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St. Joe’s Researcher and McMaster Professor Emeritus Wins Two Major Awards

 

It was a warm July evening in modest town of Zeist, Netherlands, which sits some 40 kilometres southeast of Amsterdam. A group of researchers were in the midst of their discussions on emerging techniques of Chlamydia detection, peptide microarrays, and mucosal immune responses.

The International Symposium on Human Chlamydial Infections (ISHCI) was having their fourteenth conference since 1961, bringing together experts in Chlamydia research to share their latest developments. Dr. Max Chernesky, who played host to the symposium 12 years earlier when it was held in Niagara-on-the-Lake, was being recognized as a Living Legend.

Most of those attending the conference knew who Max Chernesky was and the global influence of his work in sexually transmitted infection (STI) diagnostics. Chernesky is Professor Emeritus of Pediatrics, Pathology and Molecular Medicine at McMaster University, and an esteemed researcher at St. Joseph’s Healthcare Hamilton.

Written in the hefty book of publications given to conference attendees was a dedication recognizing Dr. Chernesky’s work. “The Chernesky Laboratory has made significant contributions to the field of Chlamydial Diagnostics,” read the missive. What followed in this dedication was a summary of 35 years of hard work, detailing numerous breakthroughs in STI diagnostics and care.

Chernesky’s team was the first to establish that urine testing could replace urethral and cervical swabs to diagnose Chlamydia trachomatis and Neisseria gonorrhoeae infections, in patients with and without symptoms. Previous testing methods were too invasive to be acceptable to infected patients without symptoms. Chernesky’s research changed that, leading to implementation of Chlamydial screening for cervical and urethral infections. If left untreated, these types of infections can have drastic effects, particularly for women, including pelvic pain, ectopic pregnancy, and even infertility. The laboratory also published cost effect strategies for screening.

The message continued in a matter-of-fact tone. It was obvious there was no need to explain in sharp detail the significance of Chernesky’s work to this group, so it seemed oddly appropriate to quickly iterate over each breakthrough one after the other – a succinct list of translational research contributions.

Chernesky demonstrated “the value of self-obtained vaginal swabs, and the effectiveness of self-obtained meatal swabs.” True – from a scientific standpoint, Chernesky’s lab proved the viability of self-obtained patient samples for STI testing. However, the fact they found that people preferred this method is what made it so revolutionary. Chernesky and his colleagues knew that in this line of work, privacy could mean the difference between a patient’s willingness to be tested and avoiding it altogether. It was as much a psychological breakthrough as it was a biological one.

A story featuring Dr. Chernesky’s research that appeared in The Hamilton Spectator on Jan. 27, 1995.

As Dr. Chernesky and his team continued to improve these new diagnostic methods, they also explored new screening options. The Pap test, so named after its inventor Dr. George Papanicolaou, was already being administered to women every few years to prevent cervical cancer. The Chernesky lab demonstrated that Pap samples could be used to test for chlamydial and gonorrheal infections, and four papers later, it became routine practice.

Having made these improvements, labs began to see that increasing numbers of specimens were being submitted for STI screening. Recognizing the bottleneck as a growing threat to increased testing, Dr. Chernesky conducted innovative studies to improve lab efficiency. His team “evaluated the instrumentation for throughput, hands on time, time to results, maintenance, reagents and waste consumption,” as the writer put it. Chernesky’s evaluative research in this area led to three landmark publications.

Despite all of the work being done by Chernesky and his team, it’s incredible that Max and his wife, Sandra, had the time to raise crops, cattle, and horses on their 100-acre farm. Max even assisted Sandra, a veterinarian, in establishing Canada’s first stand-alone cat hospital in 1978, an enterprise that lasted some 30 years.

