By Annette Taylor
Time is precious for Tamahere’s Dr Marianne Elston. The 39-year-old winner of the emerging scientist award at the recent Kudos Awards works two days a week in Waikato Hospital’s Endocrinology Department.
She is keen to continue research into her specialty area, genes responsible for pituitary tumours, but is also the mother of Brayden, 3, and Briana, 14 months. And is trying to find time to finish a chapter for a medical textbook, among other projects.
“When they both slept during the day, I could get some basic work done. Then Brayden dropped his daytime sleep, so now I’m having to do more in the evenings.”
Marianne and husband Win Meyer-Rochow, an endocrine surgeon at Waikato Hospital, have shifted 15 times for their joint careers, living in Sydney until returning to New Zealand in October. The couple recently bought their Tamahere house set in spacious gardens. “I like to think we’ll be here for a while.”
Originally from Timaru, Marianne did her medical training at Otago, where she met Win. Gaining her PhD at the Kolling Institute of Medical Research, in Sydney, was a race against time.
She was doing all the hands-on work herself and Brayden was born at the end of her second year. “So when I became pregnant I wanted to get as much done as possible.
“We took a small sample of pituitary tumours that had been surgically removed and then froze them in liquid nitrogen. Basically, I wanted to find out why the tumours occurred. Obviously in the lab you have to be ultra careful about chemicals, so I was working 12, 14-hour days, seven days a week, thinking, god, I want to get the lab work done before he’s born.”
The tumours were ground up and the genetic material extracted. “Then we put all the RNA onto a chip that contains thousands of probe sets, which gives us a snapshot of gene expression at one particular point in time. It gives us an idea of what genes are turned on or off.”
She managed to get most of the work done, before Brayden was born on November 16 2007. Her doctorate took exactly three years to complete, and she discovered she’d passed the day before Briana was born.
Pituitary tumours are usually benign, she says. “We still don’t know why they happen, and even though they are non-cancerous, they can still cause a lot of health problems because of hormonal dysfunction.”
The pituitary is situated at the base of the brain, back in behind the eyes. As the tumour grows it can press on the optic nerves and cause blindness. Symptoms vary depending on the type of tumour.
“If it’s over-producing hormones, such as prolactin, it can cause women to produce breast milk, even if they’re not pregnant. These patients often present quite early, when the tumours are small.”
Sometimes tumours are discovered as part of another procedure.
“Someone might be in a car accident, and are having their brain scanned. Or they fail their driving licence eye test, because they can’t see. It’s surprising how bad people’s vision can be, without them noticing it because it comes on gradually.”
Her doctorate research generated a huge amount of data. “I found just over 1200 genes that were different in the tumours, compared to the normal pituitary. That’s a massive amount of information to sort out, and then it’s a matter of choosing genes you want to follow up, and that might be interesting, or relevant, as opposed to just noise.”
Which is, she says, the challenge. “You spend a lot of time going over your work and then looking at what this gene does and what is known about it. I ended up focusing on a gene known as Wnt Inhibitory Factor One, or WIF1. This was markedly under-expressed in the tumours compared to the normal pituitary.”
While WIF1 had been studied in tumours, such as bladder and lung cancer, it hadn’t been looked at in the pituitary before.
Dr Elston says it appears to help suppress the development of tumours. But while her work has identified a promising gene, it’s a case of ‘slowly slowly.’
“There are so many other factors involved. One problem is that this is involved in one signalling pathway, but there’s a lot of cross talk between the pathways.
“What I found has increased our knowledge, but it’s not going to be the full answer. This is one of the genes that seems to be involved in the development of tumours, somewhere along the line.”
There is more research to be done, possibly working with Win, who has just submitted his PhD into tumours of the adrenal glands. “We haven’t done research together up until now, but are looking at setting up some projects. I plan to increase my hours as the children get older.”
Speaking of whom, Briana is due to wake up, and Brayden is dropping hints he wants to be pushed on the swing. Now it’s time for different work.