UTHCT’s Dr. Richard Wallace has devoted his career to finding treatments for little-known infectious diseases

Tuesday, March 21, 2006

In his quest to find more effective treatments for infectious diseases, Dr. Richard Wallace has spent 30 years investigating the molecular mysteries of the organisms that cause these diseases.

But the infectious disease researcher at The University of Texas Health Science Center at Tyler was initially drawn to his field by chance.

“It was serendipity. I was impressed by the caliber of the people conducting infectious disease research in Boston, where I was a resident,” said Dr. Wallace, who received his medical degree at Baylor College of Medicine in Houston.

He accepted a fellowship in infectious diseases at the Channing Laboratory of Harvard Medical Service at the Boston City Hospital. When he moved back to Houston a year later, he became an NIH trainee in infectious diseases at Baylor.

As part of his fellowship, Dr. Wallace had to do basic biomedical research in the lab. He became intrigued with a particular kind of bacteria, one closely related to the mycobacteria he has spent his professional life studying.

“At the time, no one was studying mycobacteria and almost nothing was known about it. I had seen a few patients with mycobacterial infections, and it piqued my interest,” Dr. Wallace said. While medical researchers were studying the types of mycobacteria that caused tuberculosis and leprosy, they were not particularly interested in the rest of the mycobacterial world.

“Nontuberculous mycobacteria are common soil and water organisms that occasionally cause problems in people. Because this happens infrequently, researchers were not interested in spending time learning about the organisms and how to treat the disease they cause,” Dr. Wallace said.

Nontuberculous mycobacteria can make people sick, especially people with impaired immune systems or those who have breaks in their skin that allow mycobacteria inside. For example, mycobacteria can be inhaled and cause lung infection. They are hard to kill, because they have thick, fat-filled cell walls that protect them from chemical assaults, including those launched by many antibiotics.

“There are perhaps 5,000 new cases of nontuberculous mycobacteria disease each year. That pales in comparison with the number of people who develop cancer and heart disease. Most medical research money and effort is devoted to studying those diseases,” he said.

However, the incidence of at least one mycobacterial disease is growing.

“Mycobacteriam avium complex, or MAC, lung disease in older women is a fairly rapidly expanding and emerging infectious disease. Currently, this chronic lung infection is the focus of most of our work,” Dr. Wallace said.

“The treatment of MAC recommended by the American Thoracic Society, the medical component of the American Lung Association, is based on studies we did here at the Health Center,” Dr. Wallace said. It took 10 years of research by Dr. Wallace and UTHSCT colleagues Senior Research Scientist Barbara Brown-Elliott and pulmonary specialist Dr. David Griffith to develop these treatment standards.

“Very few people can say that the studies they did in a small institution such as UT Health Science Center and in a small town like Tyler are completely responsible for the national guidelines used to treat a particular disease,” said Dr. Wallace, who joined the Health Center almost 25 years ago.

“It’s not the size of the institution or the size of the town, it’s your imagination, skills, and creativity in the lab and in treating patients that determine your success. Without the financial and technological support of UT Health Science Center, those studies would not have been done,” he said.

Physicians from all over the nation send samples of mycobacteria from their patients to Dr. Wallace and his colleagues to be identified. They use the mycobacteria’s DNA “fingerprint” to identify it, and then test the mycobacteria’s susceptibility to various drugs.

“This is an art as well as a science. You need someone who knows what kinds of disease these organisms produce, but also someone who knows how the organisms behave in the lab,” Dr. Wallace said.

Though he enjoys basic lab research, he continues to see patients.

“Everyone has gifts. My gift is being able to diagnose and treat patients, which has its own huge reward. Being able to be at the cutting edge of the science of treating and diagnosing patients has made me a better physician,” he said.

“My career has been a 30-year quest to look for better drugs and try to understand why the drugs we have don’t work. We want to use DNA fingerprinting of different mycobacterial strains to understand the disease and where it comes from,” Dr. Wallace said.

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