Disease

New research tool tackles deadly mosquito-borne diseases

Christopher.Sorensen — Tue, 07 Feb 2023 21:07:35 +0000

New research tool tackles deadly mosquito-borne diseases

Christopher.Sorensen Tue, 02/07/2023 - 16:07

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Kathryn Rozen-Gagnon, an assistant professor of molecular genetics who is a member of the Emerging and Pandemic Infections Consortium, is studying the relationship between mosquito-borne viruses and their mosquito and human hosts (photo by Betty Zou)

Betty Zou

Topic

Our Community

Emerging and Pandemic Infections Consortium

Institutional Strategic Initiatives

Temerty Faculty of Medicine

Disease

Molecular Genetics

For most people living in Canada, mosquitoes are nothing more than a summertime nuisance, intruding on nights at the cottage and evenings around the campfire. But for millions of people around the world, particularly in the Global South, they are a serious and potentially fatal threat.

According to a 2017 report from the World Health Organization, mosquito-transmitted diseases such as malaria, dengue and Chikungunya affect an estimated 347.8 million people annually and are responsible for nearly 450,000 deaths each year, making the insects one of the most dangerous animals in the world.

Yet, despite a devastating impact that’s predicted to get worse as climate change drives global temperatures higher, research on the mosquito has lagged behind that of other model organisms such as the fruit fly – in part due to the lack of appropriate tools and resources.

Kathryn Rozen-Gagnon is trying to change that.

She recently joined the department of molecular genetics in the Temerty Faculty of Medicine as an assistant professor. Her lab will study the relationship between mosquito-borne viruses and their mosquito and human hosts. Specifically, she is focusing on viruses such as Zika, dengue and Chikungunya, which have RNA as their genetic material.

“It fascinates me that you have a virus with this very small piece of single-stranded RNA that encodes about 10 genes and yet, with this minimal system, it can navigate very, very different host species,” says Rozen-Gagnon, who is also a member of the Emerging and Pandemic Infections Consortium (EPIC), one of several Institutional Strategic Initiatives at the university.

Rozen-Gagnon’s approach integrates diverse fields like computational biology, insect immunology, RNA biology and virology to dissect how these viruses succeed by interacting with their hosts’ RNA and immune systems. As a post-doctoral fellow and research associate in Nobel Laureate Charles Rice’s lab at the Rockefeller University, she developed cutting-edge methods to better understand how the mosquito immune system responds to viral infection.

One of the tools she created is a universal software package called CLIPflexR that can help researchers uncover a protein’s RNA targets. It improves upon existing software by providing a more reproducible and streamlined approach for data analysis. More importantly, CLIPflexR has the flexibility to work with genome datasets from any organism, including ones like the mosquito where genomes are not as complete or well characterized as the genomes of more commonly studied species.

Using this new software package, Rozen-Gagnon mapped out the RNA targets for a family of RNA-binding proteins called Argonaute proteins, which play a crucial role in mosquitoes’ antiviral defence. Mosquitoes rely on a system called RNA interference to protect themselves from viral infection. A specific Argonaute protein facilitates this by targeting and destroying viral RNA, which reduces virus replication.

“It’s important that the virus can maintain a high level in the mosquito without damaging the mosquito too much because it needs that mosquito to go on to bite people,” says Rozen-Gagnon. “Some scientists have argued that this RNA-based immune response enables viral persistence by keeping the virus at a level where it’s not going to have negative effects on the mosquito, but there is still enough virus to transmit to humans,”

By providing snapshots of which RNAs are targeted by Argonaute proteins, her work is providing new insights into how the mosquito’s immune system maintains this delicate balance.

To further expand the toolbox for mosquito research, Rozen-Gagnon developed the first-of-its-kind CRISPR gene editing system optimized for mosquito cells. The new tool allows scientists to conduct large genetic studies using mosquito cells grown in a lab to understand the function of different genes. In a proof-of-principle study published in Scientific Reports, she and her colleagues showed that the mosquito-optimized CRISPR system was efficient and versatile. Further, because the system uses DNA components known as plasmids, which are cheap to buy and easy to make and modify, it is more cost-effective than versions that rely on expensive purified proteins.

“This is a really great tool that will allow us to ask, what mosquito genes are important for virus replication?” says Rozen-Gagnon. “We haven’t been able to do that using updated gene editing technologies like CRISPR in an unbiased way.

“It also democratizes who can do these kinds of studies. Providing cheap methods like this one allows labs from many different parts of the world to contribute to the field in a meaningful way, which I think is very important.”

Both tools will play a central role in her lab’s work as she continues to delve into the inner workings of mosquito immunity and the interplay between viral infection and a particular type of RNA called microRNA in human and mosquito cells.

