The study of genetics enables the genes from which genetic and hereditary disorders originate to be identified. The genome thus offers a wide variety of research approaches leading to the development of therapies more specific to the genes of afflicted patients:
- Pharmacogenomics is the study of a patient’s genetic profile and its relationship to and influence on his or her response to medication. It studies a patient’s genes to optimize his or her medical treatment, choose the medications of which the molecule will generate the best response and minimize the side effects and the toxicity of these medications within a clinical environment. The Beaulieu-Saucier Pharmacogenomics Centre affiliated with Université de Montréal (UdeM) and the Montreal Heart Institute is recognized internationally for its pharmacogenomics expertise. The Beaulieu-Saucier Pharmacogenomics Centre the first platform in Canada to implement operating standards that meet the highest operating standards (GLP/BPL) in an academic and hospital setting and offers pharmacogenomics services to its academic and industrial partners.
- Nada Jabado, affiliated with the McGill University Health Centre, is a pediatric hemato-oncologist at the Montreal Children’s Hospital. With the help of her colleagues, she recently discovered, thanks to genomics, two mutations in children shielding cancer cells from existing treatments. The identification of these mutations will enable their response to chemotherapy treatments to be predicted. The identification of these two mutations in Histone H3 in children is a first, resulting in a deeper understanding the tumours’ resistance to existing treatments.
- The Institute for Research in Immunology and Cancer of Université de Montréal provides the research community with a cutting-edge environment and research infrastructure, including the largest academic medicinal chemistry platform in the country, consistent with its genomics platform and its Centre for Advances Proteomics Analyses. Dr. Guy Sauvageau, Principal Investigator at the Molecular Genetics of Stem Cells research unit, IRIC, primarily study the genes and molecules involved in acute myeloid leukemia (AML). Among other things, he has developed the Leucegene Project, bringing together Quebec scientists with various areas of expertise, whose mission is to change the treatment of AML by using targeted therapeutic approaches, to offer patients suffering from the condition, a higher recovery rate, a better quality of life and, ultimately, a longer life. He and his team recently published an article in which they identify a biomarker able to predict the therapeutic results of a patient from treatments for AML.
- The McGill University and Génome Québec Innovation Centre was established in 2002. This Centre operates as a resource for research projects in the sectors of human health, forestry, infectious diseases, agriculture and the environment. The Centre is known for its extensive expertise in the research of complex genetic disorders.
- The Research Centre on Rare and Genetic Diseases in Adults of the Montreal Clinical Research Institute (IRCM) includes specialized clinics in the areas of genetic dyslipidemias, primary immune deficiency and rare and rare kidney diseases. The IRCM also groups together a functional genomics research unit and non-coding RNA that uses human genetic data to identify genome regions associated with various diseases. The IRCM also offers technological services to researchers intend on using their technological support and platforms.
- The CERMO-FC is a research centre affiliated with UQAM that strives to better understand rare/neglected diseases in order to identify therapeutic targets and thus improve these patients’ treatments. The centre also offers the technological services of their scientific platforms.
PHC is based on more complete information and a better understanding of the patients, of their genetic profile, their environment, their behaviour, their medical history and certain metabolic features. This allows treatment methods, therapeutic and preventive solutions that are best adapted to each characterized group of individuals to be identified. In that respect, PHC builds on an extension of the traditional techniques to prevent, understand and treat pathologies. New diagnostic techniques for the purpose of personalized health care and specialized therapies are increasingly available today:
- Hôpital Maisonneuve-Rosemont is known internationally for its expertise in cellular therapy and regenerative medicine. Its Centre of Excellence for Cellular Therapy performs complex cellular manipulations, particularly on stem cells, with the goal of developing new therapeutic alternatives. Cellular therapy and regenerative medicine involve replacing damaged or cancer cells with healthy, functional cells.
- CRISPR is an ultra-precise, cutting-edge technique of modifying genes. Once the segment or a gene is identified as being a cause of certain diseases, it will be possible to withdraw it and insert a “healthy” gene segment in the DNA. Dr. Jacques Tremblay furthermore uses this technology in some of its research, among other things, to correct the mutation in the gene responsible for Duchenne muscular dystrophy. Dr. Sylvain Moineau uses the CRISPR technique/case for the characterization of bacteriophages and their mechanisms of resistance to the phages. Furthermore, Dr. Moineau heads the Canada Research Chair in bacteriophages of which the mission is to study these viruses that infect the bacteria required to maintain the balance of certain ecosystems.
- Dr. Claude Perreault and his team at IRIC study the cells that govern the immune system in order to better understand it and improve how it works. Their multidisciplinary research in specialized immunotherapy, focuses on the genetic differences in the immune system to develop preventive therapies for certain forms of cancer. Dr. Perrault is also involved in developing personalized therapeutic vaccines against lung cancer, leukemia and several other “big killers,” including breast, ovarian, lung and colon cancer. To learn more about his team’s research, watch this animated cartoon, created by Céline Laumont, a member of Perreault’s lab.
