Episode Transcript
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Speaker 1 (00:03):
Welcome to the Wellness and Healthy Lifestyle show on your VOCM.
Now here's your host, Doctor Mike Wall.
Speaker 2 (00:12):
Welcome to the show. I'm your host, Doctor Mike Wall.
Speaker 3 (00:15):
Today we're exploring two groundbreaking research projects happening right here
in New flann and Labrador, projects that are tackling multiple
sclerosis in two very different but equally powerful ways. We
begin with doctor Craigmore, a researcher whose work is focused
on the role of inflammation in the immune system NMS.
His lab is studying how immune cells might be contributing
(00:36):
to nerve damage and how that process might be slowed
or stop altogether. Then most people with doctor d pak Kashik,
who's looking at the other side of the coin, how
the brain repairs itself. His work explores how to trigger
the body's natural ability to regenerate nerve tissue, offering new
hope for recovery after damage has already occurred. Together, these
(00:56):
two researchers have received over two million in CICHR funding,
which is helping move MS research board and potentially saving
lives in the process.
Speaker 2 (01:05):
There's a lot to cover, so let's get to it. Hi,
Doctor More, Welcome to the show.
Speaker 4 (01:10):
Hey, Mike.
Speaker 3 (01:11):
So today we're celebrating something pretty monumental for you. You've just
been the recipient of a major award. But before we
get into all that exciting new news, why don't you
give our listeners a bit of a background on yourself.
Speaker 5 (01:25):
I'm a neuroimmunologist here at Memorial University within the Faculty
of Medicine Neuroimmunologists, meaning that I study the immune system
and the central nervous system and how cells in those
two systems interact with each other. I've been doing that
for approximately twenty years. I did my PhD Atdalhousie back
(01:48):
in the early two thousands and then moved around a
little bit through the States and Canada and was recruited
back here to Memorial in twenty fourteen as a Canada
research chair.
Speaker 3 (02:00):
Right, well, it's a pretty extensive career and you've been
studying MS, and you've been studying that.
Speaker 4 (02:05):
For a huge part of your career.
Speaker 3 (02:07):
But I think a lot of people may be confused
about what MS is and hoping you could give us
sort of the top level view of what's the condition
and how does it impact our health?
Speaker 5 (02:18):
Absolutely so, I too was confused of what MS was back,
but I started. So I'm sure many listeners out there
are also unsure of exactly what is MS and how
the different from other neurological diseases. But MS is the
most common neurological disease affecting young individuals between the ages
(02:40):
of eighteen and thirty five. It results in lesions that
can be found within the brain and spinal cord. And
these lesions are filled with inflammatory cells which we call
immune cells, T cells, B cells, and other granulocytes and
(03:00):
immune selves. And what happens over time is the brain
tissue within these individuals who are diagnosed with MS starts
to degrade and there are neurons, so the important cells
that transmit information throughout the body. The neurons lose their
ability to function properly, and the symptoms that we often
(03:23):
see like problems is in gate balance, replexes, eye movement,
ability to sense, touch, and vibration. These are all the
common things that we often see during a neurological exam
and patients that have been diagnosed with MS. It very
LITLA has been focused on the mental and the emotional
symptoms that are probably even more commonly observed in MS
(03:47):
than some of those physical symptoms like difficulty with cognition
and immense fatigue or depression, anxiety, and sleep disturbances. So
it's a multi Even though it's targeting the central nervous
system specifically, you can have lots of different symptoms that
(04:09):
are associated with the disease.
Speaker 3 (04:11):
Yeah, and when you think about MS, I mean, obviously
it's going to impact so many different aspects of our lives.
But it actually here in Newfoundland eleborate or we seem
to have higher rates of it than the rest of
the country. Is there any reason why it's more prevalent here. Well,
I wouldn't necessarily say that it's more prevalent here. And
one of the reasons that we can't say that definitively
(04:32):
is because health information data between provinces its collected differently.
So as your listeners and yourself know that health is
a provincial jurisdiction. So while there are some national senses
and ways to collect data across the country to be
able to standardize it, epidemiological data between provinces is gathered differently,
(04:57):
so we're not able to make a direct compare.
Speaker 4 (05:00):
However, if you do look at the.
Speaker 5 (05:02):
Population of Newfoundland and the number of patients that are
diagnosed with MS and the province it is very high
and would match some of the some of the jurisdictions
in the world that have the highest rates of MS.
So in terms of why that might be the case,
we're not clear on that at all. So we do
(05:22):
know that the predisposition for being diagnosed with MS is
both genetic and environmental. So thirty percent of identical twins
will develop MS together, but that means that seventy percent
of identical twins do not, So there must be also
a large environmental aspect. So is there something in the
(05:46):
environment that certain individuals are genetically predisposed to and once
they encounter this environmental trigger, they can then go on
to develop MS. Since some of the hypothesis and some
of the very convincing studies that have shown that that
(06:07):
is indeed the case have been linked to vitamin D
and epstein bar virus. So individuals that have been exposed
to epstein bar virus, which is a virus that is
responsible for developing mononucleosis, individuals who have been more positive
for that virus at an early age are predisposed to
(06:30):
developing NS.
Speaker 4 (06:31):
Wow.
Speaker 3 (06:32):
Yeah, so interesting. Genetics is always a plert but so
does the environment. So that's why having the data you've
been collecting is just so valuable. Since about twenty fifteen,
are correct me if I'm wrong, You've had a longitudin
bio repository of MS patients samples that allow you to
track people over time, which is amazing because you can
compare them to themselves and how they're doing. Why is
(06:52):
this so important in studying this population as it progresses
through their disease conditions?
Speaker 4 (06:58):
Right, So we.
Speaker 5 (07:00):
Started back in twenty fifteen, and you're right, it started
in twenty fifteen, so we're a decade in which is
really exciting and a big milestone. What we started myself
and doctor Michelle Bauman, also in the Faculty of Medicine,
was the health Research Innovation team in multiple sclerosis, and
it is unique in being a longitudinal bio repository and
(07:22):
it's collecting clinical neuroiminological or biomedical data, but also a
rehabilitative data and the effect of different treatments on patient symptoms.
That's done in doctor Palmon's Recovering Performance Lab at the
Miller Center. What we've been doing is looking at trying
to capture all these different unique profiles at every year
(07:46):
when an individual comes into the clinic. And we've collected
longitunal data on over three hundred and fifteen MS patients
to date. I mean there's an estimated twelve hundred to
fifteen hundred MS patients and the entire province, so you
know that's a pretty good chunk. So we've been really
happy to be able to do this research here in
(08:10):
Newfoundland for many reasons that we'll get into later. But
one thing that is unique about this study is that
it allows us to collect prospective data with longitudinal data sets.
So many studies use cross sectional data and retrospective data,
so data that's already been captured and then you look
back and you analyze the data. This is actually using
(08:34):
data in real time and catching it in real time,
and it's really really valuable, not just in multiple scross
but in many chronic neurological diseases. Another thing that is
really good for us with this unique bio repository is
(08:54):
that it's been able to open many doors both internationally
and nationally for collaborates and also for applying for different
grants and such that require different institutions to cross collaborate
with each other and that has been really successful for
(09:14):
us in terms of me collaborating with individuals across Canada,
getting additional grants, but also attracting talented other researchers like
doctor Kaushik who I know that you recently spoke with,
and also really promising graduate students and postdoctoral trainees.
Speaker 6 (09:32):
Yeah.
Speaker 3 (09:33):
I think people to understand the value of that of
having these large research projects that are making such a
profound impact and not only going to be helping patients,
but you're also creating a whole new generation of researchers.
It will continue this work and continue to find even
more effective strategies to treat a disease which still has
yet to have a real cure, even though treatments are coming.
(09:54):
One of the things, let's get into some physiology here,
So I think to pick your brain of physiology. This
is something that I'm definitely not expert in. But you
look at early detection in early disease management, and you
look at what are called extracellular vesicles. These are found
in the blood and the cerebral spinal fluid. Can you
explain what they are and how you can actually use
(10:14):
these to predict MS?
Speaker 4 (10:17):
Sure?
Speaker 5 (10:18):
Well, I'll use an analogy that I heard from somebody
else because I thought it was pretty good, so I
want you to try and come up to my own good.
