Discoveries for life

The faces of health research

Welcome to CIHR's health research storybook, where you can read about the life-changing research happening right here in Canada – presented by researchers and patients in their own words.

Hear from researchers about why they pursued a career in health research, and learn about the health problems they're tackling and the new scientific knowledge they're creating.

You can also read the stories of patients who have been involved in or touched by health research. Many of these profiles were submitted as part of CIHR’s Canada150 storybook and are identified with the Canada150 logo.

Be sure to check back often, as we'll be adding new stories all the time.

To submit a story, send your submission, photo and feedback to: communications@cihr-irsc.gc.ca. First, please review the submission details.


Title

Precision medicine in diabetes: Pharmacogenetic studies of large randomised controlled trials of diabetes therapies

Marie-Pierre Dubé (Canadian NPI)
Université de Montréal
Full Professor – Department of Medicine and Department of Social and preventive medicine

Diabetes is a chronic disease that affects how the body uses glucose and can lead to serious health problems, including cardiovascular disease, neuropathy, nephropathy, and eye disease. Type 2 diabetes is the most common type of diabetes, accounting for approximately 90% of all cases. Treatment of type 2 diabetes typically proceeds with the drug metformin, followed by a range of new combination therapy options. The latest treatment guidelines offer choices based upon risks, cost, and benefit, however there is considerable heterogeneity in who benefits and who is harmed from any of these treatments which are increasingly used in the UK and Canada.

Marie-Pierre Dubé, professor at the University of Montreal, is an expert in genetic statistics, bioinformatics, and pharmacogenomics. She is the Nominated Principal Investigator for a UK-Canada Diabetes Research team grant. This UK-Canada collaboration brings together, for the first time, genetic data on randomised controlled trials of the newer diabetes medication, including SGLT2i trials (Dapagliflozin and Empagliflozin), GLP-1RA trials (Albiglutide, Lixisenatide), and DPP-4 inhibitor trials (Saxagliptin) in over 30,000 genetic samples. These unique resources when studied in combination, provide great power to identify genetic variants that alter benefit to these medications, side effects and cardiovascular outcomes. Here, Dubé’s team will conduct a series of genetic studies making use of dense genomic data. All subjects will be analyzed using leading-edge bioinformatics and statistical approaches. They aim to identify genetic variants that alter response and outcomes of those new diabetes drugs (SGLT2i, GLP-1RA, DPP-4i) with the goal to enable the personalization of therapy for diabetes, such that they can one day prescribe the best anti-diabetes therapy suited to each individual patient.

Further reading:

Twitter: @MP_Dube, @UMontreal, @med_umontreal

Xi-Care: eXplainable intelligent system for cardiovascular disease management among women in primary care

Dr. Samira Abbasgholizadeh-Rahimi
Assistant Professor, Department of Family Medicine, and Associate member, Electrical and Computer Engineering Department, McGill University
Associate Academic Professor, Mila-Quebec AI Institute
Affiliated scientist, Lady Davis Institute for Medical Research, Jewish General Hospital

Cardiovascular disease (CVD) is the leading cause of death among women in Canada, and can be five times more fatal than breast cancer. Yet, women tend to be diagnosed with CVD years later than men. While many people turn to primary care organizations to prevent and manage CVD, according to the The American Journal of Cardiology only 22% of primary care providers feel prepared to help women. Artificial intelligence (AI) could play an important role in supporting clinicians and patients, but it is rarely used.

The objective of our Xi-Care project is to assess the different ways in which primary care providers and women would like to use AI for CVD prevention and management in primary care. Then, we will develop an AI solution that can predict the likelihood of women from having CVD in the future, and recommend personalized preventative strategies that will help them make informed and value-based decisions. We will pilot test Xi-Care among clinicians and women, and then continue to improve it.

Further reading:

Twitter: @RahimiSamira

Cutting across mental health problems

Using the Secret Agent Society to improve emotion regulation skills in kids who have problems with anxiety, depression, or anger

Dr. Jonathan Weiss
Associate Professor and Director, LaMarsh Centre for Child and Youth Research
York University

Children with neurodevelopmental disabilities (NDD), such as autism, attention deficit hyperactivity disorder, learning disabilities, or cerebral palsy, experience mental health problems that can make it difficult for them to manage their anger, anxiety, sadness, or stress. What if there was an intervention strategy that could help them? The Secret Agent Society (SAS) is a spy-themed cognitive behavioural intervention originally designed in Australia by the Social Skills Training Institute to improve the regulation of emotions and social skills among autistic children. We are investigating whether:

  1. an individual variant of SAS can improve the regulation of emotions and mental health of children who suffer from many kinds of conditions;
  2. the use of individual SAS works in an online format; and
  3. the scalability of group-based SAS can help community service providers.

