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Biomedical scientist Alan Mackay-Sim with ABC presenter Jane Hutcheon, 26 October 2017

DAVID ARNOLD: Well ladies and gentlemen, welcome to the National Museum of Australia. It’s actually lovely, looking at the number of people here. Just a few really good friends in the audience. Lovely to see some people back – familiar faces. Welcome on a Sunday afternoon. Nice place to come to on a Sunday afternoon. Welcome to this very special event. Before I introduce two people on the stage, what we customarily do of course here at the National Museum is to acknowledge that we’re on Ngunnawal, Ngunawal and Ngambri land, and pay our respects to the elders past, present and future, and to any other Aboriginal and Torres Strait Islander people who may be in the audience today. Very warm welcome, and a welcome to you. Thank you very much for coming.

This is the third annual conversation, if you like, event, for the Australian of the Year. You might recall, I don’t know if any of you were here for the Rosie Batty conversation we had a couple of years ago. Then last year we had David Morrison here, from the 2016 Australian of the Year. Of course, this year, we’re delighted to have the 2017 Australian of the Year, and I’ll see if I can get these words in the right order.

Bio-medical scientist Professor Emeritus Alan Mackay-Sim, who is 2017’s Australian of the Year, is about to be interviewed by Jane Hutcheon of the ABC’s One Plus One. Some of you may not realise it, but the cameras we’ve got, apologies if they’re a little bit in your way, they’re actually being used to record the One Plus One program. That’s why we have so many cameras in the room today for this event.

The program was developed with our very good partners, the National Australia Day Council, and Kayla Scott from the Australia Day Council is in the audience. Welcome Kayla. It’s a fantastic partnership project that we have with the National Australia Day Council. This event has become a bit of a signature event throughout the year. It heralds, if you like, the next stage of the process. It starts all over again. So, right now you’re probably be aware that the 2018 State and Territory nominations are taking place, and those people are being selected, some of whom, you already know, most of whom you already know now. Of course, we will have an exhibition here at the end of the year opening on the 14th of December down in the Hall, which will again, as we did with Alan’s, we’ll have an object, a signature object, that each of these nominees are successful people choose to have in their exhibition, which tells us something about them.

So you must come along once their exhibition is in place. From the 14th of December they’ll be here until February next year. I’d like to introduce briefly Jane Hutcheon. She probably doesn’t need any introduction to you because she’s very well-known and very loved by all of us. Jane is joining us again. She was here last year for the David Morrison conversation. Jane, for those of you who don’t know, was a correspondent, a foreign correspondent in China and the Middle East and London before returning to Australia to take up this extraordinary program that she’s run. I don’t know, Jane, how many people you’ve interviewed. Would it number in the –

JANE HUTCHEON: It’s 350.

DAVID ARNOLD: 350.

JANE HUTCHEON: In news. Yes.

DAVID ARNOLD : So look, if there’s anyone in the audience who hasn’t been interviewed by Jane, I don’t want you to feel you’ve been left out. But, I haven’t been. That’s 350, extraordinary. No, that’s not extraordinary. It’s an extraordinary number. 350. Of course, a number of well-known people. But people from all walks of life on Jane’s program, which is wonderful. We are waiting in great anticipation for this conversation, and I’d like you to warmly welcome Jane Hutcheon and Alan Mackay-Sim.

JANE HUTCHEON: Ladies and gentlemen, welcome to this special in-conversation event at the National Museum of Australia with my guest, the Emeritus Professor Alan Mackay-Sim, who is of course, the 2017 Australian of the Year.

It’s lovely to see you. You must be super-busy at the moment.

ALAN MACKAY-SIM: I have a full-time job.

JANE HUTCHEON: Being Australian of the Year.

ALAN MACKAY-SIM: Being Australian of the Year. Yes. It’s been – I was adding up the number of trips I’ve made, and five per week, I think I’ve averaged over the whole year.

JANE HUTCHEON: It must completely change your life. I guess when you’re announced as the Australian of the Year, any plans you have for 2017, go out the window. Is that how it works?

ALAN MACKAY-SIM: Completely. I had some idea talking to previous winners, thinking, ‘Gosh, I don’t think I’d like to do that’.

JANE HUTCHEON: Really? Because it’s so intense.

ALAN MACKAY-SIM: Because it seemed to be so intense, but it’s been fantastic really.

JANE HUTCHEON: You must travel the length and breadth of the country.

ALAN MACKAY-SIM: All the big cities. Some lots of times, and some regional cities, up to Darwin and the Bathurst, islands, and Cairns, and Tasmania. It’s been fantastic.

JANE HUTCHEON: And the message is to communicate the science as well as the award?