An analogy that was used was that these are little
mail trucks. Okay, so your cells, and I think everybody
most people understand what a cell is in the body,
and our body is made up of billions and billions
(10:38):
and billions of cells, and each one of those cells
releases tiny little particles, and these are what we would
call extracellular vehicles, so little tiny particles that are outside
of the cell and being released throughout the body. And
these evs used to be thought as just cellular waste
and just pieces that are falling off tofferent cells while
(11:00):
they're undergoing different biological processes. But what we appreciated in
the last ten to fifteen years is that these extracellular
vehicle i'll call them evs for short, are actually kind
of like little mail trucks. So they are packaging important
biological information, so proteins, nucleic acids, lipids, so all these
(11:25):
different biological molecules that play important roles and cells, and
they're packaging them and delivering them to other cells and
it's not just random in the way that this is
being done. It's actually much more complicated than what we thought.
So when a certain cell sell A releases its evs,
(11:48):
it actually knows to put different markers on the surfaces
of them, so that cell B, who might be the
recipient cell, specifically take that content within the extrastellar vesicles
and changes the complete biology of the recipient cell.
Speaker 3 (12:10):
That was doctor Craig Moore giving us a closer look
at the immune system's role in MS. When we come back,
we'll talk about how his research could change the way
MS is diagnosed and treated in the future. We'll be
right back after the break. Welcome back. We're continuing our
conversation with doctor Craig Moore as he explains how understanding
(12:33):
information at the cell level could unlock new therapies for MS,
and how this work is already gaining international attention.
Speaker 2 (12:40):
Let's get back to it.
Speaker 3 (12:42):
Yeah, I like to mail analogy. I think that's really
good for people to understand. And so what you're saying
is you've got these evs, these vesicles, and you're able
to track them. They're they're doing different effects withinside the body.
Are these one of the ways that you can look
at at actually treating MS by sort of addressing or
(13:04):
working or developing medications that act on these usicals.
Speaker 4 (13:09):
Yeah.
Speaker 5 (13:10):
So this is one of the really, really attractive things
about working in with evs is that they conserve multiple functions,
so one they could potentially be used to diagnose a
certain disease. So if a certain cell type is releasing
different evs and it's only releasing those evs and a
(13:31):
specific disease versus any other diseases, we may be able
to identify these evs as diagnostic tools or biomarkers is
what we call them. It's a diagnostic biomarkers. We could
also maybe use them for prognosis, So maybe they're not
good at diagnosing a certain disease, but they may be
(13:52):
able to tell us how bad the disease is going
to be, or what therapy might be the best therapy
to these patients based on their EV profile per se.
And then finally to get out what you are alluding
to in terms of being targeted at therapies is we
(14:12):
can also take advantage of the natural ability of these
evs to package biological molecules. So many people are probably
familiar with drugs being small molecules, and they take them,
you know, as tablets and swallow them every day. And
most drugs out there are indeed small, little, tiny chemicals.
(14:36):
But many more drugs that are on the market and
being approved for different diseases are what we call biologics,
which are actual proteins and lipids and nucleic acids in
which the body makes naturally, And we can actually package
these inside the eds because that's what they're meant for,
(14:57):
and then we can actually put different molecules on the
surfaces of them so that the cells of interest that
we're interested in in helping repair or helping restore to
a normal on disease state, those evs would target specifically
those cells.
Speaker 3 (15:16):
Okay, so catch me if I'm right on this. Okay.
So the body communicates to a mail system. Sometimes you
can check the mail. The mail says, oh, this person
has a condition like MS. Then you can send them
a package in the mail that goes to the cells
with a therapy that potentially could change the way the
mail is.
Speaker 4 (15:33):
Delivered exactly exactly.
Speaker 5 (15:38):
Like, uh, this is about why, this is exactly why
you're in this role. If it makes sense of things, Yeah,
I got you.
Speaker 4 (15:47):
I got you. How you're paying on? Okay, that's great.
Speaker 3 (15:50):
I think that's really interesting for people to realize how
this works on this molecular, microscopic level. I find it fascinating.
And now we're going to talk about why this is
so novel, why this is so interesting. The work you're
doing is so important and I can't underestimate this to
our listeners.
Speaker 4 (16:04):
Doctor Worr just was.
Speaker 3 (16:05):
Awarded a one point two to three million dollar grant
by what's called hr which is a very very competitive
grant and it's going to help fund your MS research here.
First of all, congratulations, tell us about that grant and
how you hope that's going to help our patients in
the long run here in the province and around the world.
Speaker 4 (16:24):
Probably, Yeah, thanks Mike.
Speaker 5 (16:27):
It is indeed very difficult and a challenging time to
get research funding health research funding from different governmental agencies,
not just here in Canada, but it's becoming more difficult worldwide.
So I don't take these things for granted, and I
thank you very much for acknowledging the hard work that
(16:48):
myself and the entire lab has put into this. One
of the most important things I think for me is sustainability.
And I started this ten years ago, and it amazes
me that ten years has passed since I joined the
faculty here at Memorial and University. This ten years now
turns us into fifteen years. So this is guaranteed meet
(17:11):
funds for the next five years to keep things at
the same level that they've been moving at, which is
really fast. And maybe we can even move a little
bit faster if I have a few more students or
a few more technicians or trainees in the lab. And
what this is going to do is going to continue
(17:31):
to build up the repository. We're going to continue to
recruit newly diagnosed MS patients so that they have the
opportunity to participate in research. And we hope that this
will rival some of the similar longitudinal databases that are
found in Europe.
Speaker 3 (17:50):
And the United States.
Speaker 5 (17:53):
This also helps to make Newfoundland and Memorial and attractive
site to recruit clinicians who are interested in participate MS research.
So we know that many neurologists and many specialists devote many,
many years of going to school, as do PhD scientists
as well. Yeah, but the clinicians also want to engage
(18:16):
in research and they often have very limited time and
resources to do that. So if I can make their
job a little bit easier by doing some of the
background grunt work but also allowing them to look at
different aspects that are important to them in MS research.
(18:36):
I want to be able to do that and that
will increase numbers of clinical trials that we participate in
you're at n LHS and M Memorial. It'll increase the
revenues that can go back towards the research that we're
doing and also provide access to new investigative and state
of the art therapies for patients right here in the province.
(18:59):
And that's something that it's kind of historically lacked here
in nicklin Land, is that because we aren't a huge
site for clinical trials, patients may not benefit from some
of the new state of the art treatments that are
being looked at within the healthcare industry.
Speaker 4 (19:17):
So yeah, it's.
Speaker 3 (19:20):
Great, it's great, And you know you've got yourself, You've
got doctor Plomer, you have to Koshik. Basically this is
becoming an epicenter for MS research. All three of you
are very successful researchers and that's creating this really positive
ecosystem here form amoral university. You know, that's got to
be something you guys are proud of being. You must
(19:40):
be recognized on a pre national level for the work
you guys are doing here.
Speaker 5 (19:45):
We indeed are, and we're not only being supported by
the CIHR, but also by MS Canada formerly the MS
Society of Canada now MS Canada.
Speaker 4 (19:59):
So I indeed have.
Speaker 5 (20:01):
Grants from MS Canada as well, and all three of
my PhD students at the present moment are also funded
through MS Canada, and many of doctor Kaushik's and doctor
Palmon's students are also funded through that nonprofiting see. So
that hasn't gone unrecognized at the national level. And ten
(20:23):
years ago, you know, there wasn't any funds coming from
MS Canada into the province. But now we're definitely the
most active MS research hospital and faculty in Atlantic Canada
and starting to rival some of the some of the
ones that we see.
Speaker 2 (20:43):
Out with excellent.
Speaker 3 (20:45):
Well that's fantastic, a little start to revel, but I
want to ask a question before we finish. You know,
with healthcare and science evolving so quickly, we hear about
the funding of research in some parts of the world
under fire these days when it comes to health research,
we look at federally support grants like you just got.
They seem to be more important than ever. But how
important is it for a smaller province like Newfoundland and Labrador.
Speaker 5 (21:09):
Yeah, so our population is small, right, so we only
make up two percent of the entire national population. Private
donations from philanthropists or medical research are relatively rare here
compared to many large urban centers, and the provincial funds
and support that we get have been limited in the
(21:31):
past due to the different economic situations faced by the province.
And that's a little bit more difficult compared to larger
provinces and larger university that can fall back on certain
funds that they already set a thide for things like
health research. So we rely really heavily on federal dollars
(21:54):
to support research in the provinces. But I like to
also emphasize that the smaller places and being here in
Newfoundland is not necessarily disadvantage at all.
Speaker 6 (22:06):
Yeah.
Speaker 5 (22:06):
So one of the big reasons why I came here
was after a conversation I have with my postdoc supervisor
at McGill who said to me, do you want to
be a big fish in a low pond or a
low fish.
Speaker 2 (22:17):
And a big pond.
Speaker 5 (22:18):
And my immediate answer, without even thinking about it, was well,
I want to be a big fishon a little pond.
