In recognition of Robarts' 30th anniversary, four prominent scientists highlight research advancements in their fields and reflect on their own careers at the Institute.
Ross Feldman, MD
Scientist Emeritus, Robarts Research Institute
Chair of Medicine, Memorial University
High blood pressure was a very different disease when I started at Robarts in 1989. We knew little of the molecular and cellular mechanisms underlying the disease, the most common drug treatments used today were only beginning to be used and blood pressure control rates in Canada were less than 20 per cent. Many of those realities of 1989 are far different today.
Since then, there has been significant advancement in our understanding of the mechanisms of hypertension, our management approaches are far more sophisticated, and blood pressure control rates in Canada are the best in the world. Several of these achievements have been significantly impacted by efforts from Robarts.
Robarts advances on the cellular and molecular front in hypertension have included the recognition of the vascular effects of insulin, and how those actions are altered in hypertension leading to its development and maintenance. Also, the identification of the molecular basis for the impairment in blood vessel relaxation, a hallmark of hypertension, through the exaggerated effects of G protein receptor kinases was a Robarts discovery.
Most recently, the characterization of sex-specific determinates in the development of hypertension and dyslipidemia has been significantly advanced from work done at Robarts.
On a hypertension management level, we successfully carried out the landmark STITCH study that has introduced a new algorithmic, or step-by-step, approach – an approach that has had wide implementation globally.
On the hypertension control front, Robarts was the first home of the Canadian Hypertension Education Program – a knowledge translation initiative which has received credit for its role in making Canadian hypertension control rates the highest globally.
My research and health policy efforts in total were greatly facilitated by the community that is Robarts. The transition of our research program toward molecular platforms and later to population genetic platforms was based on the access to the highly interactive and collaborative scientific community of the Institute. Further, my ability to coordinate both a fundamental research program and conduct multicentre clinical trials could have only been achieved in an environment where clinical and research scientists were working side by side.
Robarts has been a leader in maintaining and nurturing a transdisciplinary approach to research during the past 30 years. I think that this strategy has been critical to its success. I can only hope that this template for success developed during the first 30 years of Robarts will continue and grow through its next 30.
Lynne Weaver, PhD
Scientist Emeritus, Robarts Research Institute
Professor Emeritus, Schulich School of Medicine & Dentistry
I came to the Robarts Research Institute in November of 1986 as the first laboratory scientist from outside of London to be recruited by the founding director Dr. Henry Barnett. My expertise was nervous system control of blood pressure and I particularly focused on nerve cells in the spinal cord and how they were controlled by the brain to achieve normal cardiovascular function.
Because of that background, in 1988 I applied for and was awarded a grant from the then-called ‘Rick Hansen Legacy Fund’, although I had no background in spinal cord injury research. I planned a project to study the spinal cord nerve cells in the absence of control from the brain, the condition that happens after spinal cord injury. Soon after receiving this funding, I was asked to give a presentation in Vancouver to the Foundation. I was astonished when I entered the conference room to find almost half of the audience in wheel chairs.
That changed my scientific life forever. I spent three days talking with the cord-injured people, asking them about their most important problems. They consistently asked me to study the problem of autonomic dysreflexia. This is a very common syndrome after cord injury, in which stimulation to the urinary bladder or bowel, or to skin or muscle below the level of injury, can trigger dangerous increases in arterial pressure. The extremely high blood pressure causes massive headaches and can lead to abnormal heart rhythm, strokes and death.
I began to study autonomic dysreflexia in my laboratory, seeking to understand what causes it, and to find ways to prevent or treat it. From the early 1990’s onward we published detailed papers describing the problems within the injured spinal cord responsible for this terrible condition.
This work attracted the attention of other scientists who began to realize that problems other than the inability to walk were very important to people with spinal cord injury. In 2004, a young quadriplegic scientist Kim Anderson conducted a survey of people with cord injury, revealing that disturbances such as pain and abnormal bowel, bladder, sexual and cardiovascular function were extremely important to their quality of life, more so than confinement to a wheel chair. Our studies became the foundation for work of other scientists who began to include assessments of autonomic dysreflexia in their investigations of possible treatments for cord injury.
Dr. Andrei Krassioukov, a postdoctoral fellow working with me in the early 1990s, conducted some of our first studies of autonomic dysreflexia and now is a Professor of Medicine and Director of Spinal Cord Injury Research in Vancouver. He has become a leading world expert on autonomic dysreflexia.
