Huang Hairong, Ex­pert on Tu­ber­cu­lo­sis

Beijing (English) - - CONTENTS - Trans­lated by Wang Hui­hui Edited by Mark Zuiderveld Pho­tos by Ma Ke

In re­cent years, Huang Hairong has taken the lead in iden­ti­fy­ing my­cobac­terium species, ap­ply­ing clin­i­cal ex­pe­ri­ence to prac­tice, and im­prov­ing the di­ag­no­sis and treat­ment of tu­ber­cu­lo­sis.

In the bright Tu­ber­cu­lo­sis Clin­i­cal Lab­o­ra­tory of the Bei­jing Chest Hos­pi­tal, Cap­i­tal Med­i­cal Uni­ver­sity, Pro­fes­sor Huang Hairong, dressed in a lab coat, is work­ing with three re­searchers. The four peo­ple are sur­rounded by ad­vanced equip­ment with data keep­ing chang­ing on the dis­plays. This is an or­di­nary day in the lab­o­ra­tory, and all the staff mem­bers are con­duct­ing ex­per­i­ments un­der the guid­ance of Huang Hairong. They know that the con­clu­sions and data they ob­tain in the lab­o­ra­tory play an im­por­tant role in guid­ing clin­i­cal treat­ment and bring­ing health back to pa­tients in mis­ery.

With a gen­tle voice, Huang shoul­ders heavy re­spon­si­bil­i­ties. As a di­ag­nos­ti­cian, she leads a lab­o­ra­tory that pro­vides tech­ni­cal sup­port for a tu­ber­cu­lo­sis preven­tion pro­gramme, play­ing a ma­jor role in Bei­jing's key drug-re­sis­tant tu­ber­cu­lo­sis re­search lab­o­ra­to­ries, and rep­re­sents the high­est level of do­mes­tic tu­ber­cu­lo­sis lab­o­ra­tory di­ag­no­sis. They test more than 80,000 spec­i­mens each year, and of­fers tu­ber­cu­lo­sis test­ing for the Cen­tral Health Care Bureau.

In re­cent years, Huang has taken the lead in iden­ti­fy­ing species of my­cobac­te­ria, pro­vid­ing sup­port for dif­fer­en­tial di­ag­no­sis of non-tu­ber­cu­lo­sis my­cobac­te­ria in­fec­tions. She has also paid close at­ten­tion to new di­ag­nos­tic tech­nolo­gies at home and abroad, and in­tro­duced and car­ried out six lat­est di­ag­nos­tic tech­nolo­gies, to en­sure that the di­ag­nos­tic level of her lab­o­ra­tory catches up with in­ter­na­tional stan­dards, and plays a lead­ing role na­tion­wide. She has com­pleted the pre-mar­ket assess­ments for over ten new di­ag­nos­tic tech­nolo­gies, pub­lished over 90 papers, and led her team to win the hon­our of “In­no­va­tion Stu­dio for the New Clin­i­cal Trans­for­ma­tion and Ap­pli­ca­tion of Tu­ber­cu­lo­sis” in 2014.

A Tu­tor’s En­light­en­ment

Huang ma­jors in clin­i­cal medicine from un­der­grad­u­ate to doc­tor­ate. Her doc­toral tu­tor Ma Yu is an ex­pert on tu­ber­cu­lo­sis in China. While study­ing her doc­tor­ate, Huang learned res­pi­ra­tory medicine from her tu­tor.

For Huang, Pro­fes­sor Ma Yu comes from an older gen­er­a­tion of in­tel­lec­tu­als. Pro­fes­sor Ma went to the US as a vis­it­ing scholar in the 1980s to carry out im­muno­log­i­cal re­search, and es­tab­lished an in­ter­nal medicine lab­o­ra­tory af­ter her re­turn to China. Though Ma is 86 years old, she still sticks to her full­time job, of­fer­ing out­pa­tient ser­vices.

“A suc­cess­ful per­son must suc­ceed in both learn­ing and char­ac­ter. Although my tu­tor is an ex­pert of the Cen­tral Health Care Bureau, she is hum­ble and keeps a low profile, which makes her so re­spectable,” says Huang. Huang ad­mits that she learned a lot from her tu­tor. Huang came to Bei­jing to study her doc­tor­ate in 1998. At that time, most stu­dents lived a fru­gal life. Her tu­tor Ma gave 100 yuan to each stu­dent of each grade per month as an al­lowance.

