Sepsis is the leading cause of death worldwide with limited treatment options

MEDIA RELEASE
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LONDON, ON – Sepsis is a life-threatening condition that occurs when the body’s response to an infection triggers excessive inflammation. The inflammatory response can cause damage to organs such as the heart, liver, lungs and brain. While there are currently limited treatments for sepsis, researchers at Lawson Health Research Institute are working to change that by examining the use of carbon monoxide-releasing molecules to treat patients. “This is an unusual approach that is looking at using carbon monoxide which is the infamous gas molecule,” says Dr. Gediminas Cepinskas, Scientist and Director of the Centre for Critical Illness Research at Lawson. “If administered and used in small non-toxic concentrations, carbon monoxide can offer very potent protective and anti-inflammatory effects.”

In studies on the subject, including the most recent one published in the journal of Experimental Biology and Medicine, the research team was able to demonstrate efficacy in using carbon monoxide-releasing molecules to protect individual cells in the liver and lungs of sepsis induced inflammation in preclinical models. “We have been working on isolated organs and organ specific cells to test carbon monoxide-releasing molecules to narrow down which specific cells are more sensitive to treatment and which biochemical pathways are involved,” Says Dr. Cepinskas. “We are making great progress in our work and have had success in addressing the efficacy of carbon monoxide-releasing molecules in preclinical models.”

Dr. Cepinskas is one of just a few scientists worldwide studying carbon monoxide-releasing molecules to treat inflammatory conditions such as sepsis. While carbon monoxide is commonly known as dangerous, using it in a controlled manner does not pose a danger and may have therapeutic potential. “Our immune system is usually our defense system, but with sepsis it becomes so activated it starts to attack our own cell tissues, resulting in injury and dysfunction of the affected organs,” explains Dr. Cepinskas. “Almost each and every cell in our body naturally produces carbon monoxide which is used in defense against harmful and injured stimuli. We are taking advantage of this knowledge and currently we are the only lab in Canada working on this potential carbon monoxide-based therapy.”

Dr. Cepinskas is also collaborating with clinicians at London Health Sciences Centre (LHSC) to study the use of carbon monoxide-releasing molecules to treat limb compartment syndrome and to improve organ transplantation.

The research team, which has patents in the area of carbon monoxide-releasing molecules, is now working with the pharmaceutical industry to move this potential therapy into human clinical trials in the future.

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MEDIA RELEASE

For immediate release
February 10^th, 2022

LONDON- A heart attack can be deadly, but there are effective lifesaving procedures if treated in time. The most common procedure is called reperfusion therapy, which is when the blocked coronary artery causing the heart attack is opened up and a stent is placed inside to let blood flow freely again.

In a recent published study by a multi-center research team at Lawson Health Research Institute, St. Joseph’s Health Care London and a number of other institutions across the globe, scientists examine a condition called reperfusion injury, a problem that can take place following reperfusion therapy.

“When you open up the coronary artery in someone experiencing a heart attack the blood starts to flow. However, we found there are a number of factors that lead to other injuries due to opening up the vessel,” explains Dr. Rohan Dharmakumar, Executive Director of the Krannert Cardiovascular Research Center at Indiana University. “Opening up the coronary artery, although lifesaving and necessary, can at times cause significant reperfusion injury which is a concept that had yet to be scientifically proven until now.”

For example, when the blocked coronary artery is opened up with reperfusion therapy the blood flowing into narrower vessels can cause the smaller vessels to burst and cause internal bleeding within the heart muscle, which is called myocardial hemorrhage. 

“Those who experience a myocardial hemorrhage have a much larger piece of their heart muscle die than those who don’t have hemorrhage,” says Dr. Frank Prato, Program Lead of Lawson’s Imaging Research Program and Assistant Scientific Director at Lawson. “We have been able to show that if there is hemorrhage due to reperfusion injury, the size of the dead tissue within the heart grows, which then can ultimately lead to heart failure.”

After studying 70 patients with heart attacks, the research team was able to show reperfusion injury led to hemorrhage in excess of 50 per cent of patients who were being treated for a heart attack.

“The outcome isn’t immediate death, but heart failure that can start a few years after the heart attack,” says Dr. Dharmakumar. “So even though we are saving people initially from a heart attack, we are still losing a lot of people to heart failure within the first five years.”

This discovery was made possible through the use of Lawson’s cyclotron, a machine used to make isotopes for advanced PET/MRI scans at St. Joseph’s Health Care London.

“To validate the study with a PET/MRI we needed a specific radioactive isotope called nitrogen 13 ammonia,” explains Dr. Mike Kovacs, Scientist and Director of Lawson’s Cyclotron Facility. “We were able to create this isotope and went through Health Canada approval, so now we can use this not only in preclinical models but with human patients as well.”

The study has been published in the Journal of American College of Cardiology. The findings will now allow the research team to examine different forms of therapies that can be used in combination with reperfusion therapy to improve patient outcomes.


