A Gene Bringing Hope
Despite facing difficulties during her first year doctoral studies, Korri Elvanita El Khobar made an important breakthrough in medical science.
Korri Elvanita El Khobar
If she had decided to give up when her research proposals were being turned down, Korri Elvanita El Khobar would not have invented an effective method for the early detection of liver cancer. In her first year of her doctoral studies at the University of Sydney, Australia, she changed her research proposal three times. “In the first year, I did not go to the laboratory a single time,” said Korri, on Monday, April 29.
When Korri began studying in 2014, she had a research proposal related to fat in the livers of those suffering from hepatitis C with the manifestation of that disease. She suspected that fat in the livers of those with hepatitis underwent a change. This research did not progress because she did not obtain a needed reagent.
This frustrated this researcher from the Eijkman Molecular Biology Institute in Jakarta. However, she realized that her medical scholarship from the University of Sydney’s International Scholarship program could be revoked if her studies took too long. Korri had three and a half years left to complete her study.
She began reading more books. She also frequently talked with her professors, asking for advice. As a result of those discussions, Korri finally came up with a new research idea. She wanted to find out how a genes or proteins changed in people infected with the hepatitis C virus. “So in my research proposal I wanted to see not only its genetic expression, but its epigenetic expression as well,” said this 34-year-old woman.
For several month Korri conducted research on proteins in cells infected with the hepatitis C virus, comparing them to uninfected cells. She found that one gene, polo-like kinase 1 (PLK1), underwent more changes in patients with liver cancer. After doing additional research, it turned out that PLK1 was not only related with hepatitis C, but with hepatitis B as well. “So I thought that perhaps we could use this gene for the early detection of liver cancer, not only for hepatitis C and B,” she said.
It has not been easy to detect liver cancer in its early stages. Irsan Hasan, General Chairman of the Indonesian Association of Liver Researchers, said that the difficulty is that this disease does not have specific symptoms. Patients usually only discover they have liver cancer when clinical symptoms appear, such as nausea, vomiting, and jaundice. “They usually go to the doctor after having a chronic infection,” said Irsan.
Wiendra Waworuntu, Director of Disease Prevention and Control at the Ministry of Health, said that if not treated early, those suffering from hepatitis B and C can potentially develop liver cancer. There is a 50-70 percent possibility. “If action is not taken quickly, their lives are in jeopardy,” she said.
Before this, in order to determine if someone has liver cancer, a laboratory test was required, checking a protein in the blood, namely alpha-fetoprotein. “Blood should be checked at least once every six months,” said Korri. Other methods are biopsy and ultrasound. However, some patients are reluctant to use those methods.
Based on data from the World Health Organization (WHO), in 2018 there were 18.1 million new cancer cases and 9.6 million cancer deaths. Liver cancer was ranked as the fourth most deadly cancer, with 782,000 people dying from liver cancer. Lung cancer is ranked the most deadly, taking 1.76 million lives, followed by colorectal (colon) cancer (862,000 deaths) and stomach cancer (783,000 deaths).
Additional work is needed before her research findings can be implemented. Despite the finding being in its initial stage, David Handojo Muljono, Deputy Director of Translasional Research at the Eijkman Molecular Biology Institute, said that Korri’s research has given new hope for the medical world, especially for those with hepatitis.
David hopes that Korri’s findings are followed up by additional research so that they can be put into application. “That hope came from an expert from Indonesia, enabling early treatment,” he said.
With the finding, examining the PLK1 gene is expected to be more effective because it only requires a blood screening to look for changes to the gene. Before this, in order to determine if someone has liver cancer, a laboratory test was required, checking a protein in the blood, namely alpha-fetoprotein. “Blood should be checked at least once every six months,” said Korri. Other methods are biopsy and ultrasound. However, some patients are reluctant to use those methods.
Despite her discoveries, Korri never aspired to become a researcher. Before beginning her study of biology at the University of Indonesia (UI) in 2006, she had wanted to become a doctor. Fate took her to the Eijkman Institute after graduating from UI. She became an assistant researcher in the hepatitis laboratory unit. Three years later, she continued her studies at the University of Melbourne, Australia. Her thesis was on the mechanism of pathogenesis and fibrogenesis of the hepatitis C viral infection.
Her hepatitis research continued. In 2012, she received a scholarship to research liver cancer resulting from the hepatitis B virus at the Liver Research Centre in Trieste, Italy, for six months. Five years later, her research about the PLK1 gene was presented during Westmead Hospital Week di Australia. Despite having some difficulties in her first year, she was able to compete her doctoral studies in three and a half years.
According to Korri, her success can be attributed to the support of her parents. “Even though my mother had wanted me to become a civil servant, she supports my career,” she said. Her mother, Wartaty Djamin, who retired from the National Population and Family Planning Board (BKKBN), had questioned her child’s planned doctoral studies. She was concerned that Korri would marry too late if she studied too long. “A mother always wants what is best for her child,” said Wartaty.
However, Korri reassured her mother about her life choices. When studying for her doctoral degree in Australia, she met the man who would later become her husband. Today Wartaty is proud of the life chosen by her daughter. “I never thought my child would become a researcher and make an important discovery,” said the 67-year-old woman.