ALAN MACKAY-SIM: Certainly. It really – it gives me an opportunity to talk about the science, but it also gives me an opportunity to talk about the importance of science and the importance of, particularly, bio-medical research. I talked with teachers. I had a really good occasion where I spoke at the School of Distance Education. I talked to about 100 kids around Australia on the ends of their computers, and it was just great, really. Engaging, and they love to hear about science.

JANE HUTCHEON: Your research is ongoing, but your full-time job, I guess if you can call it that, is head of the laboratory. That finished in 2015. So how does the research become ongoing?

ALAN MACKAY-SIM: Yes. I closed my lab and retired, but have this position at the University where I can continue to contribute to the University. I have several collaborations with people inside and outside the University. It’s all done on the keyboard, on the telephone and email, and so on.

JANE HUTCHEON: So, when we hear Emeritus Professor. What does that mean?

ALAN MACKAY-SIM: It means that you’ve done well enough at your university for the University to think, okay, we’d like to keep a connection with this person. And you want to keep that connection so it gives you access to the office and the email and all the resources of the University, and allows you to continue your work into retirement, really.

JANE HUTCHEON: We’re going to go into your work and the whole world of stem cell research, which I’ve always found absolutely fascinating, in a moment. But I want to find out about the boy who was born in Roseville, northern suburbs of Sydney, some time ago. I think you’re in your 60s now. Let’s just leave it broad for all of our sakes. You grew up the third of four boys. Your dad run a series of hardware stores, I believe, and your mum had been a nurse. Just wondering where the science part came into your life and when.

ALAN MACKAY-SIM: It really came from inside. I was curious about biology and really got curious about, strangely just about how the body works, is how I’ve always thought of it, you know. And how my own body work, because introspective thinking about how does my brain control my hand? How does my heart pump blood around the body? It was something that just fascinated me.

JANE HUTCHEON: Do you remember particular time or moment, or a toy that you had that took that interest a step further?

ALAN MACKAY-SIM: Well, yes. I don’t know how much of this comes from telling and retelling of it, but the way I picture it was – in the 50s when you’re growing up and your mum’s a nurse, if you get sick, basically you just go to bed and avoid everything. So, what boys did then was to put glue, little plastic planes together and plastic cars and paint them. My mum saw my interest in the body and she brought me home this plastic model of a human, which had a clear plastic outside, and it had a skeleton and all the organs and you could paint them all in. In re-assembling that, I was learning the names of the organs and the bones and everything. I think of that as my entry into beginning to understand what the body was.

JANE HUTCHEON: I remember at school feeling that I was particularly bad at things like maths and I remember thinking physics and chemistry were quite difficult for me as well. I wondered whether at that stage I’d given up on, thankfully probably, a career in science. But I wondered, did you get that open encouragement throughout your time at school. I’m always fascinated by people’s school experience.

ALAN MACKAY-SIM: Yes. I don’t really think of my primary school as being anything to stimulate me. But I went to high school and I was just – I just loved school. I just loved learning stuff. It was really a matter of not having anybody discouraging me than – I had the odd good teacher, but it was really again, I just wanted to learn deeply about pretty much everything.

JANE HUTCHEON: What was your first job in science?

ALAN MACKAY-SIM: My first job in science. I was a student, an undergraduate student. I worked in my professor’s lab.

JANE HUTCHEON: What kind of a lab was it?

ALAN MACKAY-SIM: I was measuring some hormones in some rat’s blood.

JANE HUTCHEON: Between that and the time where you made this special connection, I suppose you’d call it, with the nose, where you always heading in that direction? Some of us get great ideas when we’re young and we don’t act on them. Was your own discovery like that or, did you have a pretty even stage of steps?

ALAN MACKAY-SIM: If I could bore you with the steps, at the end of my high school, I – again, I interested in how the body works and the brain works, and I wanted to put those together as a non-graduate, so I did that at Macquarie University. At the end of that, I wanted to I thought I wanted to get into sensory biology. There happened to be somebody there who was working on the sense of smell. That’s really how I into the sense of smell, specifically. And then after that, I decided I wanted to study the nose, the sense of, the organ that gives us the sense of smell. That was a choice because I thought there’s nobody else in Australia who does that, and that will make me – When you’re a young scientist you want to have some expertise that nobody else has that will make you somehow needed, or wanted, or in-demand.

So, I decided on that. I’m still the only person in Australia working on the sense of smell.

JANE HUTCHEON: Do you think when you made that decision as a young scientist, did you get some people who might have thought that was either an odd or – Oh gosh. The nose. Of all the things to study. Did you get any of that pushback?

ALAN MACKAY-SIM: I think in general the nose is under-studied and undervalued –

JANE HUTCHEON: I agree.

ALAN MACKAY-SIM: And in history in Australia, the history has been a lot of really good research on seeing and hearing but very little on smell. So, it’s always been a curiosity to most other scientists.

