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Announced at the 2017 Lawson Impact Awards, Drs. Muriel Brackstone and Gregor Reid were recipients of Lawson’s annual Strategic Research Fund (SRF) competition. Their project, “Re-setting the breast microbiome to lower inflammation and risk of cancer,” will examine whether taking an oral probiotic can reduce inflammation and lower the risk of breast cancer.

One in nine Canadian women will develop breast cancer during her lifetime (Canadian Breast Cancer Foundation). Many cancers are considered to be the result of inflammatory processes. While inflammation has been a focus of research in breast cancer, the role of bacteria has not.

Recently, Drs. Reid and Brackstone were collaborators on a study that was the first to describe the breast microbiome, proving the existence of bacteria in human breast tissue. Led by Dr. Reid and his former PhD student, Dr. Camilla Urbaniak, further research demonstrated that the types of bacteria found in women with breast cancer differ significantly from those found in healthy tissue.

One bacterial species from the cancerous tissue, Escherichia coli (E. coli), is capable of producing low amounts of substances known to cause cancer and induce inflammation, while the bacteria found in healthy tissue, like Lactobacillus, are known to interfere with cancer processes.

“The question is whether we can manipulate this to essentially get rid of more harmful bacteria and replace them with beneficial ones like Lactobacillus,” says Dr. Reid, a Lawson scientist and Director of the Canadian Centre for Human Microbiome and Probiotic Research.

In this new study, Dr. Brackstone and Dr. Reid will join forces to test their theory that taking an oral probiotic lactobacilli will lead to these organisms reaching the breast tissue, displacing harmful bacteria and reducing inflammation.

Drs. Brackstone and Reid will compare bacteria from the breast tissues of women at risk for breast cancer who are taking the probiotic against those at risk who are taking a placebo. They will also compare to the breast tissue of healthy women who are not at risk. The research participants will provide nipple and needle aspirates for their bacteria to be analyzed both at the beginning of the study and after three months of either taking the probiotic or a placebo. The samples will also be tested for inflammatory compounds, levels of heavy metals and pesticides that may influence cancer risk.

“I think this study will shed light into what actually occurs in the milk ducts where most breast cancers originate,” says Dr. Brackstone, a Lawson scientist, surgical oncologist and medical director for the London Breast Care Clinic. “If successful, this project could lead to larger studies and contribute to a new way of approaching breast cancer management.”

Now in its third year, Lawson’s Strategic Research Fund (SRF) supports research projects that will advance science in alignment with Lawson’s strategic research goals, as outlined in Lawson’s 2014-2018 Strategic Plan. This year’s competition once again focused on “inflammation”. Chosen projects received $50,000 over a two-year period.

Learn more about this research project:

Announced at the 2017 Lawson Impact Awards, Drs. Stewart Gaede and Gerald Wisenberg were recipients of Lawson’s annual Strategic Research Fund (SRF) competition. With their project, “Assessing acute cardiac inflammation after left-sided breast cancer radiotherapy with hybrid PET/MRI,” the Lawson researchers will explore the cardiovascular effects of radiation therapy for left-sided breast cancer.

Radiation therapy is critical to modern breast cancer treatment. It has led to improved survival rates with many patients living long lives following their treatment.

Unfortunately, when delivering radiation therapy, we cannot avoid irradiation around surrounding tissues, including the heart. This is a concern since such irradiation may lead to cardiovascular disease later in life.

Currently, the effects of radiation to the heart can only be detected one or two years afterwards. With the help of their Lawson SRF award, Drs. Gaede and Dr. Wisenberg will use PET/MR imaging to detect earlier effects of radiation and construct new guidelines and treatment strategies for left-sided breast cancer patients.

“We’re seeing more and more breast cancer survivors, but many women with left-sided breast cancer are now developing heart disease later in life,” says Dr. Gerald Wisenberg, Director of Cardiac Imaging Research at Lawson and cardiologist at London Health Sciences Centre (LHSC). “We hope to improve their outcomes through this research.”

Recently, Drs. Gaede and Wisenberg discovered that an increase in cardiac inflammation can be detected as early as one week after radiation using PET/MR imaging. This inflammation may be the cause of cardiovascular disease seen in women 10 to 15 years after treatment.