Rozen-Gagnon’s research will be further enabled by access to an insectary in the revitalized Toronto High Containment Facility, which recently received a $35 million federal investment to support its modernization. The specially designed space will allow her to infect mosquitoes with viruses like dengue and Chikungunya in a safe and secure way and conduct complementary studies in lab-grown mosquito cells and live insects.

'We're learning more every day': How �鶹��Ƶ is leading efforts to understand – and respond to – COVID-19

Christopher.Sorensen — Tue, 10 Mar 2020 23:25:17 +0000

'We're learning more every day': How �鶹��Ƶ is leading efforts to understand – and respond to – COVID-19

Christopher.Sorensen Tue, 03/10/2020 - 19:25

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From tracking its spread to developing new diagnostic tools and educating the public, �鶹��Ƶ experts have been on the front lines of the battle to understand and ultimately respond to COVID-19 and the novel coronavirus behind it.

Topic

Dalla Lana School of Public Health

Disease

Factor-Inwentash Faculty of Social Work

Faculty of Medicine

Faculty of Arts & Science

Global

Laboratory Medicine and Pathobiology

Political Science

Research & Innovation

Startups

Sunnybrook Hospital

�鶹��Ƶ Scarborough

University Health Network

As the world watches the spread of the COVID-19 virus, researchers from the University of Toronto are at the forefront of monitoring, predicting, and managing the disease – from creating mathematical models that help predict its spread to working on rapid diagnostics and potential treatments.

They are also providing critical advice to world leaders – and the rest of us via numerous appearances on TV, radio and online news sources – on the best ways to respond to an outbreak that has so far sickened more than 114,000 on every continent except Antarctica and is responsible for more than 4,000 deaths.

While Canada has so far escaped the worst of the growing health crisis, with just 65 confirmed cases, Isaac Bogoch (left), a specialist in epidemiology and infectious diseases, says it’s only a matter of time before the novel coronavirus makes its presence felt here in a much larger way.

“In Canada, we're certainly not immune to this, and we will very likely see more and more imported cases into Canada as we see more cases throughout the world,” says Bogoch, who is an associate professor of medicine in the Faculty of Medicine and a clinician investigator at the Toronto General Hospital Research Institute, part of the University Health Network (UHN).

Understanding the virus and tracking its spread

In addition to making regular appearances in the media to help inform and educate a nervous public, Bogoch is one of a number of �鶹��Ƶ researchers who is tracking the disease using official reports and computer models in an attempt to predict how bad the outbreak is likely to get. In January, he was first author on a study in the Journal of Travel Medicine that predicted the likely spread of the disease based on analyzing flights originating in or passing through Wuhan, China, which would later emerge as the epicentre of the outbreak, but at the time had only a few confirmed cases. The paper correctly predicted that the disease would soon spread to Bangkok, Hong Kong, Tokyo and Taipei.

BlueDot Health, founded by the Dalla Lana School of Public Health’s Kamran Khan, alerted its clients to the outbreak of an infectious illness in China about one week earlier than the World Health Organization (photo by TK)

Bogoch's co-authors on the paper included Kamran Khan, an associate professor at the Dalla Lana School of Public Health. Khan is the founder of a company called BlueDot that uses data analytics to track and predict infectious disease risk – essentially an automated global surveillance system that can peer into the future. The power of the technology was underscored when the company alerted its clients to the unusual outbreak of illness in China about a week before the World Health Organization alerted the world to the emergence of the novel coronavirus.

On Feb. 5, epidemiologists Ashleigh Tuite and David Fisman (both at left), both of the Dalla Lana School of Public Health, published a paper in the Annals of Internal Medicine that looked at data on the spread of the disease and concluded that it must have originated in November, a month earlier than previously thought. They also published an online model that allows researchers to test different assumptions about the novel coronavirus such as how infectious it is and how well control efforts are working.

“Modelling allows us to move from data to understanding,” says Fisman, who has also been a fixture on TV, radio and online publications in recent weeks. “You can easily do interventions or experiments on the population on your computer. And that can give you ideas, for example, about how you might slow this epidemic – what might be the impact of flattening the epidemic curve, for instance, so the epidemic is less fierce at any given point of time, but lasts longer?”

More recently, Bogoch, Khan, Fisman and Tuite wrote a paper to predict the size of the COVID-19 outbreak in Iran. At the time they wrote the paper, Iran had confirmed only 43 cases of the disease. But three international cases had also been traced back to Iran. Based on that number and an analysis of travel patterns, they calculated that Iran likely had 18,300 active cases. Since then, Iran has identified thousands of confirmed cases.

Despite successes like these, Bogoch points out that a lot is still unknown about the disease. For instance, although the mortality rate is reported at two to three per cent, the rate could go down as we discover that more people than we thought had mild cases of the disease and recovered without anyone knowing.