JANE HUTCHEON: It’s true isn’t it? Because I actually have a lot of – I won’t bore you about my nasal problems, but I have a few issues going on there. I was having this game with my daughter once that if you didn’t have one sense, which would it be? And I have to say I picked smell, and then I thought, but then that would affect my taste and I love good food. A dog couldn’t live without its sense of smell, could it?

ALAN MACKAY-SIM: No. No.

JANE HUTCHEON: So why is it that we’ve almost kind of, I don’t know, downplayed it? We have such a lot of chemical fragrances these days as well, it’s like you’re being assaulted.

ALAN MACKAY-SIM: We spend billions of dollars around the world washing off one smell and putting on another smell or putting smells into our dishwashing liquid. I got some dishwashing liquid the other day that was peppermint. This is so ridiculous because the sense of smell for most people is subliminal. We don’t attend to it, but we know what we don’t like. Most of us, the first response is we’ll draw in something we like the smell of, and really push away what we don’t like. So, it’s not an analytical sense. It’s very much an emotion-driven sense.

JANE HUTCHEON: That’s really fascinating to hear that. So then you stumble on this wonderful organ, which none of us can do without and it defines our faces, it defines so much about us. What was the area that – You knew obviously that the nose is – there’s pathway to the brain through the nose. But what about these stem cells that you’ve become, I suppose, well-known for researching. How did you find that particular connection?

ALAN MACKAY-SIM: Again, that was happening very early on. My research was, if you like, what the nose tells the brain. It was about trying to understand the electrical signals that go from the nose to the brain to interpret this sensory world. Then I learned that those sensory cells regenerate, or they die and regenerate. There’s very little mucus between the outside world and those cells, and then their direct connection to the brain. Bacteria and viruses can go straight through the nose into the brain. So we’ve evolved to drop those sensory cells if they get infected.

We have this whole defensive system there, and every creature that has a sense of smell, whether you’re a snail, or crayfish, or a fish, or a mammal, or a –

JANE HUTCHEON: Snails have a sense of smell?

ALAN MACKAY-SIM: They have a sense of smell. They have this regeneration happening, and I thought too, that’s an interesting biological question. How does that happen and how do have, how do we maintain the sense of smell when we have this turnover, and that set me off. Again as a young scientist you want to find an area of research that, you think this is a really meaty subject that I could spend a career on. Those are questions you do have when you’re in that position. Rather than most people thinking, ‘Me, I’ll just do this job, and that job, and this job’. So, you’re thinking in a very long-term sense even then.

The other aspect was, that at the time it was thought, this is the only part of the nervous system that can regenerate. Couldn’t you use that for something to regenerate the nervous system, the rest of the nervous system? There’re lessons you might learn there. So both of those things led me to start down that path.

JANE HUTCHEON: The actual element of the research into stem cells, that wasn’t your primary focus at first?

ALAN MACKAY-SIM: Well, back in the day, we didn’t know how those cells regenerated, and the concept of stem cells – let’s say the –

JANE HUTCHEON: 80s?

ALAN MACKAY-SIM: The 80s. The main stem cells that were out there, were the stem cells they give us during our bone marrow that make up our blood. In biological terms, that was how you thought about stem cells. But we didn’t know if there was a stem cell in the nose. We identified the stem cell in the nose ourselves, and kind of said, ‘That’s probably like what happening in the blood’. The stem cell idea has come into it later on.

JANE HUTCHEON: What did it feel like when you realised that there were stem cells in your favourite organ that could potentially be useful?

ALAN MACKAY-SIM: Well, again. It’s really a matter of – the implication of stem cells wasn’t there. It’s simply, these are cells which would do the same job in this tissue as the bone marrow cells do in the bone marrow. You wouldn’t get the same excited talking about a stem cell then as you do now.

JANE HUTCHEON: Right.

ALAN MACKAY-SIM: Because it was just really a much more prosaic. Here’s a cell that must be giving lives to all the others to regenerate the sensory cells.

JANE HUTCHEON: Before we leave stem cells and the nose, how do you actually extract nasal stem cells?

ALAN MACKAY-SIM: I say to my very good friend Chris Perry who’s an EMT surgeon, and he’ll go in and he’ll take the tissue that comes from up –

JANE HUTCHEON: Up there.

ALAN MACKAY-SIM: Up in here, so it’s all accessible through the nostril, and it’s a very simple procedure, a very simple EMT procedure. Taken out, worked on in the lab.

JANE HUTCHEON: I guess a lot of the talk around the nasal stem cells that you isolated was related to particular spinal cord injuries. But that wasn’t the be-all and end-all of the research, was it? Those stem cells potentially have other applications.

