Simple tests

With a suite of novel protein biomarkers patented in areas of unmet clinical need, the Christchurch Heart Institute is helping to save lives, time and money.

At almost two metres tall, Christchurch Heart Institute researcher Dr Chris Pemberton stands out from the crowd. So does his work.

The University of Otago, Christchurch, senior research fellow is currently leading a team in the development of a novel blood test to help in the early detection of unstable angina. If early results are replicated in larger international studies, this test could become a common diagnostic tool in emergency departments around the world.

“We're excited about the potential of this biomarker to make a significant difference to patient treatment and the ability for doctors to diagnose quickly and accurately,” Pemberton says.

In a paper published in the premier cardiovascular research journal, Circulation, in 2010, Pemberton and his colleagues revealed evidence of a new biomarker for early-stage heart damage.

This new biomarker, known as BNP signal peptide, is related to a biomarker called BNP, which the Christchurch Heart Institute was the first to use to diagnose heart failure – a test that has saved the lives of tens of thousands of patients worldwide.

The significant implications of Pemberton's work were recognised with the Health Research Council's (HRC) Liley Medal, awarded to him in late 2011. The medal is awarded for the single greatest contribution to health research over the previous year.

HRC chief executive Dr Robin Olds says Pemberton's work “has the potential to significantly accelerate the clinical diagnosis of heart attacks. With further work, Dr Pemberton's biomarker is likely to become a mainstay in the diagnosis or exclusion of myocardial infarction [heart attack] and related acute coronary syndromes.”

That further work is keeping Pemberton and the team very busy – and proving fruitful. He is taking his work in the laboratory into the hospital to test the real-life effectiveness of the BNP signal peptide biomarker.

A trial has been recently completed of more than 500 people who presented with chest pains to Christchurch Hospital's emergency department. Blood was taken from these patients on arrival and again soon afterwards to determine the levels of BNP signal peptide in comparison with other clinically-used markers.

“Early analysis suggests BNP signal peptide could be a fast and reliable test to identify patients who have unstable angina which results from repeated, temporary blockages in the arteries feeding the heart,” says Pemberton.

Dr Chris Pemberton

These research results are exciting as the new biomarker has the potential to save both money and lives. While there are blood tests to quickly and accurately diagnose many other common forms of heart disease, such as heart attacks, unstable angina is notoriously difficult to identify quickly.

A patient suspected of having this condition is generally admitted to hospital to undergo a barrage of tests – such as heart catheterisation or running on a treadmill – which take time and use up valuable hospital resources.

A simple blood test could give a diagnosis and guide treatment within minutes rather than days.
Pemberton says the next step in trialling the unstable angina biomarker is to verify his Christchurch results in a bigger sample with international collaborators. He and his team will then work with a company which designs and manufactures clinical tests to develop one for emergency department use.

The hope is that, eventually, it will be possible to take blood from a patient when they are picked up by ambulance so the results are available by the time they reach hospital.

The BNP signal peptide for detection of unstable angina is just one of a number of biomarkers Pemberton and the Christchurch Heart Institute have under patent protection.

“Since 2005 we have taken an organised, deliberate approach to find novel protein biomarkers,” says Pemberton. “We now have a suite of six or seven and we are intensively investigating their ability to perform in the areas of unmet clinical need. We have taken out patents and believe we are particularly well-placed to provide not only the research and clinical information, but to get economic gains.

“Our programme is only really just getting going and we have every intention of continuing this for a long time yet.”

He says his team's success reflects the dedication of his mentors and many colleagues in the Christchurch Heart Institute.

“Our success is made possible by our group's long-term commitment to creating a vibrant research environment of excellence that allows new ideas to develop. It's extremely exciting and rewarding to be a part of that.

“We also have great support and backing from the University of Otago, Otago Innovation Ltd, the HRC and the Heart Foundation, and we are very grateful for this.”

The institute, formerly known as the Christchurch Cardioendocrine Research Group, this year received a donation of $5 million to continue its world-leading cardiac research. It is also part of the University of Otago Christchurch Appeal, launched this year to raise money to support some of the best teaching and research projects on the Christchurch campus.