Knowledge Exchange

2025 2024 2023 2022

報刊專欄 (am730) -香港真實世界研究及應用中心(二)

報刊專欄 (am730) -香港真實世界研究及應用中心(二)

上星期跟大家介紹了什麼是「真實世界研究」,今次就來聊聊它到底能怎麼應用,怎麼幫我們把醫療資源用得更精明。

在每個社會,醫療開支都是一筆龐大的開銷。資源永遠不夠分,如何「把錢花在刀刃上」成了關鍵。我們可以利用真實世界數據,精準評估不同疾病對病人、醫療系統以至社會福利的實際影響,從而把有限資源優先投放到威脅最大的疾病上。如果多個地區攜手進行跨地區研究,結論更可能改變全球公共衞生政策。

舉個真實例子:我們曾經聯同19個地區,利用各地真實世界數據庫,發現全球髖部骨折個案正急劇上升,但骨折後真正接受藥物治療的病人,竟然只有大約四分之一!這項發現震動國際,一個全球頂尖衞生組織最近特意邀請我參與撰寫兩份骨質疏鬆症的全球報告,目標就是推動全世界提升對這「隱形流行病」的管理水平。

除了影響政策,真實世界研究還能大大幫助新藥臨床試驗。藥廠做臨床研究要花上天價的金錢,最頭痛的是不知道在香港能否召集到足夠合資格的病人接受臨床試驗。但我們只需翻查真實世界數據,就能準確告訴他們:「這間醫院過去三年有3,000名符合條件的糖尿病患者,那間醫院有1,800名高膽固醇患者」,讓藥廠做到心中有數,加快試驗進度。

更重要的是,臨床試驗和現實世界往往有落差。試驗為了搜集到「乾淨」的數據,會設一大堆「納入」與「排除」的條件,最常見就是把80歲以上的長者剔除——因為他們的預期壽命較短,會增加研究風險。但現實臨床中,80歲以上的病人多的是!真實世界研究正好補足這塊拼圖,讓我們清楚知道藥物在普通病人,尤其是長者身上的真實效果。有了這些鐵證,衞生當局跟藥廠談判藥價時就更有底氣,既能為市民爭取合理價格,也讓醫療系統用得其所。

以上只是冰山一角。香港真實世界研究及應用中心的成立,正是要將這片數據金礦好好開採,讓香港的醫療質素再上一層樓,同時為經濟注入新動力。

真實世界數據,不僅守護港人健康,更讓香港在全球醫療舞台上繼續發光發亮。

張正龍教授
香港大學李嘉誠醫學院
藥理及藥劑學系副教授

Last week, I introduced what "real-world research" is. This time, let's talk about how it can be applied and how it helps us use healthcare resources more wisely.

In every society, healthcare spending is massive. Resources are always limited, so the key question is how to spend money where it matters most. We can use real-world data to precisely assess the actual impact of different diseases on patients, the healthcare system, and even social welfare. This allows us to prioritize limited resources toward the most threatening diseases. If multiple regions collaborate on cross-regional studies, the findings are even more likely to influence global public health policy.

A real example: we once collaborated with 19 regions, using their local real-world databases, and found that hip fracture cases are rising sharply worldwide—yet only about one-quarter of patients actually receive drug treatment after a hip fracture! This discovery shocked the international community. Recently, a leading global health organization specially invited me to contribute to two global reports on osteoporosis, with the goal of pushing the world to improve management of this "silent epidemic."

Beyond influencing policy, real-world research can greatly assist new drug clinical trials. Pharmaceutical companies spend enormous sums on clinical studies, and their biggest challenge is not knowing whether they can recruit enough eligible patients in Hong Kong. But with real-world data, we can simply check and tell them accurately: "This hospital has had 3,000 eligible diabetes patients in the past three years; that hospital has 1,800 patients with high cholesterol." This gives companies confidence and speeds up trial progress.

More importantly, there is often a gap between clinical trials and the real world. To obtain "clean" data, trials set numerous inclusion and exclusion criteria—the most common being the exclusion of patients over 80 years old, since their shorter life expectancy increases study risks. But in real clinical practice, there are plenty of patients over 80! Real-world research fills this gap perfectly, giving us a clear picture of how drugs perform in ordinary patients, especially the elderly. With this solid evidence, health authorities have stronger leverage when negotiating drug prices with pharmaceutical companies, securing reasonable prices for citizens while ensuring resources are used effectively.

The above are just the tip of the iceberg. The establishment of the Hong Kong Real-World Study and Application Centre is precisely to properly mine this data gold mine, further elevating Hong Kong's healthcare quality while injecting new vitality into the economy.

Real-world data not only protects the health of Hong Kong people—it also allows Hong Kong to continue shining brightly on the global healthcare stage.

<刊載於《am730》>
https://www.med.hku.hk/zh-hk/media/knowledge-exchange/newspaper-columns/2025/dec/am730_20251229

報刊專欄 (am730) -香港真實世界研究及應用中心(一)

報刊專欄 (am730) -香港真實世界研究及應用中心(一)

近日,我很榮幸獲邀出任中華人民共和國香港特別行政區政府「真實世界研究及應用中心」的總監。每次跟朋友提起這個新職位,大家第一個反應都是:「什麼是真實世界研究?難道還有『虛假世界研究』嗎?」

說到醫學領域,「真實世界研究」(Real-World Study)就是利用「真實世界數據」(Real-World Data)進行研究。這些數據並非專為研究而設計,而是醫護人員在日常臨床工作中自然產生的,例如醫院或診所裡的診斷記錄、化驗結果、藥物處方等。正因為它們不是「為了研究而刻意收集」,才最能真實反映臨床實況。

在普通人眼中,這些數據平平無奇;但在數據科學家眼中,卻是無價之寶。例如,我們想知道哪一種降血壓藥最能預防心臟病,就可以利用這些數據,分析不同藥物與心臟疾病之間的聯繫。又例如,我們早前發現某種治療骨質疏鬆的藥物,竟然同時可能降低心臟病和肺炎的風險——這類新發現,往往就藏在日常數據之中。

數據科學有句名言:「Garbage in, garbage out」(垃圾進,垃圾出)。如果數據品質差,再厲害的分析也沒有用。就像你想做蛋糕,卻用了過期麵粉和變質的雞蛋,最後還能吃嗎?

