Dr Daryl Hee (left), a CGH senior manager in charge of the Shimadzu-CGH Clinomics Centre, and clinical assistant professor Troy Puar operating a liquid chromatography tandem mass spectrometer at the new facility.ST PHOTO: TIMOTHY DAVID
A cutting-edge research lab that will allow doctors to offer personalised treatment of patients with chronic diseases like hypertension was officially opened yesterday.
The centre uses technology called liquid chromatography coupled with tandem mass spectrometry that can accurately analyse clinical samples.
This will help doctors tailor more individualised treatment instead of taking a one-size-fits-all approach.
The new facility - the Shimadzu-CGH Clinomics Centre - is starting with tests for hypertension, which affects one in four adult Singaporeans and is a leading cause of heart disease and strokes.
The $500,000 mass spectrometer can take a tiny sample - 1 to 10 microlitre - of blood and accurately measure the two hormones aldosterone and renin that can identify the type of hypertension a patient has.
The machine can also detect a patient's hypertensive drug concentration from tiny urine samples, allowing doctors to ascertain if they are adhering to the medication schedule and to understand why their hypertension still persists despite taking medication.
"Treatment of hypertension is not precise as each patient is different and their cause of hypertension may differ," said clinical assistant professor Troy Puar, principal investigator and consultant in endocrinology at Changi General Hospital (CGH), which is operating the lab with Japanese firm Shimadzu (Asia Pacific). "When one medication does not work, doctors may choose to increase the dose, add another medication, or switch to another medication.
"By measuring precisely the hormone measurements that define the type of hypertension that each patient has from the outset, doctors are able to know which anti-hypertensive medication works best for the patient, thereby enabling delivery of precise and personalised medicine."
It is now understood that hypertension is due to either excessive vasoconstriction (tightening of blood vessels) or excess salt and blood volume. Also, about 5 per cent of hypertension patients have a curable form called primary aldosteronism, said Prof Puar.
Mass spectrometry has been used here only for research. This meant that for the past five years, hormone samples from hypertension patients at Singapore restructured hospitals, which total around 1,000 a month, have been pooled and sent to US labs. It takes about two weeks to get the results back.
The new lab, which was officially opened by Deputy Prime Minister and Finance Minister Heng Swee Keat, will reduce waiting time to about one to two days.
- CLINICAL ASSISTANT PROFESSOR TROY PUAR, principal investigator and consultant in endocrinology at Changi General Hospital.
It could start receiving patient samples in as soon as six months, or up to two years, depending on how soon the required validations come, said Prof Puar and Dr Daryl Hee, a senior manager at CGH who is charge of the new lab.
It could eventually process samples from the region.
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