Through the companion test, the effect of a medication and its effectiveness on our system based on our genetic profile can be understood. It is therefore used in connection with therapies targeted to select patients responding to a treatment.
- Imagia is a company that aims to develop a collaborative ecosystem in the discipline of artificial intelligence. Its mission is to create tools focused on personalized health care that are accessible to everyone. These tools include, among other things, Deep Radiomics biomarkers, which can predict in a personalized manner the progression of the disease and the response to treatments. Imagia also develops artificial intelligence solutions for diagnostic assistance.
- Certain medical technologies such as KneeKG of Emovi and the Hexoskin Smart Shirt generate a large volume of data specific to the patient’s health. This data may then be used to adapt the treatment to the particularities of a group of patients or to diagnose a disease with greater accuracy.
The disclosure of the patient’s genetic information represents significant issues for the physician. The Canadian courts mention that the duty to inform is inversely proportional to the patient’s therapeutic benefits. As such, when the benefits to the patient are minimal as is the case in research, the researcher must explain all the effects of what he wants to test on the patient. What do you do if a genetic mutation can affect an entire family? Who should disclose the information? Who is responsible for doing so?
- The Centre of Genomics and Policy and Yann Joly, Bartha Knoppers and Ma’n H. Zawati write and post articles on ethical regulations regarding personalized health care.
Personalized health care is based on the use of ever-developing technologies. In order to enable health care professionals to stay on top of the latest advancements, they are offered training opportunities:
- Genome Québec and the Network for Personalized Health Care have joined forces with Health Education England (HEE) of the United Kingdom to develop a specialized accredited professional training program in genomics.
- There are also university programs dedicated to the academic training associated with personalized health care such as the Master’s microprogram in pharmacogenomics or the Master’s microprogram in molecular pathology and personalized medicine at Université de Montréal.
- BIOGENIQ offers various analyses of genetic profiles to individuals when prescribed by a physician, and such analyses allow certain genetic predispositions to be identified. Personalized counselling based on patients’ lifestyles and genetic results are also offered. BiogeniQ is now part of Biron Laboratory.
- In partnership with BiogeniQ, SSQ Insurance offers its group insurance clients a solution in the treatment of depression. Treating depression often requires a patient to try several treatment strategies before the appropriate medication or approach is clearly identified.
- Established in 2000, Caprion is a Québec company run by Martin LeBlanc. It offers private services designed to identify biomarkers and proteomic targets. Identification of biomarkers is required in the development of new personalized health care therapies, particularly for the purpose of monitoring during clinical trials.
Québec has a large number of scientists who endeavour to understand how the human genome works and how it is influenced by the environment. Conducting research on the genome and on the proteins is the best way to predict the development of genetic and hereditary disorders. A research platform includes extensive state-of-the-art instrumentation available for researchers. As well as leading expertise to carry our the analyses and advise you. Here are a few:
- CHU Sainte-Justine’s Integrated Centre for Pediatric Clinical Genomics
- Canadian Centre for Computational Genomics
- IRCM’s molecular biology and functional genomics facility
- Concordia’s Centre for Applied Synthetic Biology
- The Exactis Personalize My Treatment (PMT) program
- CHUM’s shared research centre program
- MUHC proteomics and drug discovery platforms and McGill University and Génome Québec Innovation Centre Platform and McGill University
Génome Québec is a private not-for-profit organization that funds genomics research in four priority sectors: human health, forestry, agrifood and the environment, and sustainable development. Génome Québec also operates five technology platforms that support fundamental, applied and clinisal research.
- The Quebec Network for Personalized Health Care (QNPHC) is a not-for-profit organization created in 2011. The QNPHC brings together stakeholders who share an interest or work in personalized health care, including academic researchers, clinicians, private companies, public organizations, patient groups and opinion leaders. This not-for-profit organization promote and support initiatives and innovative ideas that help to grow the sector of personalized health care in Québec.
IN MONTRÉAL, PERSONNALIZED HEALTHCARE MEAN:
Window on several impactful companies, researchers and organizations that support the ecosystem of PHC:
- Pavel Hamet Centre hospitalier de l'Université de Montréal
- Nada Jabado McGill University Health Centre
- Anne-Marie Mes-Masson Centre hospitalier de l'Université de Montréal
- Morag Park Rosalind and Morris Goodman Cancer Research Centre
- Claude Perreault Institut de recherche en immunologie et en cancérologie de l'Université de Monréal
- Guy Rouleau Montréal Neurological Institute and Hospital, McGill University
- Guy Sauvageau Institut de recherche en immunologie et en cancérologie de l'Université de Monréal
- Jean-Claude Tardif Montréal Hearth Institute, Université de Montréal
- Michel L. Tremblay Rosalind and Morris Goodman Cancer Research Centre