Effect of long term air pollution exposure on childhood respiratory diseases in the Georgia Basin: A cohort study

Asthma is the most common chronic disease in childhood. Long term studies indicate predisposition to asthma develops in the first three to five years of life. Recent evidence suggests exposure to air pollution from traffic is associated with new cases of asthma. However, the long-term impacts of air pollution exposure and whether this exposure causes asthma are unclear. Nina Clark is investigating the association between exposure to air pollutants and childhood respiratory diseases in southwestern BC. Using the BC Linked Health Database that connects various data sources to provide individual level health outcome data, Clark is tracking the exposure and health outcomes of approximately 120,000 children who were born in the region over the four-year period beginning in 1999. She will examine resources including maps detailing air pollution concentration, medical services plan billing records and hospital discharge records. Clark will also look at variables such as age, gender, birth weight and socioeconomic status. She hopes her research will lead to targeted reductions of air pollution exposure, such as zoning or land use restrictions to limit exposure of children, and help provide focus for future interventions and policies.

Characterization of a new checkpoint in hematopoietic stem cell development

Blood cells are critically important to human health and a significant perturbation of blood production is life-threatening. In addition, the transformation of blood cell precursors leads to fatal leukemias, lymphomas and myeloma that remain difficult to treat and are often fatal within a few years of diagnosis. All blood cells must be produced from a common pool of self-maintaining cells called blood stem cells. Understanding the regulation of these cells and their immediate derivatives is critical because they are thought to be the origin of most blood cancers and it is the transplantation of these cells that is required to rescue the blood-forming system in patients who can benefit from treatment with an otherwise lethal dose of chemotherapy or require replacement of a defective blood-forming system. Although the use of blood stem cell transplants can be life-saving, its application is still limited. A major barrier to more widespread use is the extremely limited number of blood stem cells in the tissues where they are produced, and our inability to grow or expand these cells in tissue culture. Previous research has demonstrated that as they develop from fetal to adult cells, blood stem cells undergo an abrupt change that reduces their capacity to expand. Michael Copley’s research at the Terry Fox Lab focuses on improving our understanding in molecular terms of the mechanism that switches the ability of blood stem cells to expand that occurs shortly after birth. This could lead to the development of ways to block or reverse the switch, so that adult stem cells can be made more effective. It could also lead to an increased understanding of why different types of leukemias and other early onset blood disorders develop in children and adults.

Remaining patient: Transforming the practices of health care to promote positive outcomes for teen mothers and their children

Teen pregnancy is a health issue affecting Canadian youth, particularly vulnerable teens. Unfortunately, teen mothers typically do not access health care regularly which hinders their ability to receive necessary information about both prenatal and maternal health. Without effective and early intervention, young mothers and their children have ongoing health, social and education issues that strain the health care system. While researchers have differing opinions about the impact of age on these health outcomes, most research defines teenage pregnancy as a health and social problem. Genevieve Creighton is studying whether the concept of teen mothers as “ill” stigmatizes teen mothers, making them reluctant to access the health care system for fear of being judged by health care workers and educators. Creighton is working with pregnant and parenting teens and their health care providers to determine whether certain attitudes and practices have a negative impact on their relationships and how these can be transformed. This information could help health and social service providers design more effective programs for teen mothers and other vulnerable populations.

T regulatory cells and T helper 17 cells: interactions between two distinct T cell subsets important for immune homeostasis

The immune system tries to maintain an optimal balance between immune responses to control infection and tumour growth, and reciprocal responses that prevent inflammation and autoimmune diseases. Impaired immune responses, such as those that occur with autoimmune disorders (multiple sclerosis, type 1 diabetes) and organ transplant rejection, result when a person’s immune system mistakenly attacks normal cells. Currently, patients afflicted with this condition must follow a strict regime of immunosuppressive drugs for the rest of their lives. However, these treatments seriously compromise the body’s ability to fight infection and also increase the risk of developing cancer. Sarah Crome is studying the role of a newly discovered class of cells, called T regulatory (Treg) cells in immune system response. She is studying how Treg cells suppress other immune cells and essentially act as a “brake” for the immune system. She is also examining how a subset of T cells, called T helper 17 cells, cause harmful immune responses that result in the rejection of transplanted tissues. A better understanding of these cells and the interactions and factors that regulate their differentiation and function, may lead to more effective treatments for organ transplantation and autoimmune diseases without compromising normal immune function.

The role of Na+/H+ exchangers (NHEs) in pH regulation and brain function

The regulation of pH (a measure of acidity or alkalinity) is a highly sophisticated and tightly controlled process that is extremely important for proper brain function. Abnormal fluctuations in the pH of neurons (nerve cells) may be involved in the development of many neurological disorders such as epilepsy. Sodium-proton exchangers (NHEs) are membrane proteins that play an important role in maintaining and regulating cellular pH. Two forms of these proteins in humans, NHE1 and NHE5, are found at high levels in the brain. Graham Diering is investigating the exact function of NHE5, the only NHE that occurs almost exclusively and at high levels in the brain. NHE5 has been linked to familial paroxysmal kinesigenic dyskinesia (PKD), a neurological movement disorder. However, the precise involvement of the protein in PKD, and its role in proper brain function, are unknown. Diering is researching NHE5 in different brain structures, including mature and developing tissue, and examining the protein at the cellular level to determine where it may be active in nerve cells. An enhanced knowledge of the mechanisms in nerve cells that regulate pH could increase understanding of the factors that govern brain function, both in the normal and diseased state. As well, an analysis of specific molecules involved in this process could contribute to development of diagnostic and therapeutic strategies for treatment of neurological disorders.