Such kind­ness has al­ways touched Huang. When she took a job and re­ceived her first pay­check of 1,000 yuan in 2001 af­ter grad­u­a­tion, she re­alised that it was heavy pay­ment for her tu­tor to give them “pocket money” each month. “My tu­tor al­ways puts the in­ter­ests of oth­ers above her own and treats us as her own chil­dren. She teaches and touches peo­ple around her, lead­ing by ex­am­ple as well as ver­bal in­struc­tion, so we find it's a de­light to be with her. My tu­tor will al­ways be my idol, so I try hard to be­have like her when I have my own re­search team. Har­mo­nious re­la­tion­ship with the team is cru­cial to sci­en­tific re­search,” Huang says.

Un­der the guid­ance and sup­port of Ma, Huang took over and com­pleted a sci­en­tific re­search project, and won the Third Prize of Sci­en­tific and Tech­no­log­i­cal Progress in Bei­jing. At that time, do­mes­tic sci­en­tific re­search was quite back­ward. Huang, how­ever, spared no ef­forts to in­tro­duce ad­vanced tech­nolo­gies, and suc­ceeded in ap­ply­ing gene se­quenc­ing tech­nol­ogy to drug-re­sis­tant tu­ber­cu­lo­sis, mak­ing great progress in do­mes­tic gene se­quenc­ing of tu­ber­cu­lo­sis. Her re­lated papers were pub­lished in the Chi­nese Jour­nal of Tu­ber­cu­lo­sis and Res­pi­ra­tory Dis­eases, and have of­ten been quoted.

The project's suc­cess couldn't be achieved with­out Huang's ef­forts or her tu­tor's. Pro­fes­sor Ma of­fered Huang help from the per­spec­tive of a clin­i­cal doc­tor in terms of de­sign­ing sub­ject mat­ter, analysing data and writ­ing med­i­cal ar­ti­cles in English. As the ob­ject of Huang's re­search cov­ered the en­tire coun­try, her re­search con­clu­sions are rep­re­sented na­tion­wide. Be­fore her work was pub­lished, the in­ter­na­tional aca­demic cir­cles lacked suf­fi­cient data from China, and her pa­per soon at­tracted world­wide at­ten­tion.

Af­ter grad­u­a­tion, Huang felt con­fused about be­ing a doc­tor or con­tin­u­ing to carry out lab re­search. Her tu­tor again gave her ad­vice that Huang's prag­matic char­ac­ter was more suit­able for med­i­cal re­search. In ad­di­tion, China was in bad need of re­search tal­ent, so Huang de­cided to con­duct med­i­cal re­search.

“Now in ret­ro­spect, my tu­tor's ad­vice is cor­rect. Current daily work gives me a lot of fun, and our re­search helps to im­prove di­ag­no­sis and treat­ment of tu­ber­cu­lo­sis, which brings us a sense of ac­com­plish­ment. Over the past 20 years, China's re­search has ad­vanced steadily, with great im­prove­ments in the sci­en­tific re­search en­vi­ron­ment,” ex­plains Huang.

Global Ver­sion

The past 20 years, which saw Huang's ini­tial en­gage­ment in med­i­cal sci­ence, can be di­vided into two parts— the first ten years of ac­cu­mu­lat­ing knowl­edge, and the lat­ter ten years of be­com­ing more ma­ture. In her first ten years, aside from study­ing a doc­tor­ate, Huang went to the US for a post- doc­toral de­gree, one of the most mean­ing­ful things for her ca­reer and pro­vid­ing her a rare op­por­tu­nity to get a

“For a good sci­en­tific re­searcher, a spon­ta­neous and strong in­ter­est in sci­en­tific re­search is the best cat­a­lyst for re­search out­put.”

world view of medicine.

