Almost 10 per cent of women who become pregnant develop hypertension (high blood pressure). Experts agree that pregnant women with severe hypertension should receive blood pressure medication to protect them from stroke. However, it is not clear if or how much the medication would benefit pregnant women with mild to moderate hypertension. A complicating factor is that the medication may also contribute to poorer growth and lower birth weight in babies, placing them at increased risk for health problems as newborns, children and adults. According to a national survey, Canadian obstetricians are unsure about prescribing blood pressure medication to women with mild to moderate hypertension. To help clarify the issue, Dr. Laura Magee and her research team have designed a Control of Hypertension in Pregnancy Study (CHIPS), aimed at determining if it is better for the baby (i.e. better growth before birth and better health thereafter) to allow a mother’s blood pressure to be higher than normal during pregnancy or to prescribe blood pressure medication to lower it. To begin, Dr. Magee is conducting a pilot trial to assess whether or not physicians would adhere to the treatment protocols in a full trial and to confirm if sufficient patients could be enrolled. If the pilot study indicates that CHIPS is feasible, the full trial will be conducted at major maternity centres across Canada.
Program: Scholar
Regulation and role of granzyme B in Atheromatous Diseases
Atherosclerosis – hardening of arteries – is caused by buildup of plaque inside artery walls. This constricts blood flow and elevates blood pressure, and is the leading cause of heart attacks, stroke and lower limb loss due to poor circulation. There is evidence that immune cells provoke a tightly-regulated form of cell death known as apoptosis (programmed cell death) in atherosclerotic blood vessel walls, which contributes to progression of the disease. While the mechanisms are not clearly understood, the result is a change in the architecture of blood vessel walls that leads to additional plaque build-up and also to plaque instability. The latter increases the danger of pieces of plaque breaking off and potentially lodging in and blocking blood flow in smaller vessels. In previous work, Dr. David Granville and his research team have found that an enzyme used by the immune system to kill abnormal and infected cells is released in atherosclerotic blood vessels. Dr. Granville is studying the role of this enzyme – granzyme B – in vessel wall restructuring and cell death associated with atherosclerosis and transplant vascular disease. Findings from this research may reveal new opportunities for intervening to prevent or treat these vascular disorders.
Drug-related mitochondrial toxicity in HIV and HCV antiretroviral therapy: impact of mitochondrial DNA/nuclear DNA ratio changes on therapy outcome
Triple combination antiretroviral therapy has greatly reduced the rate at which people with HIV infections progress to AIDS. However, the medications used in the therapy can be quite toxic, leading to serious liver, kidney, muscle and nerve problems and reducing the length of time patients are able to tolerate the treatment. Dr. Hélène Côté and colleagues at the BC Centre for Excellence in HIV/AIDS have developed a blood test to measure toxicity from antiretroviral therapy and are now assessing its effectiveness in detecting and monitoring toxicity levels. She is also investigating whether the test could predict complications from drug therapy before serious symptoms appear. If so, it could be used to tailor use of antiretroviral therapy and improve treatment outcomes. As part of the research, Dr. Côté also is studying the effectiveness of the blood test in measuring toxicity of medications used for hepatitis C.
Translating mechanistic understanding of the systemic inflammatory response syndrome (SIRS) to clinical practice via genomics
Each year, about 75,000 patients in Canada will develop sepsis (severe infection). Although it is reversible, sepsis often causes death. Sepsis and a related condition, systemic inflammatory response syndrome (SIRS), lead to multiple organ dysfunction and are the most common reasons for admission to intensive care units. Using genetic information that became available after completion of the human genome project, Dr. Keith Walley is researching the genetic determinants of the acute inflammatory response and organ failure associated with sepsis. His aim is to clarify the genetic mechanisms which give rise to the inflammatory response and to apply this information to identify patients who are at risk for adverse outcomes based on their genotype (genetic make-up). His ultimate goal is individualized management of patients with sepsis, based on knowledge of the way their genotype will influence their susceptibility to and risk of developing life-threatening symptoms, as well as their ability to respond to treatment.
Leptin regulation of glucose homeostasis
More than two million Canadians have diabetes, a chronic metabolic disorder caused by the inability of the body to produce or properly use insulin. Obesity is a risk factor for developing type 2 diabetes, the most common form of the disease. Dr. Timothy Kieffer has uncovered links between leptin – a hormone that affects how the body manages and stores fat – and insulin producing beta cells of the pancreas, plus the liver, one of insulin’s target tissues. His research suggests there may be a defect in the interaction between leptin, fat, beta cells and liver cells. Using genetic engineering approaches, Dr. Kieffer is investigating the role of leptin in the development of diabetes and obesity, in the hopes of eventually developing novel therapeutic strategies to combat these debilitating diseases.
