A conversation with Dr Jason Phung
What’s the problem?
Preterm birth is the leading cause of under-five mortality and a significant contributor to neurodevelopmental morbidity worldwide; affecting over 15 million babies every year. Our efforts to tackle this global problem has been hindered by our limited understanding of how human labour works (both at term and preterm). Why do women go into labour when they do? What causes the uterus to contract? At the coalface, I found myself constantly feeling helpless that there were no treatment options to stop preterm labour once it begins. Therefore, in 2017, I decided to do a PhD with the support of a RANZCOG NSW Regional Committee Trainee Research Grant. Uncovering the mechanisms of labour will enable us to formulate effective new treatments to give babies the best start to life at full term.
What are you trying to find out?
I am hoping my research will help uncover the cellular and genomic changes that occur in the myometrium during normal labour and abnormal preterm labour. The first part of my study examined the gene changes in the myometrium of 60 women at term (30 in labour and 30 not in labour). In this first instance, we identified a subset of genes upregulated early in the labour pathway in term labour. Now, I’ve replicated the study in a cohort of preterm women to determine if the pathways in preterm labour are the same as in normal term labour. I am currently in the process of analysing this data. At the same time, I am also examining the genetic and molecular changes in maternal blood throughout pregnancy in women at high risk of delivering preterm. Our aim is to develop a test that predicts preterm birth, as well as being able to predict whether certain treatments (progesterone, cerclage, etc) will be successful.
What would you like to achieve?
Being able to identify and understand the genes responsible for preterm labour will go a long way in helping the development of new therapeutics for preterm birth. However, my current interest is prediction of preterm birth. Identifying women at high risk of preterm birth so that preventative measures can be taken to change the trajectory is the next focus for my post-PhD. In the near future, I will be validating a predictive blood test that my team and I have developed. On a professional development level, I’d like to improve my bioinformatics knowledge. It’s a skill I’ve had to pick up as part of my project, but something that I have surprisingly enjoyed.
What’s on the horizon for O&G?
Precision medicine is an emerging area of research that uses one’s own genome to predict disease outcomes and treatment successes. For example, there are numerous polymorphisms (genetic variants) that confer increased risk for preterm birth that we do not currently use in clinical practice. It is an emerging practice in areas such as oncology, where chemotherapy regimens are dictated by the genetics of a particular patient’s tumour. This is very novel in the field of O&G, but is slowly developing and that’s quite exciting! The ethics of obtaining research samples in pregnancy is challenging, but if we can sample something like a genome from a simple blood test or cheek swab. The possibilities are endless. It will truly be individualised care.
About Dr Jason Phung
Dr Jason Phung is a Research Fellow at Hunter New England Health Clinical and Health Services and a PhD Candidate from the University of Newcastle. He is currently a third-year trainee at RANZCOG.