Top scientists from Mount Sinai Hospital and the University of Toronto are joining forces to explore the critical role microorganisms play in chronic health conditions such as inflammatory bowel disease (IBD) — a debilitating condition that affects 1 in 150 Canadians — as well as diabetes, auto-immune disease and chronic infections.
As part of the new initiative, Mount Sinai Hospital will open Canada’s largest clinical research unit dedicated to investigating inflammatory bowel disease and helping to find better treatments to improve the lives of some 200,000 Canadians. The new facility at Mount Sinai will be funded in part by a $6 million grant announced yesterday from Canada Foundation for Innovation supporting the University of Toronto’s new Host-Microbiome Network.
The Host-Microbiome Network will explore the critical role microorganisms play in a number of chronic health conditions such as inflammatory bowel disease, type 2 diabetes and auto-immune disease as well as chronic infectious diseases like HIV and C. difficile. It will help researchers better understand how gut bacteria interact with the immune system and the genetics of people at high risk of developing IBD and other diseases by studying and sequencing the human microbiome (a collection of bacteria, viruses, and fungi that live on and in the gut).
The team is being led by Dr. Dana Philpott, Associate Professor of Immunology at the University of Toronto and Dr. Ken Croitoru, a clinician-scientist in Mount Sinai’s Zane Cohen Centre for Digestive Research, Associate Scientist with Mount Sinai’s Samuel Lunenfeld Research Institute, and a Professor of Medicine in the Division of Gastroenterology at the University of Toronto.
The new unit at Mount Sinai will allow Dr. Croitoru and his colleagues to integrate IBD research and clinical care under one roof, so that when patients visit the hospital for care, research studies will allow for patients to undergo state-of-the-art MRI imaging of the intestine to be correlated with the degree of inflammation, the nature of the gut microbiome and changes in the immune response. The goal is to create a personalized profile of a patient’s risk of developing the disease and to determine their specific triggers based on their immune responses and the profile of the microbes in their bodies.
“Today when you treat someone with inflammatory bowel disease, you use drugs that focus on decreasing inflammation. These drugs don’t change the disease – in fact, drugs only treat 50 per cent of all patients. Whatever is perpetuating the inflammation is still there. So, the challenge is to change the underlying the disease,” Dr. Croitoru says. “Our goal is to study the disease in a way we weren’t able to, even five years ago and to maximize our ability to help our patients and really alter the nature of the disease process.”
The University of Toronto laboratories will focus on studying the fundamental biology of how the immune response interacts with the gut microbiome using state of the art imaging tools, flow cytometry and a germ free facility. This would help us better understand how we live with bacteria and how this relationship can break down and lead to disease. Basic research in this area will both help explain the results of patients’ studies, and inform future studies to help improve patient care.
“Right now, we have no idea what a normal microbial profile looks like, but we do know that some bacteria can cause inflammation. If we can get rid of the inflammation-causing bacteria using targeted antibiotics or probiotic cocktails, we might be able to treat or even prevent disease,” says Dr. Philpott, noting that her research represents a new aspect of personalized medicine. “We can’t see them, but in the future these microbes will play a pivotal role in how diseases like cancer and heart disease are detected, treated and one day, prevented.”
More than 4,700 people with IBD visit Mount Sinai for care annually, many who come from outside of Toronto and Ontario. The Centre for Inflammatory Bowel Disease
at Mount Sinai is also the tertiary referral centre for all of Ontario for patients with complex IBD for second opinions and/or ongoing care.