September-November 2016 Kudos

Publications and Quality

David Picketts and his team published in Cell Reports that running could one day help prevent Multiple Sclerosis and other neurodegenerative diseases. Using mice, researchers found that running triggers the production of a molecule called VGF nerve growth factor, which helps heal the protective coating that surrounds and insulates nerve fibres. It is one of the hundreds of molecules that muscles and the brain release into the body during exercise, and also has an anti-depressant effect that helps make exercise feel good. Dr Picketts said his team need to do broader research to see whether VGF in particular can be helpful in treating these types of diseases.

Rashmi Kothary’s group has recently published in Human Molecular Genetics on research that supports the theory that other genes also play an important role in Spinal Muscular Atrophy (SMA).  SMA is a neuromuscular disease caused by mutations or deletions in the SMN1 gene. However, some people with the exact same mutations suffer much more severe symptoms than others.  The team compared SMA animal models from two different genetic backgrounds, and found animals from one background lived longer, lost weight at a slower rate, and developed muscle weakness and muscle nerve loss in the spinal cord at a later age. The difference seems to be linked to a gene called Pls3, but other genes likely play a role as well. Identifying these could provide new targets for drug development.

John Hilton, Mark Clemons and Dean Fergusson recently published in the Journal of Oncology Practice on what is the most efficient way to improve care for cancer patients.  The team came up eight key principles which form the basis for their Rethinking Clinical Trials (REaCT) Program. As described in the Journal of Oncology Practice, REaCT involves comparing different approved treatment strategies rather than developing new ones. It involves a streamlined process for obtaining oral (rather than written) patient consent, immediate randomization into treatment groups using a mobile device and simplified data collection. Their first trial, which compares two strategies to prevent chemotherapy-related infections in breast cancer patients, has recruited nearly 500 patients in just over 18 months, at a small fraction of the cost of most cancer clinical trials. Ten other REaCT cancer trials are currently underway (with support from the Ottawa Methods Centre) and the hope is to expand to other areas as well. Authors: John Hilton, Dean Fergusson, Mark Clemons…

Jim Dimitroulakos and his team found a possible new molecular target for lung cancer treatment. Their findings, published in Neoplasia, show that while the EGFR-targeting drugs can greatly benefit non-small cell lung cancer patients with EGFR mutations, those without often have to rely on chemotherapy drugs called platins. Dr. Dimitroulakos and his team found that a gene called Activating Transcription Factor 3 (ATF3) plays an important role in driving tumour cell killing by platins. Combining platins with other drugs that increase ATF3 levels could lead to even more tumour cell killing. The team will also test whether ATF3 can help identify platin-resistant tumours even before a patient receives treatment, so they can be directed to other therapies. Dr. Dimitroulakos and Dr. Goss hope to test this in patients, after further research. Authors: Theodore J. Perkins, David J. Stewart, Patrick J. Villeneuve, and Jim Dimitroulakos…

Alexander Sorisky and Teik Chye Ooi recently published in Obesity on why some obese people develop diabetes, heart disease and other life-threatening conditions, while others do not? Experts increasingly believe that part of the answer lies in how fat is stored. When existing fat cells expand to store more fat, this tends to generate damaging inflammation. However, when new fat cells are born to store the fat, there seems to be less collateral damage. Drs. Sorisky and Ooi’s team fed whipping cream to “normal” human volunteers as well as to those with certain natural variations in a gene called PCSK9. After the fatty drink, the normal white blood cells inhibited the birth of new fat cells, while the mutated white blood cells did not. This research reveals a possible novel role for the well-studied PCSK9, which is the target of several cholesterol-lowering drugs recently approved for humans.

David Stewart and Bryan Lo, Pearl Campbell and Craig Ivany led a team that has received funding from Genome Canada to develop a test that can better deliver personalized care for patients with non-small cell lung cancer.  While patients with non-small cell lung cancer may already be tested for EGFR and ALK mutations, these are only present in 10-15 percent of tumours. Researchers are constantly finding more mutations that could make a tumor sensitive to a specific targeted treatment, but right now, there are major barriers to testing them all. The team will develop a method to assess for several different mutations all at once on a small sample of tumour. While this project is not expected to increase the cure rates for this deadly cancer, it does have the potential to make patients feel better and live longer. The project is worth a total of $2 million. Co-applicants: Theodore Perkins, John Hilton…

Kevin Burns and his colleagues reported in 2015 that a kind of stem / progenitor cell from umbilical cord blood could reduce injury and improve kidney function in a laboratory model of acute kidney injury. They also found that the beneficial effects of the cells were mediated through the release of small fluid-filled sacs, known as exosomes.  The research team has drilled down even further, showing that the exosomes only work because they contain a molecule called microRNA-486-5p (which is derived from what was once thought to be “junk” DNA). This molecule is thought to enter kidney cells and stall or stop cell death by targeting a gene called PTEN. See Kidney International for details.