It's also difficult to say how widespread the disease will eventually become, or how it will compare in severity to other diseases such as SARS or the seasonal flu.

“I think we have to be careful and humble in our approach to this infection. We're learning more and more every day, and we don't have all the answers,” he says.

New tools to combat COVID-19

Robert Kozak and Samira Mubareka, both in �鶹��Ƶ’s department of laboratory medicine and pathobiology and at Sunnybrook Health Sciences Centre, are working on new tools to help hospitals diagnose the virus more quickly (photo by Nick Iwanyshyn)

Beyond understanding the spread of COVID-19, there are several �鶹��Ƶ researchers who are racing to develop new tools for physicians to combat the virus both here in Canada and around the world.

Samira Mubareka and her colleague Robert Kozak, both in �鶹��Ƶ’s department of laboratory medicine and pathobiology in the Faculty of Medicine and at Sunnybrook Health Sciences Centre, are using the latest in whole-genome sequencing technology to help hospitals characterize the virus more quickly. The research also promises to help track the virus’s evolution and spread.

“If the virus’s genome was a book, we’re going to figure out its entire story,” Kozak told �鶹��Ƶ News in late February.

At the same time, a �鶹��Ƶ startup company that was co-founded by former PhD student Ali Punjani played a key role in helping researchers create the first 3D, atomic scale map of the part of the virus that attaches to and infects human cells – a key step toward developing a vaccine that some described as a “critical breakthrough.”

There will likely be more discoveries to come. Late last week, the federal government announced it was investing $27 million in coronavirus-related research, nearly $6 million of which is going to �鶹��Ƶ and affiliated institutions.

Getting our act together

Ross Upshur, a researcher and bioethicist, says some of the responses to COVID-19 from governments have been questionable (photo courtesy of Dalla Lana School of Public Health)

Ross Upshur is a researcher and bioethicist with the Dalla Lana School of Public Health. He is especially interested in the ethics of responses to infectious disease outbreaks, and is chairing a World Health Organization working group on the topic.

Upshur says that the ethics of responses to emergencies like COVID-19 have been laid out in a number of recommendations and enjoy a general consensus. But he says that, with each new outbreak, there’s a tendency for governments tend to forget lessons of the past.

“Most outbreaks start out interesting, then they become weird, then they become weirder, but structurally the same sorts of issues arise again and again and again. That's the thing I find fascinating. When are we going to get our act together on this?”

Even though there are well-established ethical guidelines about the best ways to respond to disease outbreaks, Upshur says that governments never seem to remember those lessons from one outbreak to another.

For instance, measures to control the outbreak have been more restrictive than usual, and look more like security responses than public health measures. And Upshur thinks at least some of the measures are questionable. For instance, Japan quarantined 3,711 passengers and crew on the Diamond Princess cruise ship, and 705 eventually became sick. Upshur says an alternative would have been to send everyone home with thermometers and to check in with them daily. Such a measure was effective in dealing with a similar incident during an Ebola outbreak, he says.

Zoonotic disease

An assistant professor in the Faculty of Medicine, Kerry Bowman points to the widespread trade of wild animals as a contributor to a number of diseases, including SARS, Ebola, and now COVID-19 (photo by Jacklyn Atlas)

Kerry Bowman is an assistant professor of medicine and a bioethicist with an interest in the effects of environmental degradation and wild animal consumption on the spread of disease. Several years ago, he visited the market in Wuhan that is the epicentre of the disease and saw first-hand the wild animals for sale there.

He counted 56 species of animals for sale, wild and domestic, crowded together in stacked cages. Not only were the animals suffering, but the conditions were perfect for the spread of disease, he says.

Bowman acknowledged that there are cultural sensitivities around consumption of wild animals, and that it occurs in many countries, including eating of deer and other game animals in Canada. But he says the widespread trade of wild animals has contributed to a number of diseases, including SARS, Ebola, and now COVID-19. In each case, the disease seems to have originated in a wild animal being used for food.

“Unless we collectively begin to deal with the commodification of wildlife and the consumption of wildlife we are not going to get on top of this,” he says.

Politics and xenophobia

An associate professor of political science, Lynette Ong says China's government didn't respond well during the outbreak’s early days (photo by Riley Stewart)

Lynette Ong has been watching the effect of the outbreak on the Chinese government and its relationship with its citizens and other countries. The associate professor of political science says that China's centralized, authoritarian government did not initially respond well in the course of the outbreak.

“Because of the authoritarian nature of the political system, people are afraid to report bad news, even if it's the truth. People try to avoid responsibility,” she says. On the other hand, once the government is convinced there is a problem, it does have the ability to take strong measures.