Reaching the end of the list of research achievements, the focus broadened. “Recently,” the message read, “the laboratory has also focused on improving the diagnosis of HPV and Mycoplasma genitalium infections.” HPV – the human papillomavirus – is known for its role in cervical cancers and the HPV vaccine. In an effort to enable an accurate diagnosis of HPV-induced throat cancer, Chernesky formed a team of St. Joseph’s head and neck surgeons and pathologists. Together, they showed the effectiveness of testing novel samples using commercial assays that were originally designed for genital tract testing. Identification of an HPV-induced throat cancer meant it could be treated differently than other forms of throat cancer not caused by HPV.

Mycoplasma genitalium, an emerging pathogen, has also been the focus of Chernesky’s recent work. Max formed a national team of collaborators to demonstrate the Canadian prevalence of this infection and the scope of its antibiotic resistance in each province. This saw 2 majors papers on the topic published in 2017.

At this point in the dedication, some of the younger researchers were left wondering not only what kind of man Max is, but how he was able to achieve such a successful, model career. Quoting a series of character witnesses, the message provided some enlightenment.

Chernesky entered the chlamydia field in the late 1970s to develop diagnostics for chlamydial eye infections in infants, as part of his mandate to establish a Regional Diagnostic Virology Laboratory. Though, as Julius Schachter recalls, the reason was due to the fact that “we ate better food, and drank better wines, visited better meeting sites, and he started playing golf.” Dr. Schachter is a researcher based out of the University of California in San Francisco, and is a close colleague of Dr. Chernesky.

According to another colleague, Dr. Marc Steben, “Max is a quiet giant. He listens, he shares, he teaches, he finds solutions.” Steben is an STI researcher and clinician based out of Montreal. “Max is a mentor to so many Canadian STI experts and an example of a great scientist for all of us.”

The dedication was coming to a close, with a word from Dr. Barbara Van der Pol, a researcher at the University of Alabama at Birmingham. “From all of us who have benefited from working with you – thanks Max.” Chernesky’s colleagues had long considered him a living legend, this simply made it official.

Fast-forward to August 29, 2018, at a meeting of the Centers for Disease Control in Washington, DC. STI specialists were gathered, with Dr. Chernesky in attendance – in the field of STI diagnostics, no meeting would be complete without Max. This was another special day, as Marc Steben had nominated him for the highest honour of the American STD Association (ASTDA), the Distinguished Career Award.

Dr. Barbara Van der Pol, President of the ASTDA, presenting the Distinguished Career Award to Dr. Chernesky in Washington, DC.

Dr. Chernesky, who has written over 200 peer-reviewed papers, 38 book contributions, and 373 abstracts, has proven himself the perfect archetype of a distinguished career in health academia. He has served in leadership roles in several international committees and working groups. He was Chair of the Scientific Advisory Committee of the World Health Organization’s STD Diagnostics Initiative, founder of the Pan American Group for Rapid Diagnosis, and is a member of the Expert Working Group, responsible for writing the diagnostic and treatment guidelines for the Public Health Agency of Canada.

As chair of the Research Committee at St. Joseph’s Hospital in the 80s, he and Dr. Michael Newhouse conceived of the Father Sean O’Sullivan Research Centre (FSORC), which today is the largest program within The Research Institute of St. Joe’s – Hamilton. At the age of 80, Dr. Chernesky still has an active, well-funded research program.

Dr. Chernesky with Dan Jang (seated), his colleague of 28 years.

As Chernesky accepted the ASTDA Distinguished Career Award, he thanked his team members – from the early years, Dr. James Mahony, Sylvia Chong, Kathy Luinstra, Santina Castriciano, and the late Dr. John Sellors; and more recently, Dr. Marek Smieja, Dr. Sam Ratnam, and Manuel Arias. Max expressed particular gratitude to Dan Jang, his clinical coordinator and lab manager of 28 years.

With support from his colleagues, his wife Sandra and their son Marcus, and many government and industry sponsors, Dr. Chernesky and his lab revolutionized STI diagnostics and testing. He helped build the foundation for what is today a powerhouse of innovation and discovery, right here in the heart of Hamilton at St. Joe’s.

Thanks Max.

 

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