幸好,香港擁有全球頂尖的真實世界數據庫。這套數據庫由醫院管理局建立,背後靠的是幾代香港前線醫護人員的一點一滴、幾十年如一日地認真輸入。從1990年代至今,已累積超過1,100萬人的健康數據,時間跨度長、覆蓋人口多、記錄詳盡,國際上都極為罕見。

以前要做一個大型研究,可能要花好幾年才能收集足夠數據。現在有了強大運算能力和人工智能配合,這片「數據金礦」終於可以快速開採。我們中心的其中一個重要使命,就是把這份得來不易的香港寶藏,用得其所,造福市民以至全世界。

這份寶藏究竟能為香港和世界帶來什麼實際的改變?下星期再跟大家詳談。

張正龍教授
香港大學李嘉誠醫學院
藥理及藥劑學系副教授

Recently, I was honored to be invited to serve as the Director of the "Real-World Study and Application Centre (RWSAC)" under the Government of the Hong Kong Special Administrative Region of the People's Republic of China. Whenever I mention this new position to friends, their first reaction is always the same: "What is real-world research? Is there such a thing as 'fake-world research'?"

In the field of medicine, "Real-World Study" refers to research conducted using "Real-World Data". This data is not specially designed or collected for research purposes; instead, it is naturally generated by healthcare professionals during their routine clinical work—things like diagnosis, laboratory results, and medication prescriptions from hospitals or clinics. Precisely because it is not "deliberately collected for research," it most accurately reflects real-world clinical situations.

To ordinary people, this data may seem unremarkable. But to data scientists, it is priceless treasure. For example, if we want to know which antihypertensive drug is most effective at preventing heart disease, we can analyze the relationship between different medications and cardiac events using this data. Another example: we previously discovered that a certain drug for treating osteoporosis may also reduce the risk of heart disease and pneumonia. Discoveries like these are often hidden in everyday data.

There is a famous saying in data science: "Garbage in, garbage out." If the data quality is poor, no matter how sophisticated the analysis, the results will be useless. It's like trying to bake a cake with expired flour and spoiled eggs—would the final product still be good?

Fortunately, Hong Kong possesses one of the world's top real-world databases. This database, built by the Hospital Authority, is the result of decades of meticulous input by generations of frontline healthcare workers in Hong Kong. Since the 1990s, it has accumulated health data from over 11 million people, with long time spans, broad population coverage, and detailed records—something extremely rare internationally.

In the past, conducting a large-scale study could take years just to collect enough data. Now, with powerful computing capabilities and artificial intelligence, this "data gold mine" can finally be mined quickly. One of the key missions of our RWSAC is to make proper use of this hard-earned Hong Kong treasure, benefiting our citizens and the world at large.

What concrete changes can this treasure bring to Hong Kong and the world? I'll discuss that in more detail with you next week.

<刊載於《am730》>
https://www.med.hku.hk/zh-hk/media/knowledge-exchange/newspaper-columns/2025/dec/am730_20251222

報刊專欄 (am730) -藥到病除的「病除」

報刊專欄 (am730) -藥到病除的「病除」

之前的文章介紹過「藥到病除」的「藥到」,本文將會繼續解説藥物如何做到「病除」。

藥物需要跟特定的藥物標靶結合才會產生藥效。藥物標靶的種類廣泛,目前臨床應用的藥物,主要針對的標靶結構爲蛋白質類,也有一部分針對核酸類標靶。蛋白質類的標靶又細分為受體、酵素、離子通道和轉運蛋白。因爲受體是最普及的藥物標靶類別,所以要理解藥物跟目標之間的關係時,通常都會用受體作爲所有藥物標靶的代表,解釋如下。

藥物的化學結構與外觀,很大程度上決定了該藥物如何影響受體的功能,因為藥物與受體結合的條件,就是雙方的形狀能夠相容。這也表示,當個別藥物可跟某一種受體結合時,卻會因另一種受體形狀跟該藥物不相容而不能結合。

藥物跟受體結合之後,受體功能會因藥物的不同類別而上升或下降。致效劑會刺激受體功能,譬如令細胞内某些物質產生或某些離子濃度上升,進而加强細胞與身體組織而作出反應。一些可能比較常聼到的藥物,如某些氣管擴張藥、安眠藥,都是致效劑的例子。相反地,阻斷劑跟受體結合後,會阻止受體被刺激、減低細胞作出的反應。一種阻斷劑的例子就是個別的降血壓藥,透過阻斷特定受體 (包括如上述的酵素或離子通道),減低血管的收縮度,讓血管内血液流通的阻力降低,達到降血壓的效果。

致效劑或阻斷劑的應用,又怎樣幫助到「病除」呢?一般非傳染性疾病的起因,是體内某一或多種受體的功能過強或不足,而該些受影響的受體,正常情況下是依賴跟自身製造的致效物質結合而讓細胞產生合適的反應。普遍來説,當自身製造的致效物質不足,致效劑可以增强受體功能過弱的「病」 。至於阻斷劑,就是透過跟受體結合而阻擋太多致效物質去接觸到受體,從而治療受體功能過強的「病」。

梁偉文博士
香港大學李嘉誠醫學院
藥理及藥劑學系高級講師

In an earlier article, how a drug reaches its target site to treat an illness was described. This article will continue with how the drug actually brings about a “cure.”

For a drug to work, it needs to bind to a specific target in the body, known as a drug target. There are many types of drug targets. Most of the drugs we use in clinical practice act on targets made of proteins, and some act on targets made of nucleic acids (such as DNA or RNA). Protein targets are further classified into receptors, enzymes, ion channels, and transport proteins. Since receptors are the most common type of drug target, receptors are often used as the main example when explaining how drugs interact with their targets.