She also thinks the outbreak has made Chinese citizens more interested in holding their government accountable. “This is an awakening moment in China for people as they become aware that information is controlled tightly. People are realizing that the information being controlled can affect them,” she says.

Almost as soon as people became aware of the outbreak in China, xenophobic and racist comments began circulating in Canada and elsewhere. Carmen Logie (left), an associate professor in the �鶹��Ƶ's Factor-Inwentash Faculty of Social Work, told �鶹��Ƶ News that fear of infection during disease outbreaks can amplify existing prejudices and intensify discriminatory behaviours

That was particulary the case during the initial days of the COVID-19 outbreak, when it was largely confined to Asia, and Chinese-Canadians were being unfairly targeted.

“We need a multi-pronged approach,” Logie says in the interview. “Yes, we need the information, but we also need to share how this is connected to our biases towards, say, Chinese people in Canada, as well as the negative impacts it's currently having on communities."

Bowman, who worked as a doctor during the SARS outbreak, says that racism was a factor then, too, and it is important to address it quickly.

"An outbreak is not just a biological event,” he says. “It's a political and sociological event as well, and an economic one. And sometimes the economic and social and political can be as powerful or even more destructive than the physical threat, and ‘us against them’ is something that sets in very quickly under this kind of pressure.”

Although he says he has seen racism emerge in similar ways to the SARS outbreak, he thinks that there was more and quicker pushback against it in the media and elsewhere. He also thinks that as the virus spreads to more countries, it will no longer be associated in people's minds solely with China.

Lessons from SARS?

Passengers on the deck of the Diamond Princess cruise ship, which recorded 705 infections and raised serious questions about Japan’s decision to quarantine thousands of people aboard the vessel (photo by Kyodo News via Getty Images)

Canada, not surprisingly, has tended to look at the COVID-19 outbreak through the lens of the 2003 SARS epidemic. But Bogoch points out that they are actually very different diseases. SARS tended to cause severe illness, and had a death rate of around 10 per cent. Coronavirus, on the other hand, usually comes with milder symptoms and a lower rate of death.

Nevertheless, the experience of SARS seems to have taught Canada important lessons that will help it control COVID-19.

“Our systems are so much more robust than they were in the time of SARS, just in terms of the coordination and communication between the various levels of public health and clinical medicine,” he says. “And the infection prevention and control initiatives in hospitals are much more robust now than they were.”

Upshur isn't so sure. He acknowledges that Canada has invested a great deal in public health since SARS, including creating the Public Health Agency of Canada and the position of chief public health officer. On the other hand, the Government of Ontario has proposed cutting funding for public health service.

“Public health is always the first to go because you don't notice it when it's working,” he says. “But woe on you when you start to mess with it. Because you pay the price every time.”

In the meantime, �鶹��Ƶ experts will continue to be on the front lines of the current outbreak. That includes experts like Seema Yasmin, a former epidemic intelligence officer at the U.S. Centers for Disease Control and Prevention and global journalism fellow at �鶹��Ƶ’s Munk School of Global Affairs & Public Policy, who has been a frequent commentator on U.S. media like CNN and Wired magazine.

It also includes Abdu Sharkawy, an assistant professor in the Faculty of Medicine and infectious disease specialist at Toronto Western Hospital, part of UHN, who recently penned a viral Facebook post that, if nothing else, is helping to keep the wall-to-wall coverage of the COVID-19 crisis in perspective.

Sharkawy argued that while the illness does indeed pose a danger, the panic surrounding it could ultimately do more damage. His prescription? “Facts not fear. Clean hands. Open hearts. Our children will thank us for it.”

Deadly, animal-borne viruses like Nipah on the rise, �鶹��Ƶ researcher warns

Christopher.Sorensen — Fri, 13 Jul 2018 04:00:00 +0000

Deadly, animal-borne viruses like Nipah on the rise, �鶹��Ƶ researcher warns

Christopher.Sorensen Fri, 07/13/2018 - 00:00

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The deadly Nipah virus originates in fruit bats and, in the case of recent outbreaks, is likely being transmitted to humans via contaminated date palm syrup or fruit (Photo by: Arterra/UIG via Getty Images)

Rebecca Biason

Topic

Global Lens

Institute of Health Policy Management and Evaluation

Dalla Lana School of Public Health

St. Michael's Hospital

University Health Network

Infections like Nipah virus and Ebola have begun to appear more rapidly among human populations over the past twenty years, but experts have yet to conclude why this may be the case.

In India, the lesser-known Nipah virus has been part of a recurrent outbreak since the late 1990s, where it has a high case fatality rate of 40 to 60 per cent.