These studies will inform best practices in cognitive behaviour therapy for children with NDD by studying its use across symptoms, contexts, and modalities. It will also help us improve support for children who have NDD and their families.

Further reading:

Twitter: @DrJonathanWeiss, @yorkuniversity

The Right Timing to prevent Type 2 Diabetes: Restoring 24-hour substrate rhythmicity to improve glycemic control by timing of lifestyle factors

Dr. André Carpentier (Canadian Nominated PI)
Professor and Clinician-Scientist – Department of Medicine
Université de Sherbrooke

Recently, our 24-hour culture has been identified as a factor that can contribute to the development of type 2 diabetes. Technological and societal advances such as electric lighting and digital screens, shift work, time zone transfers, and round-the-clock food availability disrupt intrinsic and evolutionarily preserved 24-hour rhythms resulting in a desynchronization between light cues and behaviour cues to our circadian system. This mistiming of cues is now thought to be a large contributor to the current metabolic health crisis. Preclinical data indicate that differentially timed interventions throughout the 24-hour cycle may have an impact on outcomes of these interventions.

Dr. André Carpentier is an expert in diabetes, obesity, and cardiovascular complications. He is the Canadian Nominated Principal Investigator of the Dutch-Canadian research consortium entitled, The Right Timing to Prevent Type 2 Diabetes or “TIMED”. The objectives of the TIMED Consortium are to elucidate the mechanisms and the impact of differentially timed lifestyle interventions throughout the 24-hour period on type 2 diabetes to develop more effective interventions to prevent this disease. The consortium consists of experts in Canada and the Netherlands in integrative physiology, epidemiology, lifestyle interventions, patient engagement, and scientific networking. It will build on expertise in type 2 diabetes, patient engagement and lifestyle interventions and will utilize state-of-the-art methodological capacities, large longitudinal cohorts in Europe and Canada, and a large network of partners, to optimize lifestyle interventions for the prevention of type 2 diabetes, build training and mentoring capacity of the next generation of scientists, and develop a successful collaborative network engaging patients in research across Canada and the Netherlands.

Further reading:

Twitter: @CarpentierAndr3, @USherbrooke

Mobile Health Biometrics to Enhance Exercise and Physical Activity Adherence in T2D

Ali McManus (Canadian NPI)
Professor – School of Health and Exercise Sciences
University of British Columbia, Okanagan

Being physically active and exercising is critical for the management of Type 2 diabetes. Exercise helps people with diabetes control their blood sugar and reduce other serious health risks associated with the condition, but many people with Type 2 diabetes find it hard to stick to an exercise program.

Dr. Ali McManus, a UBC Okanagan Professor is the Canadian lead for the 14-person MOTIVATE-T2D team that is creating new ways that will help people living with Type 2 diabetes exercise regularly. Building on their existing partnership, the cross-disciplinary team are conducting the MOTIVATE-T2D clinical trial out of Kelowna, and Liverpool, UK. In MOTIVATE-T2D, participants are given cloud-connected heart rate monitors and receive individually-tailored counselling from an exercise specialist to help them start, and stick with exercise over a one-year period. The exercise specialist personalizes the exercise prescription and feedback to maximize health benefits. Given that the exercise is performed at home and the counselling delivered virtually, the team in Kelowna is recruiting participants from across Canada for this research study. The team believe that now more than ever, we need to meet the needs of individuals living with Type 2 diabetes by helping them manage their condition from home and are very excited that this evidence-based technology may help provide quality care from the comfort of people’s homes.

Further reading:

Twitter: @alimacUBC, @MotivateT2D, @UBC_HES, @ubcokanagan

Generation of a functionally robust stem cell-based therapy for type 1 diabetes

Dr. Francis Lynn
BC Children’s Hospital Research Institute
Associate Professor – University of British Columbia, Department of Surgery

A cure for type 1 diabetes (T1D) may lie in the replacement of insulin-producing cells by transplantation. Hundreds of patients worldwide (including ~400 in Canada) have received transplants of islets—clusters of insulin-producing cells in the pancreas—enabling better blood glucose control without the need for insulin administration. Yet because there are not enough organ donors, new sources of insulin-producing cells are needed for the millions living with this disease. We can now generate insulin-producing cells from stem cells, but these cells do not secrete insulin properly nor do they survive transplantation without immunosuppression.

