Proteomics in Proximity

Welcome to Olink Proteomics in Proximity Podcast! 
 
Below are some useful resources from this episode: 
 
Highlighted pre-print article: Malarstig A, Grassman F, Dahl L, et al. Evaluation of Circulating Plasma Proteins in Breast Cancer: A Mendelian Randomization Analysis. ResearchSquare 2023.04.04. DOI: https://doi.org/10.21203/rs.3.rs-2749047/v1
 
Highlighted platform that was used to measure proteins in this study with a next-generation sequencing (NGS) readout (Olink® Explore 3072): https://olink.com/products-services/explore/
 
 
Learn more about the consortiums or cohorts mentioned in the podcast:
 
UK Biobank Pharma Proteomics Project (UKB-PPP) is currently performing one of the world’s largest scientific studies of blood protein biomarkers conducted to date: https://www.ukbiobank.ac.uk/learn-more-about-uk-biobank/news/uk-biobank-launches-one-of-the-largest-scientific-studies 
 
Human Proteome Atlas (HPA) aims to map all human proteins using various omics technologies: https://www.proteinatlas.org/ 
 
SCALLOP consortium is a collaborative framework for discovery and follow-up of genetic associations with proteins on the Olink Proteomics platform: https://olink.com/our-community/scallop/ 
 
KARMA cohort is a prospective screening cohort for breast cancer in Sweden: https://karmastudy.org/ongoing-research/the-karma-cohort/ 
 
Swedish Twin Registry (referred as “Twin Gene cohort” in the podcast) is the largest of its kind, containing genetic information about ~87,000 twin pairs: https://ki.se/en/research/the-swedish-twin-registry 
 
 
Additional published articles and books mentioned during the podcast:
 
Hood, Leroy and Price, Nathan. The Age of Scientific Wellness: Why the Future of Medicine Is Personalized, Predictive, Data-Rich, and in Your Hands, Cambridge, MA and London, England: Harvard University Press, 2023. https://doi.org/10.4159/9780674293465
 
Suhre K, McCarthy MI, Schwenk JM. Genetics meets proteomics: perspectives for large population-based studies. Nat Rev Genet. 2021 Jan;22(1):19-37. doi: 10.1038/s41576-020-0268-2. Epub 2020 Aug 28. PMID: 32860016. https://pubmed.ncbi.nlm.nih.gov/32860016/
 
 
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In case you were wondering, Proteomics in Proximity refers to the principle underlying Olink Proteomics assay technology called the Proximity Extension Assay (PEA), and more information about the assay and how it works can be found here: https://bit.ly/3Rt7YiY 
 
For any questions regarding information Olink Proteomics, please email us at info@olink.com or visit our website: https://www.olink.com/

WHAT IS PROTEOMICS IN PROXIMITY?
Proteomics in Proximity discusses the intersection of proteomics with genomics for drug target discovery, the application of proteomics to reveal disease biomarkers, and current trends in using proteomics to unlock biological mechanisms. Co-hosted by Olink's Dale Yuzuki, Cindy Lawley and Sarantis Chlamydas.

What is Proteomics in Proximity?

Proteomics in Proximity discusses the intersection of proteomics with genomics for drug target discovery, the application of proteomics to reveal disease biomarkers, and current trends in using proteomics to unlock biological mechanisms. Co-hosted by Olink's Dale Yuzuki, Cindy Lawley and Sarantis Chlamydas.

Welcome to the

Proteomics in Proximity podcast, where

your co-hosts Dale Yazuki, Cindy

Lawley, and Sarantis Chlamydus from Olink

Proteomics talk about the intersection of

Proteomics with genomics for drug target

discovery, the application of proteomics to

reveal disease biomarkers, and current

trends in using proteomics to

unlock biological mechanisms. Here we have

your hosts, Dale, Cindy, and

Sarantis. Hello, everybody. I'm

Sarantis. I'm together today with Dale

and Cindy for another episode

of our

great podcast, Proteomics in

Proximity. We are all very happy

to have like a guest, Professor

Johann Schwenk

who holds a

position at the University of

KTH University [Royal Institute of Technology in Sweden].

And today he's

a protein expert and

a professor in

Translational Proteomics. And today we'll

discuss a little bit about his

new research, about his

research interest and how proteins can

enable multiomics approaches. Actually,

Jochen,

thank you very much for joining

today. And I would like to

start the discussion asking you: What

does translational proteomics mean to you?