So he said take the job at Memorial, and I
have no regrets in making that decision. I have more
access to certain resources by being here. There's less internal
competition with other people who are researching similar or slightly
(22:41):
similar things. Collaborations are a lot easier to maintain here,
Like if I want to collaborate with somebody, I can
just kind of walk down the hall because the province's
infrastructure to support medical research is geographically all located within
the Saint John's area for the most part.
Speaker 4 (22:59):
Totally oh it.
Speaker 5 (23:00):
You know, I can send someone to text or send
someone a phone call, and I can meet them for
our coffee and discuss ideas. And of course we all
know that the you know, Newfoundlanders are amazing people. They're passionate,
they are keen, they're generous. So just by nature being here,
you know, it's really really helped the research program.
Speaker 3 (23:23):
Fantastic, Craig, Listen, It's exciting to see everything you've got
going on. It's it's so fun to watch you and
the other researchers that are making a real impact with
these awards that recognize how hard you're working. I just
want to say huge congratulations and thanks for coming on
today to share all this information with our audience.
Speaker 4 (23:40):
My pleasure.
Speaker 5 (23:42):
Thanks for the opportunity for me to share some of
what I do.
Speaker 3 (23:48):
That was doctor Craig Moore talking about MS prevention and
early detection. After the break, we'll hear from doctor Dpak Kashik,
who's work focused on something equally important, how to promote
healing once damage has occurred.
Speaker 2 (24:00):
We'll be right back after the break. Welcome back.
Speaker 3 (24:08):
We're now joined by doctor d Pat Kashik, a neuroscientist
whose research is exploring how to regenerate nerve tissue damaged
by MS. His lab is investigating how the brain might
be guided to repair itself, potentially reversing some of the
damage MS causes.
Speaker 2 (24:23):
Let's get to it.
Speaker 4 (24:24):
Hi, dok Koschick, Welcome to the show.
Speaker 6 (24:26):
Thank you for having me. Mike, please call me Deepak.
I'm I'm looking forward to this one.
Speaker 3 (24:31):
Yeah, this is great. Well, we have a lot to
talk about. We have a lot to talk about with
your research. We also have a lot to celebrate. You've
recently won a very large research award. But maybe for
our listeners who might not be familiar with your work,
you could give us a little bit of background on yourself.
Speaker 6 (24:45):
Yeah, I'm a researcher out here. I'm an assistant professor
at the Faculty of Medicine here at no More University
of National Land. I started my program here in twenty
twenty one and I've been working on MS research and
I have a all group of trainees, very enthessiastic group
of trainees helping us watch your goals.
Speaker 4 (25:06):
Yeah, well fantastic.
Speaker 3 (25:07):
And I think that you know, MS is such a
complicated disease, you know, and it impacts a lot of people,
particularly here in New Filan and Laborador. But you're looking
at a very specific part of multiple sclerosis. What part
of the disease are you trying to understand with your research?
Speaker 6 (25:22):
Yeah, so it's as you said, it's a very complicated disease, Mike.
We are basically trying to address one piece of a
puzzle at a time. The piece that we are working
on is on understanding how these immune cells that identify
brain as a region of interest, where they go on
and target the brain. Why would they do so? And
(25:46):
the reason why they go rogue is what we're trying
to understand. Eventually, we want to understand how these immune
cells move from the periphery that is in the blood
to the brain and cause the disease.
Speaker 4 (25:58):
Yeah.
Speaker 3 (25:58):
When you think about that, I mean, and people don't
really sometimes realize that these autoimmune diseases, that the body
is really attacking itself and for some reason it thinks
the good guys are the bad guys and it causes
challenges in the body.
Speaker 6 (26:10):
Yeah, that's right. I mean, in this case, it's a
clear case of where this immune system is confused. It
starts attacking the brain as if it were fighting an infection,
which we know is not the case. So something in
the brain sort of starts this process where immunes us
are now getting interested moving into the brain and start
damaging the brain while they should not be there or
(26:32):
doing anything bad to the brain.
Speaker 3 (26:34):
To beg conroll, do you guys have any idea of
why this starts, Like why does it happen to certain people?
Is there like a match that lights the whole thing
to start off with?
Speaker 6 (26:46):
Yeah, first of all, I mean, it's a very heterogeneous disease,
meaning that there are many causes that are associated with this.
There is a theory of genes. We know there's associations
where genes may be maybe playing a role, but that's
not the whole story. The story is that there is
probably also an impact of life set factors such as diet,
(27:10):
the latitude that where we live in, exposure to sunlight,
vitamin the hygiene ipodsis and viral infections so on, and supper.
So these are all theories and we are trying to
understand what exactly is happening when we're trying to look
at how immune cells migrate and what helps them migrate,
what ruels their migration to the brain, and the element
(27:31):
here is trying to understand the energy that these immune
cells use a form of energy and if we can
curve it down to bring down the disease progression in
the mess.
Speaker 3 (27:43):
Yeah, that's so interesting. Is it unusual? I mean, I
would think about infection in other parts of the body,
but is it unusual for immune cells to attack the
brain and to create a condition like this.
Speaker 6 (27:53):
That's right, It's quite unusual if you look at the
brain in general. So it's surrounded by variety of femine cells.
There are many different types of immune cells that are
required for us for them to prevent any infission from happening.
But within the brain, inside the brain there are the
regions where neurons are or these functioning units reside or live.
(28:16):
There is no presence of immune cells from outside the body.
They do have a component of femine cell called microglia,
which does basic job right then and there, But the
cells or other very bona fide or you know, immune
cells do not really readly migrate to brain, so they're
kind of forbidden from entering this organ.
Speaker 3 (28:39):
Huh. That's interesting. And when you mentioned things like so
many different factors. It could be a viral condition when
you're younger, or your diet or our sunlight or all
these other factors that make the disease so complex. You
guys are also looking at how the energy system in
our cells, how they affect our brain health. Can you
explain in Layman's terms, how our cells burn fuel and
(29:01):
how that can impact our likelihood of developing MS?
Speaker 6 (29:06):
Sure, I didn't think of these immune cells as cars
or automobiles. They need fuel to function. Now in healthy conditions,
what happens is that these immune cells burn cleaner fuel.
Think of it as a car utilizing hybrid technology or
evie technology. On the other hand, when these immune cells
go row, they probably prefer to go aggressive by utilizing
(29:29):
more diesel or gasoline and then they go full throttle
there causing brain damage. Now what happens with this is
when they burn dirty fuels, this allows them to generate
a lot of chemicals in the brain that can be very,
very hopful, and that is what we in the lab
is trying to curve downe or basically calm them down
(29:50):
or trying to switch them back to using cleaner forms
of energy. Just to put it that way.
Speaker 4 (29:56):
That's such a great analogy.
Speaker 3 (29:57):
So it's almost like the pollution from using the raw
fuel source is causing our brain to get damaged because
it's got toxins that aren't supposed to be there.
Speaker 6 (30:07):
That's right. But the polytants, as we were talking about,
is actually the main form of energy, which is sugar
or glucose, so technically very important for the brain to function.
It's just that these immune cells somehow use it to
their benefit to cause inflammation and basically go row from there.
Speaker 4 (30:26):
That's interesting.
Speaker 3 (30:27):
Yeah, we hear so much about our diets being an
important part of it how our body metabolizes things. And
also we hear so much about inflammation. Just to steer
down that road for a second, why is inflammation so challenging.
Speaker 2 (30:39):
For things like our brain?
Speaker 3 (30:40):
I think we all used to having bad backs or
toward muscles, but maybe not our brain.
Speaker 6 (30:45):
Aside, there's a reason why there's less presence of immune
sus from outside within the brain because the brain won't
repair as better as other organ systems would, so these
inflammatory components are usually kept out.
Speaker 3 (31:00):
Now.
Speaker 6 (31:00):
Once there is damage to neurons or the function units
that sends messages for our body to function, it's very
hard for them to repair and therefore inflammation or especially
i must say long term inflammation or chronic inflammation is
damaging to brains functions. In MS, this is essentially what happens.
(31:20):
These immune cells come and reside, attack those neurons, make
them less functional. At the same time generate so many
chemicals that over the time this leads to death of
other neurons. And this also is referred to as a
lesion in MS in the brains, which is what where
(31:41):
MS gets its name from multiple sclerosses, meaning multiple plaques
and multiple leasis in the brain.
Speaker 3 (31:47):
That was doctor Kashik introducing the world of neural repair
and regeneration, and we come back we'll explore how this
work could translate into future treatments and what it means
for those living with MS. Today, we'll be right back
to the break.
