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Interview with Dr.Pierre Chan

Background

Rates of gout in Hong Kong are rising in the last decade, UCCKE igem team was honored to interview Dr. Pierre Chan, Hong Kong Special Administrative Region of China Legislative Councilor (Medical) on 30th August 2017 to know more about the current situation of this arthritis among the society. The topic of the interview was about gout, as well as the application and concerns of gene therapy.

Gout in Hong Kong

Dr. Chan summarized the cause of gout of most patients in Hong Kong as “the diet of a middle-aged man during a hot pot dinner” beer, mushroom, meat and edible viscera. Most patients in Hong Kong suffer from swelling and pain in their joints after a hot pot dinner. In fact, more than 90 percent of them can benefit from colchicine and NSAID which is commonly offered by doctors. Others are recommended to use steroid alternatively. Steroid was considered harmful to the body by most of the patients in Hong Kong. However, Dr. Chan explained that steroid used in treating gout will not cause any potential harm to the patient considering that the amount of steroid used is very small. Commonly used painkiller, Colchicine and NSAID are very effective in terms of relieving pain in joints. For example, it can relieve the pain of a gout attack within an hour after the patient took the medicine. However, Dr. Chan described the medication as a sword as the effect and side effect coexist in a patient’s body, affecting one’s digestive system. For a long-term prevention of gout, Dr. Chan emphasized that diet restriction is the best way.

Gene Therapy

As gene therapy is still in a developing stage, Dr. Chan is not very supportive towards the application of gene therapy. He suggested that this technique will require at least 10-20 years of investigation in order to gain the reliability for the therapy. He quoted thalassemia, a single-gene disorder as an example to explain the difficulty of applying gene therapy to a patient. He believes that gene therapy will be an ideal way of treating diseases once the technique is fully developed.

Interview with Dr. Karen Hui

The interview was conducted to get professional advice on how to modify our questionnaire. Dr. Hui, as a family doctor, mentioned that a rising population of elderly in Hong Kong are experiencing gouty arthritis, whereas most of them have been suffering from it over two years. She encouraged us to ask the respondents more on the causes of gout which is commonly mixed up with other diseases such as rheumatoid arthritis, which has a similar name in Chinese with gouty arthritis so that we can further investigate on the understanding of the general public to this diseases. As gene therapy is not very popular in the medical field, she seldom applies gene therapy on her patients. Therefore, she suggested that the general public may have very little understanding to this experimental technique and that we need to add information in the questionnaire to inform the respondents the theory and application of this technique.

Interview with patients

Mr. Q has been suffering from gout for over 10 years and was willing to be interviewed last September. The information we got was extremely valuable as it is an opportunity for us to understand how a patient lives with gout and how it is affecting his life. Mr. Q has been suffering from the diseases for over ten years. He mentioned that every time he drinks beef soup, he experiences a great pain in his joints which can last for more than 6 hours. Recently, he was sent to the hospital due to hematological disorders. After using medicine offered by the hospital, his joints became swollen and the arthritis was soon diagnosed with gouty arthritis. He was suggested to try another medicine to relieve the pain as the old one was affecting his digestive system and causing massive stomach pain. He tried several different medicines to relieve the pain caused by gout, but it was very inconvenient and costly. Therefore, he is supportive towards the investigation of gene therapy but his biggest concern is the reliability of the technique in the future.

Questionnaire (Coverage: 420 people)

Background

Our questionnaire on gout and gene therapy was released through social media to all age in the beginning of October. We aimed at finding out the opinion of the general public on the application of this technique and the current situation of the popularizing gouty arthritis in Hong Kong as discussions on similar topics have never been conducted among the community. As the technique is not yet very popular in the medical field, news on related topics is not common as well. By releasing the questionnaire, we hope that first-hand information can be received and awareness can be raised among the community.

Results

Receiving over 420 responses, we are surprised that whilst more than 75% of the respondents know what is gout, around 76% of all the respondents have not heard of gene therapy. Most of them reckon excess uric acid causes gout and more than 90% of them mutually agree that gout patients have to suffer from pain. Albeit the understanding they have on gout, they are conservative towards the introduction of gene therapy to the medical field. More than 50% of the respondents have shown their skepticism regarding this application. Still, around 70% of them expect a higher efficiency from this treatment while around 45% of them are expecting a lower cost comparing to the traditional approach.

Discussion

From the data we collected, we can see that most of the people are familiar with gouty arthritis and many of their friends and families are experiencing this diseases. Most of the respondents knew about the causes of the diseases but not the treatment and the cure of it. However, some of the respondents suggested that gout can be cured by Chinese medicine which is very inspirational to our teammates and maybe a topic worths further investigate on. According to the result, most of the respondents were not very sure about applying gene therapy in curing diseases. We believe the current situation can be improved by education through social media where the information can be promoted to millions of social media users.

Conclusion

Through the results of the questionnaire, we have successfully received first-hand information and recognize the government can take a step forward to introduce this brand new approach as it benefits all the stakeholders and promote this technique through education starting from middle school in order to gain more support from the society in the future.