Western researchers meeting ‘Grand Challenges’

With four entries in Round 5 of the Grand Challenges Canada Stars in Global Health competition, Western is showcasing innovative research, expected to significantly impact health care around the world.

Western’s David Spence and Daniel Hackam have already proven successful in the grant competition – funded by the Canadian government – garnering $100,000 in Round 4 for a research project meant to lower the risk of stroke by addressing the issue of resistant hypertension in Africa. The project will also be applicable to African-Canadians suffering from hypertension who are twice as likely to suffer a stroke, Spence explained.

“The risk of stroke in Africa is much higher. And patients there are taking a bunch of different medications, but their blood pressure isn’t controlled. Black people have different causes of high blood pressure that aren’t treated properly,” he said, adding a genetic mutation could be a contributing factor.

“Current (treatment) guidelines assume everyone is the same. Ours is individualized therapy versus shot-in-the-dark therapy,” said Spence, a professor of Neurology and Clinical Pharmacology, and director of the Stroke Prevention and Atherosclerosis Research Centre at Robarts Research Institute.

Resistant hypertension, defined as blood pressure higher than 140/90 even with treatment, is the major cause of stroke, heart disease and kidney failure.

Spence and his research team will work with four clinics in Africa, doing genetic testing with four different tribes, trying to isolate genes responsible for the patients’ predisposition to resistant hypertension. From there, they will tailor treatment to address the condition. The number of patients able to gain control of their blood pressure is expected to more than double, lowering the risk of stroke, heart and renal failure by more than half.

The project is an unprecedented randomized clinical trial, Spence said, involving 40 patients from clinics in Kenya, Nigeria, Rwanda and South Africa.

“We hope to help physicians in Africa control blood pressure and reduce the risk of stroke. And we hope to bring (the treatment approach) back to North America and convince physicians (here),” he added.

The idea for this project came to Spence after working with black patients from North Buxton, Ont., a community descended from slaves who escaped the United States via the underground railroad.

The project will use point-of-care devices that can be powered by solar energy in remote clinics to measure an enzyme called plasma renin, which helps regulate blood pressure, and a steroid hormone called aldersterone that stimulates the absorption of sodium by the kidneys. The gene sequencing will be done at the London Regional Genomics Centre at Robarts.

Among Western’s other entries in Round 5 of the Grand Challenges Canada Stars in Global Health competition:

  • Computer Science professor Charles Ling and his research team have developed a mobile smartphone application meant to help patients with Type 2 diabetes.
    Called Cluco Guide, the application targets patients newly diagnosed with Type 2 diabetes, aiming to teach them skills they need to manage their blood sugar and prevent complications from diabetes down the road.
    The app is user-friendly and patients are asked to input information into the app, including daily diet and exercise information, as well as their blood sugar levels, explained Jody Schuurman, a second-year MSc candidate at Western and part of Ling’s research team.
    What makes the app unlike any other is the fact that the information from the patient is transmitted wirelessly to Ling’s lab where data mining looks for correlations between the patient’s lifestyle and glucose levels, finding a pattern to help patients see what they should and shouldn’t do to reduce their blood sugar.
    “There have a handful of different lifestyle apps like this tested out in Canada but this one goes beyond the recommendations, taking it to the next step and collecting data and giving feedback as well,” Schuurman said.
  • Mandar Jog, a Neurology professor at Western, is also in the running with his Augmented Immersion Virtual Reality (AIVR) system, one he and his collaborators created as a safe and cost-effective tool to help rehabilitate patients with mobility dysfunctions and conditions such as Parkinson’s disease.
    AVIR, a virtual reality world, takes occupational therapy to the next level, providing fully interactive, customizable environments and rehabilitation scenarios that can mimic day-to-day tasks and activities for patients, allowing them to learn and become comfortable performing the task safely, anywhere.
    Learning how to do something like crossing a busy street, unsafe for some patients in the real world, is made safe and accessible by AVIR, Jog said.
    “In (occupational therapy), how are you going to show someone how to do groceries, make the bed, clean the kitchen? I don’t know what challenges (a patient) faces in their environment. I need to logically, at least, come close to simulating your environment. What this (AVIR) is going towards very fast is personalized medicine,” he explained.

Videos will be available online until May 31 and applicants will be notified of their application’s status this summer. Voting for an application is open to the public.