The chemical structure and shape of a drug largely determine its effect on a receptor. Binding is only established when the receptor is compatible to a drug, like a key fitting into a lock. This also means that a particular drug may be able to bind to one kind of receptor, but not to another whose shape does not match the drug.

Once a drug binds to a receptor, receptor activity may increase or decrease, depending on the type of drug.

An agonist stimulates the receptor. For example, it may cause a cell to produce certain substances or increase the level of certain ions, leading to increased activity in various cells and tissues of the body. Some commonly known drugs, such as certain bronchodilators (used to relax the airways) and sleeping pills, are examples of agonists.

An antagonist binds to the receptor and prevents it from being stimulated, thereby reducing activity. One example of an antagonist is certain blood pressure–lowering drugs. By blocking specific receptors (which can include enzymes or ion channels mentioned above), they reduce the extent of blood vessel constriction. Blood flow resistance is reduced which helps to lower blood pressure.

So how do agonists and antagonists help cure disease?

For many non-communicable diseases, the underlying problem is that activity of one or more types of receptors in the body is either too strong or too weak. Under normal circumstances, these receptors are activated by “natural” agonists produced by the body itself, which then trigger appropriate responses in the cells.

However, when the body does not produce enough of its own natural agonist, receptor activity becomes too weak. In such cases, agonists can enhance receptor function and “cure” this kind of “illness.” In contrast, when receptor activity is too strong, antagonists can bind to the receptors and block excessive natural agonists from reaching them in order to treat conditions owing to overactive receptors.

<刊載於《am730》>

https://www.med.hku.hk/zh-hk/media/knowledge-exchange/newspaper-columns/2025/dec/am730_20251215

 

報刊專欄 (am730) -帶狀疱疹疫苗 守護銀髮健康關鍵一步

報刊專欄 (am730) -帶狀疱疹疫苗 守護銀髮健康關鍵一步

隨著人口老化,香港社會面對愈來愈多與年齡相關的健康挑戰,其中帶狀疱疹(俗稱「生蛇」)便是一項不容忽視的疾病。帶狀疱疹由水痘病毒(Varicella-Zoster Virus)引起,病毒可在體內潛伏多年,隨著年齡增長,免疫力減弱,潛伏的病毒便可能重新活躍。

根據本地及國際研究,50歲以上人士患上帶狀疱疹的風險顯著上升,感染後不但引發劇烈疼痛和皮疹,更可導致「帶狀疱疹後神經痛」。這種痛楚可持續數月甚至數年,影響睡眠、情緒及日常活動,屬銀髮族常見而被忽略之健康威脅。值得注意的是,即使曾患水痘或已康復,年老後仍有可能「生蛇」。

幸而,現時已有有效的疫苗可預防帶狀疱疹。香港衛生署建議,年滿50歲或以上的人士,特別是患有慢性疾病或免疫功能較弱者,應考慮接種帶狀疱疹疫苗,以減低患病風險及相關併發症的發生。目前市面上主要有兩種疫苗:活性減毒疫苗及重組疫苗。重組疫苗在臨床研究中顯示出更高的保護效能,適合大部分長者使用,包括免疫力較低者。接種程序一般為兩劑,間隔2至6個月完成,其副作用多為輕微短暫的注射部位紅腫或疲倦。值得一提的是,疫苗防護力可維持多年,對減輕長者併發症所帶來的公營醫療系統負擔具重要作用。

在香港,帶狀疱疹疫苗尚未納入政府資助的疫苗計劃,市民需自費接種。不過,部分醫療保險或長者健康計劃可能涵蓋相關費用,建議市民向家庭醫生或藥劑師查詢,了解自身風險及接種安排。

總括而言,帶狀疱疹疫苗是守護銀髮族健康的重要一步。透過預防勝於治療的理念,我們不但能減少疾病負擔,更能提升長者的生活質素。希望更多市民能認識疫苗的益處,及早採取行動,為自己及家人築起健康防線。

冼樂賢
香港大學李嘉誠醫學院
藥理及藥劑學系講師

<刊載於《am730》>
https://www.med.hku.hk/zh-hk/media/knowledge-exchange/newspaper-columns/2025/dec/am730_20251208

Shingles Vaccine — A Key Step in Protecting Senior Health

As Hong Kong’s population continues to age, society faces an increasing number of age-related health challenges. Among these, shingles is a condition that deserves special attention. Shingles is caused by the varicella-zoster virus, the same virus responsible for chickenpox. After a person recovers from chickenpox, the virus can remain dormant in the body for decades. As the immune system weakens with age, the virus may reactivate and cause shingles.

Local and international research shows that the risk of developing shingles increases significantly after the age of 50. The infection not only leads to painful skin rashes but can also result in postherpetic neuralgia (PHN)—a chronic pain condition that can last for months or even years. This persistent pain commonly affects sleep, mood, and daily functioning, making it a serious yet often overlooked health concern among older adults. Notably, even individuals who have previously had chickenpox remain at risk of developing shingles later in life.

Fortunately, an effective vaccine is now available to help prevent shingles. The Hong Kong's Department of Health recommends vaccination for people aged 50 or above, particularly those with chronic illnesses or weakened immune systems, to reduce their risk of infection and complications. Currently, two main types of shingles vaccines are available: live-attenuated vaccines and recombinant vaccines. Clinical studies have shown that recombinant vaccines offer higher protection and are suitable for most older adults, including those with reduced immunity. The vaccination regimen typically consists of two doses given two to six months apart. Side effects are usually mild and temporary, such as redness or swelling at the injection site or mild fatigue. Importantly, the vaccine provides long-lasting protection and plays a key role in reducing the healthcare burden associated with shingles complications.