Erin Keely (and Claire Liddy) created a secure online platform to expedite care for thousands of patients in the Capital region. “We created the Champlain BASE™ service to allow primary care doctors to access specialists’ advice electronically rather than having to send their patients to see the specialist,” said Dr. Erin Keely. “Of the more than 15,000 patient cases that have been expedited since we started using BASE, approximately 10,000 were resolved without the patient requiring a face-to-face specialist visit,” said Dr. Liddy. Together with the eConsult team, they decided to participate in Canada Health Infoway’s Imagine Nation e-Connect Impact Challenge.  Not only did the team receive a $30,000 award, they decided to use the money to send a student researcher to Yellowknife, Northwest Territories to take a close look at the considerable amount of time patients spend waiting for specialist care in the Territories.  Their ultimate goal is to help improve wait times for patients in that region as well.

Marc Rodger thought he had settled the debate about the use of blood thinners in pregnant women at high risk of developing blood clots over two years ago. His trial of 292 women in five countries – the largest of its kind – definitely showed that the practice was not effective. However, despite publication in The Lancet with a glowing commentary, some colleagues still didn’t want to give up the injections. Therefore, Dr. Rodger convinced every colleague who had ever done a clinical trial of this procedure to combine data from all their patients, so it could be analyzed in a more powerful way. The result, published in The Lancet, confirms that blood thinners do not prevent pregnancy complications in high-risk pregnant women, except possibly in a very small subgroup. An accompanying commentary calls the analysis “invaluable” and “compelling”. The study is also an important example of the power of patient-level meta-analysis compared to trial level meta-analysis (which was inconclusive in this case).

Michael Rudnicki questions, “the debate over discovery versus applied science is a dead end” in his essay in iPolitics. He suggests we need to “redouble our efforts in fields where we already excel — and support these areas throughout, from the lab to the patient.”

Virginia Roth and Alan Forster led a study that found that screening every patient admitted to TOH for antibiotic-resistant MRSA did not reduce the rates of new infections and cost $1.16M more than screening only those at high risk of carrying the bacteria.  The study, published in PLOS One, found that screening all admitted patients cost $17.76 more per patient compared to screening only those at high risk of contracting the bacteria. These results changed practice at TOH and now only patients admitted to intensive care, rehabilitation are screened for MRSA, as well as patients transferred from the emergency department or from another hospital. Authors: Virginia R. Roth, Kathryn N. Suh, Alan Forster…

Lana Castellucci and her American colleagues have been awarded US$14.8 million ($20 million Canadian) by the Patient-Centered Outcomes Research Institute to test the safety and effectiveness of three blood thinners in a head-to-head trial. Patients who develop a potentially dangerous blood clot in their legs with no obvious cause need to take one of these medications for the rest of their lives to prevent more clots from forming. Most patients are prescribed warfarin; however, this requires regular blood tests and monitoring interactions with food and other medications. New drugs called rivaroxaban and apixaban reduce these problems and may have a lower risk of bleeding, but cost over $100 a month. The 60-centre clinical trial will prove whether these new drugs are as safe or as effective as warfarin.

Vicente Corrales-Medina and Girish Dwivedi were awarded $153,000 from the Heart and Stroke Foundation to investigate whether pneumonia can cause inflammation in the arteries of older patients. Their team previously found that after patients over 65 had developed pneumonia, their risk of cardiovascular disease rose two- to four-fold. The biological reason for this is currently unknown. Studies in animal models suggest that pneumonia can increase inflammation of the arteries, which has been linked to a higher risk of heart disease. The research team will further investigate this possibility by comparing the artery inflammation levels in pneumonia patients over age 65 with those of patients who have not had pneumonia. This is one of five Heart and Stroke Foundation grants recently awarded to researchers at The Ottawa Hospital / uOttawa. Co-investigators: Lionel Zuckier, Robert Beanlands…

Ian Stiell, Phil Wells, Martin Osmond and colleagues have been recognized for their leadership by Choosing Wisely Canada and the Canadian Association of Emergency Physicians for creating a decision rule.  The list identifies ten targeted, evidence-based recommendations that can support conversations between patients and clinicians about what care is really necessary. The rule will include reducing unnecessary imaging for ankle injuries, head injuries, neck injuries and blood clots. Three of these rules are also included on a “top five” list developed by U.S. researchers.

