DR. VERONIQUE MIRON: TINY CELLS, BIG POTENTIAL
Dr. Veronique Miron is leading a research expedition into some of the tiniest cells in our brain and spinal cord in the hunt for new MS treatments.
She’s exploring cells associated with damage to myelin, the protective layer around our nerves. Myelin damage is a hallmark of MS. Dr. Miron wants to find out if there are drugs that could control these cells – or, more radically, enlist their help in myelin repair.
Her research into a group of cells called microglia has yielded exciting results. For a long time, researchers assumed all microglia were bad actors that damaged myelin. But Dr. Miron has shaken that assumption, revealing that healthy microglia are essential for myelin maintenance and repair. In December, she published this breakthrough in the journal Nature.
“The reaction from the scientific community has been great, which is really exciting,” she says. “It was a big compliment to me when somebody said that they really thought this was a fundamental discovery.”
Now she’s keen to advance this work at the Keenan Research Centre for Biomedical Science. She’s applied for a $1-million, five-year grant to investigate exactly how microglia trigger myelin damage.
“Once we understand that, that's going to lead us to potential drugs that could act on those pathways.”
Dr. Veronique Miron is the John David Eaton Chair in Multiple Sclerosis at the BARLO MS Centre and the Keenan Research Centre for Biomedical Science. She is also recipient of Hall and Sloan MS Basic Science Research Fund.
DR. JIWON OH: BIG DATA, LASER FOCUS
Talk about Big Data. The BARLO MS Centre, one of the largest and most diverse MS clinics in North America, follows over 9,000 patients, and has captured most of these patients in its registry. Local and international researchers are tapping that patient registry to study the progression of multiple sclerosis in people of all ages and backgrounds. The goal? To develop more targeted MS drugs.
The centre’s Medical Director, Dr. Jiwon Oh oversees MS Registry research, and leads much of it. She’s probing the database to glean insights into something called PIRA, or Progression Independent of Relapse Activity.
PIRA is a slow progression of multiple sclerosis that causes irreversible disability in the absence of clinical relapses. Neurologists once thought PIRA only occurred in patients with late-stage, progressive MS, but now recognize it exists across the patient spectrum – even in the very early stages of the disease.
Dr. Oh and her colleagues are mining the MS registry to learn more about PIRA in people with MS followed here at the BARLO MS Centre. They want to know if some patients are predisposed to it, what factors make some patients more likely to have PIRA, and how PIRA affects their long-term outcomes. Unfortunately, most current MS drugs don’t appear to work on decreasing PIRA to a significant degree.
“We need to find better ways to treat it,” says Dr. Oh. “We need new drugs to address PIRA.”
This research will provide insights to help develop those drugs.
Dr. Jiwon Oh is Medical Director of the BARLO MS Centre and the Waugh Family Chair in Multiple Sclerosis Research. Scotiabank is a contributor to the MS Registry.
DR. JAMES MARRIOTT: PUTTING NEW TREATMENTS TO THE TEST
One of BARLO’s newest recruits, clinician-scientist Dr. James Marriott is taking on a lead role as head of clinical trials at the centre. He’ll be working alongside co-investigators Drs. Dan Selchen and Reza Vesoughi to test the most advanced therapies for MS patients.
A one-time MS fellow at St. Michael’s, he’s excited to test a wider range of drugs than those available when he first worked at the hospital.
“The number of medications has exploded since I was a fellow,” he says. “Drugs that were in the initial stages of development then are now commonly used in clinical practice. Now we’re looking at more targeted interventions.”
The new range of experimental therapies includes powerful drugs to support people with progressive MS. These patients have had much fewer treatment options than those with the relapsing-remitting form of the disease. Dr. Marriott is also hopeful about drugs coming down the line to treat specific MS symptoms like fatigue, which affects patients at every stage of the disease.
Not only are MS drugs more advanced, but the tools to analyze drug trial results are more sophisticated. Advanced MRI techniques that are now being used in clinical trials can pick up more subtle changes in the brain of patients than ever before. Above all, he’s excited about collaborating with colleagues around the world and down the hall at the BARLO MS Centre.
“The clinical trial is in some ways the end step after all the background work in the basic science lab and the MRI lab,” he says. “You’re one piece of the puzzle.”
Dr. James Marriott joined the BARLO MS Centre in October 2022. With an impressive and prolific background in clinical trials at the University of Manitoba’s Health Sciences Centre, Dr. Marriott is the new head of the BARLO’s clinical trials program.
Interested in learning more about or supporting advances in MS that are happening at the BARLO MS Centre? Contact Liza Smithies at SmithiesL@smh.ca.
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