This interview is part of a series that we are conducting with Key Opinion Leaders, Experts and Business Managers within the HLA field. This time, Mr. Attila Berces, Ph.D., Founder and Chairman of Omixon shares his thoughts about future technology improvements. We hope this series will shed a light on trends and challenges within the profession and will be helpful to both new and experienced HLA experts.

 

Would you please tell us a bit about yourself?

I am a chemist by training and have been working in cheminformatics and bioinformatics. I have been interested in how to make a real impact with science.

How did you decide to become an entrepreneur?

I worked at the National Research Council in Canada in the 90s. NRC was Canada’s premier research institute for applied sciences and engineering aiming at results suitable for commercialisation. By the time I left NRC, they had 58 spin-off companies with $300 million dollars of venture capital invested. Two of the spin-offs were located on the same floor where I had my office. I also collaborated with a group led by Harold Jennings that developed carbohydrate vaccines. They tested one of their vaccine first in 1999 against an outbreak of Meningitis C among hundreds of British children and it had saved many of their lives. I had a motivation to do research with an aim to make a difference. At NRC we were encouraged to be entrepreneurial. I took my first entrepreneurship classes at NRC and a participated in a longer program at Chalmers University in Sweden.

Where do you see the field of transplantation moving in 10 years?

In ten years time – at least in some clinical trial settings – transplant patients will monitor transplant rejection at home, by taking a drop of blood into a small device hooked up to a smartphone. The readings will be sent to their treating physician who will be alerted if signs of organ damage is present. Kidney recipients will have blood tests available to determine the cause of kidney allograft dysfunction and differentially diagnose acute cellular rejection, antibody mediated rejection, and acute tubular injury.

What is the role of HLA outside of transplantation?

HLA is associated with over 100 diseases, but its clinical utility outside transplantation is currently limited. I believe that it will be changing. One driver is cell therapy for cancer. While engineered T-cells can be made from the patient’s own cells, there is a significant economic advantage in having off-the-shelf cell therapeutic products. These products need to be matched similarly to donor stem cells. Another exciting area is immunotherapy. Cancer immunotherapy works only for those patients whose cancer is immunogenic. Immunogenicity requires efficient antigen presentation. HLA genotype of the patient clearly plays a role in determining antigenicity of cancer mutations and thus immunogenicity and thus the therapeutic response to immunotherapy.

What should a company do to be successful in supporting transplant labs over the next 10 years?

Technology will change faster than ever before. This is a difficult challenge for the labs as well as for companies. Companies need to play a leadership in helping labs to adopt the most efficient implementations of new technologies.

What is the future for transplantation in the 3rd world economies?

The sad reality is that income and GDP levels in many countries do not permit the widespread adoption of transplantation. Even blood transfusion is extremely under-utilised in several countries. The absolute numbers of transplants will ultimately increase, but GDP levels need to rise significantly to support more transplants. I think that it is imperative that the industrialised world supports a global development program in a Marshall Plan-like fashion. 1% of the GDP of the industrialised countries could make a tremendous difference and could lift hundreds of millions if not a billion people out of poverty. This could have many positive effects on a global scale including better utilisation of transplantation.

As DNA sequencing becomes increasingly commoditized, how will HLA/Immunogenetics labs need to adapt?

Commoditization means that we can cover more genes and have more information even outside the HLA region. Sequencing is a small part of histocompatibility workflow. The first challenge is to build better clinical utility of the available sequence information.

How do you see the future of organ allocation of transplants?

Better utilisation of living donor transplants can make a real difference. Pair-donations and chain donations to build a set of compatible pairs from a set of incompatible ones can make a real difference. Since living donation is not time-sensitive, NGS can make a significant difference in determining the best matches. Utilising epitope-based matching is desirable.

 

We would like to thank Attila his time and his interesting answers to our questions.