In Hong Kong, the shingles vaccine is not yet included in government-funded vaccination programs, so individuals must pay out of pocket. However, some private health insurance plans or elderly health schemes may cover the vaccination cost. People are encouraged to consult their family doctor or pharmacist to assess their personal risk and obtain professional advice on vaccination arrangements.

As a conclusion, the shingles vaccine represents a vital step in safeguarding the health of older adults. Embracing the principle of “prevention is better than cure,” vaccination helps reduce disease burden and enhance quality of life among seniors. Greater public awareness and timely vaccination can help every individual build a stronger health shield for themselves and their loved ones.

Conference at Macau

Conference at Macau

Prof. Aviva Chow, Prof. Ching-Lung Cheung and Prof. Shirley, Xue LI were contributing to the “2025 港澳醫藥領域發展論壇:共建醫藥發展生態圈 (Learning from Neighbours: Fostering an Ecosystem for Medical and Pharmaceutical Advancement)” on Saturday.

Their participation highlights our department’s commitment to advancing medical and pharmaceutical innovation across Hong Kong and Macau, and to strengthening collaboration with partners in academia, industry, and government.

Congratulations to our team for sharing their expertise on building a sustainable ecosystem for drug development and healthcare innovation.

https://www.linkedin.com/feed/update/urn:li:activity:7403646207316992000

Professor George Leung gave a presentation in Asian Federation for Pharmaceutical Sciences (AFPS) Conference 2025 in Sydney.

Professor George Leung gave a presentation in Asian Federation for Pharmaceutical Sciences (AFPS) Conference 2025 in Sydney.

Harnessing AI for Teaching and Learning Excellence at HKU

Harnessing AI for Teaching and Learning Excellence at HKU

Ming and Elvis presented in a conference: Anytime, Anywhere: Problem-Based Learning with a Generative AI-Powered Application
by Dr. Wang Hei Ng

AI as Patient: Practice Makes the Perfect Pharmacist
by Mr. Shek-Ming Leung

https://www.linkedin.com/feed/update/urn:li:activity:7404822287046184960

報刊專欄 (am730) -冬季流感高峰期 慢性病長者健康風險不容忽視

報刊專欄 (am730) -冬季流感高峰期 慢性病長者健康風險不容忽視

每年踏入冬季,氣溫驟降,流感及上呼吸道感染進入活躍期。對患有慢性疾病如高血壓及糖尿病的長者而言,這不僅是季節轉變,更是一場健康上的挑戰。長者在此期間應加倍留神,採取多項預防措施,以減低感染風險及併發症。

寒冷天氣對血壓影響甚大,低溫會令血管收縮,導致血壓上升,有機會增加中風及心臟病發作的風險,高血壓患者應要注意保暖, 維持健康的生活習慣及定期量度血壓 。糖尿病患者則因免疫力較弱,更易感染流感病毒以及其他引起呼吸道感染的病原體。一旦染病,血糖控制更難維持穩定,嚴重時甚至可能引發併發症。患糖尿病的長者在冬季時應該特別注意飲食,避免進食高糖、高脂肪食物,並按時服藥或注射胰島素,定期監測血糖水平。患有慢性疾病的長者若發現身體有任何異常應及早求醫,以便醫生能根據你的需要調整藥物。

為有效減低感染及併發症風險 ,疫苗接種是其中最大防線之一。根據醫學研究,長者接種流感疫苗及肺炎鏈球菌疫苗有顯著的保護作用,可預防嚴重併發症、減少住院與死亡風險。建議長者與家庭醫生商討接種安排,按個人健康狀況作出適當選擇。

除了藥物與疫苗,良好的生活習慣亦有助提升免疫力。長者應保持規律作息,確保充足睡眠,避免過度疲勞。適量運動如散步、太極、伸展運動等,不但有助血液循環,亦能改善情緒與睡眠質素。

保持良好個人衞生習慣亦不可忽視。勤洗手、佩戴口罩、避免前往人多擠迫的地方,都是有效防止病毒傳播的方法。若出現咳嗽、喉嚨痛、發燒等病徵,應盡快求醫。

家人亦應多加留意長者的身體狀況,協助安排疫苗接種、定期覆診及日常生活所需。若長者出現精神不振、食慾不振或行為改變,應及時尋求醫療協助。

朱幗珮
香港大學李嘉誠醫學院
藥理及藥劑學系高級講師

<刊載於《am730》>
https://www.med.hku.hk/zh-hk/media/knowledge-exchange/newspaper-columns/2025/dec/am730_20251201

Winter Brings Health Challenges for Seniors with Chronic Illnesses
As winter sets in and temperatures drop sharply, flu and respiratory infections enter their peak season. For elderly people living with chronic conditions such as hypertension and diabetes, this seasonal shift is more than just a change in weather—it is a serious health challenge. Experts urge seniors to stay vigilant and adopt preventive measures to reduce the risk of infection and complications.
Cold weather has a significant impact on blood pressure. Low temperatures cause blood vessels to constrict, leading to higher blood pressure and raising the risk of stroke and heart attack. Seniors with hypertension are advised to keep warm, maintain healthy lifestyle habits, and monitor their blood pressure regularly.
For those with diabetes, impaired immunity makes them more susceptible to flu viruses and other pathogens that cause respiratory infections. Once infected, blood sugar levels become harder to control, and severe cases may trigger dangerous complications. Elderly diabetics should pay close attention to their diet during winter, avoiding foods high in sugar and fat, taking medication or insulin on schedule, and checking blood sugar levels consistently. Any unusual symptoms should prompt immediate medical consultation so doctors can adjust treatment as needed.
Vaccination remains one of the strongest defenses against infection and complications. Medical studies show that flu and pneumococcal vaccines provide significant protection for seniors, helping prevent severe illness, hospitalization, and even death. Seniors are encouraged to discuss vaccination plans with their family doctors and make choices based on their individual health conditions.
Beyond medicine and vaccines, healthy daily habits also strengthen immunity. Seniors should maintain regular routines, ensure adequate sleep, and avoid fatigue. Moderate exercise—such as walking, tai chi, or stretching—not only improves circulation but also enhances mood and sleep quality.
Personal hygiene is equally important. Frequent handwashing, wearing masks, and avoiding crowded places are effective ways to control the spread of viruses. If symptoms such as coughing, sore throat, or fever appear, medical attention should be sought promptly.
Family members also play a vital role. They should monitor the health of elderly relatives, assist with vaccination appointments, follow-up consultations, and daily needs. If seniors show signs of fatigue, loss of appetite, or changes in behavior, timely medical support is essential.

