Heavily into biomedical research, a family tragedy propelled her in the direction of the early detection of oral cancer through non-invasive sampling. Poring over microscopes in her laboratory in Brisbane, Australia, or collecting samples of saliva from people fearful whether they are victims of oral cancer, her efforts have paid off, with the Food and [...]


All in the saliva: Lankan prof leads pioneering research on oral cancer


Heavily into biomedical research, a family tragedy propelled her in the direction of the early detection of oral cancer through non-invasive sampling.

Poring over microscopes in her laboratory in Brisbane, Australia, or collecting samples of saliva from people fearful whether they are victims of oral cancer, her efforts have paid off, with the Food and Drug Administration (FDA) of the United States of America (USA) giving the nod to her biomarker.

The face behind this achievement is Associate Professor Chamindie Punyadeera, very much of Sri Lankan origin. She is the Head of the Saliva and Liquid Biopsy Translational Laboratory of the Queensland University of Technology (QUT) of the School of Biomedical Sciences, Brisbane.

Prof Punyadeera taking a saliva sample

Describing herself as “a research intensive academic”, Prof. Punyadeera (50) is an innovator, translational biomedical researcher and strong advocate for women in STEMM (science, technology, engineering, mathematics and medicine). She has a team of 14 researchers including 10 PhD students of whom two are Sri Lankan.

Her simple explanation about her work is that she uses non-invasive methods of sampling (such as human saliva) for the early diagnosis of cancer and heart diseases. (See box)

The tragedy that made Prof. Punyadeera launch a research programme on head and neck cancer (oral cancer/mouth cancer and throat cancers are the two main sub-types) was very personal and close to home.

“My brother-in-law was diagnosed with a nasty form of head and neck cancer in 2005 and, sadly, within six months he succumbed to the disease. This is because when he was diagnosed it was late-stage cancer and the cancer had spread to other vital organs. So, there is an unmet clinical need to detect head and neck cancer early,” she says.

Working during these trying times of the pandemic when her laboratory was closed for two to three months and her clinical trials were put on hold for more than six months, she says that the people in Brisbane were “very fortunate” as the COVID-19 case numbers were minimal, compared to the rest of the world.

“Yes, balancing family life with a busy work life is a challenge,” she concedes and has been “my struggle” but her husband, Athanasios Mylonas, an Electrician/Electrical Engineer, is very supportive, while her Amma and Thaththa live just a kilometre from her home. “They help me a lot.” There is some sadness as her brother, Lasath, is working at the Standard Bank in South Africa and they have not been able to have a family reunion due to COVID-19.

Her one and only son, Vasileios  Nirvan Mylonas, is in the International Baccalaureate programme at the Queensland Academy for Science, Mathematics and Technology………“it is too early to say whether he would follow in my footsteps”.

Prof. Punyadeera had left Sri Lanka as a little girl of 11 in 1982, when her Thaththa and Amma headed for Botswana to work. She had returned home in 1984 for her secondary education (Grades 8-12) at Holy Family Convent, Bambalapitiya, once again leaving her motherland in 1990 for her undergraduate studies at the University of Botswana followed by an MPhil and PhD at the University of Witwatersrand, Johannesburg, South Africa.

Her primary schooling had been at Girls’ High School, Mount Lavinia, where they also lived in Colombo. Her Amma’s ancestral home was in Tangalle and her Thaththa’s in Unawatuna, Galle.

There is a note of nostalgia as Prof.Punyadeera says that among her hobbies of reading, jogging and swimming is also watching Sri Lankan teledramas.

“Of course, I miss Sri Lanka,” she says, sounding slightly indignant that such a query can even be made.

“Though I hold a Dutch passport, my DNA is Sri Lankan. Both my parents are proud Sri Lankans and I was brought up in a culture to value our identity and to know our roots. This becomes very important when you live for so long outside Sri Lanka,” says Prof. Punyadeera.

With regard to her work, her sights are set………..“We are applying liquid biopsy (the use of body fluids in place of traditional tumour tissues) to predict outcomes in head and neck cancer patients, liver cancer, brain tumours and lung cancers.”

This is while Prof. Punyadeera has recently received research funding from the National Health and Medical Research Council of Australia to develop a biosensor to predict outcomes in patients with heart failure, using saliva sampling as a non-invasive method.

The impact of such research will have far-reaching benefits, for globally more than 38 million people suffer from heart failure, with about 50% of them dying within five years.

Biomarkers as diagnostic test

A brand-new research programme to investigate biomarkers in human saliva to determine whether there are any of interest that can be used as a diagnostic test!

This is what Associate Professor Chamindie Punyadeera has pioneered in Australia.

A biomarker has been defined as ‘any substance, structure or process that can be measured in the body or its products and influence or predict the incidence of outcome or disease’, by the International Programme on Chemical Safety, led by the World Health Organization (WHO).

When asked how it will impact on people, Prof. Punyadeera says that saliva samples from people who are at higher risk of developing oral cancer can be sent to a company called Viome in the US for analysis.

At higher risk for oral cancer, strongly relevant to Sri Lanka too, are those who engage in betel-nut chewing, excessive smoking and drinking. People with bad oral hygiene or those who have multiple sexual partners, engage in oral sex or are immune-compromised such as HIV/AIDS patients are more vulnerable to throat cancer.

Explaining the processes, Prof.Punyadeera says that they used human microbiome (bacteria in the mouth) as a source of biomarkers to discern whether they can detect mouth and throat cancers early.

“We have published research papers on this topic and I have one PhD student, Dr. Yenkai Lim, graduating with an outstanding thesis from QUT. I have been researching with a company based in USA to utilise their high-throughput metatranscriptomics platform combined with artificial intelligence and machine learning to advance our research,” says Prof. Punyadeera.

Prof. Punyadeera was an inventor on the patent and the intellectual property has been assigned to the company. The company has got FDA approval under the ‘Breakthrough Device Designation’ recently.

Getting down to technicalities, she says that using their platform, her team has developed a biomarker panel with bacterial transcriptomics (gene expression changes) to detect mouth and throat cancer early.

Her team’s breakthrough research has been published as ‘The salivary metatranscriptome as an accurate diagnostic indicator of oral cancer’ with the authors: Guruduth Banavar, Oyetunji Ogundijo, Ryan Toma, Sathyapriya Rajagopal, Yenkai Lim, Kai Dun Tang, Francine Camacho, Pedro Torres, Stephanie Gline, Matthew Parks, Liz Kenny, Nevenka Dimitrova, Ally Perlina, Hal Tily, Salomon Amar, Momchilo Vuyisich, Chamindie Punyadeera, 2021, Research Square.

Some of the other important studies generated from Prof.Punyadeera’s lab are: ‘Oral microbiome: a new biomarker reservoir for oral and oropharyngeal cancers’; ‘The saliva microbiome profiles are minimally affected by collection method or DNA extraction protocols’; ‘The performance of an oral microbiome biomarker panel in predicting oral cavity and oropharyngeal cancers’; and ‘Chemoradiation therapy changes oral microbiome and metabolomic profiles in patients with oral cavity cancer and oropharyngeal cancer’.

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