​Clinical research at the Faculty of Medicine and Health Sciences (FMHS) at Stellenbosch University (SU) received a boost when Drs Charles Kyriakakis, Jen Holness and Leigh van den Heuvel each received a four-year scholarship in the prestigious Clinical Research Programme of the Medical Research Council (MRC).

With this programme, the MRC aims to address the dearth of MB,ChB graduates that read for PhD research degrees in South Africa.

Dr Charles Kyriakakis

Dr Charles Kyriakakis, a cardiologist in the Department of Medicine, is doing research on tuberculous pericarditis (TBP). His project is interlinked with a large interdisciplinary research study on tuberculosis at the FMHS. 

With his PhD study, he aims to improve on current diagnostic algorithms that are reliant on biochemical markers to establish a diagnosis of TBP. He will also be looking at potential novel therapeutic targets against the disease. 

Kyriakakis said they plan to identify a host cytokine biosignature for TBP that will ultimately provide for the development of a point of care test to diagnose the disease.

Establishing a definite diagnosis of TBP is challenging, as the yield of acid fast bacilli in pericardial fluid specimens is poor, whilst mycobacterial culture is both slow and insensitive. Acquiring pericardial tissue for histological evaluation and mycobacterial culture previously required open surgical biopsy, proven to prolong hospital stay and increase patient morbidity. "Today, we are undertaking minimally invasive pericardial biopsies under local anesthesia, with which we have achieved an excellent procedural safety record," Kyriakakis said.

"My MMed project in this field led up to my PhD research. This work is unique in that we are the only unit in Africa making use of percutaneous (through the skin) pericardioscopy for directed pericardial biopsy, thereby avoiding invasive open surgical biopsy of the pericardium," he said.

Dr Jen Holness

Dr Jen Holness, a MRC Clinician Researcher in the Division of Nuclear Medicine, is researching estimated glomerular filtration rate (GFR) in two different Western Cape populations at Tygerberg Hospital and Red Cross War Memorial Children's Hospital respectively.

"It is well known that GFR is the best indicator of kidney function, but it is not feasible to measure it in all patients due to the complexity and expense of the test. Consequently, GFR is usually estimated from the blood creatinine concentration, but the equations that were developed for this purpose have never been validated in local populations," said Holness.

An accurate measure of renal function is essential in patients who have chronic kidney disease or are receiving medication toxic to the kidneys, for example chemotherapy or antiretroviral medication. It also forms an essential part of the medical screening for potential kidney donors.

"I want to ensure patients receive accurate test results," Holness said. "The earlier kidney damage is detected, the better the chance of slowing or stopping its progression."

Dr Leigh van den Heuvel

Dr Leigh van den Heuvel is a psychiatrist and a member of the research team investigating the link between neuropsychiatric disorders and modifiable risk factors for cardiovascular disease as part of the Shared Roots project.

Shared Roots is a multidisciplinary project in the FMHS, with Prof Soraya Seedat, the Executive Head of the Department of Psychiatry, as principal investigator, and is funded by a prestigious MRC Flagship Project Grant.

Van den Heuvel's PhD study is an ancillary study to Shared Roots. She is evaluating hair cortisol levels in participants of the study. "Hair cortisol may be a possible biomarker of chronic stress, reflecting cortisol secretion over longer periods of time," said Van den Heuvel. "Performing hair cortisol analysis in participants will allow us to evaluate the impact of chronic stress on the interaction between neuropsychiatric disorders (NPDs) and the metabolic syndrome (MetS)." 

According to Van den Heuvel, evidence has shown that stress can negatively affect the heart, particularly in mood and anxiety disorders, which carry a significantly raised risk for cardiovascular disease.