ALAN MACKAY-SIM: Yes. There’s a distinction here because, we’ve already taken the cells out of the nose. The cells we put into the spinal cord are actually a support cell for the olfactory nerves. So there are the sensory cells, which have to grow a nerve from the nose up to the brain, connect the connection, and the supporting cells, which assist that regeneration, are the ones we put into the spinal cord. The stem cells are sitting in the tissue to make more of the cells there, to regenerate the tissue. We just grow them in a different kind of witch’s brew of factors to get one cell type or the other.

JANE HUTCHEON: So what kinds of potential were there from these stem cells? Tell us the kinds of things that they could potentially heal or regenerate.

ALAN MACKAY-SIM: Yes. Having taken them out, we thought, we just did it. We went into the sandpit and played around and – I mean a play pit.

JANE HUTCHEON: Yes.

ALAN MACKAY-SIM: What could we make this into? We could make them in a dish, we could make them into nerve cells, and we could make them into the support cells of the nervous system as you might predict. But we could make them into liver cells, or heart cells, muscle cells. We even did this fantastic experiment were we took them out of the nose in Brisbane, and we took them down to Adelaide, where they had a system where they could irradiate animals to destroy the bone marrow, and we put the cells in and they made blood. They contributed to the blood of the animals who had like a bone marrow transplantation.

JANE HUTCHEON: Did they have more success being turned into one thing than another?

ALAN MACKAY-SIM: It’s hard to judge. It was really a matter of examples. There wasn’t any kind of competition. But we have put them into damaged intervertebral discs. The discs between bones of the spine and they will regenerate the cells there appropriately. And we’ve put them into the brain of animals who have a movement disorder like Parkinson’s disease and they stopped the movement disorder. So, they’re incredibly flexible in what they like to do, and they can do.

JANE HUTCHEON: At one stage you meet the famous Hollywood actor Christopher Reeve, while he was still alive obviously, when he came to visit Australia. Could you tell us what the conversation – obviously he had put a lot of money and effort into finding some kind of a cure for spinal injuries. What did you talk about?

ALAN MACKAY-SIM: We talked about the whole field, and about where it might be going. This is in 2003 and I think 2004, and I visited him also in New York in his home. We discussed the personal issues of his own injury and we also discussed the signs. We also discussed the implications. He wasn’t going to subject himself to any particular therapy at that time because if he did it, the implications – too many implications I suppose. He was really, really a great rallying point for fundraising and cohesion around spinal cord injury research in the US and was a great force for being – a lot of desperate fundraising organisations together under the one umbrella and begun to then have a much bigger program of research.

JANE HUTCHEON: Where in your research did you get up to in terms of the application of those nasal stem cells and spinal injury recovery?

ALAN MACKAY-SIM: This olfactory in sheathing cells, the support cells, we show that if you take them out of the adult nose and put them into the injured animal, they will regenerate the locomotive behaviour. The movement of their lower limbs, and then we did this clinical trial where we showed it was safe to take them out of people and put them, grow them in a dish for four to six weeks and put them back in again. That demonstrated that it was very safe to do this – apart from the issues we have in major surgery, but the cells weren’t doing any damage. So, that has led to this group in Poland with this one gentleman who had received those cells after a stub wound and is now walking. Our work now at Griffith University is to start our own clinical trials in several years to further the work.

JANE HUTCHEON: Why is it that – are there many other people apart from this Polish man who have been able to walk again as a result of this –

ALAN MACKAY-SIM: No. There’s only been one human. But there’ve been thousands of animal experiments.

JANE HUTCHEON: Why is it that there’s only been one human?

ALAN MACKAY-SIM: Because it’s –

JANE HUTCHEON: What’s it down to?

ALAN MACKAY-SIM: No, it’s a good question. There have been lots of animal studies, but the question is – and we know the cells work – it’s very clear that they work. But, how do you find the right group of humans that they’re going to work in? For example, when you do the safety trial, to reduce the risk, you go to people who have paraplegic – have an injury in their chest region. But injuries in chest regions are huge because you have to smash the chest in order to break the spine, so that you have a very big biological problem to solve. If you come up to this part of the body where the injuries are smaller, the downside risks are much higher. So, there’re all sorts of very difficult ethical medical questions that arise, and then there’s the question of what’s the best time to put them in. Do you put them in fresh after the injury, or do you wait till they – there’re very technical ethical medical questions that we’ve been asking ourselves over for many years.

JANE HUTCHEON: Really.

ALAN MACKAY-SIM: Yes.

JANE HUTCHEON: So did you perhaps hope that in your lifetime you would see many more successful transplantations?

ALAN MACKAY-SIM: I’m not dead yet.

JANE HUTCHEON: I know. That’s why I say, in your many years to come.

ALAN MACKAY-SIM: Well, yes. I’m really pushing it. We can go forward with this and start to look at patients who will benefit rather than just think about whether it’s safe.