Yeah,

I think when we started thinking

about the title for a

professorship, translation was really a hot

topic at the time: to bring

something you've been doing in the lab

into a clinical context. But I think

it turns out to be much more than this. This is

actually to explain also what we're

doing in the lab to others, so that

the community can engage into

our research and we can even find a

broader utility. So it's

still the idea of

connecting the lab environment

with clinical and population

health. So I think

hopefully one day we'll contribute to that

activity. That's great.

And I saw also that you study biochemistry

in Tübingen, University of Tübingen. That's quite

famous from the biochemistry industry worldwide. Do

you have any story that you would like to

record for your first paper? For example,

being in Tübingen, and that would be great

to hear.

Yeah,

Tübingen of course gave me a

fantastic time. We were very

small number of students per semester. I had

very close connection to the

professors. I got a chance to go to

a Lindau Nobel Laureate

meeting there. And it was really,

I think, an inspirational time that

sort of created

a lot of curiosity about science. And

then after that I moved a little bit more

into technology. So in the early two

2000s, when I did my Masters and PhD, I

worked with Luminex-based

assays, which at that time

was really new.

Then sort of that took me then

to join the Protein Atlas in

2005 as a postdoc. And somehow I

got stuck with this fantastic project.

I'm

still around and

learn every day something new about

proteins. I mean, just being

there and to work with Mathias Uhlén

and all the colleagues has been truly

inspirational. So you've been at

SciLife Labs since 2005, and that was when

it began at KTH, is that correct?

Yes. SciLife lab was

inaugurated in 2010. So actually,

it was my and three other groups

that moved into the building under

construction, I think it was in

October 2010.

So I consider myself very much of an

oldie when I think about my time at

SciLife Lab. I've seen it

change, grow, and now, I think,

become a very prominent research institute

in Europe. So it's, I

think, fantastic and very

much also gave me opportunities to learn

about other technologies and to

learn how information about

proteins can be useful. And I

have many stories to tell, but

one of which is, for instance, I have a

little bit of a side activity project around

GPCRs, and that, for instance, I think

wouldn't have been possible if I would just

be sitting somewhere in a lab and

not be exposed to all these different

activities. Sure. And for those not

familiar, GPCRs

or G-

coupled protein receptors.

GCPRs, is that correct?

G-protein coupled

receptors. G-protein coupled receptors. I

got to get my acronym straight.

It's a really important drug

target, right? Membrane

proteins. Yeah, membrane proteins that are

important drug targets. Correct?

Exactly. Yeah.

And they're at the SciLife

Laboratories. Well, you said that you were

involved in the Human Protein Atlas way back

in 2005, so therefore

the genome had just been

finished in 2002.

2003.

Those must have been pretty exciting

times because there was a big pivot

and interest and focus on the

proteome, is that correct?

Yeah, of course. And then at

that time, Mathias

and us were producing all these

antibodies was fairly unique, and people

were not really sure whether that would add

any value to the field

that's dominated by mass spectrometry. But I

think now we've shown, and

the way that we've brought in new

data, trying to understand the data that we

generate, and then sort of give feedback

to other data types with

localization of

subcellular compartments

of proteins that

I think are really

super valuable and help us to disentangle

the complex biology that we

live in. And

my real interest is

proteins in the circulation. So that's even

more complicated because

you're under sort of the

constant exchange of molecules

in all parts of the body.

So it's not as organized as looking at

subcellular localizations, but it's still

fascinating. And I guess

that's something I really

sort of fell in love with, and I

really enjoy doing.

Great.

How would you see Olink because

you are a biochemist? I

mean, you are a mass spec

expert. How will you see

Olink fitting on this pipeline of

mass spectrometry? How do you see mass spec and Olink

working together from your experience?

Because you have a big experience in this

field.

I'm very fortunate to get to know Ulf Landegren

many, many years back, and we've been

sort of seeing each other on a regular

basis, partly because Uppsala [Olink] and Sweden [SciLife Labs] are

very close and sort of been

doing things in parallel. And of course,

fantastic to see the journey that with the

proximity extension, proximity ligation,

and all these different

versions of this concept have

now, I think,

been the driver for using antibodies as

molecular tools. I mean, there was

just a paper in Nature Methods, I think,

just the other day. Again antibodies

conjugated with oligonucleotides. I think

that's giving people much more

bigger field to play and use these

reagents. So

of course I've seen how it

started and we've been

very late to the game. My lab,

or the unit that I'm heading

at SciLife Lab, started to

introduce Olink in 2017.