In the new pilot study, the researchers will follow 15 left-sided breast cancer patients undergoing radiation therapy. They will be imaged one week before as well as one week and one year after radiation therapy with Lawson’s hybrid PET/MRI scanner at St. Joseph’s Hospital in London, Ontario.

Areas of inflammation, changes in blood flow, scar formation and fibrosis will be measured by looking at the differences between images. The data will help in the design of new treatment strategies that can hopefully decrease or eliminate inadvertent heart damage. By doing so, it could help to improve patients’ quality of life.

“The earlier we can detect the effects of radiation for left-sided breast cancer, the earlier we can intervene,” says Dr. Gaede, a Lawson imaging scientist and medical physicist at LHSC’s London Regional Cancer Program. “We hope to learn more about the ways in which radiation is affecting the heart so that we can construct new radiation techniques to better spare the heart.”

Learn more about this research:

Now in its third year, Lawson’s Strategic Research Fund (SRF) supports research projects that will advance science in alignment with Lawson’s strategic research goals, as outlined in Lawson’s 2014-2018 Strategic Plan. This year’s competition once again focused on “inflammation”. Chosen projects received $50,000 over a two-year period.

Amanda McIntyre was presented with the 2018 Leadership Award for Fellows & Students at this year’s Lawson Impact Awards, recognizing her skills as a leader, researcher, clinician and community advocate. McIntyre is a PhD candidate in nursing at Western University and a part of Lawson researcher Dr. Robert Teasell’s team at St. Joseph’s Health Care London’s Parkwood Institute.

McIntyre began her career at Lawson as a research assistant in 2011 and since then has built an impressive academic and research record, while at the same time obtaining a nursing degree from Western University. In addition to her many research obligations, she continues to take regular nursing shifts in the emergency department to build her clinical experience.

“We nominated Amanda because she’s kind of like a renaissance person. She does a lot of things and whatever she does, she does really well,” says Dr. Robert Teasell, medical director of the Stroke Rehabilitation Unit at Parkwood Institute.

McIntyre is involved in a variety of research projects in the field of neurorehabilitation and has been an author on 50 peer-reviewed publications.

She is the project coordinator and an editor of the Spinal Cord Injury Evidence-Based Review (SCIRE), an extensive and comprehensive review of the Spinal Cord Injury (SCI) Rehabilitation literature considered to be the leading research synthesis of SCI rehabilitation anywhere in the world. She also had an active role in the development of the Canadian Best Practice Recommendations for Stroke Care.

McIntyre is a two-time recipient of the Mary Elizabeth Horney Fellowship in Rehabilitation Research, which is funded through St. Joseph’s Health Care Foundation. As part of her fellowship, she is conducting research on the transition of stroke patients from inpatient to outpatient rehabilitation, and back to the community. Her doctoral research will focus on the delivery and access of care in emergency departments and the influence this has on patient outcomes.

McIntyre has assumed a supervisory and mentorship role in Dr. Teasell’s lab. She has been instrumental to the development of many research assistants, students and volunteers.

She is also currently the graduate students’ representative on the Nursing Research Advisory Committee, and a research practicum mentor for Nurse Practitioner students at Western University, allowing her to act as an advocate for current and future nursing students.

She says, “Winning this award is a huge privilege. It represents not just my successes but our entire team’s success, so I think it’s a win for all of us.”

Lawson scientist Dr. Robert Teasell is considered a global leader in neurorehabilitation research and has been instrumental in transforming clinical care in this area across Canada by ensuring that clinical practices are informed by the best available and up-to-date research evidence. In recognition of his accomplishments, he received the Scientist of the Year Award at the 2018 Lawson Impact Awards event this past spring.

Dr. Teasell leads the Collaboration of Rehabilitation Research Evidence (CORRE) research team at St. Joseph’s Health Care London’s Parkwood Institute. He is also the Medical Director of the Stroke Rehabilitation Unit at Parkwood Institute and has an active outpatient chronic pain practice.

He has led the development of three internationally renowned evidence-based reviews for stroke rehabilitation, brain injury and spinal cord injury, which are regarded as the three most comprehensive research syntheses in neurorehabilitation in the world. Dr. Teasell has advised and helped plan stroke care for all of Ontario’s 14 Local Health Integration Networks (LHINs) and six provincial healthcare systems. This is in addition to the many clinical guidelines and models of care he has helped develop and update.

