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Henrik Rönnberg

Henrik Rönnberg
I became a licensed veterinarian in 1994, trained at the Swedish University of Agricultural Sciences (SLU) in Uppsala and received my doctorate (PhD, VMD) in 2002 in veterinary surgery (oncology) at the Department of Clinical Sciences, Small Animals (SLU). This project was in collaboration with the Karolinska Institutet (KI) Stockholm and the Royal School of Technology (KTH) in Stockholm. I became associate professor in 2007 in veterinary surgery at the Department of Clinical Sciences (SLU) and professor in 2012 in veterinary internal medicine, companion animals at the same department. I became a diplomate in oncology at the European College of Veterinary Internal Medicine (DiplECVIM-CA (oncology)) 2009 and am one of the founders of this subspecialty within ECVIM-CA. I am in charge of the specialist oncology clinic at the SLU University Animal Hospital (UDS). I have taught clinical veterinary medicine for 25 years and am active in both the veterinary program and the veterinary nursing program at SLU. Organization and leadership interest me a lot and I have been both deputy-dean for the Faculty of Veterinary Medicine and Animal Science (VH) and vice-dean at VH with assignment for clinical affairs. I have also been active in the pharmaceutical industry for a long time, designing clinical trials and consulting in communication with regulatory agencies such as EMA and FDA-CVM to develop new cancer drugs for both dogs and humans. I enjoy lecturing and always try to make difficult topics understandable.

Presentation

As a professor of internal medicine for companion animals, DVM, National recognized specialist in canine and feline oncology, Diplomate ECVIM-CA (oncology), I am an internationally acknowledged leading specialist in clinical oncology for companion animals. I also work clinically at the SLU University Animal Hospital (UDS), teach at the veterinary and veterinary nursing program, am involved in research projects and responsible for the specialist training of oncologists at SLU.

Despite my many credentials, my driving force is simple.

It has always been to work clinically and improve the quality of life for my patients, preferably in as short a time as possible and at the same time teach students in clinical investigations and communication with animal owners and employees. However, of course research is important. Since cancer is so common, we need to find out why it is so and what we can do to understand the disease better and then reduce the percentage of animals with cancer in the long term.

The fact that I initially became interested in oncology stemmed from a "screaming need" to do something for a large patient group where there were not enough answers.

When I attended veterinary school (1989-1994), we learned very little about tumor diseases despite the large patient group. It was also difficult to find colleagues who could help, and with whom one could discuss the tumor problem.

For me, everything changed when I went on an ERASMUS + teacher exchange to Utrecht University in the late 90s and found a collegial network with a burning interest in oncology. They had come further than in most other countries in Europe, both diagnostically and in terms of treatment. They discussed each other's experiences and the opportunities that existed to increase animal welfare, response to treatment with retained quality of life. The most prominent zealots were Erik Teske in internal medicine and Jolle Kirpensteijn in surgery who together had collaboration with the USA in where an oncology specialist college had started before there was one in Europe.

When I returned home, I started an oncology practice at the University Animal Hospital which expanded as our knowledge and understanding developed. At SLU I got a doctoral position in surgical oncology in 1996 (shared 50% with the Karolinska Institutet in Stockholm) and at the same time my old teachers suddenly started asking me how they would proceed with certain cancer patients in the clinic.

It was a very good turnaround from the fact that there had largely been a lack of knowledge in the area. It started to roll and the small group of interested colleagues in Sweden started to meet. It was very stimulating!

Meanwhile, I read everything I could get my hands on.

We had our own library at the clinical center with a dedicated librarian. There we had access to the textbooks we needed and the opportunity to order the latest scientific articles. It opened the possibility for me to do research while working clinically. As the library was located at the clinic, there were opportunities to go there whenever you had a short gap.

After I received my doctorate in veterinary surgery (oncology) in 2002, I was one of the initiators of starting the oncology subspecialty within the European College of Veterinary Internal Medicine, ECVIM-CA. I am program director for the residency program in oncology at SLU and the University Animal Hospital (UDS) in Uppsala.

I went from a position as university lecturer in surgery and Associate Prof in surgery in 2007 to gradually moving over to internal medicine. This as oncology resides under the internal medicine umbrella internationally. This despite the fact that the management of tumor patients is multidisciplinary in many respects! I moved on to be a senior lecturer in internal medicine and finally a Professor in small animal internal medicine in 2012, at the age of 42.

