Advancing the Science

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August 7, 2019

Researcher challenges her team to develop solution for DRC health crisis

By Advancing the Science contributor
Marina Walther-Antonio, Ph.D.

Marina Walther-Antonio, Ph.D., has a full plate. An associate consultant in surgical research in the departments of Surgery and Obstetrics and Gynecology at Mayo Clinic in Rochester, she studies the microbiome role in human health and disease, particularly endometrial and ovarian cancer. She also develops technology in her lab, including microbial single-cell technologies for point-of-care applications. And Dr. Walther-Antonio is actively involved in astrobiological research, with projects involving NASA and the European Space Agency. A full load for any researcher.

In spring 2016 Dr. Walther-Antonio’s plate got a bit fuller, thanks to a lunchtime talk she attended. Sean Dowdy, M.D., chair of the Division of Gynecologic Surgery; along with Deborah Rhodes, M.D., Division of General Internal Medicine, presented about their experiences in the Democratic Republic of Congo (DRC) through Mayo Clinic Global Health. The talk included a discussion of the widespread sexual violence in the DRC, where four women are raped every five minutes in what is referred to as the rape capital of the world. In part as a result of this humanitarian crisis, cervical cancer — caused by human papillomavirus (HPV) — is the leading cause of cancer-related death among women in the area.

If you just stick to your own thing in your own little corner, you might miss an opportunity to do something that changes health care and helps others around the world.

Marina Walther-Antonio, Ph.D.

When they were in the DRC, Drs. Dowdy and Rhodes met with Denis Mukwege, M.D., Ph.D., a gynecologist at and founder of Panzi Hospital in Bukavu, who specializes in the treatment of women who require surgery due to injuries sustained during rape. Many of the women have been assaulted by multiple men and with sticks, knives and bullets. Dr. Mukwege received the Nobel Peace Prize in 2018, in conjunction with Nadia Murad, for efforts to end the use of sexual violence as a weapon of war and armed conflict. Dr. Mukwege said what’s most needed in his country is medical research, including knowledge to combat the high rates of cervical cancer at an early stage. To be tested for HPV requires women to make long trips to hospitals, crossing dangerous areas and risking more violence. Could a self-test be developed that wouldn’t require a visit to a lab and a provider for medical interpretation — similar to a home pregnancy test?

Dr. Walther-Antonio was moved to tears by her colleagues’ talk. “Dr. Dowdy said the DRC experience was traumatic, and he became quite emotional when discussing it,” she says. “It was remarkable to see him so affected because he’s usually quite reserved.” Dr. Walther-Antonio did her homework and created a brief presentation for her lab staff about what she’d learned. “I told them it seemed like something we could help with if we put our heads together — that we had the right people in the room. Fortunately they were all on board.

“I feel if I can help, it’s my responsibility to do so. You never know when a problem could go unsolved if you do not help. My team agreed to move ahead with a solution — a MacGyver (in reference to the TV character known for creatively engineering his way out of predicaments). We called this the MacGyver Project.”

Dr. Walther-Antonio and her research team.

Fast forward three years, and Dr. Walther-Antonio’s team has made great strides in developing an easy-to-use, affordable home urine test that provides immediate positive or negative results for HPV detection. The team is working with Sam Kounaves, Ph.D., at Tufts University in Boston, Massachusetts, to develop test prototypes and is enrolling patients in a phase 1 test.

Dr. Walther-Antonio's research is supported by Mayo's KL2 mentored career development program and by a Mayo Clinic Discovery Translation Program grant. Her work on HPV test has benefited from a Mayo Clinic benefactor gift, and she received a market assessment from Mayo Clinic Ventures to explore applications of the test for the U.S. market. Within a year, her team plans to begin phase 2 testing and next steps — identifying a company to license the test and, eventually, selecting a partner to distribute the test in the DRC.

This whirlwind effort is Dr. Walther-Antonio’s first foray into test development. She met with colleague David Ahlquist, M.D., who developed the Cologuard colorectal cancer test. “Dr. Ahlquist was very helpful, sharing his experiences and advising about how to navigate the road ahead,” says Dr. Walther-Antonio.

While her motivation to develop the test was related to the crisis in the DRC, Dr. Walther-Antonio is excited about other applications for the test. Women around the world lack easy access to, time for and resources to pay for preventive health care. Some cultures consider it taboo for a male physician to perform a Pap test. And diseases associated with sexual transmission cause shame and, therefore, inaction, among some people. “It bothers me that many people die from preventable diseases for no logical reason every year,” she says. “In my work, I try to think of simpler ways to solve complex problems. I knew my team was resourceful enough to solve this problem for a vastly underserved part of the world. I can’t say enough about my team.”

Heidi Nelson, M.D., was Dr. Walther-Antonio’s Department of Surgery chair and a chief supporter. “The development of this HPV test kit is a great example of what happens at Mayo Clinic when clinicians and scientists come together and solve a complex problem,” she says. “A compelling human problem engages with a thoughtful, motivated leader such as Dr. Walther-Antonio, a team of experts creates a brilliant technical plan and health care gets a little bit better.”

Realistically, within a few years, a woman in the DRC could be handed a test kit from a worker in a humanitarian aid mobile unit and shown how to use the kit in the privacy of her home — without having to make an often-dangerous trip to a medical facility. The test strip will indicate whether or not she needs to seek lifesaving medical care.

About that scenario, Dr. Walther-Antonio says she’ll be able to retire happy (one day) knowing she accomplished something meaningful. “My background is in astrobiology. When you work in a field such as that, you do it for future generations — often you know you won’t see your work come to fruition in your lifetime. In comparison, I hope to see the impact of the HPV detection kit — saving lives and improving the world.”

When asked what would have happened had she not attended the lunchtime talk by Drs. Dowdy and Rhodes, Dr. Walther-Antonio says, “I often go to these kinds of talks because I have to eat anyway — I may as well learn at the same time. It’s important to keep your eyes and ears open and learn what else is going on around Mayo Clinic. If you just stick to your own thing in your own little corner, you might miss an opportunity to do something that changes health care and helps others around the world.”

This article was originally published in Mayo Clinic's Alumni Magazine, Issue 2, 2019.

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Tags: cervical cancer, Deborah Rhodes, Education, endometrial cancer, general internal medicine, gynecologic surgery, gynecology, Heidi Nelson, HPV, human papillomavirus, Innovations, KL2, Marina Walther-Antonio, Mayo Clinic Ventures, obstetrics, ovarian cancer, People, Sean Dowdy, surgery

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