“Nipah virus is different from Ebola in that it more readily affects the lungs and the brain,” says Dr. Sharmistha Mishra an assistant professor at the University of Toronto's Institute of Health Policy, Management and Evaluation and an infectious disease physician and epidemiologist at St. Michael’s Hospital. “While Ebola attacks the organs and shuts down the body in large part due to fluid loss, Nipah can have severe neurological side effects that vary depending on how the body reacts to the virus.”

Treatment of those infected with Nipah requires intensive supportive care, but symptoms can also appear on a spectrum of severity. Some people develop only flu-like symptoms, while others can suffer seizures or end up in a comatose state.

“There is no vaccine as yet, though investigational agents are being considered,” says Mishra who is also a clinician scientist at the La Ka Shing Knowledge Institute.

The unassuming date palm fruit is the likely point of animal to human transmission of the virus in the case of the most recent outbreaks. In the country of Bangladesh, which has seen a yearly outbreak of the disease since the late 90s, the virus was transmitted to humans from consumption of raw date palm syrup or the date fruit, which can be contaminated by the saliva or urine of the fruit bat.

“The fruit bat is the animal reservoir for this particular virus, and the reason why these types of infections are known as zoonotic,” says Mishra.

Dr. Sharmistha Mishra is an assistant professor at �鶹��Ƶ's Institute of Health Policy, Management and Evaluation and an infectious disease physician and epidemiologist at St. Michael’s Hospital (photo by Rebecca Biason)

According to the World Health Organization, the Nipah virus is also considered to be an emerging zoonosis – a disease or infection that is naturally transmissible from animals to humans. Infectious disease epidemiologists are still learning about how these viruses move from animal to human, but the growing trend seems to imply that more of these outbreaks are likely to occur in the future. Humans and wildlife are coming into closer contact, through farming or abattoirs, and, in the case of Nipah, human encroachment on forest territory could be another factor in the virus’s spread.

The first outbreak of Nipah occurred in Malaysia before it spilled into Singapore in 1998.

“It spread from bats to pigs that were being farmed, and from pigs to their human farmers,” says Mishra.

The virus has since continued to resurface, often in India and surrounding regions like Bangladesh. Following a 2004 outbreak in the country, researchers worked to find out more about how the virus was spread from human-to-human.

“Person-to-person transmission in the case of Nipah is largely through respiratory secretions, like saliva and sputum (phlegm), but is usually contained to those who are caring for individuals already sick with the virus,” says Mishra. She adds that there is currently no suggestion that the virus is spreading from human to human across states in India.

The unassuming date palm fruit is the likely point of animal to human transmission of the Nipah virus in the case of the most recent outbreaks (photo courtesy of iStock images)

However, the recent outbreak of Nipah virus highlights the need for continued field epidemiology and case investigations of zoonotic infections, as well as the strengthening of front-line health care facilities for early detection of cases, and in infection prevention and control.

“We need to figure out what happened to the virus in the bats, we don’t yet know if it is another strain, and there is much to also learn about animal-to-human and human-to-human transmission,” says Mishra. Referring to the British physician who successfully traced a cholera outbreak in London in 1854, Mishra added: “The things we learned from John Snow and his work on the cholera virus in investigating outbreaks continues to be a massive part of what we do now in the field.”

Further, baseline strengthening of a country’s health-care system is also key to controlling zoonotic outbreaks and preventing further human-to-human transmissions. According to Mishra, India has more than enough expertise in this area. During the Ebola crisis, team members from the National Centre for Disease Control in India as well as members of various medical colleges, came to West Africa to provide epidemiological support.

An additional challenge that remains is communicating and working with the local panchayats, or village councils, to create awareness and address the fears and stigmas that can undermine rapid response control efforts.

“There is still a lot of stigma attached to these kinds of viruses,” Mishra says, “making individuals fearful of going to health-care facilities – especially when health-care workers become infected.”

A more powerful way to develop therapeutics?

lanthierj — Thu, 21 Jul 2016 19:17:17 +0000

A more powerful way to develop therapeutics? lanthierj Thu, 07/21/2016 - 15:17

Heidi Singer

Author legacy

Heidi Singer

Topic

Breaking Research

Medicine

Faculty of Medicine

Research & Innovation

Subheadline

New method for identifying proteins should have “a major impact on the development of new biologics,” �鶹��Ƶ researcher says

A University of Toronto scientist has developed a new method for identifying the raw ingredients necessary to build ‘biologics’, a powerful class of medications that has revolutionized treatment of diseases like rheumatoid arthritis and some cancers.

Biologics are a type of drug that results from the high-tech manipulation of our own proteins, as opposed to more traditional drugs built from synthetic chemicals. Because of their success so far, scientists are racing to create new biologics – and now, a �鶹��Ƶ researcher has developed a way to make that process more powerful.

