. Global Scientific Interest in the Gut-Brain Connection This study follows groundbreaking research from Harvard University and Massachusetts General Hospital, which identified a link between a specific type of gut bacteria and depression. Additionally, in January, a team of French and Italian scientists announced a major scientific breakthrough, using X-ray imaging to uncover processes that connect gut nerves to the brain—mechanisms that could potentially play a role in triggering Alzheimer's disease. These discoveries reinforce the growing body of evidence that gut health is intricately linked to mental and neurological well-being, making probiotic-rich foods like yogurt an essential component in maintaining a healthy mind and body.