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Lawson Health Research Institute is one of Canada’s top hospital-based research institutes, tackling the most pressing challenges in health care. As the research institute of London Health Sciences Centre and St. Joseph’s Health Care London, our innovation happens where care is delivered. Lawson research teams are at the leading-edge of science with the goal of improving health and the delivery of care for patients. Working in partnership with Western University, our researchers are encouraged to pursue their curiosity, collaborate often and share their discoveries widely. Research conducted through Lawson makes a difference in the lives of patients, families and communities around the world. To learn more, visit www.lawsonresearch.ca.

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LONDON, ON – In a published study, a team from Lawson Health Research Institute has found that a simple device can reduce swelling after kidney transplantation. The geko™ device, manufactured by Sky Medical Technology Ltd and distributed in Canada by Trudell Healthcare Solutions Inc., is a muscle pump activator which significantly improves blood flow by stimulating the body’s ‘muscle pumps.’ Patients using the device following kidney transplantation experienced shorter hospital stays and reduced surgical site infections by nearly 60 per cent.  

Kidney and simultaneous pancreas-kidney transplantations can significantly reduce mortality and improve the quality of life for patients with end stage renal disease. “After surgery, many of these organ recipients require a longer hospital stay due to delayed kidney function, infection, lack of mobility or edema,” says Dr. Alp Sener, Lawson Scientist and Transplant Surgeon in the Multi-Organ Transplant Program at London Health Sciences Centre (LHSC).  

Edema is swelling caused by excess fluid trapped in the body’s tissues which can impact wound healing. The current standard of care for managing lower-limb edema and improving blood flow is thrombo-embolic-deterrent (“TED”) stockings used with compression devices. Sleeves pumped with air squeeze the lower legs to boost circulation. They can be uncomfortable to wear, and the large pump can inhibit early mobility and disrupt sleep after surgery. 

In a randomized controlled clinical trial spanning two years, 221 transplant recipients at LHSC either wore the standard TED stocking and pump or the geko™ device for six days after surgery. Dr. Sener’s research team found that wearing the device increased urine output by 27 per cent and lowered weight gain by over a kilogram. With more urine produced and less fluid retention, patients experienced 31 per cent less swelling. The duration of costly hospitalization was shortened by over one day after kidney transplantation compared to the standard of care.  

A 60 per cent reduction in wound infection rates was a striking observation. “Transplant patients are at a higher risk of infection due to the immunosuppressant medications needed after surgery,” explains Dr. Sener, who is also the President of the Urologic Society for Transplantation and Renal Surgery, a global organization affiliated with the American Urological Association. “Reducing infection means a much better outcome for the patient and considering that recent data shows wound infections can cost the health care system thousands of dollars per person, it’s a win-win situation.”  

Some of the study participants wore pedometers to track their steps, and those using the geko™ device had improved mobility after surgery. The team suspects this may be due to reduced swelling which could improve ease and comfort when moving.

“The study results have been both surprising and exciting. Not only have we cut down wound infection rates but we have also seen a considerable improvement in the new organ’s function following transplantation. Patients report feeling more satisfied with the transplant process and are more mobile,” says Dr. Sener. The geko™ device is now being offered to patients at LHSC in recovery after receiving a new kidney. 

Ruben Garcia, 68 years old, recently received a new kidney from his daughter, Ruby, who was a match as a living kidney donor. Following his surgery, Garcia found it difficult to get out of bed due to the pain and swelling, and the function of his new kidney was very low. “My surgeon explained in very simple terms that it was as if my new kidney wasn’t awake yet,” describes Garcia.  

Dr. Sener recommended that Garcia use the geko™ device to help stimulate blood flow in a way that is similar to walking. Garcia was soon able to sit up on a chair and by the next day he was walking. “My kidney woke up and starting working again! I could feel the device working and it was comfortable to wear, almost like a massage for my legs. I’m very grateful for the care that I received.” 

Dr. Sener adds that “using a muscle pump activator could be a game changer for other procedures like orthopedic implants where wound infection can have disastrous consequences or in surgeries where wound infections are more common such as in cancer and intestinal surgery.”  

The geko™ device is non-invasive, self-adhering, battery-powered and recyclable. It generates neuromuscular electro-stimulation and unparalleled systemic blood flow that equates to 60 per cent of that achieved by walking. Pain-free muscle contraction compresses deep veins in the lower legs to create better blood flow in these vessels and return blood to the heart. It is particularly well suited to hospital settings as it portable and requires minimal training. For the indications for the use of the geko™ device, go to www.gekodevices.com. 

“The results of the study provide further evidence that the geko™ device is an effective treatment option that can improve outcomes for patients and help them return home sooner, while reducing costs for the health-care system,” says George Baran, Executive Chairman of the Trudell Medical Group and a Director of Sky Medical.

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Dr. Alp Sener, Lawson Scientist and Transplant Surgeon in the Multi-Organ Transplant Program at London Health Sciences Centre

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The geko™ device being applied on the leg

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The geko™ device

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