JANE HUTCHEON: Because there’s so much hope invested in a spinal code injuries, and I suppose the length of time it’s been since people have had those injuries. I know a few people who have injuries and their hope is just incredible. You just think, ‘I’d never want to blow that for you’.

ALAN MACKAY-SIM: When we first started this many years ago, it was a concept of, ‘We don’t want to give people false hope’. But on the other hand, all of the developments, all of the experiments that had been done in injured animals with these cells, and really, the proof that the spinal cord can regenerate in animals, and the first proof. So up until, let’s say the year 2000, you’d say, no there’s no hope, but now I think there is hope. Whether it can be translated for the individual is the other question. But I really think that the spinal cord can be regenerated and it’s a matter of finding the right conditions that it might be so.

JANE HUTCHEON: What about the cures for other illness and other application for stem cells. We’ve been hearing for many, many years that diseases like Parkinson’s and so forth are on the verge of making breakthroughs. Is that hope that is possible that is possible within your lifetime?

ALAN MACKAY-SIM: Yes. I think that the first concept of using stem cells was to make cells or tissues for transplantation. Right early on, there were cells for diabetes, the cells for Parkinson’s disease, and they’re still going. I think there’s some, now it’s the first trials coming for Parkinson’s disease, and with diabetes, they’ve finally worked out how to make the beta to make the insulin. But then you have the problem of how do you put them in so that the immune system doesn’t attack them. There’re all sorts of technical problems, and that’s for making whole organs for transplantation. That’s right on the track. Really, I was really interested in that at first and then I thought, now I’d rather go somewhere where we can more quickly into the clinic. And that would be to use the stem cells from patients and from healthy controls and compare them to try and understand the biological difference.

In cancer, you look at a cancer skin cell and a normal skin cell and you say, what’s the biological difference? And then you use that biological difference to find a drug to kill the cell. Whereas this concept is you look for the biological difference and you try to find a drug to treat the cell. That’s really now probably a very strong thing now in stem cell researches, what my main thing is stem cell research now is. For brain disease like Schizophrenia, Parkinson’s disease, some major neuron diseases.

JANE HUTCHEON: Are you saying the use of transplanting stem cells –

ALAN MACKAY-SIM: Not transplanting. No. No. It’s really much more about the basic biology.

JANE HUTCHEON: The biological difference of the cells.

ALAN MACKAY-SIM: The biological difference. Can we find out – let’s say, these are from this patient group, how do they differ from healthy controls and understanding what’s going on in those cells. Could you find a drug to treat them? With one of the diseases that we’re looking at, a rare disease called hereditary spastic paraplegia, we’ve gone from taking the patient cells and we now have a drug to take into patients as a result of that. It’s a different way of finding new treatments, but through the stem cells. And through the stem cells of the nose.

JANE HUTCHEON: I’m I right in saying that you yourself some years ago when you were not very well, you received stem cells?

ALAN MACKAY-SIM: I did.

JANE HUTCHEON: Can you tell us that story?

ALAN MACKAY-SIM: Yes. Well, I have a disease of leukaemia called multiple myeloma and, in the leukemias, when you get a bone marrow transplant, now it’s called a stem cell transplant because we understand what the biology is –

JANE HUTCHEON: What was in the marrow –

ALAN MACKAY-SIM: What was in the marrow – bone marrow transplants have been around for about 50 years. It’s interesting, they’re not – the stem cells are given because you get such a huge hit of chemotherapy and it kills all of your own stem cells, so that if you don’t get the stem cells, you die. The stem cells are use there to rescue you from chemotherapy.

JANE HUTCHEON: It’s not the same thing as enabling a spine –

ALAN MACKAY-SIM: No.

JANE HUTCHEON: Spinal tissue to regenerate?

ALAN MACKAY-SIM: No. No. It’s like rebooting your whole blood and immune system from the transplant itself.

JANE HUTCHEON: Apart from the fact that you were probably quite sick as all that was going on, that must have been quite mind-blowing as a scientist. Even understanding what you knew – that that injection of stem cells was saving you.

ALAN MACKAY-SIM: You’re still a patient and you’re still reacting as a patient and as a person who is in a very life-threatening situation, throughout all of that. I was very fortunate that my oncologist and I had this great relationship where all the way through the process, we were talking as scientists on one hand, and then when I needed it, we were talking as patient-doctor. I guess I was terribly engaged with the whole biology as it was happening to me.

JANE HUTCHEON: Did it give you a kind of different insight into treating patients, being a patient yourself?

ALAN MACKAY-SIM: It really gave me an insight into the importance of that doctor-patient relationship. I think you understand that, that person is being a professional, right, that you know is a patient but you’re actually depended on that professionalism and that – even if its professional empathy if you like, you know how much you need. It was interesting in all sorts of levels actually.