Dr. Francis Lynn is an Associate Professor at the University of British Columbia and is the Nominated Principal Investigator on a team grant funded by CIHR and JDRF Canada in Stem Cell-Based Therapies for the Treatment of Type 1 Diabetes. His team aims to use their combined expertise in single cell technologies, genome editing, immunology, and stem cell and islet biology to produce a new and improved cell source for cell replacement therapy in T1D that can be tested in clinical trial in a few years. Such an advance could not only transform the lives of thousands of Canadians living with T1D, but also greatly reduce the tremendous economic and health burden that diabetes places on Canada today.

Further reading:

Twitter: @nictitate, @beta_cell, @BCCHresearch, @BCChildrenHosp, @UBC, @UBCmedicine

How are Canadian public health agencies addressing COVID-19 through social media?

It is important to develop a stronger community of practice that includes community leaders and researchers

Dr. Anita Kothari
Professor
Western University

Over the past year, our research team has been exploring how organizations use social media as a way to relay public health messages, address misinformation, and increase acceptance of COVID-19 vaccines across Canada.

We have built our own machine learning model to assess sentiment of Canadian public health officials through their tweets, and tracked public reactions to social media communications through government accounts. This work complements our content analysis of tweets related to COVID-19

We have also spoken to 40 community health leaders from nonprofit groups, patient advocacy groups, and community health centers who have asked for support in communicating public health restrictions. We explored ways that they can tailor their communications strategies for equity-deserving groups.

This work is raising another question though: How might we emerge from this pandemic as a more connected and resilient public health ecosystem? Over the course of the summer, our research team will continue to communicate with researchers and organizations, and encourage them to join our monthly knowledge exchange and networking sessions.

Further reading:

Twitter: @anitarena

Helping parents support kids during COVID-19 pandemic

Evaluating the efficacy of an online family intervention (I-InTERACT-North)

Dr. Tricia Williams
Health Clinician Scientist
Hospital for Sick Children (SickKids)

COVID-19’s unprecedented quarantine policies have increased stress among Canadian families. Those who have children who suffer from pre-existing neurodevelopmental difficulties (e.g., ADHD, autism) could experience enormous strain due to disruptions to their routines and decreased support. Providing opportunities for mental health support to these families is essential, with options that are flexible and matched to the family’s needs. I-InTERACT-North is already an active SickKids parenting program that has a strong record of success in providing virtual service delivery to families.

This current study is evaluating whether a ‘stepped care’ approach of virtual mental health parent intervention can best treat the intensity of families’ needs during COVID-19. We have partnered with the Province of Ontario Neurodevelopmental Disorders (POND) Network to offer the program to children (ages 3-9) and their families in four Ontario centres (Holland Bloorview Kids Rehabilitation Hospital, SickKids, University of Western Ontario, and Queen’s University). Overall, our work will evaluate matching mental health care to family needs so that further mental health and family difficulties can be avoided, and help us foster the program’s growth beyond immediate crises.

Further reading:

Twitter: @WilliamsTS_Dr

Probiotics not as beneficial as they are touted to be

Research into the use of a probiotic in children with acute gastroenteritis finds no associated benefits

Dr. Stephen Freedman MDCM, MSc
University of Calgary

Probiotics administration in children with acute gastroenteritis has been a controversial topic for nearly two decades. Although the evidence to support use has been limited and often contradictory, bolstered by strong marketing campaigns from industry, usage has increased significantly. With the support of CIHR, Dr. Freedman’s team has conducted landmark studies assessing both the clinical benefits and potential mechanisms of action associated with the administration of a Lactobacillus rhamnosus/Lactobacillus helveticus combination product to Canadian children with acute gastroenteritis.

In an evaluation of 886 children who presented to one of six participating emergency department with gastroenteritis, they found that twice-daily administration of the probiotic did not prevent the development of moderate-to-severe gastroenteritis within 14 days after enrollment (NEJM 2018). This was followed by a sub-study that explored whether there were virus-specific benefits in terms of reducing clinical symptoms or viral nucleic acid clearance from stool specimens collected up to 28 days following enrollment. This study yielded similar findings – that there were no benefits, either clinical or microbiologic associated with the use of the probiotic product evaluated in children with acute gastroenteritis (Nature Communications 2020). Recently the team further analyzed stool specimens collected as part of this study and found no effect of the probiotic preparation, relative to placebo on stool secretory immunoglobulin A concentrations (American Journal of Clinical Nutrition 2021). Taken together, these findings highlight the need for a re-evaluation of probiotic use in children with acute gastroenteritis and until future research provides a convincing evidence of benefit, probiotics should not be provided to children with acute gastroenteritis.

Further reading:

Twitter: @UofCr4kids, @UCalgaryMed, @pert_calgary, @PERC_Network

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