Philip M. Kim, an associate professor in �鶹��Ƶ’s Donnelly Centre for Cellular and Biomolecular Research, combined high-tech computer simulation and high-throughput laboratory experiments to create what he hopes will be the most effective way to discover the proteins that are key to new biologics. His research was published online in the journal Science Advances on July 20, 2016.

“A large fraction of new therapeutics these days involve engineered proteins that latch onto a drug target, for instance on a cancer cell,” says Kim, also of the departments of molecular genetics and computer science. “Finding a protein that effectively binds to a target can feel like looking for a needle in a haystack.

“Our method should open up new opportunities to find those key proteins – and make a major impact on the development of new biologics.”

Under the traditional approach to developing a biologic, researchers identify a protein of interest and then test billions of variants, either randomly generated or from a natural source, hoping to find an effective binder. But these methods allow very little control over where and how the protein performs this crucial function on its target – a major factor in its effectiveness.

Kim and his team took a different approach. They used a computer to simulate the binding process, and then designed proteins that would work on the target. This type of theoretical approach has been in development for several decades, but is still not effective enough. So Kim combined the best of both methods. Instead of randomly creating massive libraries of variants, as with the traditional approach, he used computer modelling to generate a smaller, but intelligently designed repertoire of variants. Designing each variant allows for the tight control of all its properties, in contrast to conventional approaches.

“We showed that this method gives you binders that are somewhat stronger than what you get with the conventional approach,” says Kim. “The much smaller library also solves many technical problems, and we can screen for new, previously unscreenable, targets. It’s a very exciting time for cancer research, and for biologics.”

For Kim, the next step is to produce proteins that are important to certain types of cancer, but have not been screened before due to the difficulty producing them.

Fast-food "swamps" linked to greater diabetes risk: �鶹��Ƶ research

krisha — Thu, 09 Jun 2016 19:31:06 +0000

Fast-food "swamps" linked to greater diabetes risk: �鶹��Ƶ research krisha Thu, 06/09/2016 - 15:31

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(Lead image by Daniel Oines via Flickr)

Nicole Bodnar

Author legacy

Nicole Bodnar

Topic

Breaking Research

Diabetes

Dalla Lana School of Public Health

They're called fast-food swamps – and if you live near one, a new study from the University of Toronto shows you're at greater risk of developing diabetes.

Researchers at �鶹��Ƶ's Dalla Lana School of Public Health say Canadians under the age of 65 have a greater risk of developing diabetes if they live near a high number of fast-food restaurants with few healthier dining options.

The study, Relative and absolute availability of fast-food restaurants in relation to the development of diabetes: A population-based cohort study, published on June 9, 2016 in the Canadian Journal of Public Health, is the first in Canada to examine whether living within walking access to various types of restaurants within urban residential areas influences the risk of developing diabetes among adults.

At the outset of the study, researchers identified people without diabetes and followed them forward in time to see who did or did not develop diabetes. After accounting for individual- and neighbourhood-level socio-economic factors and neighbourhood walkability, researchers found that individuals had a 79 per cent higher risk of developing diabetes when their neighbourhoods had a disproportionately high volume of fast-food outlets and few restaurants of another type.

“Our results show that having restaurant options that offer healthier alternatives to fast-food – for example cafes, sit-down restaurants or coffee shops – may be important for mitigating people's risk of developing diabetes,” said Polsky, a PhD candidate in the Division of Social and Behavioural Health Sciences.

“The double whammy of having high numbers of fast food restaurants with few healthier alternatives was associated with the highest risk of diabetes.”

�鶹��Ƶ home to new national network on diabetes

sgupta — Thu, 31 Mar 2016 09:36:40 +0000

�鶹��Ƶ home to new national network on diabetes sgupta Thu, 03/31/2016 - 05:36

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“Diabetes is a huge burden to our health system right now,” said Professor Gary Lewis, who will co-lead the SPOR Network in Diabetes and Related Complications.

Liam Mitchell

Author legacy

Liam Mitchell

Topic

Zika virus: �鶹��Ƶ experts on what you need to know

sgupta — Wed, 27 Jan 2016 10:24:06 +0000

Zika virus: �鶹��Ƶ experts on what you need to know sgupta Wed, 01/27/2016 - 05:24

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A firefighter in Brazil inspects a pool for mosquito larvae (photo courtesy Agência Brasília via flickr)

Dominic Ali

Author legacy

Dominic Ali

Listen to the complete interview on CBC

(Visit flickr to see the original of the photo used above)

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At the intersection of dance and nitroglycerin

sgupta — Fri, 04 Dec 2015 02:32:51 +0000

At the intersection of dance and nitroglycerin sgupta Thu, 12/03/2015 - 21:32

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“I feel happy after I dance,” Kangbin Zhou says, “and that happiness helps me overcome despair or frustration after a difficult day in the lab.”