Shek-Ming Leung shared insights from his Teaching Development Grant (TDG) project with colleagues at the School of Biomedical Sciences, at the Teaching & Learning Chalk Talk.

Shek-Ming Leung shared insights from his Teaching Development Grant (TDG) project with colleagues at the School of Biomedical Sciences, at the Teaching & Learning Chalk Talk.

LinkedIn post:
https://www.linkedin.com/feed/update/urn:li:activity:7400111219174588416

Shek-Ming Leung gave a talk for parents of children with special educational needs (SEN), entitled “Navigating Medication Choices for SEN Children: What Parents Need to Know” for YWCA Jockey Club Family Wellness Club.

Shek-Ming Leung gave a talk for parents of children with special educational needs (SEN), entitled “Navigating Medication Choices for SEN Children: What Parents Need to Know” for YWCA Jockey Club Family Wellness Club.

LinkedIn post:
https://www.linkedin.com/feed/update/urn:li:activity:7399794201762369536

報刊專欄 (am730) - 脂肪因子FABP4 在缺血性中風中的作用及治療潛力
Newspaper Article (am730) - The Role of Adipocyte Factor FABP4 in Ischemic Stroke and Its Therapeutic Potential

脂肪因子FABP4 在缺血性中風中的作用及治療潛力
中風是全球永久性殘疾和死亡的主要原因,主要分為兩大類:出血性中風和缺血性中風。當中缺血性中風佔發病率80%以上。缺血性中風是由大腦動脈阻塞引起,到目前為止,組織纖溶酶原激活劑仍是美國食品和藥物管理局唯一批准使用於治療缺血性中風的藥物。因此,有迫切需要研發新的有效藥物,以改善缺血性中風的後果。

國際研究發現,不同的脂肪酸結合蛋白(FABPs)家族成員如心臟(FABP3)、表皮(FABP5)和腦(FABP7)的脂肪酸結合蛋白,均與缺血性中風有關,引起廣泛關注。FABP3和FABP5是引發缺血神經元線粒體損傷的關鍵因素,而FABP7在缺血條件下可調節神經元幹/祖細胞增殖和維持新生細胞。

脂肪細胞脂肪酸結合蛋白4(FABP4)是人體內主要的脂肪因子之一,能在內皮細胞及巨噬細胞中表達,在脂質代謝和脂肪酸運輸方面擔綱重要角色。港大醫學院研究發現,缺血性中風患者在發病24小時內,血液中FABP4含量明顯升高。在小鼠模擬人類缺血性中風的手術實驗中,研究人員發現外周血單核巨噬細胞及腦內神經膠質細胞,是缺血性中風引起FABP4增加的主要細胞來源。此外,研究人員對剔除FABP4基因的小鼠體內注入FABP4蛋白會加劇缺血性中風的後果,包括更大的梗塞範圍、腦水腫,導致神經功能缺損,並降低存活率,證實循環FABP4對缺血性中風後果產生不良影響。

機理上,FABP4透過誘導基質金屬蛋白酶加劇血腦屏障的破壞,令缺血性中風的後果惡化。研究人員進一步利用小鼠雜交瘤技術產生標靶FABP4的單株抗體(6H2),並評估了6H2抗體在模擬中風小鼠和健康小鼠中的療效。6H2抗體治療能顯著緩解血腦屏障破壞、改善腦水腫、減少腦梗塞面積、改善腦神經元功能,同時降低中風小鼠死亡風險。

總括而言,研究結果確立FABP4在缺血性中風中發揮關鍵作用,循環FABP4有望成為缺血性中風的新治療靶點,6H2抗體有潛力成為候選單株抗體藥物,為缺血性中風病人帶來希望。

2024年12月30日
何麗莊教授
香港大學李嘉誠醫學院
臨床醫學學院藥理及藥劑學系助理教授

<刊載於《am730》>

The Role of Adipocyte Factor FABP4 in Ischemic Stroke and Its Therapeutic Potential
Stroke is a major cause of disability and death worldwide, categorized into two main types: hemorrhagic stroke and ischemic stroke. Ischemic stroke, accounting for over 80% of cases, is linked to artery blockage in the brain. Currently, tissue plasminogen activator (tPA) is the only approved drug for treating ischemic stroke. Therefore, there is an urgent need to develop new effective drugs to improve outcomes of ischemic stroke.

Recent international studies have highlighted the role of certain fatty acid-binding proteins (FABPs) in ischemic stroke. FABP3 and FABP5 are key players in causing damage to brain cells during ischemic events, while FABP7 helps regulate the growth and maintenance of new brain cells under such conditions.

Among these proteins, FABP4 stands out as a major player in fat metabolism, mainly found in fat cells, blood vessels, and immune cells. A research study from the Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, HKU, revealed that levels of FABP4 significantly increased in the blood of ischemic stroke patients within 24 hours of the event. In surgical experiments in mice simulating human ischemic stroke, researchers found that peripheral blood monocytes and brain astrocytes are the main cellular sources of increased FABP4 due to ischemic stroke. Importantly, when FABP4 protein is introduced into genetically modified mice with FABP4 gene deletion, it worsens the effects of ischemic stroke, leading to larger brain damage, swelling, impaired brain function, and lower survival rates.

