For many years, the Angelo King Medical Research Center at De La Salle Medical and Health Sciences Institute (DLSMHSI) has been a pillar of excellence in the field of research. Inaugurated in 1994, it prides itself on being “a home for like-minded individuals to promote research,” said Vice Chancellor Dr. Charles Yu.
It has earned many recognitions both locally and abroad as a research center that is committed to providing consistent quality service “for the welfare of the people of Cavite, the country and global community in general.” They are best known in the medical world as one of the major researcher centers that is into new ways of treating tuberculosis. DLSMHSI is the only Clinical Research Site (CRS) in the Philippines that is recognized by the AIDS Clinical Trial Group (ACTG) of the US – National Institutes of Health’s National Institute of Allergy and Infectious Diseases (NIAID). As a CRS, it is under the Emory University-Center for Disease Control Clinical Trial Unit in Atlanta, Georgia.
DLSMHSI is also at the forefront of the pursuit of the public health research agenda of the Philippine Council for Health Research and Development (PCHRD) of DOST, with the Center conducting the most number of clinical trials in the country. It is also the host of Region IV’s Health Research and Development Consortium, with one of its lead researchers, Dr. Melchor Frias as convenor. These regional consortiums have been developed by PCHRD to rally research and educational institutions around the country in supporting its public health research agenda.
Now turning 25 years old, this research center aims to further uplift the lives of every Filipino through their medical and health research projects.
Herbal Medicines for Charity
One of the first units established here is the Center for Indigenous Medicine, which aims to establish validated scientific evidence on the effectiveness of alternative medicine. Further, they are also looking into the use of herbal and marine products, such as local plants and shells as medicine. One of the papers they had published deals with the use of the akapulco plant to treat scabies or galis. As of now, one of the most promising projects of the center is an anti-dengue drug. A seven-year-long endeavor by Dr. Rita Alvero, the drug is made of a blend of three plants that are common in the Philippines. It has recently entered Phase 1 of safety testing, and they hope it will be available commercially by 2021 to 2022. Should the drug hit the market, Dr. Yu expressed that they will be placing the proceeds in their charity funds. As they serve one of the largest number of patients in the region, they aim to build a one-hundred-bed facility for charity patients in their De La Salle University Medical Center as soon as the drug becomes marketable.
Filling in the gaps in TB medication
The center is working on developing more convenient methods of TB medication, along with expanding the focus of the medication.
According to Dr. Yu, normal TB treatments take about 20 to 24 months to take effect, and often have adverse, even fatal, side effects. It is also very inconvenient, as it requires the patient to go to facilities every day for their directly-observed treatment, more commonly known as DOTS. Recommended by the World Health Organization, DOTS remains to be the most effective way of stopping the spread of TB in the community.
In order to make treatment more convenient, the Center is collaborating with international partners and sponsors such as the US-NIH, National University of Singapore, Liverpool School of Tropical Medicine in the United Kingdom, Otsuka Pharmaceuticals, and Unitaid, among others, to develop new and more efficient forms of treatment for tuberculosis. One of these is the Video Observed Therapy (VOT), which allows the patient to take their medications at home, provided that they film themselves with a phone camera. The video is then encrypted and uploaded into a server where the doctors can document the patient’s progress.
Another project they are doing is called COACH, which is more community-based. This involves the training of Kagabays and local barangay health workers to become treatment partners in the communities.
“It’s much the same way as DOT (Directly Observed Therapy), but off-facility,” said Dr. Melchor Victor G. Frias, one of the investigators of this study and the former Vice Chancellor for Research here at DLSMHSI.
Breaking through Pediatric TB
Dr. Frias is also conducting multiple researches in the field of Pediatric Tuberculosis, some of which have become the basis of current WHO guidelines in the treatment of tuberculosis in children.
According to him, the current challenge for managing TB in children, especially if they have multi-drug resistant tuberculosis (MDRTB), lies in the fact that the drugs have not been studied among children, thus the dosage of the drugs are usually based on results from studies or clinical trials involving adult patients. This is problematic because “the doses are not really designed for children, so you really don’t definitively know whether they are effective or not for children.”
To address this gap in TB research, clinical trials of the TB drug Delamanid was conducted in 2013 to establish the proper dosages of the drug in children with MDRTB. This groundbreaking study involved four countries – Russia, South Africa, Uganda, and the Philippines. The Philippine study was conducted here at DLSMHSI, with Dr. Frias as principal investigator. Through a six month period of administering the drug, followed by two years of observation, the researchers were able to establish the appropriate and exact dosage and frequency of the drug for children. This protocol is now included in the current guidelines of the WHO in treating adolescents with MDRTB.
In 2016, another groundbreaking study was spearheaded by Dr. Frias here at DLSMHSI involving a new drug by another developer to address another gap in the management of tuberculosis in children.
Recently, DLSMHSI was also chosen as the Philippines partner of another multi-country study that involves various partners. Funded by Unitaid, the study will be spearheaded by South Africas’s Stellenbosch University, in partnership with TB Alliance, University of California San Francisco, De La Salle Medical and Health Sciences Institute, Johns Hopkins University, BJ Medical College, Uppsala University and Chiang Mai University. Called the Better Evidence and Formulations for Improved MDR-TB Treatment for Children (BENEFIT Kids) project, it aims to develop child-friendly treatments and regimens that will stop TB from developing into an active disease among children.
Support from abroad
With the rising number of multi-drug resistant tuberculosis cases, doctors around the world are working harder to control the disease. Fortunately for DLSMHSI, the United States National Institutes of Health (US-NIH), has chosen them to be a partner and a trial site for an international, multi-center study. Called “Protecting Household Contacts on Exposure to Newly Diagnosed Index Multi-Drug Resistant Tuberculosis Patients”, or Phoenix MDRTB, the study aims to prevent other members of the household from contracting the disease. The project is headed by Dr. Frias.
“.. Hindi ito naka-concentrate sa mga taong may sakit. Itong project na ito ay naka-focus sa mga nakatira sa bahay ng mga may sakit,” said Dr. Yu.
According to Dr. Melchor Frias, expanding the focus to “household contacts” is important because they are at a much higher risk of contracting the disease. Moreover, there is significant growth in the number of multi-drug resistant tuberculosis cases in the Philippines. This is a more severe form of TB, making Filipinos more at risk than ever before.
Likewise there are also projects studying gadgets and novel combinations of drugs that aim to augment TB treatment effectiveness.
These collaborations will not only help eradicate TB, but has also cemented the Research Center’s reputation as a “center of excellence in research,” said Dr. Yu.
The Centers under the Angelo King Medical Research Center:
- The Center for Biopharmaceutical Research
- The Center for Tuberculosis Research
- The Center for Complementary and Integrative Medicine
- The Center for Basic Biomedical Research
- The Center for Clinical Epidemiology and Biostatistics
- The Center for Allied Health Sciences Research.
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– Saint La Salle