Thirty years ago, this was a very poorly understood condition, but now, cord-injured people can expect timely and correct care when they suffer from this condition. Our work, and that of others who followed, has led to proven or developing treatments to prevent or relieve this condition.
The studies that began at Robarts have inspired other scientists to attack this important problem and the new scientific focus spread to the clinical world, leading to better awareness and treatment of autonomic dysreflexia in cord-injured people. I still collaborate with my colleagues at Robarts, Drs. Greg Dekaban and Arthur Brown, and we are developing an exciting anti-inflammatory treatment that greatly prevents the development of autonomic dysreflexia as it protects the injured cord from secondary damage. This important collaboration, with its potentially huge impact on spinal cord injury treatment, has been possible because of the diversity of disciplines of scientists who work together in a supportive environment at Robarts.
Aaron Fenster, PhD
Scientist and Director, Imaging Research Laboratories, Robarts Research Institute
Professor, Schulich School of Medicine & Dentistry
Twenty-nine years ago Dr. Barry Hobbs, the incoming Chair of the Department of Radiology and Nuclear Medicine at Western University at the time, was trying to convince me to start an radiological imaging research group in London and invited me to come to London to meet Dr. Henry Barnett.
Our meeting took place in the newly built Robarts Research Institute with an unfinished basement and some space on the first floor. I described to him my vision to start with an initial core group of three additional scientists and a research program focusing on vascular imaging.
Drs. Barnet and Hobbs recognized the potential for this group and helped to establish the Imaging Research Laboratories with the recruitment of Drs. Rutt, Cunningham and Lee, as well as three graduate students from the Department of Medical Biophysics.
Our initial research program focused on carotid imaging using x-ray, ultrasound and MRI. Since then, our research program has grown to 17 scientists and more than 90 graduate students. Research has expanded greatly, with programs focused on the brain, image-guided intervention, cardiovascular, cancer, lung, musculoskeletal and functional imaging.
Our imaging capabilities have also advanced significantly.
- We now can image the brain with a 7-Tesla MRI scanner, giving very precise detail of structure and functions of the brain;
- We can identify subtle lung abnormalities with hyperpolarized MRI;
- We’ve made advancements in liver and heart perfusion;
- We’ve helped guide interventional instruments and needles into the body with robotic systems and tracking software to repair heart valves and destroy cancerous tumours;
- We’ve studied the erosion of metallic implants used for hip replacement;
- We’ve developed functional imaging techniques used to identify cancers.
When we started nearly 30 years ago, we only dreamt about the possibilities imaging could provide. But now, with the tools and knowledge we have at our disposal at Robarts, the possibilities are endless.
Perhaps in another 30 years, we will see the many techniques we are currently developing converge on an 'imaging phenotype', merging with genotyping to establish true precision (personalized) medicine. With this capability, we will be able to identify and treat the earliest signs of disease with methods identified specifically for the individual patient.
Terry Peters, PhD
Scientist, Robarts Research Institute
Professor, Schulich School of Medicine & Dentistry
Twenty years ago during a stroll in between sessions of a meeting we were attending at UBC, my colleague Aaron Fenster, PhD, suggested that Robarts Research Institute was planning to establish a focus on image-guided interventions. He asked if I would be interested in moving from McGill to head it up. Having already spent close to 20 years in Montreal, I felt that it might be time for a move.
Fast forward to today, and the image-guided intervention program is thriving. Our program has grown to support more than 80 students and staff, who are working on the development of techniques to treat diseases in organs using minimally invasive procedures. This is thanks to four CFI awards, a re-direction of the work of my colleagues Aaron Fenster, PhD, and Maria Drangova, PhD, to image-guided surgery and therapy, and a number of successful CIHR and Ontario Research Fund grants to the team.
Our imaging research has attracted significant support from numerous companies in the medical device and imaging field, leading to the development of new devices and techniques to perform prostate biopsies and therapies, liver ablations, heart valve repairs, guidance of catheters to treat cardiac arrhythmias, injections of anesthesia to the spine, and procedures to treat epilepsy and Parkinson’s. With this work, we have also established five spin-off companies related to instrumentation or software development, as well as 20 licenses to external companies.