Speaker 1 (32:02):
You're listening to what we broadcast of The Wellness and
Healthy Lifestyle Show with Doctor Mike Wall. Listen live Thursday
nights at seven pm and Sundays at four pm.
Speaker 3 (32:12):
Let's continue our conversation with doctor d Pak Kashik as
he walks us through the latest findings from his lab
and why this type of research.
Speaker 2 (32:19):
Could be a game changer for MS care.
Speaker 3 (32:23):
It's interesting because there are certain risk factors. I've read
that MS affects women more often, but men tend to
have more severe symptoms. Do you have any idea why
this might be the case.
Speaker 6 (32:37):
Yeah, so you're right that there are spent three times
more women that GEMS over men, but when men have it,
they usually have or present with a primary progressive form
of MS. Now that's not exactly true in every quohota
or every sample that's been looked at, but there are
certain cases where men do present or try to or
(32:59):
do progress faster over females. Now, this is something we
are still learning about. We don't know a whole lot
why that is the case. It could be because of
differences in hormones or how the brain responds to damage
in men versus women. In fact, to that end, our
own lab is interested in looking at both male and
(33:19):
female mice as well as these cells grown dishes to
understand what is the difference between these sort of fuels
that these male and female brain might be utalizing, and
is there any difference? If there is, is there a
way that we can tweak them to sort of lessen
the severity that we observe in male cases.
Speaker 3 (33:43):
And that is something I think a lot of people
will wonder. You know, we're in animal studies here, You're
using living cells, living organisms that are very translatable to
human beings. What will it take from the work that
happens in your lab to transfer to the care that
our patients get. What's the role of the research you're doing.
Speaker 6 (34:01):
Yeah, I must just give you a brief backup background.
Like twenty twenty five years ago, we didn't have as
many drug options for MS and a majority of drug
options now they're over sixteen or seventeen have come in
the past twenty twenty five years. This all has been
possible by basic research labs such as ours, and most
of these drugs went through a pipeline where basic research
(34:23):
on sales and animals were conducted. Eventually they were performed
in higher animals before going to clinical trials, so I
would so this is exactly the path that has to
take for our own research. Right now. We are at
at a stage where we have promising results in the
lab that we can curb or calm these rogue immune
(34:47):
cells down, and eventually the idea would be to take
them in higher animals and eventually to clinical trials. So
it's say step by a process, but each step brings
us closer to treatment that can truly help.
Speaker 3 (35:02):
That's unbelievable and this is one of the reasons I
wanted to chat with you today. You have recently won
a major grant of over a million dollars from one
of the most competitive grants you can get, a CHR grant.
Can you tell me a little bit about that grant
but also how that's going to help the work that
you're currently doing.
Speaker 6 (35:22):
Yeah? Sure, Thank you, first of all, Mike for acknowledging
that this is a big, big deal, and it indeed is.
It's a ci CHIB, which is Canadian Institute for Health
and Research, meaning it's a federal grant, a very competitive one,
and we are fortunate to have some of these grands
come to us here at Faculty Medicine, including doctor Craig
Moore who also received this gland alongside. So we are
(35:45):
very very excited to have this opportunity come to us. Now.
First of all I would also say is that research
is very, very expensive to perform. Most of our money
is go to hiring great talents such as students, research associates,
post talcs. That t building is very essential and that
comes at the price to research equipment. Chemicals regions are
(36:09):
very expensive as well. So all this million dollars will
certainly help us support acquire all the infrastructure that's required,
the personal that's that's needed to run the program. And
in terms of what it means for us here in
newfernand and Labrador, it does put us out on the
map right and it also means that New Phernon and
(36:29):
Labrador gets to be part of exciting medical discoveries and
we make sure that we research we do helps people
here at home. So it's a big deal. It's it's important,
it's important for the province, it's important for our research group.
And this puts US as I said, not only on
national map, but also an international arena basically totally.
Speaker 3 (36:52):
And when I think about like a CHR grant for
anybody listening from an academic standpoint, is could be a
once in a career thing. It's still a mile it's
a huge milestone people to accomplish. Many people never come
close to getting one of these grants. And not only
did you get this, but also doctor Moore, both of
you doing work in MS. Is there something to be
said about the research environment when it comes to MS
(37:13):
here at Memorial. Yeah.
Speaker 6 (37:16):
So when I moved about four years ago during COVID times,
the only few labs that we knew were of doctor
Moore's and doctor Plomins, who have very active research labs
around here. And that kind of also gave me a
motivation to move because they had a very successful program
and self established MS research around here. In general, I
(37:38):
got a very good support from a moyal university. The
idea of this research collaboration was fantastic. Now we also
have access to patient samples to other partners, including doctor
Moore and you know, through the clinics because in newful
Land we are part of TIT need community, which is
what I learned throughout this process that is inspised to
(38:00):
sure that our research actually helps real people, not just
in theory but in practice. So I find particularly it
to be very very supportive environment.
Speaker 4 (38:12):
Yeah, I think so too.
Speaker 3 (38:14):
And it's so nice to see our colleagues like yourself
succeeding in being able to do the work that you
came here to do, which is really you know, rewarding
for all of us to watch. And when we think
about the disease that you're dealing with, this is a
chronic disease. This impacts of Finland and labora oriients disproportionately.
It's a high rate in Canada as well. Why do
you think research and of course you're going to be
(38:36):
partial to this, but like research and this type of
disease is just so important these days.
Speaker 6 (38:42):
Yeah, I think just that there are two point eight
million people worldwide living with MS, or nine two hundred
thousand Canadians living with MS speaks to the fact that
this is a very prevalent disease. Another thing to keep
in mind, the incidents of this disease or the rate
at which it's increasing is a very at a five
(39:03):
space so long diseases such as MS, they are becoming
more common, yes, and they'll usually hit people when they're
in their twenties, thirties, and forties. So keep in mind
this is when people are building their careers, their families.
So if we can understand that this is better now,
we can improve lives of thousands of people in the
years to come. And that's why research creates a very important.
Speaker 3 (39:26):
It does it does in those are such critical years.
I've talked to the folks that young adult Cancer Canada,
when people get cancer at any time in their life,
is challenging, especially when they're.
Speaker 4 (39:35):
In their youth.
Speaker 2 (39:36):
Same thing with the disease like this.
Speaker 3 (39:37):
Now, people listening here today, they're hearing that there's research happening,
that there's things progressing in the field. If somebody is
listening and they're dealing with MS or have a family
member dealing with MS, what would you want them to
know about the future of treatment and the potential for hope.
Speaker 6 (39:55):
That there is a lot of hope. Treatments have come
a long way, and interests around the world, including right
here in Newfoundland, including our own lab, are working very
hard every day to find treatments, to find better answers.
The challenges remain though. There are the different forms of
this disease, the early forms of this disease, which eventually
(40:17):
progressive forms of this disease. So in our own lab,
we're trying to address what and how we can we
can we can control the progression of the disease from happening.
So ass research is moving fast and we are closer
than ever to make real breakthroughs. That's all I have
to say. I also want to say and reach out
(40:38):
to your means a general audience that do take part
in fundraising events whenever there is an opportunity. We have
ms walk around here, we have other fundraising opportunities. These
donate issues help research and also also help us to
get closer to the to the community which has steps.
So and this is what my my whole program is about. People.
Speaker 4 (41:00):
It's fantastic.
Speaker 3 (41:01):
It's excellent to see I know that our division is
creating a next generation of researchers. Grants like yours also
allow us to fuel a fostering and mentorship among the
next generation of researchers as well, which means there's more
people out there without interest trying to solve the problems.
Speaker 2 (41:16):
Deback.
Speaker 3 (41:16):
Congratulations and an amazing accomplishment, and thank you so much
for doing everything you do.
Speaker 6 (41:21):
Thank you so much, Mike for having me, and also
for all the support that the division has extended me,
including you, especially what you're doing is amazing. This is
important aspect. We should do this more often.
Speaker 3 (41:33):
I would say I look forward to having you back on.
Speaker 6 (41:36):
Thank you, Mike.
Speaker 3 (41:37):
Well, that's our show this week. A huge thank you
to doctor Craig Moore and doctor dpak Kashik for joining
us and for the incredible work they're doing to advance
multiple scrosses research. The efforts are being made possible by
programs like the Canadian Institutes of Health Research, which fund
the science that drives real world impact. This isn't just
academic work, it's the future of healthcare happening right here
(41:58):
on More University and to learn more about their research
or to support their work, you can visit the Memorial
Faculty of Medicine's website. Thanks for tuning in, I'm your host.
Doctor Mike Wall I'll see you back here next week
for another episode of the Wellness Healthy Lifestyle Show on
the Stingray podcast Network and your vocm
Welcome to the Wellness and Healthy Lifestyle show on your VOCM.