Erin Howe

Author legacy

Erin Howe

Subheadline

PhD student leads on the dance floor and in researching why angina treatment works

By day, Kangbin Zhou researches what makes nitroglycerin – a common treatment for chest pain also known as angina – effective.

By night, the fourth-year pharmacology and toxicology PhD student can be found tearing up the dance floor as the founder and instructor of a �鶹��Ƶ urban dance club.

Zhou is the first recipient of the Dr. Malle Jurima-Romet Award in Pharmacology and Toxicology, which recognizes both his academic excellence and his involvement in the arts. The award is named in honour of Jurima-Romet, who earned her PhD from the department while doing research into pharmacogenetics.

Before her death last year from cancer, Jurima-Romet had a diverse range of interests encompassing both science and art. As a scientist focused on drug metabolism, she wrote more than 60 peer-reviewed publications, and co-edited books on biomarkers in drug development as well as drug-to-drug interactions. During her career, she worked as a scientist for Health Canada followed by a successful career in the pharmaceutical and biotechnology industry and served as an adjunct professor at both the University of Montreal and the University of Ottawa.

Jurima-Romet was also an accomplished artist who worked with watercolour and oil paints as well as pastels. She received invitations to display her work at group and solo shows, and her paintings can be found in private collections in Canada, the United States and Europe. She was also a master instructor of Japanese Ikebana flower arranging and had a love for music with included experience playing piano and violin.

Like Jurima-Romet, Zhou’s passions include science and art.

“Dance not only gave me a brand new experience, it also gave me a new way to reduce stress,” he says.“I feel happy after I dance and that happiness helps me overcome despair or frustration after a difficult day in the lab.”

Zhou’s PhD studies explore nitroglycerin, which has been most commonly used to treat angina for more than 100 years. Despite the drug’s well-established utility for treating chest pain, scientists still don’t understand why it is effective, and why people become less responsive to it during long-term therapy. Zhou focuses on a special protein called aldehyde dehydrogenase (ALDH-2), which some scientists believe could be responsible for making nitroglycerin work. This protein might become inactivated during chronic treatment.

Many people, and especially people with Asian ancestry, carry ALDH-2 in a mutated form. Current literature suggests this mutation may cause the protein to function less efficiently. Zhou wants to know if this protein is what makes the drug work, and if so, whether the dose and delivery method need to be tailored for people with the enzyme mutation. He also wants to know how this protein becomes inactivated in patients during long-term treatment.

“My mother had angina when I was a child. I can remember her asking me to grab her medication whenever she had acute chest pain. That’s what inspired me to become involved in drug research.”

As Zhou completed his BSc at the University of British Colombia, he began to dabble in salsa dance. While he pursued his MSc, Zhou also trained at a professional Latin dance school, helping him maintain a balanced lifestyle and grow a broad social network. As he began his PhD studies at �鶹��Ƶ, he joined the �鶹��Ƶ Dance Club and took dance classes at Hart House. He went on to launch a new club called Urban Dance Revolution, which offers affordable lessons to �鶹��Ƶ students.

“Graduate and PhD students may not have opportunities to pursue outside interests because often they just don’t have that extra money to do it,” says Tiit Romet, Jurima-Romet’s husband of more than 25 years, who established the award. “There’s more to a person than academics. If a student can realize some of their other potential and feed their passion for something else like music or art while they are furthering their education, their university experience will be all the better.”

The award will help Zhou further his own dance training while expanding the dance club and its work.

“I want students to have a chance to learn from – and be inspired by – their peers instead of professional instructors,” Zhou says. “These students might say, ‘I see my dance ‘instructor’ is taking the same academic classes I am, so maybe one day I can become like them.”

(Learn more about Urban Dance Revolution)

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World AIDS Day: researchers launch free resource to improve patients' quality of life

sgupta — Tue, 01 Dec 2015 06:48:59 +0000

World AIDS Day: researchers launch free resource to improve patients' quality of life sgupta Tue, 12/01/2015 - 01:48

Cutline

University College at �鶹��Ƶ's downtown Toronto campus is lit up each year for World AIDS Day (photo by Johnny Guatto)

Heidi Singer

Author legacy

Heidi Singer

Topic

Global Lens

Read a Toronto Star article by Nixon

“Many people living longer with HIV are thinking about their future hopes and dreams,” Nixon says. “Rehabilitation can help people with the goals that matter to them.”

HIV can cause disease in every part of the body. Because it targets the immune system, infections and other diseases are a constant threat. Techniques such as chest physiotherapy, for example, help people with lung infections breathe effectively. The neurological system is a target for HIV damage, leading to strokes, spinal cord infections and nerve damage in legs. These problems require rehabilitation to help people walk, swallow, live independently, and support themselves and their families.