JANE HUTCHEON: Are you well now? Do you have a good prognosis?

ALAN MACKAY-SIM: Myeloma is a disease which kind of becomes chronic. So you relapse and you remit, then you go into different drugs, then at some point, the drugs don’t work.

JANE HUTCHEON: It’s always with you.

ALAN MACKAY-SIM: It’s always with you, yes.

JANE HUTCHEON: Does that give you sense of urgency when you work?

ALAN MACKAY-SIM: It does actually. It does. It does. Yes. It’s not just something like a heart attack, which you might get over, because it’s there all the time, we’re all going to die aren’t we, but it gives us a, it does give a sense of emergency. It really drives my – the science I’m doing, I really want to push some of these things that I’m interested in.

JANE HUTCHEON: Gives you a great sense of purpose, I guess.

ALAN MACKAY-SIM: Yes.

JANE HUTCHEON: When you were interviewed in January, very soon after you were announced as the 2017 Australian of the Year, you spoke about the desire to have a conversation with Australia in a sense. A public conversation about building a scientific infrastructure in Australia in the long-term, and also the idea of how to give young people a career in bio-medical science, again, in the long-term. Why is this such an issue at the moment?

ALAN MACKAY-SIM: I think that I’m, it’s important – what I’ve learned this year, it’s not only politicians who don’t understand the long-term need in science. So, I can tell my story of this kind of long-term interest, but any bio-medical project requires commitment for many years. I think that trying to get that message across to the general populace that this is an enterprise that has to have this long-term view. In a small way, I’ve been able to, in the audiences that I’ve had, have been able to let people know that. I think politicians I understand now, they do gather that, they do realise that but the situation, which they find themselves is that they aren’t going to support it unless it has the short-term consequences for elections.

JANE HUTCHEON: Right. That must be very frustrating.

ALAN MACKAY-SIM: But I think intellectually when you talk to them, they –

JANE HUTCHEON: Of course, it’s a great idea to have a cure for this and that.

ALAN MACKAY-SIM: They know. Yes.

JANE HUTCHEON: So how would you rate your success in somehow in making this a public conversation?

ALAN MACKAY-SIM: That’s very difficult. I think that you have a success with the individual level. I’ve been to so many activities. It’s been school kids. It’s been people in the street. It’s been teachers training. It’s been Rotary Clubs. It’s been corporate boards. Getting this view out there across, whether people take it in you don’t know. It’s like sending out ripples I suppose. I don’t know how you measure it really.

JANE HUTCHEON: Because I know at one stage when you were out there looking for funding for your own research work, I don’t know whether this is because I just happened to see the right article about this, but I think it was Tony Abbott at the time who saw your work and I think he liked this in particular because it was adult stem cells as opposed to the much more controversial area of embryonic stem cells. How dependent is scientific research on catching the eye of an influential politician?

ALAN MACKAY-SIM: I think it’s played a great role. It happened with the embryonic stem cell research. They were extremely well funded at the time as well. I guess the politics allowed them to fund other stem cell research. So there’s both those direct political donations to institutions in all sorts of, around Australia as well as the competitive grounds of funding that happen through The National Health and Medical Research Council for example. But philanthropy plays a great role –

JANE HUTCHEON: Well, I was going to ask you about that because I think there’s an expectation as we go forward that philanthropy should play bigger part in a lot of those bigger funding institutions than government. I mean, how do you get the message out to philanthropists? Is it as popular to give to a long-term scientific project where there might not be a very certain outcome again in a short space of time?

ALAN MACKAY-SIM: I think there’s philanthropy, there’s the kind of the big-bucks philanthropy where people would give a lot of money for a particular centre. That’s something that I think is gradually developing among the rich and corporate end of town. But there’s a huge amount of philanthropy happening with cancer councils and smaller groups, which actually play a very important role, because they’re willing to fund more risky research, they’re willing to fund younger people. Whereas the government agency, like The National Health and Medical Research Council, by nature of the beast, tends to fund really good but conservative science. Whereas the charity, they’re just focusing on their disease and I just want to, they can find new ideas, inject new ideas. There’s a mix here that I think is an important driver in all sorts of ways.

JANE HUTCHEON: You’re going to come to an end of your 2017 term as Australian of the Year, what excites you going into the future?

ALAN MACKAY-SIM: It’s still the science we’re doing. It’s the spinal cord injury repair. It’s really driving to get this clinical trial for this hereditary spastic paraplegia.

JANE HUTCHEON: What’s stopping that? Is it money?

ALAN MACKAY-SIM: It will be money, but at the moment it’s planning. It’s just getting it planned and going. The spinal cord injury work we’ve just been funded well from the state government, the Queensland Government. So, we’re looking for matching funds to – because these things are very expensive. I’ve also been thinking and trying to work out a way to get some kind of commercial driver into this clinical work, into this clinical trials funding. Could we place a value on the savings, the future health cost savings, let’s say to insurance companies, for spinal cord injury, and could we use that savings later to drive investment now.