In 2002, Huang came to Colorado State Uni­ver­sity for lab­o­ra­tory re­search. The lab­o­ra­tory she stud­ied at is famous for its study on tu­ber­cu­lo­sis, with 100 re­searchers world­wide. At that time, Huang re­alised the gap be­tween do­mes­tic and foreign re­search. What she learned at home was nearly at a pri­mary level in the US lab­o­ra­tory, mak­ing her feel she lacked ex­pe­ri­ence and knowl­edge.

“Ad­vanced Amer­i­can sci­en­tific re­search re­ally broad­ened my horizon. They car­ried out de­tailed and in-depth stud­ies, in­clud­ing ba­sic re­search, mech­a­nism and im­ple­men­ta­tion re­search, which was much closer to clin­i­cal prac­tice.” Huang said that dur­ing the four years she spent in the US, she not only wit­nessed world-lead­ing med­i­cal re­search, but also un­der­stood the rea­son why the US held a safe lead in med­i­cal re­search. She con­tin­ues to say, “Amer­i­can re­search aims to serve the fu­ture and take the lead with strate­gic mean­ing. Although the num­ber of tu­ber­cu­lo­sis cases in the US is quite low, there are many re­searchers en­gaged in tu­ber­cu­lo­sis-re­lated ba­sic re­search there. Some­times we joked that tu­ber­cu­lo­sis re­searchers are much more than pa­tients. When I joined their team, I re­alised that we mustn't be im­petu­ous in terms of ba­sic sci­en­tific re­search. In­stead, we need to con­sider it from a long-term per­spec­tive for the fu­ture of the coun­try. If we fo­cus only on im­me­di­ate in­ter­ests, quick suc­cess and in­stant benefits in sci­en­tific re­search, we might lose sight of the fu­ture. We have to al­low some re­searches that may seem use­less for now.”

Dur­ing her post­doc­toral study, Huang's team en­gaged in iden­ti­fy­ing the func­tions of the un­known genes of my­cobac­terium tu­ber­cu­lo­sis. My­cobac­terium tu­ber­cu­lo­sis has more than 4,000 genes, but the func­tions of many genes are still un­known. Her team specif­i­cally iden­ti­fied the func­tions of a gene and pub­lished es­says. The ex­per­i­ment pro­vided her new life ex­pe­ri­ences through­out the years.

A few years ago, an in­ter­na­tional phar­ma­ceu­ti­cal com­pany paid a visit to China. The prin­ci­pal of the com­pany spoke with Huang, say­ing they were work­ing with the US lab­o­ra­tory to de­velop a pill based on Huang and her team's re­search in the US. Huang said, “The world is so small. I feel so proud when peo­ple find value in my work. I also re­alise that what I've done may be able to ben­e­fit all mankind in the fu­ture. As a par­tic­i­pant, I may not nec­es­sar­ily get any fi­nan­cial profit from it, but I'm still glad. Re­search goes like this—it might not gen­er­ate in­stant ben­e­fit in clin­i­cal re­search, and it may even take a long time. Dur­ing the first ten years, I tried to study more. My tu­tor once told me that I'm suit­able for sci­en­tific re­search. The truth is I didn't re­alise how for­ward-look­ing and de­ci­sive she was in the be­gin­ning. As ba­sic re­search is quite dif­fer­ent from clin­i­cal re­search in China, I thought it was sim­ply a rou­tine job. Ten years later, I'm so glad that I made the right choice.”

In 2006, Huang re­turned to China. At that time, the do­mes­tic re­search en­vi­ron­ment had im­proved, with more sci­en­tific re­search projects and eas­ier fund­ing ap­pli­ca­tions. In 2007, she was se­lected in Bei­jing's Sci­ence and Tech­nol­ogy Nova Pro­gramme set up by the Bei­jing Mu­nic­i­pal Sci­ence & Tech­nol­ogy Com­mis­sion for tal­ent train­ing. In ad­di­tion to sup­port­ing im­ple­men­ta­tion of spe­cific re­search projects, the pro­gramme also fo­cused on train­ing in­di­vid­ual ca­pac­ity, giv­ing pro­fes­sional and tech­ni­cal train­ing, and im­prov­ing their English pro­fi­ciency. The pro­gramme spon­sors or­gan­ised classes and ex­change plat­forms to cul­ti­vate pro­fes­sion­als in all of Bei­jing's sec­tors.