Researchers further found that FABP4 worsens ischemic stroke outcome by damaging the protective blood-brain barrier. Thus, they developed a specific antibody, 6H2, that targets FABP4 in the blood. In tests on stroke-induced mice and healthy mice, the 6H2 antibody showed promising results by reducing brain damage, swelling, and improving brain function, ultimately lowering the risk of death in stroke-affected mice.

In conclusion, these findings highlight the detrimental role of FABP4 in ischemic stroke and suggest that FABP4 is a therapeutic target. The 6H2 antibody shows potential as a future drug candidate that could bring hope to ischemic stroke patients.

30 December 2024
Professor Hoo Lai Chong Ruby
Department of Pharmacology and Pharmacy
Li Ka Shing Faculty of Medicine
The University of Hong Kong

https://www.med.hku.hk/zh-hk/media/knowledge-exchange/newspaper-columns/2024/dec/am730_20241230

報刊專欄 (am730) - 利用AI優化個體化腫瘤免疫治療
Newspaper Article (am730) - Optimizing Individualized Tumor Immunotherapy Using AI

利用AI優化個體化腫瘤免疫治療
癌細胞的生存和繁衍過程可以通過達爾文的自然選擇理論來解釋。就像動植物一樣,癌細胞也經歷一個「適者生存」的過程。在這過程中,最適應環境的癌細胞會存活並繁衍,形成腫瘤。然而,這一過程也導致癌細胞對治療藥物產生耐藥性,成為癌症治療的主要難題。

癌細胞的耐藥性與腫瘤微環境中的進化壓力密切相關。腫瘤微環境是一個複雜的動態系統,包含多個無序增生和相互競爭的癌細胞種群。在無藥物治療的情況下,敏感型(不耐藥)癌細胞通常佔據主導地位;而在藥物治療期間,敏感型細胞的生長受到抑制,耐藥型癌細胞反而獲得競爭優勢。

因此,在癌症治療中,我們不僅需要殺死盡量多的癌細胞,還要考慮如何利用敏感型癌細胞來抑制耐藥型癌細胞的生長,延緩耐藥性的發展,從而達到更好的治療效果。

在臨床實踐中,醫生可以使用簡單的反饋調節策略來控製藥物劑量。在腫瘤規模增加到預定閾值時增加藥物劑量,而在縮小到另一個預先設定的閾值時減少劑量或停藥,即間歇性用藥。

然而由於每個患者的腫瘤均高度個性化,統一的治療方案往往效果欠佳。最新的臨床試驗顯示,前列腺癌的間歇性治療雖可減少總用藥量,提高患者生活質素,但生存時間未見顯著改善。因此,個性化的治療方案非常重要。

我們團隊近期提出了一種新的前列腺癌治療策略,利用強化學習算法針對個別患者優化用藥時機和劑量。每個患者的用藥判斷閾值都是個性化的,並根據癌細胞種群的競爭態勢進行動態調整。

這種方法不僅可提高治療的個性化水平,還展示了人工智能在解決耐藥性問題和提升癌症治療效果方面的巨大潛力,有望適用於多種癌症類型,為未來的癌症治療開闢新方向。

2024年12月23日
張清鵬教授
香港大學李嘉誠醫學院
藥理及藥劑學系副教授

<刊載於《am730》>

Optimizing Individualized Tumor Immunotherapy Using AI
The survival and proliferation of cancer cells can be explained through Darwin's theory of natural selection. Like animals and plants, cancer cells also undergo a "survival of the fittest" process. During this process, the cancer cells that are best adapted to their environment survive and proliferate, forming tumors. However, this process also leads to drug resistance in cancer cells, which is a major challenge in cancer treatment.

Drug resistance is closely related to evolutionary pressures in the tumor microenvironment. The tumor microenvironment is a complex and dynamic system, containing multiple disorderedly proliferating and competing populations of cancer cells. In the absence of drug treatment, sensitive (non-resistant) cancer cells usually dominate; however, during drug treatment, the growth of sensitive cells is suppressed, and resistant cancer cells gain a competitive advantage.

Therefore, in cancer treatment, we need to not only kill as many cancer cells as possible but also consider how to use sensitive cancer cells to suppress the growth of resistant cancer cells, delaying the development of resistance and thus achieving better treatment outcomes.

In clinical practice, doctors can use simple feedback regulation strategies to control drug dosages. Increase the drug dosage when the tumor size reaches a predetermined threshold, and reduce the dosage or stop the medication when it shrinks to another preset threshold, i.e., intermittent medication.

However, as each patient's tumor is highly individualized, standardized treatment plans often fall short. Recent clinical trials have shown that although intermittent treatment of prostate cancer can reduce the total amount of medication and improve the quality of life for patients, it has not significantly improved survival times. Therefore, personalized treatment plans are very important.

Our team has recently proposed a new treatment strategy for prostate cancer, using deep reinforcement learning to optimize the timing and dosage of medication for individual patients. The medication decision thresholds for each patient are personalized and dynamically adjusted based on the competitive state of the cancer cell populations.

This method not only improves the level of personalized treatment but also demonstrates the huge potential of artificial intelligence in solving drug resistance problems and enhancing cancer treatment outcomes. It is expected to be applicable to various types of cancer, paving new directions for future cancer treatments.

23 December 2024
Professor Zhang Qingpeng
Department of Pharmacology and Pharmacy
Li Ka Shing Faculty of Medicine
The University of Hong Kong

https://www.med.hku.hk/zh-hk/media/knowledge-exchange/newspaper-columns/2024/dec/am730_20241223

Dr-Qingpeng-Zhang_400x577

報刊專欄 (am730) - 癌症與骨折的死亡率哪個更高?
Newspaper Article (am730) - Which Has a Higher Mortality Rate: Cancer or Fractures?

