Ask MEDICUS

 

Ask MEDICUS

From questions on medical education to research on diabetes and COVID-19 variants—you asked—and we answered! So, in this latest issue of MEDICUS, our experts are back and ready to answer your burning questions again: how long is a career in medicine, how are 2D images converted to 3D images and can we use CRISPR to treat various forms of cancer.

Experts from our Signature Research Programmes and Research Centres as well as our clinical specialists and faculty are here to share their expertise and perspectives. We welcome all your questions and will focus on those that intrigue and where our experts can provide the most meaningful insights and answers.

So, continue to send us your burning questions and we’ll sate your scientific curiosity.



postgraduate Medicine

How long is a career in medicine? And are there scholarships for foreigners?

@briana_alarcon16

A career in medicine may continue for as long as one remains committed to it. There are many different paths that a medical career may take, apart from the typical clinical route. Many doctors have expanded their horizons into medical education, research, healthcare management and leadership, innovation, entrepreneurship, public and global health, and even healthcare advocacy.

What is needed is a passion for improving the health and wellbeing of people, a willingness to explore new and different frontiers, and a commitment to pursuing excellence in how we care for and help our patients. Limitations exist only when we cease to dare to dream, learn and try.

Our cosmopolitan city embraces diversity—which is vital for our ongoing growth and development, advancement and ability to provide the highest standards of healthcare regionally.

To that end, we warmly welcome students from all over the world to join us and be a part of our vibrant healthcare community. To find out more about the various financial aid schemes that are available at Duke-NUS, please visit our page here or get in touch.


- Dr Suzanne Goh, Assistant Professor and Associate Dean for Student Affairs




Zika virus particles

How do 2D images convert to 3D during modelling? Are there any pretty images to share?

@adrianncz

Recent advances in technology have enabled scientists to study biological samples ranging from viruses to purified cellular structures like ribosomes and even whole cells—down to the atomic level by reconstructing three-dimensional (3D) models from 2D images captured using cryo-electron microscopy (cryo-EM)—a powerful modern tool of structural biology, which makes use of a specially designed electron microscope.

First, the 2D images are scanned to select our objects of interest—for example, Zika virus particles. This crucial step is usually done by the scientist with the help of a software, which selects many particles in order to capture sufficient information to reconstruct the 3D image. Next, the selected particles are further sorted into groups of similar shapes and sizes.

Details from the selected images are then extracted and analysed using special computer algorithms to build a 3D map of the virus particle, enabling scientists to zoom in on intricate details such as the protein backbone or side chains on the virus at a very high resolution.

Using this method, our group has successfully applied this highly computationally-demanding technique to obtain 3D structures of the Zika virus.

3D structure of a mature Zika virus

3D structure of a mature Zika virus

Zika virus with antibodies bound to its surface

Zika virus with antibodies bound to its surface


- Dr Victor Kostyuchenko, Senior Research Fellow from the Emerging Infectious Diseases Programme, Laboratory of Virus Structure and Function




CRISPR

Can we use CRISPR as a general therapy to treat various forms of cancer? 

@alt_f03_13

CRISPR is a cutting-edge technology that enables researchers to manipulate genes and RNAs in eukaryotic cells such as cancer cells. While this revolutionary technology is now a common experimental procedure in laboratories worldwide, only a limited number of CRISPR-based clinical therapies have progressed into clinical trials, especially for certain diseases with known gene mutations such as sickle cell disease and transthyretin amyloidosis. However, most of these trials still focus on the safety and feasibility of CRISPR-based treatment strategies rather than the efficacy. While some of these trials have shown promising clinical outcomes, none of these therapies have been approved by FDA so far for use in cancer therapy.

Currently, almost all CRISPR-based cancer treatment trials in human patients are developed based on immunotherapy, e.g., CRISPR knockout of PD-1, a checkpoint in immune cells such as T cells or CAR T cells. Whether these CRISPR-based immunotherapies are able to replicate the success of antibody-based immune checkpoint inhibitors that have worked in multiple cancer types remains to be answered.

Lastly, although CRISPR has equipped us with a tool for modulating many (if not all) targets of existing anti-cancer agents as well as undruggable targets, delivering the CRISPR system only to cancer cells in the body remains challenging. Many hypotheses, possibilities as well as concerns surround the use of CRISPR in cancer treatment and we will need more time and effort to carefully explore its potential.


- Dr Zhong Zheng, Research Fellow from the Cancer & Stem Cell Biology Programme, Laboratory of Molecular Cancer Biology