A Portfolio for Health Innovation – Canadian Institutes of Health Research Annual Report 2013–14

Knowledge Creation

A Platform for Innovation

Health innovation is a long and complex process. Research plays a critical role throughout this journey, starting with investments in fundamental research to create the knowledge that will fuel health innovation.

In the past fiscal year, CIHR has worked to increase the capacity of Canada’s research community to produce this knowledge. In 2013–14, CIHR invested in more than 3,600 operating grants that fuelled the ideas and supported the research teams of 6,844 investigators. This investment in support of investigator-initiated research represents over 50% of CIHR’s grants and awards budget.

Sustaining knowledge creation requires world-class people – those with the passion, curiosity, persistence and intelligence that can make a difference. In 2013–14, CIHR continued to provide substantial training and professional support to the research community. This included awards to 639 faculty members through the Canada Research Chairs as well as direct training support for 773 postdoctoral fellows and 917 doctoral students through individual scholarship programs.

Throughout 2013–14, CIHR also continued to play an active role in major international research collaborations, a key driver of knowledge creation. By keeping Canada highly visible in international research efforts, and by positioning our best researchers as leaders in such efforts, CIHR ensures Canadian researchers influence the direction of science at a global level and gain access to cutting-edge ideas, data and research facilities. CIHR facilitates close cooperation between the world’s leading health research experts and attracts the brightest minds to study and work in Canada.

For example, CIHR representatives assumed the chairs of both the International Rare Diseases Research Consortium and the International Human Epigenome Consortium. CIHR is also leading the Joint Programming Initiative on Antimicrobial Resistance , a collaboration between Canada, 17 European Union countries and Israel. And, as a result of the tremendous output of Canadian researchers studying dementia, Canada was the first non-European country to be invited to join the EU Joint Programme – Neurodegenerative Disease Research (JPND), the largest global research effort focused on neurodegenerative diseases.

Finally, CIHR is committed to harnessing knowledge creation to drive health innovation forward. In December 2013, Canadian experts in dementia research joined counterparts from the G8 countries to discuss the current state of knowledge about dementia and to define future international collaborative research efforts. Canada, with France as its partner, will host one of four follow-up legacy workshops; CIHR was tasked with organizing this important event.

Activating Muscle Regeneration

Around age 40, people begin to experience a steady loss of their muscle bulk, an aging process known as sarcopenia. Age-related muscle loss can result in injuries from falls that lead to chronic disability or premature death. Similarly, in muscle-wasting diseases such as muscular dystrophy, muscle loss results in severe life-long disability with death in young adulthood. Dr. Jeffrey Dilworth and his lab at the Ottawa Hospital Research Institute have been studying how the body regulates muscle growth, and they have discovered a protein trigger that is key to sustaining muscle renewal. The protein, known as Mef2D, acts as a “switch” regulating the conversion of muscle stem cells into functional muscle fibres (see above). Dr. Dilworth’s group discovered that a single gene codes for two competing forms of the Mef2D protein: one version triggers muscle stem cells to turn into muscle fibres, while the other inhibits this transformation. Which version of Mef2D a cell produces is determined by epigenetic factors – long-term changes in gene activity rather than changes in gene sequence. The protein could be a target for a medication designed to combat muscle loss.

Building a Faster, More Sensitive TB Test

The conventional method for detecting tuberculosis (TB; see above) is time-consuming and labour-intensive. It involves collecting sputum samples from patients, sending them to a specialized TB lab and waiting weeks for the results. Dr. Dan Bizzotto is part of a multidisciplinary team working at the University of British Columbia (UBC) to develop a device similar to a blood glucose monitor that could detect TB DNA in a matter of minutes. With support from graduate students at UBC, specialists from the fields of electrochemistry, synthetic chemistry, electrical engineering and medical microbiology are working on the device. In addition, an industrial partner is contributing technology to speed up detection of TB DNA in sputum samples. The device could potentially plug into a smartphone, enabling results to be transmitted instantly to a hospital or doctor’s office. Ultimately, the team hopes such a device would detect different strains of TB, including those resistant to antibiotics. This would allow the public health system to act quickly to prevent the TB from spreading.

Personalizing Breast Cancer Risk Prediction

Dr. Jacques Simard of Laval University is helping improve our ability to estimate a woman’s risk of developing breast cancer and how that risk is reported to patients. Dr. Simard leads the CIHR Team in Familial Risks of Breast Cancer, which includes more than two dozen Canadian and international researchers. The team, which is working with the Breast Cancer Association Consortium involved in the Collaborative Oncological Gene-environment Study (COGS), is developing a personalized risk stratification system to identify women who will most benefit from earlier screening, detection and targeted treatment of breast cancer. In 2013, COGS released the results of a study that identified 49 new genetic markers, or genetic “spelling mistakes,” related to breast cancer. These markers can be used to better estimate a woman’s genetic risk of breast cancer. In addition, the CIHR team has found that the risk communication format (how test results are presented to patients) most commonly used by researchers is the least preferred and understood by breast cancer patients. Their findings have led to changes in the way risk is reported in BOADICEA, the world’s primary breast cancer risk prediction model.

Determining What Canadians Think is Fair in Health Care

How can we ensure that Canada’s health care system is both sustainable and equitable? To help answer this fundamental question, Dr. Jeremiah Hurley of McMaster University is probing public attitudes in Canada about what constitutes fair allocation of health care resources. For example, Dr. Hurley’s recent research on public funding for orphan drugs (treatments for rare diseases) produced new insights into the public’s decision-making process on this important issue. He found that Canadians want provincial health authorities to consider the severity of the illness – not just the rarity – when deciding whether to lower the threshold for approving these drugs under the provincial formularies. The European Union Committee of Experts on Rare Diseases has disseminated these findings. Building on this body of work about public opinions of fairness, Dr. Hurley and his colleagues are working to develop methods for formally measuring equity in health care.

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