S$50 million Research Funding Awarded for Research on Eye Disease and Severe Psychotic Disorders

13 May 2008

Two programmes have been awarded S$25 million each under the Translational and Clinical Research (TCR) Flagship Programme to conduct extensive research in major causes of blindness and schizophrenia & related psychotic disorders.

The programmes, for research in eye disease and neuroscience, are two of the five identified strategic disease areas of the TCR flagship programme under Singapore’s Biomedical Sciences Initiative Phase II.

The TCR programme for eye disease is awarded to a team led by the Singapore Eye Research Institute (SERI) and the programme for neuroscience is awarded to a team led by the Institute of Mental Health (IMH).

Multi-centre collaborations

Both TCR programmes are multi-centre studies which involve collaborations with teams of researchers, clinicians, clinician scientists from various institutions within the healthcare clusters, research bodies as well as international tertiary institutions, hospitals and disease centres. The extensive network ensures that the teams tap on the respective expertise areas relevant for the research.

"The TCR Flagship Programme provides the platform for researchers and clinician scientists from various disciplines to pool their resources and expertise, and collaborate to solve scientific problems and translate their research into quality healthcare solutions to benefit patients.  The eye disease and neuroscience research projects by SERI and IMH respectively address clinical problems that are of particular significance to Singaporeans and more generally, to the wider community in the world.  These two efforts, along with the earlier one for Gastric Cancer, are fundamentally transforming how the research and clinical community may collaborate across the entire community with a clear focus on bringing about impactful outcomes for Singapore and beyond. ,"says Mr Lim Chuan Poh, A*STAR Chairman and Co-Chair of the Biomedical Sciences Executive Committee.

Tackling the major causes of blindness

The TCR programme for eye disease - Translational Research Innovations in Ocular Surgery (TRIOS) - is led by Professor Donald Tan, Director of SERI & Medical Director of SNEC, aims to tackle the two major causes of blindness globally – glaucoma and corneal disorders.

An estimated 1.5 million to 2 million new cases of blindness, as a result of corneal diseases or glaucoma, is reported every year, mostly in Asia with the elderly experiencing a higher prevalence.

SNEC alone attended to over 15,000 cases of corneal diseases and over 34,000 cases of glaucoma annually, making up 6.3% and 13.7% of total cases respectively. In Singapore, approximately 3% of people over the age of 50 years have glaucoma. This percentage increases with age while it is about 2-3% among those 50-60 years of age, the prevalence increases to about 10-12% for those over the age of 70 years.

Whilst both conditions are treatable at the initial stage with medical treatment, many cases progress and ultimately require surgery (about 6.3% for corneal diseases and 1.9% for glaucoma). The success of surgery, and hence avoidance of blindness, depends largely on the appropriate amount of wound healing.

Based on past studies, it is found that Asians have a high rate of scarring and failure after surgery[1]. This highlights the need for better wound healing (anti-scarring) therapy to improve outcome.

Working on this principle, the TRIOS programme aims to develop novel anti-scarring or wound healing treatments as well as work on better and safer alternatives in new drug approaches. These techniques will eventually translate to better outcomes in corneal and glaucoma surgery and improve care for our patients, reducing the incidence of blindness.

Getting to the bottom of Schizophrenia and related psychoses

The neuroscience programme led by the Institute of Mental Health (IMH) focuses their study in schizophrenia and related psychotic disorders. This group of common disorders are among the most disabling, with schizophrenia listed as among the five leading causes of disability worldwide.

In Singapore, schizophrenia ranks ninth (together with breast cancer) among all the various diseases in terms of the burden of disease. Psychotic disorders create huge disease burden in both economic terms and human suffering in patients and, perhaps more so, their families and friends. Unfortunately, more often than not, there are often delays[2] in the detection and treatment of schizophrenia and psychotic disorders in Singapore due to various factors ranging from social stigma to a generally low awareness on the illnesses.

The team led by Associate Professor Chong Siow Ann, Vice Chairman, Medical Board (Research) of IMH, aims to identify key genetic, biological, cognitive and social risk factors for these disorders which will enable the very early detection of those at imminent risk of developing psychosis and pave the way for more effective interventions. The programme will also test the efficacy of a neurocognitive enhancing agent[3] for patients with schizophrenia. .

Keen competition for TCR grants

This is the second grant call for the TCR flagship programme and competition has been keen. A total of 8 projects (4 for each disease areas) were received by the TCR selection panel. After rounds of rigorous local and international reviews, the selection panel awarded the grants to the two programmes based on the strong scientific merits of their programmes and the potential positive clinical outcomes from their research.

“The submissions by SERI and IMH demonstrated strong scientific and clinical foundations in their research. The modules within each programme are distinctive with clear objectives and yet interlinked. Given the complexity of the disease areas, the teams demonstrated high level of insights with clear directions on their research objectives,” said Professor Edward Holmes, Executive Chairman of the National Medical Research Council (NMRC) and Chairman for the TCR review committee.

The Translational & Clinical Research Flagship Programme

Funded by the National Research Foundation (NRF) and administered by the NMRC, the TCR programme has a budget of S$125 million over 5 years. The aim of the TCR Flagship Programme is to establish Singapore as a leader in a number of strategic disease orientated areas.  It achieves this by building on existing, local, highly competitive programmes and providing highly productive platforms for collaboration with top overseas research institutions and industry.

The programme aims to help build up a critical mass of excellent researchers in the five selected areas of i) cancer, ii) neurosciences, iii) eye diseases, iv) cardiovascular / metabolic disorders and v), infectious diseases .

The TCR programmes will help to position Singapore as a leader in scientific and medical research, in addition to improving the quality of clinical care. Every TCR programme is for a period of five years. The first TCRgrant was awarded to the Singapore Gastric Consortium in 2007.

Permanent Secretary for Health and Co-Chair for the Biomedical Sciences Executive Committee Ms Yong Ying-I concludes, “Since the launch of the Biomedical Sciences Initiatives Phase II in 2006, we have made good progress in harnessing our capabilities in translational and clinical research. While there are many areas to be exploited, it is important to stay focused given our limited resources. Positive research outcomes will also bring about better evidence-based approaches to healthcare to eventually benefit our patients in terms of quality healthcare delivery. Our TCR flagship programmes aim to fulfill these objectives through directed research in the strategic disease areas. ”

Click here to see programmes' fact sheets (55KB)

Ministry of Health and A*STAR

13 May  2008

[1]The recently completed Singapore 5-Fluorouracil trial (a randomised controlled trial) has provided prospective data on long term outcomes after glaucoma surgery. After 3 years, 44% of normal glaucoma surgeries had failed in terms of raised intraocular pressure. In the group in which an anti-scarring agent (5-fluorouracil) was added, the failure rate was lower (34%). From hospital data, the failure rate with mitomycin-C (another antiscarring agent) was better (about 20% after 3 years) but this is still not ideal.In summary, the overall outcome of glaucoma surgery is not good enough with high rates of failure after a few years.

[2]Late detection refers to the relatively long lag time between the onset of the first psychotic symptoms and diagnosis & first adequate treatment.

[3]Patients with schizophrenia have a range of neurocognitive impairments including difficulty in formulating plans, as well as difficulties with concentration and memory. This "neurocognitive enhancing agent" is a chemical compound which has the potential of addressing these deficits.