Now here's your host, Doctor Mike Wall.
Speaker 2 (00:12):
Welcome to the show. I'm your host, Doctor Mike Wall.
Speaker 3 (00:15):
Today we're exploring two groundbreaking research projects happening right here
in New flann and Labrador, projects that are tackling multiple
sclerosis in two very different but equally powerful ways. We
begin with doctor Craigmore, a researcher whose work is focused
on the role of inflammation in the immune system NMS.
His lab is studying how immune cells might be contributing
(00:36):
to nerve damage and how that process might be slowed
or stop altogether. Then most people with doctor d pak Kashik,
who's looking at the other side of the coin, how
the brain repairs itself. His work explores how to trigger
the body's natural ability to regenerate nerve tissue, offering new
hope for recovery after damage has already occurred. Together, these
(00:56):
two researchers have received over two million in CICHR funding,
which is helping move MS research board and potentially saving
lives in the process.
Speaker 2 (01:05):
There's a lot to cover, so let's get to it. Hi,
Doctor More, Welcome to the show.
Speaker 4 (01:10):
Hey, Mike.
Speaker 3 (01:11):
So today we're celebrating something pretty monumental for you. You've just
been the recipient of a major award. But before we
get into all that exciting new news, why don't you
give our listeners a bit of a background on yourself.
Speaker 5 (01:25):
I'm a neuroimmunologist here at Memorial University within the Faculty
of Medicine Neuroimmunologists, meaning that I study the immune system
and the central nervous system and how cells in those
two systems interact with each other. I've been doing that
for approximately twenty years. I did my PhD Atdalhousie back
(01:48):
in the early two thousands and then moved around a
little bit through the States and Canada and was recruited
back here to Memorial in twenty fourteen as a Canada
research chair.
Speaker 3 (02:00):
Right, well, it's a pretty extensive career and you've been
studying MS, and you've been studying that.
Speaker 4 (02:05):
For a huge part of your career.
Speaker 3 (02:07):
But I think a lot of people may be confused
about what MS is and hoping you could give us
sort of the top level view of what's the condition
and how does it impact our health?
Speaker 5 (02:18):
Absolutely so, I too was confused of what MS was back,
but I started. So I'm sure many listeners out there
are also unsure of exactly what is MS and how
the different from other neurological diseases. But MS is the
most common neurological disease affecting young individuals between the ages
(02:40):
of eighteen and thirty five. It results in lesions that
can be found within the brain and spinal cord. And
these lesions are filled with inflammatory cells which we call
immune cells, T cells, B cells, and other granulocytes and
(03:00):
immune selves. And what happens over time is the brain
tissue within these individuals who are diagnosed with MS starts
to degrade and there are neurons, so the important cells
that transmit information throughout the body. The neurons lose their
ability to function properly, and the symptoms that we often
(03:23):
see like problems is in gate balance, replexes, eye movement,
ability to sense, touch, and vibration. These are all the
common things that we often see during a neurological exam
and patients that have been diagnosed with MS. It very
LITLA has been focused on the mental and the emotional
symptoms that are probably even more commonly observed in MS
(03:47):
than some of those physical symptoms like difficulty with cognition
and immense fatigue or depression, anxiety, and sleep disturbances. So
it's a multi Even though it's targeting the central nervous
system specifically, you can have lots of different symptoms that
(04:09):
are associated with the disease.
Speaker 3 (04:11):
Yeah, and when you think about MS, I mean, obviously
it's going to impact so many different aspects of our lives.
But it actually here in Newfoundland eleborate or we seem
to have higher rates of it than the rest of
the country. Is there any reason why it's more prevalent here. Well,
I wouldn't necessarily say that it's more prevalent here. And
one of the reasons that we can't say that definitively
(04:32):
is because health information data between provinces its collected differently.
So as your listeners and yourself know that health is
a provincial jurisdiction. So while there are some national senses
and ways to collect data across the country to be
able to standardize it, epidemiological data between provinces is gathered differently,
(04:57):
so we're not able to make a direct compare.
Speaker 4 (05:00):
However, if you do look at the.
Speaker 5 (05:02):
Population of Newfoundland and the number of patients that are
diagnosed with MS and the province it is very high
and would match some of the some of the jurisdictions
in the world that have the highest rates of MS.
So in terms of why that might be the case,
we're not clear on that at all. So we do
(05:22):
know that the predisposition for being diagnosed with MS is
both genetic and environmental. So thirty percent of identical twins
will develop MS together, but that means that seventy percent
of identical twins do not, So there must be also
a large environmental aspect. So is there something in the
(05:46):
environment that certain individuals are genetically predisposed to and once
they encounter this environmental trigger, they can then go on
to develop MS. Since some of the hypothesis and some
of the very convincing studies that have shown that that
(06:07):
is indeed the case have been linked to vitamin D
and epstein bar virus. So individuals that have been exposed
to epstein bar virus, which is a virus that is
responsible for developing mononucleosis, individuals who have been more positive
for that virus at an early age are predisposed to
(06:30):
developing NS.
Speaker 4 (06:31):
Wow.
Speaker 3 (06:32):
Yeah, so interesting. Genetics is always a plert but so
does the environment. So that's why having the data you've
been collecting is just so valuable. Since about twenty fifteen,
are correct me if I'm wrong, You've had a longitudin
bio repository of MS patients samples that allow you to
track people over time, which is amazing because you can
compare them to themselves and how they're doing. Why is
(06:52):
this so important in studying this population as it progresses
through their disease conditions?
Speaker 4 (06:58):
Right, So we.
Speaker 5 (07:00):
Started back in twenty fifteen, and you're right, it started
in twenty fifteen, so we're a decade in which is
really exciting and a big milestone. What we started myself
and doctor Michelle Bauman, also in the Faculty of Medicine,
was the health Research Innovation team in multiple sclerosis, and
it is unique in being a longitudinal bio repository and
(07:22):
it's collecting clinical neuroiminological or biomedical data, but also a
rehabilitative data and the effect of different treatments on patient symptoms.
That's done in doctor Palmon's Recovering Performance Lab at the
Miller Center. What we've been doing is looking at trying
to capture all these different unique profiles at every year
(07:46):
when an individual comes into the clinic. And we've collected
longitunal data on over three hundred and fifteen MS patients
to date. I mean there's an estimated twelve hundred to
fifteen hundred MS patients and the entire province, so you
know that's a pretty good chunk. So we've been really
happy to be able to do this research here in
(08:10):
Newfoundland for many reasons that we'll get into later. But
one thing that is unique about this study is that
it allows us to collect prospective data with longitudinal data sets.
So many studies use cross sectional data and retrospective data,
so data that's already been captured and then you look
back and you analyze the data. This is actually using
(08:34):
data in real time and catching it in real time,
and it's really really valuable, not just in multiple scross
but in many chronic neurological diseases. Another thing that is
really good for us with this unique bio repository is
(08:54):
that it's been able to open many doors both internationally
and nationally for collaborates and also for applying for different
grants and such that require different institutions to cross collaborate
with each other and that has been really successful for
(09:14):
us in terms of me collaborating with individuals across Canada,
getting additional grants, but also attracting talented other researchers like
doctor Kaushik who I know that you recently spoke with,
and also really promising graduate students and postdoctoral trainees.
Speaker 6 (09:32):
Yeah.
Speaker 3 (09:33):
I think people to understand the value of that of
having these large research projects that are making such a
profound impact and not only going to be helping patients,
but you're also creating a whole new generation of researchers.
It will continue this work and continue to find even
more effective strategies to treat a disease which still has
yet to have a real cure, even though treatments are coming.
(09:54):
One of the things, let's get into some physiology here,
So I think to pick your brain of physiology. This
is something that I'm definitely not expert in. But you
look at early detection in early disease management, and you
look at what are called extracellular vesicles. These are found
in the blood and the cerebral spinal fluid. Can you
explain what they are and how you can actually use
(10:14):
these to predict MS?
Speaker 4 (10:17):
Sure?
Speaker 5 (10:18):
Well, I'll use an analogy that I heard from somebody
else because I thought it was pretty good, so I
want you to try and come up to my own good.
