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Dr Yung is currently Assistant Professor in the Department of Medicine at the University of Hong Kong. She graduated in Applied Biology from Cardiff University, U.K., and obtained a Ph.D. at Cardiff University School of Medicine, U.K. Dr Yung received post-doctoral training at Cardiff University School of Medicine and University of Alabama at Birmingham, USA.
Dr Yung’s research interests include:
- Mechanisms of inflammation and fibrosis in renal disease and peritoneal dialysis
- Mesothelial cell biology and peritoneal dialysis
- Immuno-pathogenesis of lupus nephritis
Patients with end-stage renal failure require life-long dialysis or kidney transplantation to sustain life. Peritoneal dialysis (PD) is an established renal replacement therapy that is used by approximately 11% of the global dialysis population and is the predominant form of dialysis used in Hong Kong. Although PD has greatly improved patients’ quality of life, a major concern of this treatment is that conventional PD fluids are bio-incompatible since they contain elevated glucose concentrations 15-20 times higher than that of physiological concentrations in order to provide the osmotic drive required for net fluid removal. Constant exposure of the peritoneal membrane to PD solutions results in structural abnormalities that compromise the functional integrity of the peritoneal membrane as a dialyzing organ. Structural changes are exacerbated by episodes of infective peritonitis that induce peritoneal inflammation and fibrogenesis. My research focuses on the underlying pathophysiological mechanisms that mediate peritoneal inflammation and fibrosis, the contribution of mesothelial cells lining the peritoneal cavity in these processes, and methods to preserve the peritoneal membrane during long-term PD. We have demonstrated that glycosaminoglycans and proteoglycans play important roles in mesothelial cell function and in the regulation of p38 MAPK signaling, epithelial-to-mesenchymal transition, and matrix protein synthesis. These studies provide not only mechanistic insights into how mesothelial cell function is altered during PD and peritonitis, but also provide a platform that will allow us to assess novel compounds that may improve/preserve the structural and functional integrity of the peritoneal membrane.
Representative images showing structural changes in the peritoneal membrane before (panels A&C) and after (panels B&D) PD. Constant exposure of the peritoneal membrane with PD fluids induces mesothelial denudation, infiltration of immune cells, thickening of the submesothelium and matrix protein accumulation resulting in peritoneal fibrosis. Panels A&B: hematoxylin and eosin staining, panels C&D: fibronectin staining.
Collaborative research with Prof T M Chan focuses on inflammatory and fibrotic processes during lupus nephritis and other renal diseases. Using in vitro and in vivo studies, we have shown that hyaluronan, a non-sulfated glycosaminoglycan, plays an important role in the recruitment of infiltrating cells into the renal parenchyma and also intra-renal inflammatory and fibrotic processes. We made the novel discovery that anti-dsDNA antibodies bind to human mesangial cells through cell surface annexin II, and are internalized to induce synthesis and secretion of pro-inflammatory and fibrotic mediators including hyaluronan. Specific pharmacological inhibition of hyaluronan synthesis was shown to suppress kidney inflammation and fibrosis in a murine model of lupus nephritis.