癌症與骨折的死亡率哪個更高?
每次跟朋友聚會,提及癌症研究的最新發展時,大家都會很感興趣,同時非常熱情參與討論。偶爾有朋友會問「你的骨質疏鬆研究做得如何」,在我回答了後,大家的回應通常是「兩句起,三句止」。

骨質疏鬆有這麼不重要嗎?也許是身邊朋友比較年輕,覺得骨質疏鬆是一個老人病,不太與自己相關。又或者覺得骨質疏鬆本身是一個普通常見的病, 患了又如何?其實,我某程度上也認同單單患了骨質疏鬆並不可怕,可怕的是骨質疏鬆帶來的骨折。這個概念與高血壓相似,單單患了高血壓並不可怕,可怕的是高血壓帶來的其他嚴重後果,如中風及心臟病。因此,我常常公開的說,患有骨質疏鬆猶如帶有一個計時炸彈,它甚麼時候爆炸你並不知道,但爆了後你可能一輩子要坐輪椅,不能下床,甚至很快死亡。

既然大部分人都覺得癌症比骨質疏鬆及骨折更可怕,於是我做了一個研究,比較一下香港常見癌症跟髖骨骨折,哪個的死亡率較高。

研究根據差不多20萬個香港癌症病人及髖骨骨折病人的數據,當中我們發現,撇除了年齡及常見主要疾病對死亡率的影響,髖骨骨折相關的5年死亡率均顯著比乳癌(女性)、甲狀腺癌(女性)及前列腺癌高。由於有新型藥物及骨折管理的出現,過往十年香港骨折的死亡率在女性身上有顯著下降的趨勢,可是男性卻沒有此下降趨勢。

如果你害怕患有乳癌,甲狀腺癌及前列腺癌,我想給你一個溫馨提示,原來髖骨骨折相關的5年死亡率可以更高。

2024年12月16日
張正龍教授
香港大學李嘉誠醫學院
藥理及藥劑學系副教授

<刊載於《am730》>

Which Has a Higher Mortality Rate: Cancer or Fractures?
Whenever I catch up with friends and bring up the latest breakthroughs in cancer research, the room lights up with curiosity and lively debate. But when someone occasionally asks, “How’s your osteoporosis research going?” my response is often met with a quick nod and a change of subject—two sentences in, and the conversation stalls.

Is osteoporosis really so trivial? Maybe it’s because my friends are younger and see it as an “old person’s disease” that feels distant. Or perhaps they view osteoporosis as a common, no-big-deal condition—what’s the harm? To be fair, I partly get it: osteoporosis itself isn’t the scariest thing. What’s truly frightening is the fractures it can cause. It’s like high blood pressure: having it isn’t the end of the world, but the complications—like stroke or heart disease—can be devastating. I often tell people that living with osteoporosis is like carrying a ticking time bomb. You don’t know when it might go off, but when it does, it could mean a lifetime in a wheelchair, being bedbound, or even a swift decline and death.

Since most people seem to fear cancer far more than osteoporosis or fractures, I decided to dig deeper. I conducted a study comparing mortality rates of common cancers in Hong Kong with those of hip fractures.

Analyzing data from nearly 200,000 Hong Kong patients with cancer or hip fractures, we found something striking. After adjusting for age and major health conditions, the 5-year mortality rate for hip fractures was significantly higher than for breast cancer (in women), thyroid cancer (in women), and prostate cancer. While new treatments and better fracture management have led to a notable decline in fracture-related deaths among women in Hong Kong over the past decade, men haven’t seen the same progress.

If the thought of breast cancer, thyroid cancer, or prostate cancer scares you, here’s a sobering heads-up: hip fractures can carry an even higher 5-year mortality risk.

16 December 2024
Professor Cheung Ching Lung
Department of Pharmacology and Pharmacy
Li Ka Shing Faculty of Medicine
The University of Hong Kong

https://www.med.hku.hk/zh-hk/media/knowledge-exchange/newspaper-columns/2024/dec/am730_20241216

CL_Cheung

報刊專欄 (am730) - 藥劑師看益生菌
Newspaper Article (am730) - Pharmacist's Perspective on Probiotics

藥劑師看益生菌
益生菌近年大行其道,許多人視其為管理日常腸道健康的一部分。常見的益生菌包括乳酸桿菌屬(Lactobacillus)、雙歧桿菌屬(Bifidobacterium)以及酵母菌屬(Saccharomyces)等。透過改善腸道的微生態平衡,益生菌能有助減少腹瀉、便秘、腸易激綜合症等腸道問題。益生菌也能刺激腸道免疫細胞的活性,從而間接提高人體的免疫力。

一些研究顯示,益生菌還能夠減少過敏反應的發生。另外,益生菌可影響代謝過程,幫助調節血糖及膽固醇水平。不少科學家亦正在研究腸道與大腦之間(簡稱為「腸—腦軸」)的聯繫及益生菌在當中的功用,了解益生菌能否通過影響腸道微生態,進而影響神經遞質的分泌,有機會改善焦慮、抑鬱等問題。

儘管益生菌有許多潛在益處,但服用益生菌產品時,還是有不少需要注意的地方。首先,要選擇合適的菌株,因為不同菌株的益生菌會有不同的功效。例如,乳酸桿菌屬常用於改善腸道健康,雙歧桿菌屬則對增強免疫力較有幫助。

此外,要確保產品的菌數是否足夠。一般來說,每天攝取至少10億到500億個活菌才可有明顯的效果。還有,部分益生菌需要存放在低溫和乾燥的環境,以確保其活性。

對於正在服用藥物的患者,使用益生菌時需格外謹慎。某些益生菌可能會與特定藥物發生相互作用,影響彼此的效果。例如,抗生素可能會殺死某些益生菌,降低其功效。因此,患者在使用益生菌之前,應該與醫生或藥劑師商討,以確保益生菌與現有藥物的兼容性。只有正確選擇和使用益生菌,才能真正發揮其作用。

2024年12月09日
梁栢行教授
香港大學李嘉誠醫學院
藥理及藥劑學系副教授

<刊載於《am730》>

Pharmacist's Perspective on Probiotics
Probiotics have become increasingly popular in recent years, with many people considering them a part of their daily gut health management. Common probiotics include Lactobacillus, Bifidobacterium, and Saccharomyces. By improving the balance of the gut microecology, probiotics can help reduce gastrointestinal issues such as diarrhoea, constipation, and irritable bowel syndrome. Probiotics can also stimulate the activity of gut immune cells, thereby indirectly boosting the body's immunity.