Tu­ber­cu­lo­sis Anal­y­sis

In 2007, af­ter re­turn­ing to China, Huang joined the Na­tional Tu­ber­cu­lo­sis Ref­er­ence Lab­o­ra­tory of Bei­jing Chest Hos­pi­tal. Be­cause Huang has been learn­ing clin­i­cal medicine, she per­forms well in the lab­o­ra­tory. Based on a thor­ough un­der­stand­ing of clin­i­cal medicine, Huang suc­ceeds in ap­ply­ing lab­o­ra­tory re­search to clin­i­cal prac­tice, achiev­ing de­sir­able re­search re­sults.

Due to pre­vi­ous lim­ited sci­en­tific re­search, germs of tu­ber­cu­lo­sis weren't di­vided in de­tail in China, lead­ing to a long-term neg­li­gence of non-tu­ber­cu­lous my­cobac­te­ria (NTM) in­fec­tions. On the one hand, dif­fer­ent NTM in­fec­tions need dif­fer­ent medicines for treat­ment, so re­li­able germ iden­ti­fi­ca­tion tech­nol­ogy is the premise for cor­rect di­ag­no­sis and treat­ment; the other hand, NTM iso­lated from the clin­i­cal spec­i­mens doesn't nec­es­sar­ily cause a dis­ease, as a con­sid­er­able pro­por­tion

of germs has noth­ing to do with the dis­ease.

“With de­tailed in­for­ma­tion of germs, pa­tients don't need to pay for un­nec­es­sary costs, or bear strong side ef­fects of an­ti­tu­ber­cu­lo­sis drugs,” says Huang. Af­ter join­ing the lab­o­ra­tory, she has done much for the iden­ti­fi­ca­tion of germs, know­ing the in­fec­tion and species of NTM in­fec­tions, as well as re­port­ing the clin­i­cal rel­e­vance of NTM for the first time in China. Mean­while, she has de­vel­oped the first soft­ware for iden­ti­fy­ing species of my­cobac­te­ria to of­fer ser­vices to clin­i­cal and sci­en­tific re­search all over the coun­try. The soft­ware puts an end to the sit­u­a­tion where Chi­nese re­searchers have to log in the US NCBI web­site to carry out se­quence align­ment if they want to iden­tify species of my­cobac­te­ria based on gene se­quenc­ing. It is con­ducive to pro­tect­ing the safety of species in­for­ma­tion in China, pro­vid­ing more pro­fes­sional, con­ve­nient and ac­cu­rate ser­vices for do­mes­tic ba­sic re­search and clin­i­cal treat­ment, and im­prov­ing do­mes­tic di­ag­no­sis and treat­ment of NTM in­fec­tions.

Thanks to her clin­i­cal ex­pe­ri­ence, Huang con­ducts med­i­cal re­search with high pro­fi­ciency. Her re­search re­sults serve as a good help for clin­i­cians to en­hance clin­i­cal treat­ment. She says that the di­ag­no­sis and treat­ment of NTM in­fec­tion is not a new thing in foreign coun­tries, but it at­tracts al­most zero at­ten­tion in China. To­day, med­i­cal in­sti­tu­tions have in­vited Huang to give lec­tures. Her re­search re­sults have in­spired many in fields such as tu­ber­cu­lo­sis, res­pi­ra­tory medicine and in­fec­tious dis­eases. She says proudly, “I write down ex­perts' con­sen­sus, and share this ex­pe­ri­ence with the med­i­cal com­mu­nity, hop­ing to open a win­dow to this area. To make things bet­ter, out­side this win­dow is a vastly dif­fer­ent land­scape.”