Dr. Teasell also bridges the gap between research and clinical practice through collaborations between his research and clinical teams. His multidisciplinary Rehabilitation Knowledge to Action Project (REKAP) team received the 2014 Sandra Letton Quality Award for their quality improvement project designed to make Parkwood Institute a leader in stroke rehabilitation by improving care through implementation of best practices.

In addition to his neurorehabilitation research, Dr. Teasell has published extensively on chronic pain with a recent focus on the role of obsessive personality traits in determining chronic pain disability and coping abilities. 

Drawing on his clinical and research expertise, Dr. Teasell has supervised many students and has been committed to developing the next generation of medical researchers.

“Dr. Teasell has been successful in a number of areas. Certainly in terms of publications and mentorship of students who have gone on and had very successful careers of their own. Despite a busy clinical schedule, he always makes a point of engaging with his research team every day. His staff and students really appreciate the opportunity to work with him,” says Dr. Cheryl Forchuk, Beryl and Richard Ivey Research Chair in Aging, Mental Health, Rehabilitation and Recovery, and Assistant Director, Lawson Health Research Institute.

Dr. Teasell has authored 335 peer-reviewed articles, as well as many other collaborative group peer-reviewed articles, book chapters, published abstracts, posters, presentations and monographs. He has also been the editor for 14 special journal editions and is on the editorial boards for Topics in Stroke Rehabilitation, Journal of Rehabilitation, and Pain Research and Management. 

In 2016, he was invited to present the Ramon J. Hnatyshyn Lecture, the leading annual national stroke lecture at the Canadian Stroke Congress in Quebec City. In 2010, he received the Canadian Association of Physical Medicine and Rehabilitation Merit award for his many contributions to the field of physiatry. He was also awarded the Royal College of Physicians and Surgeons of Canada McLaughlin-Gallie Visiting Professor in 2012.  This year he will be awarded the Post-Acute Stroke Award of Excellence from the American Congress of Rehabilitation Medicine and the National Stroke Association in the United States.

“I’ve received a lot of national and international awards but there’s nothing better than being recognized by your peers and particularly your peers in the city where you work. It’s been a nice acknowledgement of not just my work, but also the work by the whole research team and all the people who have supported me over the years,” says Dr. Teasell.

Sarah Best, research manager at Lawson Health Research Institute, was a recipient of this year’s Staff Award of Excellence, presented at the 2018 Lawson Impact Awards. The award was created to honour the contributions of dynamic, hardworking staff members who help advance science at Lawson.

Best is a part of the Cognitive Clinical Research Group at St. Joseph’s Heath Care London’s Parkwood Institute. In addition to managing the research group’s staff and trainees, she has a wide range of responsibilities, including developing strategies for recruitment and retention of clinical trial participants, budgeting, assisting with grant applications, and ensuring the team has the appropriate space, hardware and training to complete their research. 

“Sarah has grown a team of skilled, well-trained staff and her leadership has ultimately resulted in an increase in the volume and complexity of trials we can offer for patients with mild cognitive impairment and Alzheimer’s disease,” says Dr. Michael Borrie, Lawson researcher and medical director of the Cognitive Clinical Research Group. 

Best is also the budget officer for the Consortium of Canadian Centres for Clinical Cognitive Research and a member of the platform implementation team for the Canadian Consortium on Neurodegeneration and Aging (CCNA). The CCNA was formed by more than 350 clinicians and researchers throughout Canada to accelerate progress in age-related neurodegenerative disease research. 

The Comprehensive Assessment of Neurodegeneration and Dementia (COMPASS-ND) Study is a CCNA study collecting clinical, neuropsychological, and MRI imaging data as well as blood, saliva, and urine samples from participants to learn about who is at risk of developing dementia, to determine how early dementia can be detected and to find out what tests are most effective at detecting dementia. Best has helped facilitate the study start-up and patient recruitment for the more than 30 sites involved in COMPASS-ND, including Parkwood Institute.

“Working in the field of neurodegeneration is really important right now as we see the numbers of individuals that have cognitive impairment growing exponentially. Currently, we only have symptomatic treatments so we’re really looking to find that breakthrough that will lead to a disease-modifying treatment to better serve patients and actually change the course of their disease,” says Best.

She adds, “I’m really honoured to receive this award, especially knowing the previous recipients and the impact that they've had on the London research community.”