Research led by John Bell, David Stojdl and Brian Lichty has led to Turnstone Biologics, a company established last year through a partnership between the OHRI, CHEO Research Institute, McMaster University and the Ontario Institute for Cancer Research.   This start-up company has secured US$41.4 million to advance viral immunotherapy for cancer; this is believed to be the largest venture capital deal in Ottawa since 2013.  Their most advanced product is a genetically engineered Maraba virus that attacks cancer cells directly and stimulates an anti-cancer immune response. It is currently being tested in a clinical trial led by Derek Jonker. This new funding will enable the team to launch several concurrent trials, including Maraba in combination with a checkpoint inhibitor to help awaken the anti-cancer immune response.

Curtis Cooper received $17,500 from The Canadian HIV Observational Cohort for: A comprehensive review of hepatitis B characteristics and clinical outcomes in HIV co-infected individuals on antiretroviral therapy.

John Bell’s group received $15,000 from Queen Elizabeth II Graduate Scholarships in Science and Technology (QEII-GSST) for: Understanding the impact of adipose tissue and fat cells in virus-based therapy responses

Harold Atkins and Mark Freedman were honoured by the Ottawa REDBLACKS for their research on multiple sclerosis during a recent game. They were called down to the field and presented with a “wood cookie”.

 

 

Media

Antoine Hakim, Shawn Marshall (driving ability in older people) and Barbara Collins (psychological and legal issues) were interviewed by Rodgers TV on a series called “The impacts of the aging brain”.

Shawn Marshall was interviewed by the Globe and Mail about research that aims to improve helmet design to prevent concussions. 

Lauralyn McIntyre was interviewed by The Ottawa Business Journal about her world-first clinical trial of mesenchymal stem cells for the treatment of septic shock. 

Curtis Cooper was interviewed by the CIHR about his research to improve care for people co-infected with HIV and Hepatitis C.

Heather MacLean and Howard Nathan were interviewed by the Ottawa Citizen about the University of Ottawa’s new Academy for Mindfulness and Contemplative Studies.

Allen Huang was on the front page of the TOH Journal, his pilot study, the SoloWalk robotic walker.  “Getting patients to walk early on during their hospital stay can shorten their stay and improve their recovery,” said Geriatrician. The robotic walker slowly lifts a senior patient to a standing position and then supports him as he takes some progressive steps. If he stumbles or feels weak, the safety harness and the robot will support his weight, saving him and his physiotherapist, nurse or other caregiver from a potential fall.  Using a robotic walking device may help older patients walk more when they are in the hospital, thus leading to a faster recovery.”

John Bell and other top researchers were asked by The Ottawa Citizen if immunotherapy is a cancer game-changer.  The story also features a patient who participated in an immunotherapy clinical trial led at The Ottawa Hospital by Xinni Song.

Elianna Saidenberg was in her element as a clinical hematologist when she was interviewed by CTV Ottawa about her personal and professional reasons for sponsoring a blood drive. Dr. Saidenberg took some of the CTV news crew on a tour of the inner workings blood donations.  Dr. Saidenberg and Dr. Mitchell Sabloff  “adopted” a blood drive at a Carling Avenue clinic for a week in September and encouraged those who have never given blood in the past to consider it. “We say every minute of every day, one Canadian needs blood,” explains Maureen Millette with Canadian Blood Services, “and yet only 1 in 60 Canadians donates blood once a year.”Dr. Saidenberg hopes to increase those numbers.

Paul Wheatley-Price, a medical oncologist at TOH and President of Lung Cancer Canada, was interviewed by CBC radio about the P.E.I government adding Afatinib to its formulary.  Afatinib, is a drug which works against specific types of cancer that makes up about 15 per cent of cases.  P.E.I is the last province to add this to its formulary.  “It’s a very effective oral medication that’s taken once a day with really good response rates,” said Wheatley-Price.

 

 

Announcements:

Vladimir Contreras- Dominguez was the recent recipient of the CAME Certificate of Merit Award 2016.  The objectives of this award are to promote, recognize and reward faculty committed to medical education in Canadian medical schools and to promote CAME at each of the Canadian medical schools.

Ian Burwash was the well-deserved recipient of the Canadian Society of Echocardiography’s Annual Achievement which will be presented at the CCS.  Dr. Burwash has made outstanding contributions to the field, which has impacted patient care, training and research.