Does timing matter? A trial of intermittent fasting in haematological malignancies

Does when we eat make a difference to our health? We know that food choices can impact cancer risk but what if the timing plays a role as well? Evidence shows that fasting may slow cancer growth through a process called autophagy. Through an interdisciplinary research team, I am currently running a small trial testing the effects of intermittent fasting (IF) in patients with chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL) at BCC-Victoria who not on anti-cancer treatment. Specifically, I am asking whether IF regimens, differing in fasting timing and duration, stimulates autophagy, improves quality of life, impacts gut microbiome, and/or results in clinical benefit (i.e. reduced lymphocyte count). I am also following participants’ safety, ability to follow the fast, and fasting preferences. While early results look promising, I propose growing this study into a larger trial with three phases to clarify the effects of IF on cancer and the microbiome. Understanding these effects may help discover simple diet recommendations for patients with cancer that cause a response in cancer cells or slow cancer progression, are safe and reduce treatment side effects when used alongside current, standard treatments.

HIV In My Day: Destigmatizing HIV through theatre, living history, and storytelling

Despite advancements in HIV treatment and care, HIV stigma remains a challenge today. “HIV In My Day” is a community-based research project that has collected and digitally archived 100+ interviews with long-term HIV survivors and caregivers across British Columbia. It is crucial to share these stories more widely with communities who are still disproportionately impacted by HIV/AIDS as well as healthcare providers who serve these communities in order to continue destigmatizing HIV.

In collaboration with “In My Day”, a verbatim theatre production adapted from these stories, our proposed knowledge translation activities will be part of a larger arts-based event in December 2022 at The Cultch in Vancouver, including post-show interactive audience engagement; multimedia presentations of the findings from “HIV In My Day”; intergenerational forums with “HIV In My Day” participants; storytelling workshops for people living with HIV; performances of the “Viral Monologues”.

Together these activities will benefit attendees, including community members and healthcare providers, by teaching HIV history, building storytelling skills, and fostering intergenerational dialogue around HIV within and between affected communities.

Team members: Ben Klassen (Community-Based Research Centre); Michael Montess (University of Victoria); Kelli Stajduhar (University of Victoria); John Paul Catungal (University of British Columbia); Leah Tidey (University of Victoria); Rick Waines


Endothelial calcium dynamics regulating cerebrovascular function and capillary stalling in the healthy and diabetic brain

The brain is a metabolically demanding organ . Mismatch between blood flow and demand (from neurons) leads to a disruption and in extreme cases injury. Because the smallest blood vessels in the brain are narrow, they are prone to becoming obstructed by circulating cells and debris. This is exacerbated in Diabetics, with “sticky” blood vessels. The cells of blood vessels, endothelial cells, are more than just “pipes”, they form large physically connected networks between themselves. An important regulator of these networks, and a signal to communicate between them, is waves of calcium flowing into cells, which can propagate between these cells. How Diabetes affects these networks of blood vessels, and in turn impact the health of the brain is unknown. Thanks to new genetic tools with state of the art microscopes, we can directly observe these calcium fluxes into endothelial cells in the living, awake, mouse brain, and especially when these blood vessels become occluded. Combined with simultaneous monitoring of blood flow and neural activity I will be able to directly measure concurrent changes in brain activity, blood flow and calcium fluxes to investigate these dynamics in the living healthy or Diabetic mammalian brain.

Honouring all our relations: Advancing health and wellness of uncounted Indigenous peoples in BC through addressing gaps in population health and wellness reporting

Reporting on population health is important to monitor trends, identify priorities, and track progress to address inequities. All Indigenous peoples have the right to be counted. Yet, over 88,000 Indigenous people in British Columbia (BC) who do not have ‘Status’ under the Indian Act or are not registered with Metis Nation BC are currently ‘uncounted’ in population health reporting.

Responsibility for reporting on health of BC residents lies with the Office of the Provincial Health Officer, including collaborative reporting on health of diverse Indigenous peoples in BC. Currently, there is no process to report on health of uncounted Indigenous peoples. Gaps include: lack of formal relationships with those representing uncounted Indigenous peoples; no way of identifying this population in BC health data; absence of research frameworks reflecting uncounted Indigenous peoples’ perspectives; and no implementation plan for province-wide surveillance involving uncounted Indigenous peoples.

This study aims to support health of uncounted Indigenous peoples in BC by addressing current gaps in population health reporting, through partnerships that uphold Indigenous self-determination, decision-making and perspectives of health and wellness.

The impact of the loss-of-function ankyrin-B p.S646F variant on cardiomyocyte and neuronal excitability: Implications for diagnosis and treatment of heart disease

The electrical rhythms underlying heart and brain function are sustained by proteins that form pores in cellular membranes that flux ions like calcium and sodium. These pores are anchored in place by a molecule called ankyrin-B (ANKB). We discovered a genetic change in the Gitxsan Nation of Norther BC that results in a version of ANKB (ANKB p.S646F) associated with heart defects at birth, arrhythmias, sudden death, seizures, and cerebral aneurysms. We showed that this version of the ANKB molecule is mishandled by immature heart cells; however, we do not fully understand how this ANKB version contributes to clinical manifestations. As a clinician-scientist and expert in microscopy-based measurement of cellular excitability, I am well-positioned to bridge this important knowledge gap. By imaging calcium and voltage changes in living cells, I will study the impact of partial loss of ANKB and expression of disease-associated ANKB p.S646F versions on heart and brain cell excitability. I will also compare heart cell excitability data with patient electrocardiograms to help understand the connections between fundamental laboratory and clinical observations.

