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Low oxygen levels behind pathological blood vessels in the eye

Numerous eye diseases are caused by an excess of pathological blood vessels. Helder André's research interest has led to important answers about how and why these blood vessels form in ocular diseases.

Helder André.

Helder André is a full-time researcher and has demonstrated that a lack of oxygen in ocular tissue often precedes the formation of pathological blood vessels, as is the case of wet or neovascular, age-related macular degeneration.

“The aim of our research is to study and understand the molecular mechanisms that cause oxygen deficiency in eye tissue, which then result in diseases. We are studying a number of molecules linked to low oxygen levels, directly involved in vision impairing diseases,” says Helder André, Head of Molecular and Cellular Research at St Erik Eye Hospital and researcher at Karolinska Institutet.

Once the process has been clarified more extensively, new and more effective forms of treatment will be possible. Wet macular degeneration is currently treated with injections. The major disadvantage of these treatments is that they must be administered regularly, and for the rest of a patient’s life.

“Our development of gene and cell-based therapies means injections will become significantly less frequent. Our therapies are aimed at long-term and sustainable treatment of neovascular diseases in the eye, and therefore one single injection could be potentially all that a patient might need,” says Helder André confidently. “In fact, St. Erik Eye Hospital is involved in a gene therapy clinical trial that will treat retinal diseases with one single injection per patient.”

Manipulated cells

In cell-based therapy, cells that occur naturally in the body can be extracted from a person and then treated in vitro.

“The cells are provided with therapeutic active properties which enable them to change the microenvironment that causes abnormal growth of ocular blood vessels, which can then be transplanted as a form of treatment,” explains Helder André.

In gene therapy, a human cell is assigned a new status, and it is possible to introduce new genes, correct defective genes in the cell, or introduce external genes capable of competing with unwanted cell processes.

The technology involved has been tested and approved for clinical treatment of retinal diseases. Nevertheless, for pathological blood vessels greater precision and accuracy are needed.

“We only want to treat the cells causing the disease, which is why we need to know precisely which cells are involved and how the disease affects them before we can correct them by manipulating the genome,” Helder André says.

Patients treat themselves

Helder André believes in dramatically improved treatment for patients. Routine injections will no longer be needed, as patients will be able to fight the disease ‘more naturally’.

“We might not be able to cure patients. However, using gene and cell therapy, we can supply the eyes with substances that remain in the ocular tissue and continually produce the molecules needed to stop pathological blood vessels forming. This is how we stop the disease.”

From Lisbon to Stockholm

Helder André moved to Stockholm after completing his degree in Lisbon in 2000.

“I moved here in order to conduct research at Karolinska Institutet. Sweden felt like an agreeable country to settle in and has a thriving research climate. I love living here but still try to visit my family in Lisbon often.”

Helder André recalls his inquisitive attitude was encouraged by teachers at school.

“We often learned not to take knowledge for granted, but to question it. Just because something appears in various media does not always mean it’s the truth!”

He describes himself as an optimist who likes to try new things, and he is motivated by everyday challenges in the lab and by his fellow researchers.

“I love what I do – asking important questions. With science you have to always question what you want to do. And that always takes you into new roads, because as soon as you have answered one of your questions, you are ready to move on and ask the next one. You have to be curious, prepared to fail and willing to take those failures on board and do better with that knowledge.”

Relaxes by reading

In his free time, Helder André likes to read and watch movies.

“It’s nice to read something else than science in my downtime. Science fiction and adventure are genres that offer a healthy dose of fantasy and keep my curious mind at wonder!”

Text: Anders Möller

Helder André

Title: Head of Molecular and Cellular Research at St Erik Eye Hospital and researcher at Karolinska Institutet.
Research role: Research group leader on molecular mechanisms that cause oxygen deficiency in ocular tissue, which in turn results in diseases.
Motto: “I am still learning.” (Michelangelo)

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