And since then, we've been super

happy to have the system in-house

and do this

for others, users that

come to SciLife Lab to just want to

have data, but also for our

research. So I think, again, any

data type adds a value to what we do. And I

think Olink has truly

enabled us to do many things we weren't

able to before. So,

fantastic. I'm dying

to ask

in front of you,

based on what you see, the

opportunity in front of you

with this technology, whatever

technologies, right. What is it that you're

most excited about for the

future? Are there aspects

of

work that you've been doing or a

direction that you're going in, that

you would like to share, that you're

comfortable sharing:

I just want to know

what's the part that makes

you go into

flow? What do

you want to do next?

Yeah, I started

doing a lot of assay development myself

when I worked with Luminix 20 years

back. That sounds a little bit silly when I

say this, but it's the truth.

Of course, that sort of

has always been something to try, something

new to maybe try, something that's

difficult, maybe not immediately

rewarding, but in the

long term, something that could

be very fruitful or something that

makes you proud as the researchers that you

say [to yourself]: "Okay, this is something I believed in,

and I see it's happening." So the

next sort of moment for me,

when I had this type of thinking was

when COVID started and when

lots of people went into serology

testing or protein testing in

the classical way, when me

and my colleagues at KTH, we said,

"Let's try something different and use dried

blood spots. Let's not ask

people to come to the clinic, let's send

the devices back to them,

to their home, so they can collect

bloods in their kitchen

and sofa, wherever, and send

them the samples back to us, to the lab,

where we can do the research."

So that, I think, really

inspired a lot of new ways of

doing this. When you think about cutting

costs, simplifying workflows, freeing

the time of people in the clinic,

but also to think about

doing health monitoring. I

think people

always often ask me, what do I think is

proteomics best used

for? And I think it's monitoring.

It's like looking at who you are and looking

how you change. And I think this

combination, I think, now is sort

of shaping towards something I really

am passionate about. And dried blood spots

is a fantastic tool.

It's more challenging than doing it

the classical way. There's so much more to

learn, and then maybe even go

further. When

Sarantis and I talked a couple of

weeks back, also to look at even smaller

sample volumes, looking at other body

fluids, such as interstitial

fluid, that could even tell us something

extra that blood is not able to tell us.

We'd need a

baseline to understand the reference of

dried blood spots to be making that

comparison, right? Yeah. And

so enabling in areas where we

can't get a blood draw,

a phlebotomist out to do a

blood draw.

I think that's going to be really

important. Dale?

So if you can give us some background

on dried blood spots, and I'd appreciate it,

because my only familiarity with it was when

I had my first child, and they did a

heel prick, and then they went ahead

and used the blood from

that little lancet onto a

particular card. Is there something

special about the material they

use for a dried blood spot?

And what are the challenges as far

as working with proteins in that context?

I think

let's say if you think

from an analytical

perspective and a precision

perspective, the dry blood spots your

kids

donate, they are just put in a

filter paper to do a plus/minus test.

So it's really a binary answer you're

after. But if you really want to look

at subtle changes in the human

phenotype, I think then you need

to ensure that the precision of the

material you use in your system is

there.

Normally when you have a dry blood spot, you

get sort of a donut distribution of the red

blood cells, so it really matters where you

do the punch. So you want to avoid these

type of things, especially if you want to do

it at scale, if you want to do it

consecutively. So I

started to work with a local company that

was founded by one of my colleagues at

KTH. And they use a

microfuidic system to exactly collect

ten microliters. So just knowing

that what you put into your system is ten

microliters, of course,

then there are different levels of

hematocrits, there are different other

things that you need to consider, but you

at least eliminate some of the concerns that

you have. That,

I think, is really the key. And of course,

it's a simplicity of this

procedure that you can assure it's

easy for people to do. And

they manage, even though they may not

be trained. I failed also

when I did it the first times.

But if you

get used to it, the quality is

really excellent. And I think there are also

studies showing that more and more are using

other devices

that are out there, I

think now you have a new material

which is sort of similar to plasma,

but it has some bonus. And the question is,

how do you manage that bonus? Is

it something that is a challenge, it's a

burden that makes it difficult for

you

to be analytically

precise? Or does it open up

opportunities that were not possible

when you looked at the regular blood,

plasma samples? Because of,

let's say, the

hematopoietic cells that are still there,

they may leak out something that could be

really exciting. So it's

this balance between things that, I think ...