JANE HUTCHEON: It sounds like a great idea.

ALAN MACKAY-SIM: It sounds like a great idea. I’m talking to all sorts of people. It’s, I think, extremely difficult to pull off but, I’d like to find another way rather than just to go cap in hand. It would be great if we could find some kind of inherent driver for it.

JANE HUTCHEON: Sounds like a wonderful idea to me, and ladies and gentlemen before we move to questions, and actually I might just say that, but again, for television I don’t think they’re using the questions bit. Ladies and gentlemen, I hope you’ll join me in thanking Emeritus Professor Alan Mackay-Sim, it’s been fascinating. Thank you. Thank you so much, but we’re not finished there, because you do have a chance now to ask Professor Mackay-Sim some questions.

I just find it mind-boggling, the potential, and also with my limited science brain. It was all knocked out of me. I’m sure there must be some questions that you have here. Can we maybe bring up some house lights and – here we go, and we have, question. We might give you a microphone if you can just wait for two seconds, thank you.

QUESTION: Thank you very much Professor Mackay-Sim for a fascinating talk today. I was just wondering whether there’re any other areas of the body, which give rise to adult stem cells and sources of research?

ALAN MACKAY-SIM: Any part of you that regenerates, has a stem cell. In fact, in all of our tissues, the job of a stem cell – it’s obviously what the skin does. It protects, seals ups, has hairs in it, and so, the differentiated cells. When you cut yourself, it’s not those cells, which divide and become more skin cells. It’s a stem cell that sits there and is often doing nothing until stimulated and then it just buds off and makes lots and lots of cells, which go on to repair the tissue. In muscle, in skin, in the gut, virtually every tissue has some stem cells in them.

QUESTION: Thank you. Hi, this is sort of going back to the biology of what you’re doing. You mentioned that it was the support cells that support the nerve cell regeneration. Are these support cells the sheath cells that surround a nerve cell? And are these sheath cells on all unearthed cells in the body?

ALAN MACKAY-SIM: Yes. Yes. Every nerve cell has some kind of cell that’s wrapped around it. They go by different names. In the nose they’re called olfactory and sheathing cells. Whoever named them – in the peripheral nervous system of the nose going out to, they called Schwann cells, and in the brain, the central nervous system, they’re called oligodendrocytes, and there’s another one called the glia astrocyte. Each of them is slightly different. The Schwann cells that protect the peripheral nerves, they will allow the generation. So, if somebody has, the hand, they cut their nerves, the nerves will grow into those, and re-innovate and you can get back touch and so on. The cells of the nose, people said, well maybe, because they’re allowing regeneration of the nerve fibres from the nose to the brain continually, and because they actually go into the nervous system to allow the nerves to get into the nervous system. That’s what first suggested to people that they might be useful put into the spinal cord, because they could live inside the nervous system and they will also make a path for the regenerating nerves.

JANE HUTCHEON: Amazing. This lady in orange, thank you.

QUESTION: I know there’s research being done in North America and Europe to help people who’ve had their turbinates surgically damaged. Do those – and I know there’s stem cell research being done to repair that damage – I wonder if those people know about your work?

ALAN MACKAY-SIM: I have no idea. The turbinates are the – inside the nose – there are these very light curls of bone, a bit like this, upon which all of the epithelium is and the sensory cells are located, and they’re often taken out if you have polyps and nasty infections in the nose.

QUESTIONER: I’ve have septoplasty and turbinectomy. I am one of 20 per cent of people who now have Empty Nose Syndrome. It’s awful. I would love to know if those people in Europe know what you have done.

ALAN MACKAY-SIM: Unfortunately, although the tissue regenerates, we don’t know how to repair itself in any circumstances, when it’s lost. So, it’s one of those terrible conundrums. We just don’t know how to get that repair back at the moment.

JANE HUTCHEON: This gentleman here.

QUESTION: Dean Beaumont.

ALAN MACKAY-SIM: Hi Dean.

QUESTION: Hi. A question. Animals have a vomeronasal organ as well as an olfactory system, and we as foeti have that. Has the olfactory system taken over the role because it’s no longer there for us other than a few pits? Do you know the answer to that one?

ALAN MACKAY-SIM: No. In most animals, the vomeronasal system is a separate sensory organ, and has a lot of similarities in those, to the structure and sound of the olfactory organ. It’s usually used for either signalling prey, detecting prey, or detecting members of the opposite sex and directing sexual behaviour. But, we just don’t have it. There’s some evidence with humans that we are detecting members of the opposite sex. If you wear a t-shirt and, women wear t-shirts and men wear t-shirts overnight, and they give them to men and women the next day, they can tell who wore which t-shirt. So, we can detect members of the opposite sex but, whether or not we use that greatly, but in the same manner as animals would use the vomeronasal, I don’t know.