Elucidating the signal transduction pathways by which the host defence peptide LL-37 initiates immunomodulatory responses by bronchial epithelial cells

The immune system must strike a balance between fighting off illness and infection and damaging tissues in the body. If the balance swings too far in either direction, the results can be disastrous. Over-stimulation of the immune system can result in tissue damage, low blood pressure, organ failure and death. A good example is toxic shock syndrome, which occurs when an enormous overreaction by the immune system triggers a rapid drop in blood pressure, leading to multiple organ failure. Mortality is as high as 30 to 40 per cent Researchers recently suggested that this type of reaction may explain, in part, why the 1918 flu epidemic was so deadly. A protein called LL-37 is involved in healing wounds and growing new blood vessels, a process that is vital for repairing damaged tissue. Niall Filewod is investigating whether or not LL-37 can help calm an activated immune system. Thus diminishing the effect of excessive immune responses and protecting the body from toxic shock. If so, this research could lead to new drugs to treat conditions ranging from sepsis to arthritis that result from immune system reactions gone awry.

Heme binding and transport by the Staphylococcus aureus Isd system

Staphylococcus aureus is a bacterial pathogen that is of considerable medical concern. Though it normally lives externally on humans or animals, S. aureus causes problems when it is introduced into breaks in skin or mucosal surfaces, enabling it to invade the surrounding tissues and move into the blood stream. S. aureus poses an especially great threat in the hospital setting where it is one of the most commonly acquired bacterial infections and a serious cause of disease and death. The emergence of multidrug-resistant “superbugs” has highlighted the potential threat S. aureus poses in the health care system. There is an imperative need for new means of inhibiting the growth of S. aureus. As in many other organisms, iron is required for growth in S. aureus – an element that the bacteria must either extract or scavenge from within the human system. The majority of iron in the human body is found in heme, and many other organisms have evolved to utilize heme as an iron source. Recently, S. aureus was also shown to preferentially use heme-iron in early growth, but little is known about its heme uptake mechanism. Jason Grigg is exploring the function and structure of a set of four cell surface heme binding proteins found on S. aureus. By describing how the bacteria grows by extracting iron from its host, this research may lead to new ways to “starve” the bacteria and inhibit its pathogenesis.

The role of RyR2 in palmitate-induced beta-cell apoptosis in primary human and mouse pancreatic islets

Type 2 diabetes is a chronic disease affecting more than 2.2 million Canadians. The disease is characterized by the body’s inability to produce sufficient amounts of insulin — a hormone that regulates blood glucose levels. Over time, high levels of blood glucose can lead to complications like blindness, heart disease, stroke and kidney problems. Although the incidence of type 2 diabetes is increasing, its cause is still poorly understood. Type 2 diabetes results from a combination of beta-cell failure and insulin resistance. Obesity has long been known to be a major risk factor in the development of diabetes, and a leading hypothesis is that high saturated free fatty acids in the blood stream (hyperlipidemia) contribute to beta-cell death. Recent studies have also found that variations in certain genes, called “diabetes genes,” may increase susceptibility to the disease and play a role in beta-cell death. Kamila Gwiazda is investigating how these networks of diabetes susceptibility genes and acquired risk factors, such as hyperlipidemia, regulate beta-cell death and cause the onset and progression of type 2 diabetes. Gwiazda’s research could explain how obesity leads to diabetes and triggers other diseases that commonly occur in diabetics, ultimately leading to new therapies to prevent and treat the disease more effectively.

Measuring equity in access to pharmaceuticals

Canadians spend about $27 billion each year on pharmaceuticals, which represents the largest component of private health care costs. For some, this means significant financial hardship. For others, the costs are too high, prohibiting access to necessary care. To date, very little attention has been paid to equity in access to prescription drugs, even though a central goal of Canadian health care policy is to promote access to necessary health care. British Columbia’s Pharmacare program of income-based drug coverage has been proposed as a national standard. Gillian Hanley is examining the degree of income-related inequity in accessing prescription drugs, before and after the program was introduced in 2003, to assess the potential impact of national implementation. She is looking at how a change in coverage affects equity of access to medicines at a population level as well as within and across population subgroups. Previous research by Hanley and her colleagues has shown that the major impact of BC’s Pharmacare program is one of redistributing costs from public to private sources and across various income levels. Part of this research suggested that individuals of higher income generally have higher total drug expenditures. As previous research has shown that higher income individuals are often healthier than those of lower income, their higher drug spending is unexpected and warrants further examination. . Her goals are to offer policy makers insight into how to improve current Pharmacare models and to provide researchers with new methods to examine equity in access to medicines and health services.

Identification of Positive Transcriptional Regulators of the tap-1 Gene

Worldwide in 2000, there were 10.1 million new cases of cancer, 6.2 million deaths due to cancer, and 22 million people living with the disease. The immune system plays an important role in limiting the emergence of cancers and aiding recovery from the disease. As such, researchers are looking for ways to boost the body’s own immune response as a way of improving cancer care. The immunological approach to fighting cancer involves the science of understanding and manipulating the body’s immune defenses. Our bodies already have all the tools needed to fight cancer. However, efforts to manipulate the immune system to destroy or inhibit the development of cancer cells have met with limited success. This is because the approach has been to stimulate the immune system to kill the cancer cells. The limitation of this approach is that cancer cells have ways of disguising themselves from the immune system. Jennifer Hartikainen’s approach comes from the other direction. She is working on making cancer cells recognizable to the immune system. Key pathways are depressed in cancer cells, which allows cancer to avoid immune detection and grow unchecked. Hartikainen aims to add back the components that are missing in cancer cells so the immune system can recognize and kill them, with the long-term goal of providing new therapeutic and diagnostic tools for battling cancer.