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Course Description -MSC7000Y
The Clinical Problem
Organ failure, defined as the inability of an organ to function in sustaining homeostasis, is a pervasive medical problem that results in immense personal and economic costs, morbidity, and death. Resulting in over 50,000 deaths per year in Canada, organ failure costs society in excess of $20 billion annually.
At present, the only truly effective treatment for organ failure is transplantation. The deficiencies of this option are increasingly apparent, and include a chronic shortage of donor organs, side effects from harsh immunosuppressive medications, and chronic rejection leading to the eventual loss of most transplanted organs. Thus, it is apparent that organ failure constitutes a medical and social problem for which the best solutions are imperfect and temporary.
Regenerative Medicine: Hope for the Future
Despite this discouraging state of affairs, there are developments on the horizon that hold great promise. The nascent field of regenerative medicine, defined as the practice of repair, regeneration, or replacement of tissues and organs that have failed, has enormous potential to revolutionize diagnostic and therapeutic approaches via the development of radical new therapies. This broad field encompasses numerous innovative areas including stem cell therapy, therapeutic cloning, tissue engineering, tolerance research, and gene therapy.
The Training Program in Regenerative Medicine
At present, there are few scientists and practitioners of regenerative medicine, and no comprehensive training program exists in this important field in Canada or--to our knowledge--anywhere in the world. The mandate of the CIHR Training Program in Regenerative Medicine ensure that there will be qualified researchers and practitioners to develop and practice in this field which has the potential to greatly reduce medical and social costs, to provide qualified, innovative personnel for the biotechnology and pharmaceutical industries, and to prolong and improve the lives of hundreds of thousands of Canadians.
This pioneering and comprehensive training program in all aspects of regenerative medicine, including:
- Cutting-edge science and technologies at the interface of molecular therapy, stem cell technology, tissue engineering and innovative biomaterials
- Ethics of emerging technologies and their impact on Canadian society and the world,
- Clinical and outcomes research, and economics related to these emerging technologies
- Biotechnology, technology transfer and public institutions
Graduates of the program will be well-poised to assume leadership roles in advancing the scientific development and clinical application of emerging discoveries, and will have a firm understanding of the political and business realities which impact on the treatment of organ failure.
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Trainees will spend a minimum of two years in the training program either with a view to obtaining an MSc or PhD degree under the auspices of a degree-conferring graduate department, or as post-doctoral fellows in the discipline of Regenerative Medicine. Participating universities and departments will confer degree status on program trainees from within existing graduate programs (e.g. the University of Toronto's Departments of Immunology and Laboratory Medicine, and its Institute for Medical Science). Each student accepted to the program will be supervised by a member of the Regenerative Medicine Training Program faculty who also has a faculty appointment in a graduate degree-granting department at one of the participating universities. Each graduate's committee will be broad-based, with representation from the Training Program in Regenerative Medicine.
Mentors
The core faculty for this program will consist of teachers selected from across a broad spectrum of disciplines, departments and institutions. Their expertise will be complementary and synergistic, combining scientists (basic science and clinical research), medical and nursing practitioners, and educators from diverse backgrounds and faculties including medicine, immunology, biochemistry, cell and molecular biology, microbiology, engineering, nursing, bioethics, cross-cultural health, religion, biotechnology, and finance.
Basic Science
- Dr. Gary Levy
- Dr. Keith Stewart
- Dr. Gregory Downey
- Dr. Michael Sefton
- Dr. Michael Ratcliffe
- Dr David Kelvin
- Dr. Jack Gauldie
- Dr. Michael Rudnicki
Ethics
- Dr. Abdallah Daar
- Dr. Heather Ross
Clinical Issues/ Clinical Research and Epidemiology
- Dr. Atul Humar
- Dr. Lianne Singer
- Dr. Lisa Cicutto
Curriculum
The Program will consist of several components which will employ a variety of approaches to teaching and learning, including innovative information technologies.
Regular Lecture Series
The Regular Lecture Series is the core course in regenerative medicine and will be designed to offer a broad-based transdisciplinary overview of the current concepts and issues related to the field of regenerative medicine. The course will be a required component of the Training Program in Regenerative Medicine and credits obtained for the course will be accepted as elective credits in the graduate programs of participating Departments. This course will be unique in its breadth and subject matter and similar courses are currently non-existent in Canadian graduate programs. The primary objective of the course is to provide a state-of-the-art review of various aspects of regenerative medicine including background material, the key scientific components of the field of regenerative medicine, and ethical, economic and other issues important to regenerative medicine. Also, trainees will take additional courses to fulfill their degree requirements. For example, students in clinical epidemiology will be expected to take biostatics and epidemiological methodology courses as required by their curriculum. This course will be applicable to all students interested in the field of regenerative medicine, whether their interests and career goals are in basic sciences, clinical epidemiology, bioethics, or other areas.
These weekly lectures will feature members of the program faculty. They will be grouped thematically and will address a breadth of topics. Lectures will be broadcast via live webcast. Lectures will occur in a classroom setting at the University of Toronto, where most of the Institute's faculty and facilities are located, and will be broadcast live via webcast for trainees at remote centers
The Regular Lecture Series will span thirty weekly lectures of two hours each. A tentative schedule follows:
Part I: Background: Organ Failure
Topics:
- Heart, Lung, Liver, Kidney, Pancreas Failure including physiology, human impact, ethics and cost and the implications for regenerative medicine
- Current Approaches to Management of Organ Failure including transplant and non-transplant approaches
Part II: Regenerative Medicine and Innovative Technologies
This section represents the main focus of the course.