Some studies show that probiotics can also reduce the occurrence of allergic reactions. Additionally, probiotics can influence metabolic processes, helping to regulate blood sugar and cholesterol levels. Some scientists are also researching the connection between the gut and the brain (referred to as the "gut-brain axis") and the role of probiotics in this connection, to understand whether probiotics can affect neurotransmitter release by influencing the gut microbiome, potentially improving issues such as anxiety and depression.

Although probiotics have many potential benefits, there are still several things to consider when taking probiotic products. First, it is important to choose the right strain, as different strains of probiotics have different effects. For example, Lactobacillus is commonly used to improve gut health, while Bifidobacterium is more helpful in enhancing immunity.

Additionally, it is important to ensure that the product contains a sufficient number of bacteria. At least 1 billion to 50 billion live bacteria are usually needed daily for noticeable effects. Furthermore, some probiotics need to be stored in a cool and dry environment to maintain their activity.

For patients who are taking medication, extra caution is needed when using probiotics. Certain probiotics may interact with specific drugs, affecting each other's efficacy. For example, antibiotics may kill certain probiotics, reducing their effectiveness. Therefore, patients should consult their doctor or pharmacist before using probiotics to ensure compatibility with existing medications. To truly experience the benefits of probiotics, it is essential to choose and use them correctly.

9 December 2024
Professor Leung Pak-Heng George
Department of Pharmacology and Pharmacy
Li Ka Shing Faculty of Medicine
The University of Hong Kong

https://www.med.hku.hk/zh-hk/media/knowledge-exchange/newspaper-columns/2024/dec/am730_20241209




HKUMed develops groundbreaking monoclonal antibody for treating cerebral ischaemia injury
HKUMed develops groundbreaking monoclonal antibody for treating cerebral ischaemia injury

https://www.hku.hk/press/press-releases/detail/27103.html


Ruby20240228
HKUMed achieves breakthrough in photoactivatable nanomedicine for the treatment of age-related macular degeneration
HKUMed achieves breakthrough in photoactivatable nanomedicine for the treatment of age-related macular degeneration

https://www.med.hku.hk/en/news/press/20231123-HKUMed-achieves-breakthrough-in-photoactivatable-nanomedicine

HKUMed finds 52% and 66% death reduction for molnupiravir and nirmatrelvir-ritonavir users among inpatients with COVID-19; supports early use of oral antivirals in this population of patients
HKUMed finds 52% and 66% death reduction for molnupiravir and nirmatrelvir-ritonavir users among inpatients with COVID-19; supports early use of oral antivirals in this population of patients

https://www.med.hku.hk/en/news/press/20221003-molnupiravir-nirmatrelvir-ritonavi (English)

https://www.med.hku.hk/zh-hk/news/press/20221003-molnupiravir-nirmatrelvir-ritonavi (Chinese)

HKUMed finds risk of myocarditis in adolescents significantly reduced after receiving only one dose of Comirnaty; adolescents urged to get the first dose of COVID-19 vaccine
HKUMed finds risk of myocarditis in adolescents significantly reduced after receiving only one dose of Comirnaty; adolescents urged to get the first dose of COVID-19 vaccine

Click to view full text of Press Release

Media coverage:

The Standard Online

Date: January 25, 2022

Topic: Single BioNTech jab significantly reduces myocarditis risk for teens – HKU research


RTHK Chinese Instant News

Date: January 25, 2022

Topic: 青少年延長至少三個月打第二針復必泰可降心肌炎機會


RTHK Chinese Instant News

Date: January 25, 2022

Topic: 學者建議 12 歲或以上青少年盡快接種第一劑疫苗


CRHK Instant News

Date: January 25, 2022

Topic: 港大研究:青少年接種 2 劑復必泰後 患心肌炎風險較接種 1 劑高 6 倍


Now TV News

Date: January 25, 2022

Topic: 港大:僅打一針復必泰可大幅降低青少年患心肌炎機會


Ming Pao Instant News

Date: January 25, 2022

Topic: 港大研究:12 歲以上青少年打兩針復必泰 患心肌炎風險為打一針 7 倍


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Topic: 【抗擊新冠肺炎】港大籲青少年首針後隔 3 個月再打


am730 Instant News

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Sky Post Instant News

Date: January 25, 2022

Topic: 新冠疫苗|兒童染疫失嗅覺險釀火警 專家指勿輕視後遺症 籲快打針


Sky Post Instant News

Date: January 26, 2022

Topic: 青少年推遲次針復必泰 降心肌炎風險


HK01

Date: January 25, 2022

Topic: 復必泰|港大:青少年打第一針 隔 3 個月打第二針可降心肌炎風險


Topick.hket.com

Date: January 25, 2022

Topic: 【疫苗接種】港大研究發現青少年接種 2 劑復必泰患心肌炎風險較接種 1 劑高 6 倍 建議延長 3 個月後再打


etnet

Date: January 25, 2022

Topic: 【新冠肺炎】研究:青少年接種1劑復必泰,患心肌炎風險較兩劑低


Hkcna.hk

Date: January 25, 2022

Topic: 港大研究:僅打一針復必泰可降低青少年患心肌炎機會


Udn.com (Taiwan)

Date: January 26, 2022

Topic: 香港研究稱:青少年 2 劑 BNT 心肌炎風險較 1 劑高 6 倍

Facing the dilemma between unmet needs and costly drugs: what are the strategic solutions for rare diseases?

Dr Shirley Li spoke as a panelist at the WHO webinar series on country pharmaceutical pricing policies and presented the “Global Access and Unmet Needs of Orphan Drugs” based on the team’s previous work published in Value in Health.

Click to view the full text of paper