Developing patient-specific technologies to improve functional outcomes following joint replacement

The inability of patients to perform daily tasks after joint replacement remains a significant challenge as well as a burden on health systems because these poor results often require additional treatment (e.g. rehabilitation) and re-replacement. This challenge can be addressed by surgeons using individual patient characteristics to personalize how they perform joint replacement surgery. However, many surgeons perform too few procedures to effectively personalize their plans and thus technologies are needed to provide assistance.

The goal of this research is to develop an improved understanding of how patient specific factors affect the results of joint replacement as well as to develop technologies that can collect data about each patient’s individual characteristics and use these data to assist surgeons in optimally planning each surgery. This will be achieved by a combination of computer-based biomechanical research, statistical modelling, and novel sensor development. This work will improve our understanding of personalized joint replacement, yield new clinical technologies, enable surgeons to more effectively personalize surgery, result in improved patient function, and improve the health systems in BC and beyond.

Exploring the role of insulin in regulating female reproductive health and age-related reproductive decline

Female reproductive decline (indicated by rising rates of infertility, birth defects, and miscarriage) is an early sign of aging, and is largely due to deteriorating quality of oocytes, or egg cells. Identifying the signaling pathways and mechanisms that control oocyte quality and reproductive decline is essential for better addressing female reproductive health issues, and can also provide key insights into other aspects of aging.

Our research focuses on the ties between nutrients, reproduction, and aging. In organisms ranging from worms to humans, signaling pathways that detect nutrients — such as the insulin signaling pathway — seem to play crucial roles in coordinating metabolism, reproduction, and lifespan. We will use a mouse model of genetically reduced insulin to determine how lowering insulin affects oocyte quality and reproductive success during aging. We will also study how insulin levels determine features of polycystic ovary syndrome, a common hormonal disorder, and evaluate long-term consequences of temporary nutrient excess or depletion.

We anticipate that this research will inform effective strategies to better manage female reproductive health, as well as to improve health during aging.

Childhood obesity management using innovative digital technology

Childhood obesity is a major public health challenge in Canada. Without intervention, overweight children will likely continue to be overweight during adolescence and adulthood. Family-based lifestyle programs delivered at local communities can be effective. However, many families cannot attend these in-person programs due to travel distances and program availabilities. The current situation has turned increasingly dire in the COVID-19 landscape, where face-to-face, group, and facility-based interventions are no longer viable. With continued improvements in the sophistication and access to digital communication technology (e.g. Internet, wearables, smartphones), delivering tailored lifestyle programs using these tools may be well-suited to meet these challenges.

The goal of this project is to evaluate the long-term efficacy and the cost of delivering a stand-alone web-based and a blended in-person and web-based program in improving health-related outcomes in children who are overweight or obese in British Columbia (B.C), Canada. This project can be incredibly impactful for B.C. residents as this web-based program can improve the access, reach and personalization of family-based childhood obesity management programs.

Addressing food insecurity and the double burden of malnutrition in a changing climate

Malnutrition is a serious public health concern in Inuit and northern regions of Canada, driven by a complex array of social and ecological determinants, including poverty, food insecurity, and climate change. In northern communities, country foods (wild foods harvested from the lands and waters) often comprise an integral component of food systems and contribute to food security, nutrition, and social and cultural integrity. Yet, many country foods are also high in environmental contaminants (e.g., mercury and persistent organic pollutants), which have negative implications for health. Meanwhile, due to transportation challenges, available retail foods in northern and Inuit communities tend to be pre-packaged, processed, and expensive.

In this research program, I will use existing health survey data to evaluate dietary patterns in Nunavik (northern Quebec) and associated nutritional benefits and health risks. Through interviews and community workshops, I will also identify political, social, geographical, and environmental factors that impact food access, affordability, and desirability. Findings will be shared with decision-makers to generate evidence for sustainable and healthy food systems in northern regions across Canada.

The impact of parasites and microbes on immunity at mammalian mucosal surfaces

Under normal healthy circumstances our intestines are home to hundreds of species of microbes, collectively termed the microbiota. Our intestines can also be colonized by parasites, such as parasitic worms (helminths). Both the microbiota and helminths can affect the functioning of our immune system, which in turn, can influence our susceptibility to a variety of infectious, allergic, and inflammatory diseases. Research in my laboratory is focused on understanding the mechanisms by which helminths and the microbiota affect immune system functioning during normal development and during states of disease.

The incidence of allergies and inflammatory bowel diseases has increased dramatically in Canada over recent decades, and there is an urgent need both to understand the factors driving disease development and to identify new treatment strategies. My laboratory uses the mouse model system where the molecular mechanisms of interaction between components of the immune system, the microbiota, and helminths can be identified. Understanding the mechanisms by which the microbiota and helminths can influence immune system functioning may reveal new ways to treat or prevent allergic and inflammatory diseases.