An analogy that was used was that these are little
mail trucks. Okay, so your cells, and I think everybody
most people understand what a cell is in the body,
and our body is made up of billions and billions
(10:38):
and billions of cells, and each one of those cells
releases tiny little particles, and these are what we would
call extracellular vehicles, so little tiny particles that are outside
of the cell and being released throughout the body. And
these evs used to be thought as just cellular waste
and just pieces that are falling off tofferent cells while
(11:00):
they're undergoing different biological processes. But what we appreciated in
the last ten to fifteen years is that these extracellular
vehicle i'll call them evs for short, are actually kind
of like little mail trucks. So they are packaging important
biological information, so proteins, nucleic acids, lipids, so all these
(11:25):
different biological molecules that play important roles and cells, and
they're packaging them and delivering them to other cells and
it's not just random in the way that this is
being done. It's actually much more complicated than what we thought.
So when a certain cell sell A releases its evs,
(11:48):
it actually knows to put different markers on the surfaces
of them, so that cell B, who might be the
recipient cell, specifically take that content within the extrastellar vesicles
and changes the complete biology of the recipient cell.
Speaker 3 (12:10):
That was doctor Craig Moore giving us a closer look
at the immune system's role in MS. When we come back,
we'll talk about how his research could change the way
MS is diagnosed and treated in the future. We'll be
right back after the break. Welcome back. We're continuing our
conversation with doctor Craig Moore as he explains how understanding
(12:33):
information at the cell level could unlock new therapies for MS,
and how this work is already gaining international attention.
Speaker 2 (12:40):
Let's get back to it.
Speaker 3 (12:42):
Yeah, I like to mail analogy. I think that's really
good for people to understand. And so what you're saying
is you've got these evs, these vesicles, and you're able
to track them. They're they're doing different effects withinside the body.
Are these one of the ways that you can look
at at actually treating MS by sort of addressing or
(13:04):
working or developing medications that act on these usicals.
Speaker 4 (13:09):
Yeah.
Speaker 5 (13:10):
So this is one of the really, really attractive things
about working in with evs is that they conserve multiple functions,
so one they could potentially be used to diagnose a
certain disease. So if a certain cell type is releasing
different evs and it's only releasing those evs and a
(13:31):
specific disease versus any other diseases, we may be able
to identify these evs as diagnostic tools or biomarkers is
what we call them. It's a diagnostic biomarkers. We could
also maybe use them for prognosis, So maybe they're not
good at diagnosing a certain disease, but they may be
(13:52):
able to tell us how bad the disease is going
to be, or what therapy might be the best therapy
to these patients based on their EV profile per se.
And then finally to get out what you are alluding
to in terms of being targeted at therapies is we
(14:12):
can also take advantage of the natural ability of these
evs to package biological molecules. So many people are probably
familiar with drugs being small molecules, and they take them,
you know, as tablets and swallow them every day. And
most drugs out there are indeed small, little, tiny chemicals.
(14:36):
But many more drugs that are on the market and
being approved for different diseases are what we call biologics,
which are actual proteins and lipids and nucleic acids in
which the body makes naturally, And we can actually package
these inside the eds because that's what they're meant for,
(14:57):
and then we can actually put different molecules on the
surfaces of them so that the cells of interest that
we're interested in in helping repair or helping restore to
a normal on disease state, those evs would target specifically
those cells.
Speaker 3 (15:16):
Okay, so catch me if I'm right on this. Okay.
So the body communicates to a mail system. Sometimes you
can check the mail. The mail says, oh, this person
has a condition like MS. Then you can send them
a package in the mail that goes to the cells
with a therapy that potentially could change the way the
mail is.
Speaker 4 (15:33):
Delivered exactly exactly.
Speaker 5 (15:38):
Like, uh, this is about why, this is exactly why
you're in this role. If it makes sense of things, Yeah,
I got you.
Speaker 4 (15:47):
I got you. How you're paying on? Okay, that's great.
Speaker 3 (15:50):
I think that's really interesting for people to realize how
this works on this molecular, microscopic level. I find it fascinating.
And now we're going to talk about why this is
so novel, why this is so interesting. The work you're
doing is so important and I can't underestimate this to
our listeners.
Speaker 4 (16:04):
Doctor Worr just was.
Speaker 3 (16:05):
Awarded a one point two to three million dollar grant
by what's called hr which is a very very competitive
grant and it's going to help fund your MS research here.
First of all, congratulations, tell us about that grant and
how you hope that's going to help our patients in
the long run here in the province and around the world.
Speaker 4 (16:24):
Probably, Yeah, thanks Mike.
Speaker 5 (16:27):
It is indeed very difficult and a challenging time to
get research funding health research funding from different governmental agencies,
not just here in Canada, but it's becoming more difficult worldwide.
So I don't take these things for granted, and I
thank you very much for acknowledging the hard work that
(16:48):
myself and the entire lab has put into this. One
of the most important things I think for me is sustainability.
And I started this ten years ago, and it amazes
me that ten years has passed since I joined the
faculty here at Memorial and University. This ten years now
turns us into fifteen years. So this is guaranteed meet
(17:11):
funds for the next five years to keep things at
the same level that they've been moving at, which is
really fast. And maybe we can even move a little
bit faster if I have a few more students or
a few more technicians or trainees in the lab. And
what this is going to do is going to continue
(17:31):
to build up the repository. We're going to continue to
recruit newly diagnosed MS patients so that they have the
opportunity to participate in research. And we hope that this
will rival some of the similar longitudinal databases that are
found in Europe.
Speaker 3 (17:50):
And the United States.
Speaker 5 (17:53):
This also helps to make Newfoundland and Memorial and attractive
site to recruit clinicians who are interested in participate MS research.
So we know that many neurologists and many specialists devote many,
many years of going to school, as do PhD scientists
as well. Yeah, but the clinicians also want to engage
(18:16):
in research and they often have very limited time and
resources to do that. So if I can make their
job a little bit easier by doing some of the
background grunt work but also allowing them to look at
different aspects that are important to them in MS research.
(18:36):
I want to be able to do that and that
will increase numbers of clinical trials that we participate in
you're at n LHS and M Memorial. It'll increase the
revenues that can go back towards the research that we're
doing and also provide access to new investigative and state
of the art therapies for patients right here in the province.
(18:59):
And that's something that it's kind of historically lacked here
in nicklin Land, is that because we aren't a huge
site for clinical trials, patients may not benefit from some
of the new state of the art treatments that are
being looked at within the healthcare industry.
Speaker 4 (19:17):
So yeah, it's.
Speaker 3 (19:20):
Great, it's great, And you know you've got yourself, You've
got doctor Plomer, you have to Koshik. Basically this is
becoming an epicenter for MS research. All three of you
are very successful researchers and that's creating this really positive
ecosystem here form amoral university. You know, that's got to
be something you guys are proud of being. You must
(19:40):
be recognized on a pre national level for the work
you guys are doing here.
Speaker 5 (19:45):
We indeed are, and we're not only being supported by
the CIHR, but also by MS Canada formerly the MS
Society of Canada now MS Canada.
Speaker 4 (19:59):
So I indeed have.
Speaker 5 (20:01):
Grants from MS Canada as well, and all three of
my PhD students at the present moment are also funded
through MS Canada, and many of doctor Kaushik's and doctor
Palmon's students are also funded through that nonprofiting see. So
that hasn't gone unrecognized at the national level. And ten
(20:23):
years ago, you know, there wasn't any funds coming from
MS Canada into the province. But now we're definitely the
most active MS research hospital and faculty in Atlantic Canada
and starting to rival some of the some of the
ones that we see.
Speaker 2 (20:43):
Out with excellent.
Speaker 3 (20:45):
Well that's fantastic, a little start to revel, but I
want to ask a question before we finish. You know,
with healthcare and science evolving so quickly, we hear about
the funding of research in some parts of the world
under fire these days when it comes to health research,
we look at federally support grants like you just got.
They seem to be more important than ever. But how
important is it for a smaller province like Newfoundland and Labrador.
Speaker 5 (21:09):
Yeah, so our population is small, right, so we only
make up two percent of the entire national population. Private
donations from philanthropists or medical research are relatively rare here
compared to many large urban centers, and the provincial funds
and support that we get have been limited in the
(21:31):
past due to the different economic situations faced by the province.
And that's a little bit more difficult compared to larger
provinces and larger university that can fall back on certain
funds that they already set a thide for things like
health research. So we rely really heavily on federal dollars
(21:54):
to support research in the provinces. But I like to
also emphasize that the smaller places and being here in
Newfoundland is not necessarily disadvantage at all.
Speaker 6 (22:06):
Yeah.
Speaker 5 (22:06):
So one of the big reasons why I came here
was after a conversation I have with my postdoc supervisor
at McGill who said to me, do you want to
be a big fish in a low pond or a
low fish.
Speaker 2 (22:17):
And a big pond.
Speaker 5 (22:18):
And my immediate answer, without even thinking about it, was well,
I want to be a big fishon a little pond.