When you have a discussion a little bit

with other proteomics expert about

dry blood spots, there's always a question

about how you control and

normalize. Because, I don't know,

from what I have heard,

actually, it's not easy to have always

the same type of dry blood spots. I'm

guessing that there's a lot of varieties,

a lot of variation can be there. Would you

have any idea how one can normalize this

data in order to have like, longitudinal

studies or studies for different cohorts? Do

you have any idea on that? That would be

great to hear, actually.

Yeah. I mean, there are analytical

concepts that you can think about to do

precision. You, probably similar

to other studies, try to

find some housekeeping

markers. And we found some, for

instance, that are related to skin.

The skin, when you do

the landset,

or punching through your upper

layers of the skin, these proteins will

probably always be there.

So trying to figure out

what are the markers that are constant. And

then again, what we talked about

before, if you have a phenotype that

is changing, then you can sort of do this

resampling. You can learn from the

resampling what are the

constant constituents and what are those

that are variable, what are those that are

unreliable.

And again, the more data you have, the

easier it is to make that exercise,

because you can rank things

in a much more refined way.

That's very knowledgeable. You mean

using housekeeping kind of

housekeeping proteins in a way, right, to

normalize? That's pretty much the idea

around? Yeah, exactly.

And then, of course, it's just also a matter

of using different

statistical models to do

normalization and things like this. I

mean, whenever you have

a variable sample source, I

guess we have that also in

plasma, different

degrees of hemolysis, different fat

content, different

hydration states, they can

influence so many things. So I think just

keeping being on your toes when you look at

the data and not get carried

away too quickly,

I think

something that's very helpful.

Coming back again, and I'm sorry I

monopolized the questions, coming back

again to Cindy's

question: Do you think there will be a

new breakthrough? You'll be like going

through new matrices, like

interstitial fluid, for

example, do you think that new materials

will open new ways, new research areas,

and learn quite a lot? What is your

feeling about that? What is your vision?

I

think we should accept

the concept that not all material

will be informative for all

studies we do. So I think if we

find the niche, that they are

informative. So again, this

study we did on interstitial fluid, we

also detected, for instance, antibodies

against SARS-CoV-2 in interstitial

fluid. And then of course, that

is a proof-of-concept we did

because we were curious and we had

material, or we had plus/minus as the

phenotype. But imagine you're

treating someone with melanoma, with a

biologics. How can you assure

that the biologic actually

reaches the area where it should act?

I think these things could,

of course, be much more informative than

looking at a blood sample where you

say, yeah, it's in your system,

but we don't know if it actually reached the

point where it should be

doing the job. So again,

these things, I think, open up new ways

and, and trying these

these new methods of sample

collection. And then, of course,

having the perfect tool that analyzes these

samples. And again, the

fantastic low

volume requirement of Olink

has, for us, been this

perfect match.

So we're super happy that we have a

tool that we can test these ideas and we

can demonstrate it's actually

feasible.

To return to what you're excited about in

terms of these longitudinal studies,

have you had much interaction with the UK

Biobank in terms of samples at

scale? I guess you don't have to worry about

sort of the dried blood spot collection.

I mean, that's really promising, but

here it is. We have a huge

data set. Have you been involved much with

the UK Biobank?

Indirectly, yes. I mean, I've been

talking to Chris Whelan and others. And of

course, when

Karsten Suhre, Mark McCarthy, and I

started to write this review in

Nature Genetics a couple of years back,

we thought of UK Biobank as the

audience,

especially Mark

McCarthy who I consider my mentor.

He was in Stockholm and I talked to him

and said, "Mark, you're doing this fantastic

work. And I think proteomics like Karsten

Suhre has shown, is a perfect match with

genetics. Can't we write up something as

bringing different perspectives together

into one piece of

information?" And that's sort of how this

whole idea started. We actually called

up Karsten and said, "Karsten, we have this idea,

do you want to join?" And this is sort of

where we joined forces. I learned so much

about genetics, and others learned about

proteomics. So I think that

sort of was, of course,

the dream

coming true as writing

something that adds value, but learning

something at the same time. And then, of

course, UK Biobank

being, as has been shown, a

fantastic study

now being powered by all these

new data that is coming out.

