If you live in the Fraser Valley region of BC, just outside of Vancouver, you may no longer need to trek into the city to see an ILD specialist. Dr. Alec Campbell recently completed a two-year Robert Davidson CPFF Fellowship and is taking up a position with another respirologist at Surrey Memorial Hospital.
“It’s one of the fastest growing areas of the province and I’m very pleased to be joining a practice there,” says Dr. Campbell. “In addition to being more convenient for patients living in the Fraser region, it may also be closer than Vancouver for patients in other parts of the province.”
Dr. Campbell credits his mentors and colleagues at the University of British Columbia and the Interstitial Lund Disease (ILD) Program at St. Paul’s Hospital in Vancouver, for his increased confidence in caring for ILD patients and for expanding his research skills.
One Robert Davidson fellowship, two research projects
During his fellowship, Dr. Campbell undertook two complex research projects, both involving next-generation research applications.
AI (artificial intelligence) to interpret CT scans
The first project investigated artificial intelligence (AI) interpretation of subtle changes in CT scans of patients with SSc-ILD (systemic sclerosis ILD). In particular, he assessed what effect the measures of inspired (inhaled air) volume can have on different AI methods of looking at disease progression. You can read more about this study in the May 2023 issue of this newsletter. The results of this work have been submitted for publication and are being peer reviewed.
Genetic analysis of blood samples to aid in ILD diagnosis and treatment
Dr. Campbell’s second project analyzes the genetic signatures in blood samples from patients early in their disease to determine the combinations of genes that predict particular ILD disease, risks of progression and responses to treatment.
This study involved examining the molecular interactions within individual cells, a technique known as single-cell RNA-sequencing (scRNAseq). This has been used in end-stage ILD to understand the behaviour of the cells involved, but whether the technique can be applied to early-stage ILD is unknown.
Blood samples from about 35 patients with ILD early in their disease course, including a few healthy individuals of a similar age for comparison purposes, were tested using scRNAseq to find whether there are markers in the blood that could help diagnose ILD earlier, more reliably, and more safely than is currently possible.
Originally, Dr. Campbell had planned to use a new, cheaper test, but its reliability was not good enough, so a more expensive test was used, cutting the number of subjects to about half.
Early analysis of the results does not show clear cell markers that define which type of ILD, among those tested, the subject has, says Dr. Campbell. And we did not find a common genetic marker that suggests if their disease is going to progress.
“With so much variation in the population, and with the size of our sample, it was going to be a challenge to find genetic indicators,” says Dr. Campbell. “What these preliminary results do confirm for us is that how we ‘label’ the type of ILD is less important than the results of CT scans and individual histories and symptoms.
Still, smaller studies with less significant results do help expand our body of knowledge. “Going forward, the data from this study will be available for future researchers in Canada and abroad as technology progresses and becomes more affordable,” says Dr. Campbell.
The final analysis of the data should be completed soon and a manuscript submitted for publication shortly thereafter. We will keep you posted when it is published.
CPFF donors support the advancement of pulmonary fibrosis research and clinical care
As he transitions from a researcher in Vancouver to a clinician in Surrey, Dr. Campbell reflects on what the CPFF Fellowship has given him. “I’m very grateful to the donors to CPFF that have enabled me to learn and grow. I have made some great connections through my mentors and colleagues and I will continue to tap into their expertise during weekly MDD (multi-disciplinary discussions) for years to come.
“I’m more confident in managing my patients and I look forward to passing along my knowledge and research skills to residents in the hospital,” he says. “If nothing else, I hope to expose more young physicians to pulmonary fibrosis and encourage them to investigate further if they suspect ILD in their future patients.”