So he said take the job at Memorial, and I
have no regrets in making that decision. I have more
access to certain resources by being here. There's less internal
competition with other people who are researching similar or slightly
(22:41):
similar things. Collaborations are a lot easier to maintain here,
Like if I want to collaborate with somebody, I can
just kind of walk down the hall because the province's
infrastructure to support medical research is geographically all located within
the Saint John's area for the most part.
Speaker 4 (22:59):
Totally oh it.
Speaker 5 (23:00):
You know, I can send someone to text or send
someone a phone call, and I can meet them for
our coffee and discuss ideas. And of course we all
know that the you know, Newfoundlanders are amazing people. They're passionate,
they are keen, they're generous. So just by nature being here,
you know, it's really really helped the research program.
Speaker 3 (23:23):
Fantastic, Craig, Listen, It's exciting to see everything you've got
going on. It's it's so fun to watch you and
the other researchers that are making a real impact with
these awards that recognize how hard you're working. I just
want to say huge congratulations and thanks for coming on
today to share all this information with our audience.
Speaker 4 (23:40):
My pleasure.
Speaker 5 (23:42):
Thanks for the opportunity for me to share some of
what I do.
Speaker 3 (23:48):
That was doctor Craig Moore talking about MS prevention and
early detection. After the break, we'll hear from doctor Dpak Kashik,
who's work focused on something equally important, how to promote
healing once damage has occurred.
Speaker 2 (24:00):
We'll be right back after the break. Welcome back.
Speaker 3 (24:08):
We're now joined by doctor d Pat Kashik, a neuroscientist
whose research is exploring how to regenerate nerve tissue damaged
by MS. His lab is investigating how the brain might
be guided to repair itself, potentially reversing some of the
damage MS causes.
Speaker 2 (24:23):
Let's get to it.
Speaker 4 (24:24):
Hi, dok Koschick, Welcome to the show.
Speaker 6 (24:26):
Thank you for having me. Mike, please call me Deepak.
I'm I'm looking forward to this one.
Speaker 3 (24:31):
Yeah, this is great. Well, we have a lot to
talk about. We have a lot to talk about with
your research. We also have a lot to celebrate. You've
recently won a very large research award. But maybe for
our listeners who might not be familiar with your work,
you could give us a little bit of background on yourself.
Speaker 6 (24:45):
Yeah, I'm a researcher out here. I'm an assistant professor
at the Faculty of Medicine here at no More University
of National Land. I started my program here in twenty
twenty one and I've been working on MS research and
I have a all group of trainees, very enthessiastic group
of trainees helping us watch your goals.
Speaker 4 (25:06):
Yeah, well fantastic.
Speaker 3 (25:07):
And I think that you know, MS is such a
complicated disease, you know, and it impacts a lot of people,
particularly here in New Filan and Laborador. But you're looking
at a very specific part of multiple sclerosis. What part
of the disease are you trying to understand with your research?
Speaker 6 (25:22):
Yeah, so it's as you said, it's a very complicated disease, Mike.
We are basically trying to address one piece of a
puzzle at a time. The piece that we are working
on is on understanding how these immune cells that identify
brain as a region of interest, where they go on
and target the brain. Why would they do so? And
(25:46):
the reason why they go rogue is what we're trying
to understand. Eventually, we want to understand how these immune
cells move from the periphery that is in the blood
to the brain and cause the disease.
Speaker 4 (25:58):
Yeah.
Speaker 3 (25:58):
When you think about that, I mean, and people don't
really sometimes realize that these autoimmune diseases, that the body
is really attacking itself and for some reason it thinks
the good guys are the bad guys and it causes
challenges in the body.
Speaker 6 (26:10):
Yeah, that's right. I mean, in this case, it's a
clear case of where this immune system is confused. It
starts attacking the brain as if it were fighting an infection,
which we know is not the case. So something in
the brain sort of starts this process where immunes us
are now getting interested moving into the brain and start
damaging the brain while they should not be there or
(26:32):
doing anything bad to the brain.
Speaker 3 (26:34):
To beg conroll, do you guys have any idea of
why this starts, Like why does it happen to certain people?
Is there like a match that lights the whole thing
to start off with?
Speaker 6 (26:46):
Yeah, first of all, I mean, it's a very heterogeneous disease,
meaning that there are many causes that are associated with this.
There is a theory of genes. We know there's associations
where genes may be maybe playing a role, but that's
not the whole story. The story is that there is
probably also an impact of life set factors such as diet,
(27:10):
the latitude that where we live in, exposure to sunlight,
vitamin the hygiene ipodsis and viral infections so on, and supper.
So these are all theories and we are trying to
understand what exactly is happening when we're trying to look
at how immune cells migrate and what helps them migrate,
what ruels their migration to the brain, and the element
(27:31):
here is trying to understand the energy that these immune
cells use a form of energy and if we can
curve it down to bring down the disease progression in
the mess.
Speaker 3 (27:43):
Yeah, that's so interesting. Is it unusual? I mean, I
would think about infection in other parts of the body,
but is it unusual for immune cells to attack the
brain and to create a condition like this.
Speaker 6 (27:53):
That's right, It's quite unusual if you look at the
brain in general. So it's surrounded by variety of femine cells.
There are many different types of immune cells that are
required for us for them to prevent any infission from happening.
But within the brain, inside the brain there are the
regions where neurons are or these functioning units reside or live.
(28:16):
There is no presence of immune cells from outside the body.
They do have a component of femine cell called microglia,
which does basic job right then and there, But the
cells or other very bona fide or you know, immune
cells do not really readly migrate to brain, so they're
kind of forbidden from entering this organ.
Speaker 3 (28:39):
Huh. That's interesting. And when you mentioned things like so
many different factors. It could be a viral condition when
you're younger, or your diet or our sunlight or all
these other factors that make the disease so complex. You
guys are also looking at how the energy system in
our cells, how they affect our brain health. Can you
explain in Layman's terms, how our cells burn fuel and
(29:01):
how that can impact our likelihood of developing MS?
Speaker 6 (29:06):
Sure, I didn't think of these immune cells as cars
or automobiles. They need fuel to function. Now in healthy conditions,
what happens is that these immune cells burn cleaner fuel.
Think of it as a car utilizing hybrid technology or
evie technology. On the other hand, when these immune cells
go row, they probably prefer to go aggressive by utilizing
(29:29):
more diesel or gasoline and then they go full throttle
there causing brain damage. Now what happens with this is
when they burn dirty fuels, this allows them to generate
a lot of chemicals in the brain that can be very,
very hopful, and that is what we in the lab
is trying to curve downe or basically calm them down
(29:50):
or trying to switch them back to using cleaner forms
of energy. Just to put it that way.
Speaker 4 (29:56):
That's such a great analogy.
Speaker 3 (29:57):
So it's almost like the pollution from using the raw
fuel source is causing our brain to get damaged because
it's got toxins that aren't supposed to be there.
Speaker 6 (30:07):
That's right. But the polytants, as we were talking about,
is actually the main form of energy, which is sugar
or glucose, so technically very important for the brain to function.
It's just that these immune cells somehow use it to
their benefit to cause inflammation and basically go row from there.
Speaker 4 (30:26):
That's interesting.
Speaker 3 (30:27):
Yeah, we hear so much about our diets being an
important part of it how our body metabolizes things. And
also we hear so much about inflammation. Just to steer
down that road for a second, why is inflammation so challenging.
Speaker 2 (30:39):
For things like our brain?
Speaker 3 (30:40):
I think we all used to having bad backs or
toward muscles, but maybe not our brain.
Speaker 6 (30:45):
Aside, there's a reason why there's less presence of immune
sus from outside within the brain because the brain won't
repair as better as other organ systems would, so these
inflammatory components are usually kept out.
Speaker 3 (31:00):
Now.
Speaker 6 (31:00):
Once there is damage to neurons or the function units
that sends messages for our body to function, it's very
hard for them to repair and therefore inflammation or especially
i must say long term inflammation or chronic inflammation is
damaging to brains functions. In MS, this is essentially what happens.
(31:20):
These immune cells come and reside, attack those neurons, make
them less functional. At the same time generate so many
chemicals that over the time this leads to death of
other neurons. And this also is referred to as a
lesion in MS in the brains, which is what where
(31:41):
MS gets its name from multiple sclerosses, meaning multiple plaques
and multiple leasis in the brain.
Speaker 3 (31:47):
That was doctor Kashik introducing the world of neural repair
and regeneration, and we come back we'll explore how this
work could translate into future treatments and what it means
for those living with MS. Today, we'll be right back
to the break.