But, yeah, again,

it's often a one timepoint

picture, but we want to create a movie of

our lives, right? And the movie tells the

story much better. And we should probably

just explain Mark McCarthy, although I don't

think he needs an introduction. He's such

a well-known figure in

our world, certainly, but he's at

Genentech, of course, but he's one of these

geneticists that has

crossed over into industry. And

just anything he

focuses on I like to

keep an eye on, because it

moves and shakes. He was at

the International Congress of Human

Genetics, and so involved in the

leadership, talking about how to

increase diversity in genetics. And

I love

that Nature Genetics paper. So I just wanted

to say, "Karsten,

you, and Mark M, it's just

such a pleasure to have

you even talking about our technology. It's

very exciting."

And I think,

of course, we wanted to be

as agnostic and fair as

possible, because I think

every technology has its pros

and cons, and I think it's up

to everyone to make a decision what is the

best fit for the situation.

Absolutely. But I guess

coming back to your question about

longitudinal studies,

which we've been also doing

locally, led by

Mathias Uhlén, and we've been working with

Jochen Schwenk from the SCALLOP

cohort. You know, of course, that

that is when it all sort of comes to life,

right? When you see a signature, you can

understand stability, you can understand

that a person has had an infection,

things go up, things go down, but someone

loses weight, things change. So that's

when the information actually becomes

clearer. And that's a

fascinating thing: to be able to look

at this real time biology.

I appreciate you talking about this

review paper for the audience.

The paper I believe you're talking about is

"Genetics meets Proteomics:

Perspectives for Large Population-based

Studies." It was in Nature Review Genetics in

January 2021.

I'm trying to remember a

different Karsten Suhre review. I

think you're talking about maybe one from

or 2019. At any rate,

the ability to

monitor real time health as

people transition from a state of

health to one of disease.

I finished a book recently, "The Age of

Scientific Wellness," from Leroy Hood

and Nathan Price,

and it talked about these disease

transitions, where if

somebody's healthy, they don't have

symptoms, but something's happening

in the body, something's happening with

their metabolism, something's happening with

their metagenomics, something's happening

with their proteomics and the

circulation. And that is just

this fascinating thing because you're

talking about wellness, right? We need to be

sampling "well" people. And I think

the UK Biobank gives this unique

perspective. I'd like to hear your

perspective on that.

Yeah, of course, I mean,

UK Biobank offers, as far as I

understand, really a range

of phenotypes. I assume

some involvement was in selecting particular

sort of

disease groups and enriching them for those

that are maybe more prevalent than others.

But just to have that

breadth is really amazing

because often you're limited

to

certain sample collections.

And maybe I

take another sort of, open another bracket

and take a little detour here. But again,

when you do this dried blood spot random

sampling that we did, you include everyone.

You don't include only the ones that are

sick, and they only come when they're sick.

So, you know, okay, CRP [C-reactive protein] and all the other

friends, they're all already up, right?

But we want - so how do you get

that cross sectional, that

true sort of population-based

variance? And I think that's only possible

in a coordinated way, like UK Biobank did.

And there are other biobanks that

all of us in the U.S. and

others are trying to do similar

things. That when you learn this

is the human variability with all the

genetics, with lifestyle, with

social economic factors

influencing

who you are on a molecular level.

So yeah, fantastic. And then having

proteomics in that play is of course

something I get particularly excited about.

And it's this

combination - I'm sorry, go

ahead. I'm sorry, Dale,

go first.

Oh no, Sarantis, this is your show. Go right

ahead, please.

Thank you. Now I'm talking

about how you mentioned about

proteomics, genomics and

disease, and there's

a preprint with Anders Malarstig now

that recently came out, and they're going to

be soon published - finger crossed - with Olink.

Would you like to share a little bit

information about the research there

and the cohort that you use and what's your

main findings? Because it's exciting

to use the circulating proteome

to identify prognosis [biomarkers] for

breast cancer, early prognosis for breast

cancer. I'm happy to hear a little bit more

from you, actually.

Yeah, so

we're talking about the KARMA Cohort, which

is a Swedish breast cancer population

cohort that invites all women

in Sweden undergoing mammography

screening to participate. This is

spearheaded by Per Hall and

Kamila Czene at Karolinska

Institute. And with both I've been

collaborating already for quite some

time and we recently got

some funding to continue our collaborations

and then brought in also

Olink data that we generated

in the lab

to look at breast

cancer risk. So in addition to this

paper that you mentioned, Sarantis, there's

also another one that's been

circling around now

where we wanted to primarily

identify - Can we use proteins

to predict short term risk of

breast cancer? Genetics can do that on

a more longer period

of time, but can proteins

add something to it? And then, of

course, with Anderson and

the leader and the SCALLOP

consortium, and we want to also to bring

also genetics into this. And

I'm not a geneticist. So for

me, again, it's always fascinating to see

proteomics data in action.