My interest in teaching has meant that for over 25 years I have always had a foot in the clinical supervision of students in both the veterinary and veterinary nursing programs at SLU. I have also participated as lecturer in PhD-courses both at SLU and at faculties of human medicine.

My great interest in organization and leadership has been put to use in faculty management at VH, partly as Deputy-dean and then as Vice-dean with special assignments for clinical affairs.

The major global challenges we face in disease control, dealing with the resistance problem in antibiotics and ensuring that we have good and sustainable food occur within the umbrella of One Health (OH). I have lectured at several OH conferences and also sat on the steering committee for One Health Sweden. I am really passionate about raising the importance of One Health both in undergraduate education and research.

Teaching

For over 25 years, I have taught in various clinical subjects at SLU, first at the Faculty of Veterinary Medicine and after the merge with Animal Scientists, the new VH-faculty. I have walked through several different disciplines in clinical teaching and have a humble understanding of the importance and difficulty of teaching many different elements. I hope this avoids me becoming a "professional idiot" or stubbornly defending your own discipline in the fabric of knowledge we are all a part of in the pre- and clinical training/development of our students. I see it as that we teachers in the veterinary and animal nursing programs are building a house of knowledge that the students should be comfortable in. After graduation, they can continue to decorate this house according to their own preferences, but together we must have built a stable and durable construction where they still can stay. Of course, there are doors and windows out that allow them to take in new knowledge (as well as air out old outdated "truths") and of course also get out of the house and explore the surroundings as they please. However, there must be a safe hearth to return to and live in if desired. A house must have a stable foundation to prevent weathering and a tight roof to prevent rain and snow. Here somewhere I find myself with my efforts that turn into a couple of bricks, or insulation. It gives a humble respect for everyone's importance and it feels good to belong to this community of knowledge-building teachers at VH/SLU!

Research

My research has always been anchored in the clinic. I proceed from the animal's own best interest and to optimize health and animal welfare. Many times there are parallels to corresponding diseases in humans. Then we can benefit from increased knowledge, both for animals and humans. This type of research is called “comparative” or “translational medicine”. My main focus is different types of cancer research. It can be divided into understanding the emergence of cancer (oncogenesis), identification of risk factors and thereby the possibility of cancer prevention, cancer diagnostics and the development of new cancer treatments.

In 2004 I attended one of the first canine and feline genetics conferences in Utrecht, the Netherlands. Here, Kerstin Lindblad-Toh was one of the Key Note Speakers and described a study to map the entire dog's DNA sequence! I was invited by her to lecture about dogs, cancer, and possible parallels to similar types of cancer in humans at the Broad Institute in Boston, USA later that year. After that lecture, I met Broad's leader Prof Eric Lander, who gave me a one-year grant to diagnose and collect cancer samples from dogs at SLU! This was the starting point for a deeper collaboration between SLU and the Broad Institute in general, which has led to countless fantastic projects and a multitude of dissertations, not only in cancer, but also in many other disease complexes. We have since expanded the collaboration to include many other types of animals, e.g. horses and of course the lovely cats! At SLU and Uppsala University, we have a dog- and feline genome project and a dog and cat biobank. I have continued to work with Prof Kerstin Lindblad-Toh and she is currently, among other things, co-supervisor to a PhD-student of mine. Within genetics, I have mainly worked with trying to find genetic risk factors. These can be used both to increase the understanding of why certain tumors arise and here lead to the development of new targeted therapies. But also to catch animals (and people) at an early stage that are at increased risk of suffering from cancer. Here, these individuals can then be selected for a higher degree of examinations in order to detect the cancer as early as possible. Then you have a greater opportunity to treat it successfully.

In animals, knowledge of genetic risk factors can also lead to the fact that in the long run we can reduce the incidence of cancer, as through wise planning, individuals with a high risk of developing cancer are not mated. In all forms of breeding planning, however, one must also always consider the risk of simultaneously increasing the incidence of other, unwanted diseases. My group has a good collaboration with a number of fantastic and dedicated dog breed clubs, where tumor diseases have been identified as a particularly big health problem. We work actively to try together to understand the reasons for this and find ways to reduce the occurrence of tumors. This is because it is a major quality of life problem to get cancer and it is difficult for the entire dog owner family to be affected by these sad news.