Mammalian organelle-membrane Type Na+/H+ exchangers
The cell is the basic unit of structure and function in the body. Many of the functions of cells are performed by particular subcellular structures called “organelles”. Acidity (pH balance) is important for organelle function and disruptions in this environment can lead to uncoordinated communication between brain cells, compromised immunity and uncontrolled cell growth or death. Dr. Masayuki Numata is studying the mechanisms for pH regulation in cells. Dr. Masayuki Numata and his research team have isolated ion transporter proteins that may regulate acidity inside organelles. Using biochemical, cell biological, genetic and immunological techniques, he is investigating how these transporters are delivered to the right destination when they are needed and how they are regulated by different factors. The research could ultimately increase understanding of the mechanisms by which brain cells transmit signals to each other and how disruptions in these signaling pathways cause damage leading to Alzheimer’s disease and other neurodegenerative disorders.
Regulation of NMDA receptors and excitotoxicity
Glutamate mediates signaling between neurons (nerve cells) by binding to protein receptors. Over-activation of one type of glutamate receptor, NMDA, can result in damage to neurons. Dr. Lynn Raymond is researching how neuronal activity and cell proteins regulate NMDA receptors, with the goal of better understanding how irregularities or disruptions in regulatory pathways are implicated in damage associated with neurological disease. Dr. Raymond is especially interested in Huntington’s Disease. This inherited neurological disorder causes progressive neurological damage in specific brain regions leading to movement abnormalities, personality changes, psychiatric disorders and memory loss. Studies have suggested that over-activation of NMDA receptors plays a major role in this selective destruction of brain cells. Dr. Raymond is investigating interactions between mutant huntingtin (the protein produced by the Huntington’s Disease gene) and NMDA receptors to gain a more detailed understanding of the causes of neuronal death in Huntington’s Disease – research that may help in the development of new therapies for this incurable disease.
Synaptic and non-synaptic modulation of neuronal excitability
Neurons (nerve cells) communicate through a process in which one cell stimulates another with an electric pulse transmitted by secreting special chemicals called neurotransmitters into the synapse (gap) between the cells. Learning and memory are influenced by changes in the strength of these synaptic connections and by alterations in the excitability of neurons (how readily they produce an electrochemical response). Abnormalities in the regulation of neuronal excitability give rise to neurological diseases including epilepsy and psychiatric diseases such as schizophrenia. Dr. Brian MacVicar is studying two aspects of synaptic transmission: mechanisms that regulate neuronal excitability and mechanisms that influence synaptic plasticity (the ability of neurons to adapt the way they communicate with each other). In one series of experiments, he is examining cells that surround neurons in the brain to determine if they influence neuronal activity through the regulation of blood flow or other mechanisms. He is also studying how past synaptic experience modifies activity in dendrites, the part of the neuron that receives synaptic transmissions. This research into how brain activity is regulated will contribute to improved understanding of many aspects of neuroscience, including stroke, mental illness and learning and memory.
Molecular controls of embryonic facial patterning
The transformation of the embryo from a mass of undifferentiated cells into a fully formed, functioning organism is a complex process. In early embryonic development, discrete buds of cells fuse to create a face. If proper fusion fails to occurs, the result is severe developmental abnormalities including cleft lip with or without cleft palate. The embryonic segments that form the face are similar in chickens and mammals. Using the chicken embryo as a model, Dr. Joy Richman is studying how the jaw is formed and what goes awry in the process to cause cleft lip. By investigating the mechanisms that designate which embryonic facial bud will develop as a particular facial feature and how appropriate growth is initiated at key times to form a face, Dr. Richman will identify genes and gene signaling pathways that underlie normal and abnormal development of the face and jaw. Such information is critical for improved treatment and prevention strategies for defects such as cleft lip.
Postural Control in individuals with stroke
Every year about 50,000 Canadians will have a stroke, which is the number one cause of neurological disability leading to impaired balance and mobility. Those affected face a seven-fold increase in hip fractures because of falls due to poor balance. Unfortunately, there are very few community-based programs to help individuals with stroke improve or maintain mobility and balance, and a lack of research assessing the effectiveness of such programs. Dr. Janice Eng is investigating the effectiveness of a 12-week exercise program for improving balance and mobility in two groups of people with stroke: a group participating in an intensive exercise program, and another group doing arm exercises. Results of her research could assist in developing guidelines for community-based exercise programs to improve the health of people with stroke, and to reduce hospital admissions due to falls.