Which is what

it makes me most proud

because I think

what it is exciting to

learn when other datas inform you about

your own data and when others take the data

that you generate or that you

know more about and they tell you new

stories. And then, of course,

the KARMA cohort is really a population-based

code and it's really unique in a sense that

we're not only looking at

breast cancer cases,

or the study could

continuously collect sample

patient information or personal information,

and eventually some of these persons will

become patients. And luckily, then

we would have, let's say, a blood

sample from the last time when the patient

was still a person, so to speak, when you

think about these two categories. So we can

go back in time and see are there any

things in the

prior history that could

lead towards okay, you

are actually on a much different

trajectory than the remaining

individuals, so that's all that

people have different lives. We know drugs

played a role, pre- post-menopausal

plays a role,

hormonal replacement therapy plays a role.

So lots of things happen. But then genetics

can tell you an unbiased story about all

these phenotypes and that,

again, gives a new angle to

this whole problem. And in this study,

we used Mendelian

Randomization and found five

interesting proteins that

presumably have a causal role in breast

cancer. And of course, this is the study.

Now, it's only nowadays

600 individuals, but still, it's a

really very fine selection of

samples that could

lead the way. And then again, taking the

road that genetics has

taken, we can use data that exists in

other biobanks and we can sort

of look, do we see the

same associations in these? And

that's, of course,

when multiomics doesn't

become a picture, it becomes a movie, where

we take different [aspects] of these

relationships.

What a great illustration

and analogy.

That's a

great analogy, right? Not a picture. We've

got a movie.

Yeah. And I think that's what

we need, right?

You take

a look at a picture and you interpret so

many things into this, whether you

know something about the painter or

the time when the painting was made.

But if you have a movie, it tells you

much more. It tells you a dynamic that

you cannot really see in a

picture. But anyway, so

again, we had this opportunity, and then,

Asa [Hedman] and Anders [Malarstig] have been really leading

this together with colleagues at Olink

and others, to sort of

find out whether these things we

identified in the Swedish KARMA study also

we can see in the UK Biobank or

in Finngen and it seems so to be the case.

And of course, that gives much more

certainty about that. These are interesting

findings to follow up. And

again, I think what we talked, I guess

before this podcast started,

that then you can

start to develop drugs, and you can see what

actually happens when you give someone a

drug that addresses one of these proteins.

Then you, again, start a new movie,

right? But,

on a different direction.

And again, then use

proteomics to follow and see what

happens. So,

that's fascinating, I think. And so

who does that follow up?

Are you involved in that

kind of

obviously,

proteomics

is your field,

and I just wonder if there's

another

function that takes that to the

clinical trial or to the

test bed to

try out

these drugs that

affect these pathways.

Yeah.

Of course, I guess it would require that

we have the right partners who would have

the libraries to do drug screening on these,

and sort of it's an army of new

things to engage.

But of course,

primarily to see that

what we do in these

studies has a value and then

again, translate it back to functional

studies, which, again, is something

I think will also happen in the next couple

of years, is taking all these big

biobank screenings back into some sort of

functional studies to see, okay, is it

really the molecule? Is it really the

phenotype? Is it

really the drug or the

lifestyle effect? And

that's going to be sort of looping back

where it started, from cellular

studies into

systemic studies, and then back into the -

Wouldn't it be amazing to

find a lifestyle effect that

we never thought might have

an impact?

Yeah. Having the tools to

be able to start parsing these things. It's

fascinating.

To talk a little bit about the

study itself, right? This Nature

Preprint looked at 300

individuals from this mammography study who

had breast cancer

diagnosed over those two years, that

they took a look at them, and then you

matched it with 300 normal individuals from

that same study. You had genotype

information, right? And the

genotypes combined with the

Explore 3000 [platform] in

terms of the 2900

proteins. So you had 600

individuals, 2900

proteins, and then you discovered

800 pQTLs [protein Quantitative Trait Loci]

and controlling

737 proteins. And I

thought that was fascinating, right? That we

have genetic control of

737 proteins that can

identify the variants

pQTLs, and then you can drill down

and get five likely

causative proteins of breast cancer. Do I

understand that correctly? That these

five proteins you identified

were previously not

investigated or investigated with

certain sort of weak associations

of breast cancer? But the take home

message is that these five proteins were

new discoveries.