Early diagnosis is central to being able to treat cancer successfully. Within this research, I work with the development of so-called biomarkers - mostly in blood. I have worked a lot investigating the protein thymidine kinase 1 (TK1), which is important for cell division. When you suffer from cancer, the amount of TK1 in the blood increases and we can analyze this with different methods. I have published articles for TK1 in cancer in dogs, cats and horses. Recently, I started an exciting collaboration with PetDX in the USA, which has developed a method to find tumor DNA in the blood of dogs. This technique, also called "liquid biopsy", will certainly be used more in human and veterinary medicine in the coming years.

Different forms of treatment techniques are very important to study. This is because we should constantly strive to find more effective methods that at the same time produce fewer side effects. For several years, I worked part-time as Chief Medical Officer in animal health at a company that developed new cancer treatment for dogs and humans. During this period, I was part of the organization developing a new treatment for ovarian cancer in women that was finally registered and approved by the EMA, the European Medicines Agency. The basis for this development was, among other things, successful clinical studies in dogs with tumors, which were also carried out at SLU.

Today, we strive more and more for individualized therapy, so-called “precision medicine”. In cancer treatment, we target specific mutations in the cancer for which we can find a specific treatment (so-called "targeted therapy"). Use of the body's own immune system has gained a huge interest! Here too, with the help of fantastica and inspiring collaborations with human oncology groups, I have carried out clinical studies on dogs with severe cancer. With Uppsala University and the University of Helsinki, we have used so-called oncolytic virus therapy with genetic engineering to stimulate the immune system to attack malignant melanomas. An immunotherapy project is currently underway with Astrid Lindgren's Children's Hospital in bone cancer (osteosarcoma) in dogs. This is a very serious disease, which unfortunately also affects children. We need to research even better treatment methods here, and dogs have a type of osteosarcoma that is very similar to the one we see in humans. I am a co-supervisor for a doctoral student at KI, where our goal is to try to stimulate the immune system to have a better effect than today, to the benefit of both dogs and humans!

Another immunotherapy project is CAR-T. Here, the patient's own immune cells (T cells) are armed with a receptor that recognizes a target that is expressed specifically on the patient's tumor. The technology is already used today for blood cancer in humans (lymphoma and acute leukemia). But it is also hoped to develop CAR-T that works for so-called "solid tumors". These include brain tumors, malignant melanoma and mammary tumors (breast cancer). Together with the Sahlgrenska Cancer Center in Gothenburg, we have so far treated a number of dogs with high grade tumors (such as malignant melanoma) and for some dogs have succeeded in slowing tumor development for a long time with good quality of life.

We also have a couple more immunotherapy projects under development and it is so stimulating to work with such motivated, talented people and to be able to help our fabulous dogs at the clinic with their nice pet owners. What actively prevents us from being able to perform more advanced treatments is a lack of funds. We need more active vets and others within our group if we are to catch up - because the need is immense! However, it is unfortunately difficult to get money for veterinary medical research. These studies are so advanced that a great deal of knowledge about tumor disease in animals is required. Therefore, it is perfect to conduct the research at the SLU University Animal Hospital, where we have access to so many other talented specialists and advanced technology. This is to optimize the situation for our patients.

Supervision

During my years at SLU, I have supervised over 30 students in their master's theses in the veterinary program.

I have also been the main and co-supervisor for PhD-students who did their dissertations at SLU.

Currently, I am the main supervisor for a PhD student at the Dept. of Clinical Sciences with a project to study risk factors for cancer in autoimmune disease in dogs and main supervisor for an industrial PhD-student doing his project in liquid biopsies in canine mammary tumors. Finally, we are also starting a new PhD-project together with the Sahlgrernska Cancer Center on adoptive cell therapy and comparative oncology in dogs and man with me as the main supervisor for a DVM PhD-student at SLU. I am also co-supervisor for a PhD-student (MD) at Karolinska Institutet with a project on osteosarcoma in children (and dogs).

Links

https://orcid.org/0000-0001-6098-5364

https://scholar.google.com/citations?user=AsZkzAsAAAAJ&hl=sv


Contact

Professor at the Department of Biomedical Science and Veterinary Public Health; Pharmacology and Toxicology Unit
Telephone: +4618671363, +46706909601
Postal address:
BVF, Avd för farmakologi och toxikologi, Box 7028
75007 UPPSALA
Visiting address: Ulls väg 26, Uppsala

Publications list: