SGH receives S$6 million grant to combat deadly autoimmune disease

Media Release

Singapore, 23 May 2025 – A multi-centre and interdisciplinary team of researchers, led by Singapore General Hospital (SGH), has been awarded a S$5.77 million IAF-PP grant from A*STAR for a project to better diagnose and treat systemic sclerosis (SSc) - a life-threatening autoimmune disease that causes the death of one in two with the disease within four years of diagnosis.

Known as the Singapore Systemic Sclerosis Precision Medicine Project, or SYSMIC, it brings together experts from various fields: clinician scientists, laboratory and big data scientists, and imaging specialists, to analyse and integrate data derived from patients’ genes, immune systems, proteins, gut bacteria, and more, over the next five years, using artificial intelligence (AI) and multi-omics platforms.

"SSc is particularly challenging as it affects each patient differently in both severity and progression. With Asian patients showing poorer survival rates and known genetic differences in SSc risk, the goal is to develop more personalised treatments and better ways to predict how the disease will progress in different patients", explains Associate Professor Andrea Low, SYSMIC Lead and Senior Consultant, Department of Rheumatology and Immunology, SGH.

SYSMIC comprises a total of six different themes. Other than SGH, participating institutions include SingHealth Duke-NUS Translational Immunology Institute (TII), a joint institute under the SingHealth Duke-NUS Academic Medical Centre (AMC), Duke-NUS Medical School, National Neuroscience Institute (NNI), Lee Kong Chian School of Medicine at Nanyang Technological University, Singapore (NTU Singapore), Tan Tock Seng Hospital (TTSH), National University Hospital (NUH), and Sengkang General Hospital (SKH).

The next phase of research will see A/Prof Low lead a region-wide collaboration to validate SYSMIC's findings as Singapore's diverse mix of Chinese, Malay, and Indian ethnic groups, means the findings is likely to be relevant across other Asian countries.

SSc can bring about widespread inflammation, narrowing of blood vessels and the hardening of tissues in multiple organs, including the skin, heart, lungs and gut. However, currently symptoms can only be managed with medications and there is no effective treatment for the condition which affects around 8 per 100,000 people or 384,000 people in Asian populations.

The IAF-PP (Industry Alignment Fund-Pre-Positioning Programme)

The A*STAR grant funds promising research programmes for up to 5 years, connecting industry partners with researchers to transform laboratory findings into patient treatments. This initiative, led by A*STAR, Economic Development Board, and National Research Foundation, bridges public research with industry needs to create economic impact

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Annex

The SYSMIC project aims to better understand Systemic Sclerosis (SSc) and group patients more effectively so that treatment can be personalised based on their disease stage and risk level.

This will be done in three ways:

Create a detailed map of the immune map of SSc within the human body
Define how active the disease is in patients
Predict how the disease will progress

Theme 1: Systems Genomics

Theme Lead: Associate Professor Jacques Behmoaras, Deputy Director, Centre for Computational Biology, Duke-NUS Medical School

To fully understand how the immune system behaves in SSc patients, researchers will study in detail, circulating immune cells in patients at different points in time during the disease progression. They will use three main approaches:

Examine individual immune cells' genetic activity (using a technique to sequence every single immune cell in the body, called scRNA sequencing)
Study the complete genetic code (whole genome sequencing)
Look at proteins in immune cells (using a method called CyTOF)

All this information will be combined using advanced computer analysis (artificial intelligence) to create a complete picture of how the immune system works in SSc patients.

Theme 2: Translational Immunobiology

Theme Lead: Professor Salvatore Albani, Director, SingHealth Duke-NUS Translational Immunology Institute (TII), SingHealth Duke-NUS Academic Medical Centre

The researchers will use advanced technology (CyTOF) to study immune cells from SSc patients, comparing them with healthy individuals. They will examine tissue samples from skin, gut, and blood to understand how the disease affects different parts of the body.

By combining these approaches, researchers hope to better understand SSc and develop more effective treatments.

Theme 3: Clinical Sciences
Theme Lead: Associate Professor Andrea Low, Senior Consultant, Department of Rheumatology and Immunology, SGH

For the study, SGH, TTSH, NUH, and SKH will recruit 200 patients at different stages of SSc and different activity states. These patients will be followed up with serial blood tests, imaging and other investigations to determine their disease state and outcomes over a two-year period

This research builds on existing cohort of patients that the lead PI has established since 2008 in Singapore that collects patients' clinical information and samples over time and track disease progression.

Theme 4: Microbiome Analysis

Theme Lead: Professor Sven Pettersson, Principal Investigator, Department of Research, National Neuroscience Institute (NNI); Director ASEAN Microbiome and Nutrition Centre

The theme will investigate the role of the gut microbiome that influences the immune system, in driving SSc stage and activity. This theme focuses on studying the gut bacteria of SSc patients.

Researchers will:

Collect stool samples from patients
Analyse the genetic material of gut bacteria
Compare microbiome profiles with disease stages and activity

This research could reveal how gut bacteria might influence SSc development and progression.

Theme 5: Metabolomic Analysis

Theme Lead: Assistant Professor Shen Xiaotao, Asst Professor of Metabolomics, Lee Kong Chian School of Medicine, NTU Singapore

The researchers will study chemical compounds (metabolites) in stool and blood samples from a group of SSc patients. These metabolites that are secreted by the gut bacteria may influence the immune system and overall SSc disease state.

They will identify what these metabolites and combine the information with the gut bacteria findings to understand how they relate to different stages of SSc, how active the disease is, and how it progresses.

This work builds on existing work that studies the relationship between gut bacteria and inflammation in SSc patients.

Theme 6: Functional Imaging
Theme Lead: Professor David Ng, Senior Consultant, Department of Nuclear Medicine and Molecular imaging, SGH

Lung fibrosis is one of the major causes of death in SSc. The theme will examine a novel method of imaging the lung cells that are actively producing fibrous tissue that harden the lung. This will enable clinicians to better manage and predict patients who are worsening, so that timely treatment can be given. This theme uses advanced imaging techniques to study the lungs of SSc patients.