The medications that allow people to live with HIV can cause problems to the heart, lungs and liver. People living long-term on HIV treatments can also experience bone death in their hips and knees. Rehabilitation helps people address the impact of these conditions on their daily lives. For example, physiotherapists help to manage pain and increase function and mobility. Occupational therapists devise “workarounds” and other ways for people achieve their goals. And speech therapists help people learn to swallow and talk after brain injury. Rehabilitation also addresses the profound stigma related to both HIV and to disability.

Read about World AIDS Day at Hart House

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Northern exposure: how this anthropology professor is changing health care in Nunavut

sgupta — Tue, 24 Nov 2015 13:56:56 +0000

Northern exposure: how this anthropology professor is changing health care in Nunavut sgupta Tue, 11/24/2015 - 08:56

Blake Eligh

Author legacy

Blake Eligh

Topic

Dalla Lana School of Public Health

Cancer

Anthropology

Research

Subheadline

UTM's Tracey Galloway

In a career that has taken her from an urban intensive care ward to the farthest reaches of Canada, Assistant Professor Tracey Galloway is helping to change the delivery of health care in Canada’s icy north.

Before earning a PhD in anthropology, Galloway spent nearly a decade working 12-hour shifts in the intensive care ward of a London, Ontario hospital where she saw the same patients admitted over and over. They suffered from chronic ailments, like diabetes or heart disease, and many were also coping with poverty, poor nutrition and marginalization.

“I kept seeing people who had fewer resources do less well in the ICU setting,” Galloway says. "I wanted to explore why those patterns exist in our population, and how we could use policy and programs to provide service for marginalized people more effectively."

That curiosity led Galloway to a career in anthropology, including a post-doctoral position at the Dalla Lana School of Public Health. “I took a step back from hands-on work to try and effect change for a greater number of people,” Galloway says. “I wanted to understand the backdrop against which those critical illnesses emerged.”

Galloway, who joined the University of Toronto Mississauga's anthropology department in July, was awarded funding from the Canadian Institutes of Health Research to investigate how cancer care is delivered to residents in Inuit communities. Over the three-year study, the team will collect stories from 10 families who have experienced cancer, and use the information to improve processes and supports.

In the north, relationships have a unique and important role, which is reflected in both the collection of data and the way it will be presented. Field interviews will be conducted by Lily Amagoalik, one of the first graduates of the Nunavut nursing program. She is fluent in many dialects of Inuktitut and has deep roots in northern communities.

Galloway’s team will use two methods to analyze responses – traditional Western-style content analysis, and a groundbreaking Inuit epistemology called “Piliriqatigiinniq.” Translated, it means “working in a collaborative way for the common good” and reflects traditional Inuit values around relational knowledge creation.

For northern residents, the experience of chronic disease takes place in a very different context than the one southern Canadians experience, Galloway says. Twenty-five small communities are spread across Nunavut’s vast expanse of land, making it challenging to deliver health care close to home. For diagnosis and treatment, residents with serious health issues must travel to southern care referral centres in Yellowknife, Edmonton, Winnipeg, Ottawa and Montreal.

“That necessitates lengthy travel when people are facing critical choices about their diagnosis and care, absence from family and a lot of health issues back in the community for worried family members,” she says.

Galloway’s team will work closely with the Nunavut Department of Health, Qaujigiartiit Health Research Centre and Nunavut Tunngavik Incorporated with the goal of improving health care access and support programs.

“We’ll be asking people to share their experiences—what parts were positive, what supports could have made a better experience at home or in the referral centres in the south,” she says. “What worked, what didn’t, what could be done better?”

The team will collect similar data in a related end-of-life care study, initiated by Arviat Elders.

“Many people die from chronic diseases while they’re in treatment in the south and away from family members,” Galloway says. The team will collect information about the supports available to patients and families. Health care agencies will use that data to improve pain management, end-of-life care, family supports and advanced care directives.

“If someone has reached the terminal stage, how do we plan for their care in the referral centre and at home? Some of those recommendations will be practical tools, such as improving forms and processes.”

Galloway says she sometimes misses the hands-on work of nursing, but sees greater impact in long-range research and health care planning.

“I work with change makers, gathering information and delivering it in a package that they can make the most use of,” she says. “At any moment, there is some elderly Inuit person in a treatment centre, who would rather be sitting on the floor, but is forced to sit in a chair and listen to a strange doctor tell them that they might die far from home. We have to make those experiences better.”

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Listen to the complete interview on CBC

At the intersection of dance and nitroglycerin

World AIDS Day: researchers launch free resource to improve patients' quality of life

Read a Toronto Star article by Nixon

Read more about AIDS-related research at �鶹��Ƶ

Read about World AIDS Day at Hart House

Northern exposure: how this anthropology professor is changing health care in Nunavut