JANE HUTCHEON: Right in here, look in front of you.

QUESTION: Alan, that was a great talk so far. I was wondering, what do you tell people who say, I’ve lost my sense of smell?

ALAN MACKAY-SIM: Yes. It’s very difficult to – as I was saying before, the most losses of sense of smell, whether it’s through surgical loss or whether it’s through traumatic injury, we don’t know how to put it back. We don’t how to repair it, and with Parkinson’s disease, and with Alzheimer’s disease, it’s a loss of smell, which seems to precede those diseases. And again, in that case we don’t know whether that lies in the nose or whether it lies in the rest of the brain as well as other diseases are lying in the rest of the brain. It’s really a matter of counselling. We really can’t do anything about it.

QUESTION: Because a friend of mine in Germany said, if you lose your sense of smell and you take out an insurance, they’re apparently regarded as more than likely having a major issue, but I’m not sure if that happens in Australia.

ALAN MACKAY-SIM: I know that compensation for loss of sense of smell, in the kind of excellent conversation, it’s very little. You don’t get much. It’s not regarded as being a great impairment. Although, if you’re a chef or a winemaker or just somebody who loves food, it’s a huge impairment.

JANE HUTCHEON: I’m interested to find out whether expertise in the nose today around the world, has it picked up from the time when you first started to research the wonders of this organ?

ALAN MACKAY-SIM: No, I don’t think so. I think that, well I mean, they inevitably increase in the number of people in a scientific field yes. But, not greatly. Most of the research around the world is probably done by food and drug companies, and perfume companies. So, there’s a lot on that sensory evaluation side of things. There’s not a lot of people still who are working on the sense of smell. I think part of it is, it’s so hard to study. It’s hard to define an odour, hard to give an odour, and it turns out that the way we, biologically we detect odours, although now we have a deep sense of how that occurs, is still extremely difficult to study in a biological sense. We’ve got about, let me think, in mice, it’s about, let’s say, 10 per cent of the genes of the mouse are given over to the sensory detection in the nose. So, it’s very complex. It still remains to be very complex.

JANE HUTCHEON: What about humans, what per cent are we?

ALAN MACKAY-SIM: Well, yes. So, we have about 600 genes evolved into our sense of smell. Out of about 1000, we each have slightly different combinations. And we have about 20,000 genes that we use.

JANE HUTCHEON: Amazing. Sorry. Anyone else have a question? Probably got time for one more after this.

QUESTION: Hi Alan, just a question. The sheathing cells you described, which side of the blood bone marrow do they derive the nutrients?

ALAN MACKAY-SIM: Both. Because they live in the marrows, so that’s outside the blood bone marrow, and then they penetrate and take the nerve fibres from the nose into the brain itself, so they’re on the outside as well.

QUESTION: So, they interface between the brain and –

ALAN MACKAY-SIM: Yes. That was why they would – one of the reasons why they were thought that they might be good candidates for repairing the spinal cord. The Schwann cells have come out of nerves, which you could grow if you take a piece of nerve out. They stop. They won’t go into the brain, whereas these will pass into the brain. The first experiments were done to try and reconnect spinal nerves that had cut, and they found out that if a spinal nerve is cut, as you might, let’s say, if you rip an arm or something, you can move the brachial plexus, and the spinal nerves coming into the spine. But if you sew them back together and inject these cells in there, then the sensory cells can grow, sensory nerve fibres will grow into the spinal cord. So it’s just being able to live in both parts, is one of their great attributes.

JANE HUTCHEON: Any more questions? Last chance. Here we go.

QUESTION: As a fellow high school student of yours, many, many years ago, I just wonder if you wanted to comment or offer some insights into the value of the education process, that you went through in terms of contributing to your brilliant career? Robert Castle.

ALAN MACKAY-SIM: [Laughs] So we went to North Sydney Boys High School and, I think it was a great school. I think that, I have no concept of how high schools are right now but, we had a great education I thought, and we had really good teachers in general. I don’t know what other insight I could give except that, we were all full of – being a selective school I think, lots of people where, it wasn’t shameful to do well, shall we say. So, it’s probably because we were all boys, it’s probably the heat of competition and so on. Everyone was competing against each other within that, in that system. But I think the value was that, to me the value was that the effort that the teachers put into us and their interest in us and our academic advancement.

JANE HUTCHEON: And that’s all we have time for in this in-conversation with the 2017 Australian of the Year, Professor Alan Mackay-Sim. Thanks for joining me, we’ll see you next time.

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Date published: 01 January 2018

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