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The legalization of cannabis in Canada in October 2018 created an important concern for the health of mothers and babies during pregnancy and beyond. Studies from 2002 – 2014 indicate that one in five pregnant women between the ages of 18 and 25 use cannabis, as the  perception is common that it will reduce anxiety and pregnancy-induced nausea. 

Although there is a large body of evidence detailing the mode of action of the main component of cannabis (Δ9-tetrahydrocannabinol (THC)) in adults, little research has focused on understanding how it may impact development of the fetus. This is a critical knowledge gap considering that fetal growth deficits are accompanied with an increased risk of developing chronic metabolic disease later in life.

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Dr. Edith Arany, Scientist at Lawson, is studying the implications of cannabis use during pregnancy on the offspring’s pancreas development “in utero” and its effects on glucose control in adulthood. 

With the increased epidemic of Type 2 diabetes due to environmental factors, her research in cannabis consumption might bring to light another contributor to this burden. 

Dr. Arany’s study is being funded through Lawson’s Internal Research Fund (IRF).

“I’m extremely grateful for this IRF award as it will help me open up a new direction in my research program.” Dr. Arany states.  “These IRF grants are crucial to basic scientists to get preliminary data to support future grant applications. Without this support, it is difficult to test novel directions of research and to maintain research programs.”

Lawson’s IRF is designed to provide Lawson scientists the opportunity to obtain start-up funds for new projects with the potential to obtain larger funding, be published in a high-impact journal, or provide a clinical benefit to patients. Funding is provided by the clinical departments of London Health Sciences Centre and St. Joseph’s Health Care London, as well as the hospital foundations (London Health Sciences Foundation and St. Joseph’s Health Care Foundation).
 

A multidisciplinary team at Lawson Health Research Institute is exploring whether fecal transplants can improve outcomes in melanoma patients treated with immunotherapy.

Immunotherapy drugs stimulate a person’s immune system to attack and destroy cancer. While they can significantly improve survival outcomes in those with melanoma, they are only effective in 40 to 50 per cent of patients. Preliminary research has suggested that the human microbiome – the diverse collection of microbes in our body – may play a role in whether or not a patient responds.

“The gut microbiome helps establish immunity from an early age. It makes sense that a healthy gut could improve response to immunotherapy,” explains Dr. Jeremy Burton, a Lawson Scientist who specializes in human microbiome research. “This led us to consider the potential of fecal transplants.”

Fecal transplants involve collecting stool from a healthy donor, preparing it in a lab and transplanting it to the patient. The goal is to transplant the donor’s microbiome so that healthy bacteria will colonize in the patient’s gut.

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Above (from left): Drs. Michael Silverman and Jeremy Burton

In a phase I clinical trial, the research team is the first in Canada to study the use of fecal transplants to alter a cancer patient’s microbiome and improve their response to anti-PD1 immunotherapy drugs.

Research participants will be 20 melanoma patients recruited from the London Regional Cancer Program (LRCP) at London Health Sciences Centre (LHSC). They will undergo a fecal transplant at St. Joseph’s Hospital, a part of St. Joseph’s Health Care London, followed by immunotherapy at LRCP. The transplant will consist of taking a number of specially-prepared oral capsules. 

Patients will be assessed over time for any changes to their cancer, microbiome, immune system and overall health. The primary goal of the study is to evaluate safety of the novel treatment combination, but researchers will also evaluate patient outcomes.

“Melanoma is the least common skin cancer but it is the most deadly and rates are going up,” says Dr. John Lenehan, Associate Scientist at Lawson and Oncologist at LHSC. “Anti-PD1 immunotherapy drugs can be extremely effective but we want to help more patients respond. That’s our goal.”

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Above (from left): Drs. Saman Maleki and John Lenehan

While the team is studying the combination of fecal transplants and immunotherapy for melanoma, they see potential for other cancers as well.  

“We’re one of the first in the world to study fecal transplants in cancer patients. This study is as cutting-edge as it gets with potential applications for multiple disease sites,” notes Dr. Saman Maleki, a Lawson Associate Scientist who specializes in cancer immunology. “With experts in microbiology, infectious disease, cancer and immunology, our institute is well-positioned to carry this forward.”

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Dr. Michael Silverman, Lawson Associate Scientist and Chief of Infectious Disease at St. Joseph’s and LHSC, is a pioneer in the field of fecal transplants. St. Joseph’s is a leading centre for the procedure, performing them for Clostridium difficile (C. diff) patients across the province. 

“Fecal transplants have saved the lives of countless patients with recurrent C. diff,” says Dr. Silverman. “We’re now starting to see its potential for the treatment of other diseases.”

Lawson researchers are planning fecal transplant studies for multiple other conditions including non-alcoholic fatty liver disease, multiple sclerosis (MS) and cancer treatment toxicity.“But in order to conduct this research, we need stool donors,” notes Dr. Silverman.

Check out media coverage of this research:

• CTV News: Why fecal transplants could be the next frontier in fighting skin cancer
• Forbes: Could poop be the next treatment for cancer?
• London Free Press: Researchers seeking poop donors for skin cancer treatment study
• Daily Mirror: How human poo 'transplants' could help doctors treat deadliest form of skin cancer
• CBC: London cancer researchers make number 2 their number 1 priority