Speaker 1 (32:02):
You're listening to what we broadcast of The Wellness and
Healthy Lifestyle Show with Doctor Mike Wall. Listen live Thursday
nights at seven pm and Sundays at four pm.
Speaker 3 (32:12):
Let's continue our conversation with doctor d Pak Kashik as
he walks us through the latest findings from his lab
and why this type of research.
Speaker 2 (32:19):
Could be a game changer for MS care.
Speaker 3 (32:23):
It's interesting because there are certain risk factors. I've read
that MS affects women more often, but men tend to
have more severe symptoms. Do you have any idea why
this might be the case.
Speaker 6 (32:37):
Yeah, so you're right that there are spent three times
more women that GEMS over men, but when men have it,
they usually have or present with a primary progressive form
of MS. Now that's not exactly true in every quohota
or every sample that's been looked at, but there are
certain cases where men do present or try to or
(32:59):
do progress faster over females. Now, this is something we
are still learning about. We don't know a whole lot
why that is the case. It could be because of
differences in hormones or how the brain responds to damage
in men versus women. In fact, to that end, our
own lab is interested in looking at both male and
(33:19):
female mice as well as these cells grown dishes to
understand what is the difference between these sort of fuels
that these male and female brain might be utalizing, and
is there any difference? If there is, is there a
way that we can tweak them to sort of lessen
the severity that we observe in male cases.
Speaker 3 (33:43):
And that is something I think a lot of people
will wonder. You know, we're in animal studies here, You're
using living cells, living organisms that are very translatable to
human beings. What will it take from the work that
happens in your lab to transfer to the care that
our patients get. What's the role of the research you're doing.
Speaker 6 (34:01):
Yeah, I must just give you a brief backup background.
Like twenty twenty five years ago, we didn't have as
many drug options for MS and a majority of drug
options now they're over sixteen or seventeen have come in
the past twenty twenty five years. This all has been
possible by basic research labs such as ours, and most
of these drugs went through a pipeline where basic research
(34:23):
on sales and animals were conducted. Eventually they were performed
in higher animals before going to clinical trials, so I
would so this is exactly the path that has to
take for our own research. Right now. We are at
at a stage where we have promising results in the
lab that we can curb or calm these rogue immune
(34:47):
cells down, and eventually the idea would be to take
them in higher animals and eventually to clinical trials. So
it's say step by a process, but each step brings
us closer to treatment that can truly help.
Speaker 3 (35:02):
That's unbelievable and this is one of the reasons I
wanted to chat with you today. You have recently won
a major grant of over a million dollars from one
of the most competitive grants you can get, a CHR grant.
Can you tell me a little bit about that grant
but also how that's going to help the work that
you're currently doing.
Speaker 6 (35:22):
Yeah? Sure, Thank you, first of all, Mike for acknowledging
that this is a big, big deal, and it indeed is.
It's a ci CHIB, which is Canadian Institute for Health
and Research, meaning it's a federal grant, a very competitive one,
and we are fortunate to have some of these grands
come to us here at Faculty Medicine, including doctor Craig
Moore who also received this gland alongside. So we are
(35:45):
very very excited to have this opportunity come to us. Now.
First of all I would also say is that research
is very, very expensive to perform. Most of our money
is go to hiring great talents such as students, research associates,
post talcs. That t building is very essential and that
comes at the price to research equipment. Chemicals regions are
(36:09):
very expensive as well. So all this million dollars will
certainly help us support acquire all the infrastructure that's required,
the personal that's that's needed to run the program. And
in terms of what it means for us here in
newfernand and Labrador, it does put us out on the
map right and it also means that New Phernon and
(36:29):
Labrador gets to be part of exciting medical discoveries and
we make sure that we research we do helps people
here at home. So it's a big deal. It's it's important,
it's important for the province, it's important for our research group.
And this puts US as I said, not only on
national map, but also an international arena basically totally.
Speaker 3 (36:52):
And when I think about like a CHR grant for
anybody listening from an academic standpoint, is could be a
once in a career thing. It's still a mile it's
a huge milestone people to accomplish. Many people never come
close to getting one of these grants. And not only
did you get this, but also doctor Moore, both of
you doing work in MS. Is there something to be
said about the research environment when it comes to MS
(37:13):
here at Memorial. Yeah.
Speaker 6 (37:16):
So when I moved about four years ago during COVID times,
the only few labs that we knew were of doctor
Moore's and doctor Plomins, who have very active research labs
around here. And that kind of also gave me a
motivation to move because they had a very successful program
and self established MS research around here. In general, I
(37:38):
got a very good support from a moyal university. The
idea of this research collaboration was fantastic. Now we also
have access to patient samples to other partners, including doctor
Moore and you know, through the clinics because in newful
Land we are part of TIT need community, which is
what I learned throughout this process that is inspised to
(38:00):
sure that our research actually helps real people, not just
in theory but in practice. So I find particularly it
to be very very supportive environment.
Speaker 4 (38:12):
Yeah, I think so too.
Speaker 3 (38:14):
And it's so nice to see our colleagues like yourself
succeeding in being able to do the work that you
came here to do, which is really you know, rewarding
for all of us to watch. And when we think
about the disease that you're dealing with, this is a
chronic disease. This impacts of Finland and labora oriients disproportionately.
It's a high rate in Canada as well. Why do
you think research and of course you're going to be
(38:36):
partial to this, but like research and this type of
disease is just so important these days.
Speaker 6 (38:42):
Yeah, I think just that there are two point eight
million people worldwide living with MS, or nine two hundred
thousand Canadians living with MS speaks to the fact that
this is a very prevalent disease. Another thing to keep
in mind, the incidents of this disease or the rate
at which it's increasing is a very at a five
(39:03):
space so long diseases such as MS, they are becoming
more common, yes, and they'll usually hit people when they're
in their twenties, thirties, and forties. So keep in mind
this is when people are building their careers, their families.
So if we can understand that this is better now,
we can improve lives of thousands of people in the
years to come. And that's why research creates a very important.
Speaker 3 (39:26):
It does it does in those are such critical years.
I've talked to the folks that young adult Cancer Canada,
when people get cancer at any time in their life,
is challenging, especially when they're.
Speaker 4 (39:35):
In their youth.
Speaker 2 (39:36):
Same thing with the disease like this.
Speaker 3 (39:37):
Now, people listening here today, they're hearing that there's research happening,
that there's things progressing in the field. If somebody is
listening and they're dealing with MS or have a family
member dealing with MS, what would you want them to
know about the future of treatment and the potential for hope.
Speaker 6 (39:55):
That there is a lot of hope. Treatments have come
a long way, and interests around the world, including right
here in Newfoundland, including our own lab, are working very
hard every day to find treatments, to find better answers.
The challenges remain though. There are the different forms of
this disease, the early forms of this disease, which eventually
(40:17):
progressive forms of this disease. So in our own lab,
we're trying to address what and how we can we
can we can control the progression of the disease from happening.
So ass research is moving fast and we are closer
than ever to make real breakthroughs. That's all I have
to say. I also want to say and reach out
(40:38):
to your means a general audience that do take part
in fundraising events whenever there is an opportunity. We have
ms walk around here, we have other fundraising opportunities. These
donate issues help research and also also help us to
get closer to the to the community which has steps.
So and this is what my my whole program is about. People.
Speaker 4 (41:00):
It's fantastic.
Speaker 3 (41:01):
It's excellent to see I know that our division is
creating a next generation of researchers. Grants like yours also
allow us to fuel a fostering and mentorship among the
next generation of researchers as well, which means there's more
people out there without interest trying to solve the problems.
Speaker 2 (41:16):
Deback.
Speaker 3 (41:16):
Congratulations and an amazing accomplishment, and thank you so much
for doing everything you do.
Speaker 6 (41:21):
Thank you so much, Mike for having me, and also
for all the support that the division has extended me,
including you, especially what you're doing is amazing. This is
important aspect. We should do this more often.
Speaker 3 (41:33):
I would say I look forward to having you back on.
Speaker 6 (41:36):
Thank you, Mike.
Speaker 3 (41:37):
Well, that's our show this week. A huge thank you
to doctor Craig Moore and doctor dpak Kashik for joining
us and for the incredible work they're doing to advance
multiple scrosses research. The efforts are being made possible by
programs like the Canadian Institutes of Health Research, which fund
the science that drives real world impact. This isn't just
academic work, it's the future of healthcare happening right here
(41:58):
on More University and to learn more about their research
or to support their work, you can visit the Memorial
Faculty of Medicine's website. Thanks for tuning in, I'm your host.
Doctor Mike Wall I'll see you back here next week
for another episode of the Wellness Healthy Lifestyle Show on
the Stingray podcast Network and your vocm
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