Topics:
- Stem Cells
- Gene Therapy
- Tolerance
- Xenotransplantation
- Tissue Manufacturing
Part III: Clinical Applications of Regenerative Medicine
Topics:
- Translation of New Therapies from Bench to Bedside
- Fundamentals of Clinical Trials Design
- Evaluation of Health-Related Quality of Life
- Cost-Effectiveness & Health Economics
- Adoption of New Therapies
Part IV: Contextual Issues Related to Regenerative Medicine
Topics:
- Ethics
- The Regulatory Process and Legal Implications
- Financing and the Role of the Biotechnology Industry
- Patient Issues and Concerns
- Cultural Perspectives and Implications: Influence of Ethnicity, Gender and Religion
- The Business of Regenerative Medicine
Seminar Series
After each weekly lecture, a seminar will be held by the lecturer which will expand on the topics covered. Students will be expected to attend and be prepared to discuss issues addressed by the previous week's lecture. The lecturer may invite other experts to participate in the seminar to provide in-depth information and commentary. Seminars will be held via videoconference.
Journal Club
A weekly journal club will be held and relevant journal articles will be selected by the students enrolled in the training program. The student supervisors will take turns attending and leading discussions on the articles. This will expose students to a broad range of topics relevant to the field of regenerative medicine.
Invited Speaker Lecture Series
In addition to the core Regular Lecture Series, a series of lectures by invited speakers will afford students the opportunity to learn from world leaders in the field of regenerative medicine. Four such lectures will be held.
Research-in-Progress Meetings
On a quarterly basis, students will present their research to a multidisciplinary group of peers and mentors. Grant and manuscript writing and peer review workshops will also form a component of these meetings. Funds will be allocated to allow students and their mentors to travel to the host Program site.
Interface with Existing International Events
Students will be funded to present at a number of important national and international meetings including meetings of the Canadian Society for Immunology, the National Centres of Excellence Stem Cell Network and TransNet Annual Meetings, and the Royal College of Physicians and Surgeons Annual Meeting.
Partnerships, Collaborations and Industry Support
The CIHR training program in Regenerative Medicine will function as a hub with spokes reaching out and linking with other research institutions in the region. Partner sites and institutions include:
- Ottawa Hospital Research Institution (Stem Cell Network)
- University of Western Ontario (TransNet)
- McMaster University
- Sunnybrook and Women's College Health Sciences Centre
- The Department of Pathology at McMaster University
- The Department of Immunology at the University of Western Ontario
- Stem Cell Network
We also have the full support of the graduate departments of the University of Toronto, including:
- The Institute of Medical Sciences
- The Department of Pathology
- The Department of Immunology
- The Department of Medical Genetics
- The Institute of Biomaterials & Biomedical Engineering
- The Faculty of Nursing.
The hub of this collaboration will be the University Health Network, located at the University of Toronto. However, the opportunity to interact and collaborate with centres in London, Hamilton and Ottawa will broaden the scope of thinking and stimulate the cross-pollination of research ideas.
Facilities Available
Trainees will be accommodated in state-of-the-art research laboratories at the University of Toronto and its associated research institutes (Sunnybrook Hospital, University Health Network, St Michael's Hospital), University of Western Ontario, McMaster University, and University of Ottawa under the supervision of principal investigators associated with this training proposal. At the UHN, a new state-of-the-art research facility is under construction which will have space for at least 140 trainee positions onsite. Trainees will have office space, access to computers, library facilities, Internet access and access to web-based educational programs. They will be registered in the graduate faculty of their primary supervisor and have access to courses within all of the participatory institutions. In addition, all trainees will take part in the Multidisciplinary Course and Seminar series in Regenerative Medicine.
The core UHN facility has numerous support services and trainees at other sites will link to these to ensure economies of scale and non-duplication of effort. These facilities include:
- Clinical Studies Resource Centre--a $1 million center dedicated to providing ethics, administration, educationion, biostatistics and analysis services for research studies.
- UHN Multi Organ Transplant Program Clinical Trials Division—a unit devoted to clinical trials in the area of transplantation, Clinical Trials has its own Medical and Nurse Directors, several nurse specialists, data entry personnel and informatics specialists. It is currently conducting 38 separate trials at a face value of $2.7 M.
- U of T Faculty of Medicine Division of Educational Computing—this newly expanded facility will offer webhosting, web design and consultation, video conferencing, and live webcasting at reduced prices to a consortium of CIHR-sponsored Training Programs at University of Toronto.
- UHN Informatics Program
- UHN Department of Pathology
- Research Information Systems Department
- UHN Animal Resource Centre: a four-site centre offering facilities, care and technical services for rodent, small animal and non-human primate research models
- Ontario Cancer Institute's Genomics and Proteomics Facility
- Advanced non-invasive imaging technology service
Members of the Program in Regenerative Medicine have long-term relationships with industry including Novartis Pharmaceutical, Roche Pharmaceuticals and Fujisawa Canada which will translate into access to state-of-the-art resources.
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