At the same time, Huang made great strides in treat­ing tu­ber­cu­lo­sis, high­light­ing ad­van­tages in com­bin­ing re­search with clin­i­cal treat­ment. Pre­vi­ously, tu­ber­cu­lo­sis pa­tients had al­most the same med­i­ca­tion and treat­ment. But Huang's study shows that dif­fer­ent peo­ple have dif­fer­ent meta­bolic abil­i­ties for the same drug, so dif­fer­ent peo­ple should be given var­ied doses ac­cord­ing to their meta­bolic abil­ity, which won't only im­prove heal­ing, but re­duce side ef­fects. Based on pre­vi­ous work, Huang's team has achieved the trans­for­ma­tion of a cer­tain tech­nol­ogy, which can iden­tify pa­tient's geno­type within two hours to guide pa­tient's drug dose. Cur­rently, the tech­nol­ogy has been re­ported to the China Food and Drug Ad­min­is­tra­tion (CFDA) for ap­proval. Huang says the rea­son her team can make it is be­cause many do­mes­tic doc­tors lack knowl­edge in cre­at­ing prod­ucts needed for clin­i­cal treat­ment.

Stal­wart Re­searcher

Now a pro­fes­sor of Cap­i­tal Med­i­cal Uni­ver­sity, Huang is also a doc­toral tu­tor, and CFDA as­sess­ment ex­pert of in vitro di­ag­nos­tic reagents. She also serves as a con­sul­tant for in vitro di­ag­no­sis for the World Health Or­ga­ni­za­tion, to pro­vide tech­ni­cal ad­vice on mak­ing strate­gies for global tu­ber­cu­lo­sis lab­o­ra­to­ries, and mak­ing ra­tio­nal use of dif­fer­ent lab­o­ra­tory di­ag­nos­tic tech­nolo­gies around the world.

When it comes to her achieve­ments, Huang says she's en­coun­tered no great ob­sta­cles but has en­joyed her sci­en­tific re­search so far, be­cause she never gives pri­or­ity to in­ter­ests. All she wants is to at­tain mu­tual benefits for ev­ery­one. This work ethic helps her win a rep­u­ta­tion and makes co­op­er­a­tion smoother. Her lab­o­ra­tory plays a piv­otal role in the hos­pi­tal. Huang ad­mits that it's not money that in­spires her. As long as her re­sults are pub­lished, she is will­ing to do re­search even if she doesn't re­ceive com­pen­sa­tion.

Huang de­votes her all en­ergy to her team. The Na­tional Tu­ber­cu­lo­sis Clin­i­cal Lab­o­ra­tory now has 21 staff mem­bers, of which seven spe­cialise in sci­en­tific re­search and four are post-80 gen­er­a­tions. Huang keeps a re­laxed out­look in tal­ent man­age­ment, and doesn't give as­sign­ments de­lib­er­ately. In­stead, she gives full sup­port to the younger gen­er­a­tion. When re­searchers ap­ply for projects, she'll help them with coun­sel­ing. She some­times also sup­ports those who don't have project fund­ing. Huang has al­ways been a sup­porter for use­ful at­tempt. She says that re­searchers shouldn't be given too many rules and reg­u­la­tions, but the free­dom in both be­hav­iour and think­ing. Even if some ideas aren't ma­ture enough, she'll en­cour­age her re­searchers to give it a shot and find new dis­cov­er­ies.

“For a good sci­en­tific re­searcher, a spon­ta­neous and strong in­ter­est in sci­en­tific re­search is the best cat­a­lyst for re­search out­put. Car­ry­ing out sci­en­tific re­search is ben­e­fi­cial to ev­ery­one.” Huang says, “There are many young re­searchers in my team, and they all get along. I feel lucky to re­spect, help and sup­port them like fam­ily.”

Huang's pos­i­tive at­ti­tude makes her work worth­while. Due to the spe­cial func­tion of the lab­o­ra­tory, she of­ten re­ceives calls for as­sis­tance af­ter work. Call mak­ers of­ten feel sorry to bother her, but Huang says, “Feel­ing needed gives me a sense of ac­com­plish­ment. The strength of our lab­o­ra­tory lies in anal­y­sis and ad­vice we of­fer when other med­i­cal in­sti­tu­tions can't. Doc­tors some­times talk to me about the prob­lems they have. Our com­mu­ni­ca­tions help them im­prove their treat­ment, and help us at­tain new re­search sub­jects, so I'm al­ways very glad to take part.”

Huang Hairong (mid­dle) gath­er­ing test­ing sam­ples to test for TB

Huang Hairong (right) puts blood sam­ples into a blood cen­trifuge.

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