In 2023, a new research group focused on virology and molecular carcinogenesis was set up in the Node Olomouc of NICR in the Institute of Molecular and Translational Medicine of Palacký University, Olomouc. Its head, Vladimíra Koudeláková, allowed us to take a peek into its multidisciplinary ‘kitchen’.
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How do your research targets fit into the overall picture of cancer research at the NICR?
Our research group focuses mainly on cancers associated with human papillomavirus (HPV) infection which affects mucous membranes and the skin. HPV is encountered by a majority of the population during their lifetime, with most cases being resolved by the immune system. However, in a minority of cases, HPV persists and can lead to cancer.
At the Institute of Molecular and Translational Medicine of the Palacký University, we have been investigating this subject for a number of years … I believe we started with it in about 2011 or 2012. Our long-term goals are especially the development and optimalisation of non-invasive or minimally invasive methods of biological material collection that can be used, among other applications, to test for presence of the abovementioned HPV.
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Do you have some past results you are especially proud of?
The most prevalent oncological diseases associated with HPV infection is cervical cancer. Our work has primarily focused on addressing the challenges of cervical cancer screening, particularly among women who cease regular gynaecological visits post-menopause, resulting in late-stage diagnoses.
We've pioneered self-collection methods for cervicovaginal samples with subsequent laboratory HPV testing, empowering women to participate in cervical cancer screening from the comfort of their homes. We have been collaborating on this for a very long time with a number of clinical institutions, including the Charles University, but also private gynaecological centres.
We have also published several studies focused on self-sampling with subsequent HPV testing and we are now preparing the further results for publication. The self-sampling is very simple: female participants of the study have received Evalyn Brush self-sampling kits with detailed instructions by mail and a link to instruction video. The cervicovaginal samples we have received from those study participants, again by mail, we analysed using the PCR for presence of HPV infection in our laboratory. In all our studies, we have – as did many other studies – found a strong correlation with standard sample collection and therefore confirmed the possibility of using this method in routine screening.
Aside from that, we are also very pleased with a recent publication in the European Journal of Public Health from January of this year (see a separate box, editor’s note) which confirmed that self-sampling of a cervicovaginal smear at home is a method that was extremely well accepted by Czech women and that it can be an adequate alternative to a sample collection by a gynaecologist. It seems therefore that self-sampling could, before long, became part of routine practice. It makes us very happy to see that our work has such tangible impact.
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What will come next? What are you focusing on in virology and molecular carcinogenesis at the moment?
Our group is active in several areas but at this point, we are focusing on oropharyngeal cancers, especially those associated with HPV infection. Unlike in the case of cervical cancer, there is no routine screening for their early detection. As a result, while we see a decrease in the number of new cases of cervical cancer in the population, the incidence of HPV-associated oropharyngeal cancers is increasing year on year and is a real problem. Therefore, we have developed a ‘gargling test’ that would enable easy collection of biological material from the oral cavity. A sample collected in this way would be, among other applications, suitable also for testing for oral HPV infection presence . A person gargle with plain water, which means that the collection is totally safe. After collection, the liquid is placed into a test tube containing a lyophilised stabilisation medium. A sample collected in this way is stable for at least 14 days. In a laboratory, the sample is then centrifuged to separate biological material and DNA is isolated and tested for HPV presence using PCR.
Several validation studies are taking place at this point but even the preliminary results show that the test seems to be very well suitable for the oral HPV infection detection and could be thus used in the screening of oropharyngeal cancers.
Another problem is that oropharyngeal tumours tend to recur and there are currently no possibilities of the early recurrence detection. We are therefore working on an optimalisation of test from blood plasma, i.e., so-called liquid biopsy, that is based on testing for the presence of short fragments of HPV DNA using digital-droplet PCR. By this test, we can recognise the return of cancer before any of the currently available imaging methods.
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Where do you see the greatest contribution of NICR to your research group?
Nowadays, if you want to do research that delivers results, multidisciplinary collaboration is a must – and that is doubtless one of the advantages of existence of the NICR. In NICR, there meet various research groups that may apparently work on the same subject, that is, cancer research, but in fact cannot independently encompass all the necessary areas because each type of tumour represents a whole group of various more or less rare subtype. One cannot focus on just one of these: it is necessary to have a more comprehensive perspective that includes genetics, genomics, proteomics, molecular biology… That is why what the NICR offers is so important – the possibility of collaboration of various teams and groups that can not only share their knowledge but also put together for instance also large patient cohorts, which can help us to actually prove something. That is something a small, independently working team cannot do, just like it is impossible for a team of a handful of people to have knowledge of all the modern technologies, be it new-generation sequencing, mass spectrometry, or many other things. And finally, one also needs capable experts in bioinformatics and biostatistics, because correct data processing is a crucial part of research and one that requires a lot of work and collaboration.
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What professions in particular are represented in your group? And what units all of you – aside from ‘just’ research? In other words, does the ‘chemistry’ of your team work?
Most people in our group are molecular biologists and geneticists, but we also have a statistician, a colleague who specialises in bioinformatics, and a physician. I would say we really fit well together – it is often the case that you chose people who are like you and with whom you can work well. So, although we specialise in different things we share a sense of humour and various interests. Strong interpersonal relationships are integral to fostering effective collaboration and, ultimately, producing impactful research outcomes.
