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Phyllis Hu, Brigitte Nanan and Ralph Nanan in lab

Dr Mingjing 'Phyllis' Hu, Dr Brigitte Santner-Nanan and Professor Ralph Nanan are uncovering clues to preeclampsia and allergies.

Nepean Hospital research inspired by patients

10 Sep 2019


Caring for seriously ill patients not only inspires Nepean Hospital clinicians to deliver better care today and every day, but drives them to conduct bold research to push the boundaries of knowledge and shape the treatments of tomorrow.

In the past eight weeks, two research teams led by Nepean Hospital clinicians have published papers in leading international science journal, Nature Communications.

The teams have forged new directions in the globally significant research fields of influenza, pregnancy complications and allergies.

“There are clear benefits for patients when treating clinicians are involved in research,” says researcher and paediatrician at Nepean Hospital, Professor Ralph Nanan.

“You are always at the cutting edge of clinical treatment because you have the experts with the international reputation and who actually producing new knowledge," says Professor Nanan.

“If you are embedded in clinical trials for any disease your health outcomes can often be much better than if you are in routine care. There is a real patient implication.”

Seven years ago Professor Nanan began leading a team investigating the impact of diet on one of the most common complications in pregnancy, preeclampsia, and the longer term impact on the babies’ immune system.

Recently his team published their latest study in the international journal Nature Communications which is set to open a whole new avenue of research and may help to explain a rise in allergies and immune system problems in those following a typical, low fibre, Western diet.

“The latest scientific paper is the culmination of seven years of work, but it’s just the beginning,” says Professor Nanan.

“The next phase will be a large multi-year study of increased fibre intake in one to two thousand pregnant women. The research will examine whether preeclampsia in pregnant women, and allergies and other immune problems for their babies later in the life, can be prevented.”

At the time Professor Nanan first began to unravel the role of diet in preeclampsia and immunity, his colleague Nepean Hospital intensive care specialist Associate Professor Benjamin Tang was treating patients infected with swine flu during the 2009 global pandemic.

“Healthy people in the prime of their lives were ending up in our intensive care unit with the flu. It didn’t make sense and it inspired us to look deeper. To look for the mechanism that triggers mild flu to suddenly become severe and potentially deadly,” says Associate Professor Tang.

Maryam Shojaei, Benjamin Tang and Sally Teoh

Dr Maryam Shojaei, Associate Benjamin Tang and Sally Teoh are researching influenza

That search lead Associate Professor Tang’s group to invent the patented High-risk Influenza Screen Test (HIST) which measures ‘an early warning signal’ released by the patient’s body into their blood to ‘kick start’ the immune system’s fight against the infection.

The test needs only a single drop of blood and a few hours to predict, with 91 percent accuracy, which influenza patients will develop potentially deadly secondary infections, such as pneumonia.

Associate Professor Tang has also recently published related work in Nature Communications which has for the first time revealed a possible explanation why otherwise healthy people sometimes die from the flu.

From 2009 to 2016, Nepean Hospital led a team of the researchers who collected and analysed blood and airway samples from 720 patients across 20 hospitals in Australia, Canada and Germany. The research found key immune cells, called neutrophils, drive an ‘over-reaction’ in some patients’ immune systems which damages their lungs.

X ray lung inflammation and microscope view of neutrophils infected with flu

“This causes breathing difficulty, dangerously dropping blood oxygen levels and sadly, in some cases, causing respiratory failure and death.”

While Associate Professor Tang and Professor Nanan’s projects are focused on very different health challenges, they share a common heritage.

Their research is inspired and informed by the patients they treat today at Nepean Hospital.

Tomorrow, it will be the patients in all hospitals that benefit from new tests and treatments that could flow from their research.


Find out more about innovation at Nepean Blue Mountains Local Health District