Yeah, that's our

understanding. I mean, of course,

maybe someone else has already figured this

out, but not told the public about

it. But I

think

an important aspect is also to say

that these 300 cases,

they were not cases at the time of

sampling, they were future cases. So when

they were actually sampled, they were still

considered persons, not patients.

So that's, again, also

to understand,

then we have this list

of proteins that all tell

different stories. And I think it's

fascinating to be sort of in your

mind, thinking about what actually the

role is. But what we need now is, of

course, the hard data that tells us this

is true, or this is

actually the opposite.

And I guess to back up

to the original KARMA study, which was out

of KTH. There were some

70,000 women from Karolinska who

volunteered. From Karolinska.

Okay. 70,000 women,

though, over a couple of years. Is

that correct? I think about

the effort

involved.

Yeah. This is the nice thing about

doing science. In Sweden -

I originally come from

Germany - it's a different

system. But in Sweden,

maybe because of the Nobel Prize, maybe

because of the public interest

in science, there's much easier

engagement. And in

women, I think, in other countries, have

this regular sort of health checkup. So

there's this mammography screening program,

and then you get basically asked, "Do

you want to participate?" And then Per Hall

and his colleagues do the

magic and keep people

engaged, and people

follow, which

is super. And

then you mentioned briefly

the power of replicating these

results, because that,

I think, is an important dimension of this

paper, in that it wasn't just a

single finding in a particular

population that you were able

to find. We're actually able then to go

back to was it? Finngen and the UK

biobank? And then look

at the genotypes, look at the

protein levels, and then being able to

actually show, yes, this connection holds

up. I think that's pretty

significant.

Could you comment on that?

Again,

this work was spearheaded by Asa Hedman,

but again, what I see is

you have, let's say you create this

currency, let's say the

pQTLs. This is a currency you can

go and you can pay in other

countries or in other

biobanks. You can use that currency to

exchange information. And

this is, I guess, what genetics has

really enabled us to do. And now

proteomics is learning how it can do

it. We have different

technologies, they may have different

outcomes, different information. But again,

you can anchor it on the genetics. You can

use the pQTLS, you can

use them as instruments in mendelian

randomization to exchange this information.

And that's

amazing. Yeah. Here it is. You're

talking about empowering proteomics with

genomics, right?

Turning it around instead of coming at, I

mean, I come from a genomics background. So

I think of it in terms of proteomics adding

to the genomics. Here it is. You come from

the proteomics background, and it's the

genetics that is really enriching

the findings. And I think that's

great. Jochen, I have a basic

question, and it's very basic. We

mentioned that one of the factors

could be lifestyle, like

environment, but also could be the hormones.

Do you have, let's say, relatives,

like mother, sister, or twins

that you can control in this cohort? I

imagine there will be also some twins that

you can, let's say, somehow

discriminate and identify the genetic

background versus the environment. This

is the first part of my

question. The second part is for sure,

you would check, like, post- and

pre- menopausal. Then have you seen

differences? What's

your feedback on that? What's your

experience around this type of

observations?

Yeah, I mean, we have had

previous studies that we published using

other own technologies that we

used 510 years ago, where we

specifically looked at hormonal replacement

therapy as one of the factors which,

to our surprise, had really a long

lasting effect on the women's

proteome, which

again, is really

quite significant.

And then, of course, that pre- and

post-menopausal breast cancer.

Again, this is something I've been

learning from my colleagues that I work

with, is very different.

Then, of course, you need to

disentangle. So,

I'm sorry, I want to click

back to what you just said about

hormone replacement therapy having a lasting

effect on the proteome.

What do you mean by that?

Meaning that it shifts

the proteome? But what about the

risk, the cancer risk, right.

Because certainly the women's health

study here in the U.S.

had led to some concerns around

that. I'm just curious

if that's part

of the impact on the proteome,

do you think? Or maybe what we

found in this other study is that we

had a subset of women that really

we could sort of see that previous

use of hormones had

a significant change

in their proteome and also increased their

future risk that they were developing breast

cancer. So, of course, this really

sort of showed up. But it's a

small subset of all the women

that we tested.

It's a great thing to follow up.

Of course, we still need to understand is

what is the effect of taking hormones?

Do you actually have remodeling of

some

reproductive pathways that

constantly do something?

And if they get sort of, let's say, pushed

off track, they will stay on that off

track path for a longer period of time. And

then there will be feedback loops with,

let's say, the liver and other organs to

just try to adapt

with the sort of external trigger.

So that was sort of part

of our sort of understanding of

the use of drugs. But again, it

showed that taking medication has

a quite substantial effect on

your proteome. And we

found it fascinating that it actually seemed

to be consistent

over many years, a

picture of real time biology, the

proteome, right.

And, what we

know about effects of certain

treatments, what we know about effects of

certain drugs, we're just scratching the

surface. Right. A number of our pharma

partners and customers of Olink

are finding out so much with just

a limited set of proteins.

They're not looking at the proteome, they

might be looking at a panel

of 50 or 90 [proteins], or what

have you. But there is just so much to

learn about the biology.

Sarantis, you started to ask, I think you

were down a path of a couple of questions. I

was curious.

I want

to ask just a more

philosophical question about

if you have some, let's

say, mother,

sisters, some relatives, or if

you have some twins that you can follow.

And you can see the change comes from

genetic background, or comes from the

proteomics background, or combination, or

neither. Do you have any experience on

that? Have you seen some patterns

around [that]?

I don't think we

necessarily looked into this.

But I've been working with

another twin cohort from Sweden called Twin

Gene, which the name says

has a quite clear

focus on these aspects.

And

no,

not that I think in particular, but of

course, it's, again, what we

pass on to our children is something

that will be, in the future,

helpful for them to know.

And maybe

they will change their lives when they know.

Okay. I'm at a higher risk of a certain

disease because both my parents

passed away. I guess you see a lot of these

breast cancer studies and effects in

Iceland, I think, right.

But

not in these studies. I cannot

recall that we actually specifically looked

into this. Yeah. What was I think really

interesting about this particular paper

on breast cancer is that you looked

into so many different kinds

of connections

in terms of inherited risk

as well because the title

is paper, "Evaluation of

Circulating Plasma Proteins in Breast

Cancer and Mendelian Randomization

Analysis," you're actually

looking at, then, the entire genetic

backgrounds of unrelated

individuals and just saying what

is elevating that particular

risk. And understand, these five

proteins that were differentially

regulated were basically

lifetime

exposures. That a person

was exposed to a high level of

protein throughout their whole life. And I

think that's what makes this really

fascinating, right? The

proteomics being informed by the

genetics controlling the levels of

protein, and then saying these

five proteins actually become drug

targets, which I thought was

just a fascinating realm.

Before we wrap up, Jochen, would you

like to make any final comments?

Either, I don't know, about

where we are,

where we're going, working with

Olink? Oh, I understand, right? We

didn't even talk about a very

famous

postdoc, famous at Olink,

Philippa [Pettingill] came out of your lab. I don't know

if you want to talk about what it was like

working with her. She has helped

me, Cindy, with her title. She's

Director [of Application Sciences]. She's a superstar.

She runs the field application

scientist team within

the European

region, and she

is absolutely magnificent.

She's also helped lead

our discussions around

statistical analyses in the

UK Biobank Project. She's

just such a magical

human being to

have at Olink. We're so lucky to

have her. And she is a product

launched

out of your lab. At

some point,

you had an impact on

her trajectory. So, yes,

please, anything you have to say about her

would be greatly appreciated. We had

hoped we'd be able to have her on, but

we weren't able to get her

into the timing that we had

going. No, I

mean, all the success that

she has now is because

of her

engagement, her knowledge, and her

curiosity. But, yeah, it was fantastic

to work with her. She was with me about

one and a half, two years. It

was

inspirational and fun

from the first to the last day.

And I think

to see someone leaving the lab

and making such a

wonderful career

is fantastic. I guess if my

contribution is that I showed her all these

different tools that we had in lab,

including Olink and others, and we talked a

lot about the different assays, the

different concepts. So if that has

helped her in achieving these

fantastic things that she's doing with

you, it makes me proud and

happy. I think she deserves it.

And I wish, of course, her

all the success, and

anytime we see her, we see

each other on the media calls,

it's like old friends.

I think she came out

absolutely a leader, and I think

she has such great things to say

about the time that she spent in your

lab. And I think that's

pretty sweet. Thank you.

That's great to hear. All right,

well, thank you very much for joining us

today, Jochen. We've really enjoyed the

conversation. Thank you for having me.

It was fantastic. And

continue with this great podcast.

It's really a treasure. Thanks a lot

for setting this up and running

it. You're so

kind. Thank you.

Okay, well, I think

that's it. Thank you.

Thank you for

listening to the Proteomics in Proximity

podcast brought to you by Olink

Proteomics. To contact the hosts

or for further information, simply

email info@olink.com.