Science & Research

History of excellence

Manitoba researchers have helped change the face of health care

Winnipeg Health Region
Wave, November / December 2012

Manitoba has a special place in the annals of modern medical research history.

Over the years, this province's researchers have made major contributions in a variety of fields, ranging from the discovery of new treatments to cure disease to the development of new approaches to enhance the delivery of health care.

It all started more than 40 years ago with pioneers like Drs. Bruce Chown and John Bowman. In the 1960s, this remarkable duo teamed up to develop a vaccine for Rh disease, a potentially deadly disorder for fetuses and newborns. Their work has benefitted thousands of women worldwide, and is often cited as the single most important medical research discovery in Manitoba's history.

These scientists and many others like them have laid the foundation for Manitoba's rich heritage in health research. While some have been recipients of Manitoba Health Research Council (MHRC) funding, all have demonstrated the importance of home-grown research. Their contributions underscore the benefits of supporting the scientists who follow in their footsteps. Here is list of some Manitoba researchers who have played a major role in advancing the delivery of health care, not just here in Manitoba, but around the world.

Dr. Arnold Greenberg

Dr. Arnold Greenberg helped shed new light on the role of cells in preventing disease. In doing so, he helped shape modern medicine's understanding of cancer, immunology, cardiology and genetics.

Born in Winnipeg in 1941 and educated at the University of Manitoba and Johns Hopkins Medical School in Baltimore, Greenberg helped found the Manitoba Institute of Cell Biology, serving as its director from 1988 to 2000.

A distinguished professor at the University of Manitoba, Greenberg was one of the first to understand the molecular mechanisms at play when a cell became damaged, eventually leading to its death. He is renowned in the medical community for discovering that human bodies have natural defences - specific immune system cells - that identify and attack disease.

Prior to his work on cellular immunology, medicine's understanding of how the immune system selected damaged cells and then induced their death was largely a mystery. His team found the smoking gun molecule that played a central role in the cellular biochemistry - a discovery that may lead to new vaccines, antibiotics and treatments for cancer, heart diseases and degenerative neurological disorders, just to name a few.

Greenberg died in 2001. An obituary that ran in Nature - one of the world's leading scientific journals - called him "a beloved and highly admired member of the scientific community."

Dr. Lyonel Israels

Without the work of Dr. Lyonel Israels, it's hard to fathom where clinicians' understanding of hematology would be today. The former professor of medicine at the University of Manitoba's Faculty of Medicine died in 2003, yet he has left a profound legacy of research in Winnipeg and beyond.

A founding member of the Manitoba Institute of Cell Biology, Israels conducted research to build our understanding of how blood works on a cellular level. He explored the role of red blood cells in maintaining our health and their connection to bone marrow.

His studies included groundbreaking observations on the role of hemoglobin - which carries oxygen to cells in the body - and blood clotting. Most importantly, he helped provide an understanding of how these two functions of the blood become impaired by illness.

Israels, who was born in Regina in 1926 and obtained a medical degree from the University of Manitoba in 1949, also studied the role of Vitamin K in fetal development and tumour formation. And as the first director of the Manitoba Institute of Cell Biology, he set its course for decades to come, advancing its role in exploring the origins of cancer, cell biology and our understanding of how the body heals itself. Perhaps most notably, he was a dedicated mentor and teacher who helped build Manitoba as a medical research centre for the world, including helping to establish the Manitoba Health Research Council.

Dr. John Hamerton

Any discussion about Canada's most distinguished medical geneticists must include Dr. John Hamerton.

Born in England in 1929, he arrived in Canada to carry out genetic research in 1969 at Winnipeg's Children's Hospital. His contributions to research include uncovering the role genetics play in pediatric illness. He also made significant contributions to the advancement of the Human Genome Project, which mapped the blueprint of our genes.

Hamerton passed away in 2006, but his legacy is alive and well. He helped establish the University of Manitoba's Department of Biochemistry and Medical Genetics at the Faculty of Medicine. And he was responsible for putting Winnipeg on the map as a centre for serious study of human genomics - a potential treasure trove of cures for many of the leading causes of disease around the world.

A founding member and former president of the Canadian College of Medical Geneticists, Hamerton brought modern genetic research into the centre of the medical establishment. Without his groundbreaking work in the study of cytogenetics - the study of chromosomes within the nucleus of the human cell - some of the advances today in preventing in utero genetic-related diseases would not have been possible.

Dr. Bruce Chown

Born in Winnipeg in 1893, Dr. Bruce Chown was one of the first Manitobans to make a major contribution to the world of medical research.

The son of a surgeon, Chown is best known for his work on Rh disease, a potentially deadly condition affecting in utero and newborn babies.

Rh - or Rhesus factor negative syndrome - is a type of blood antigen, similar to A, B, O and AB antigens. People are born either Rh positive or negative. When a mother and her unborn child have different Rh factors - namely the mother is Rh negative and the fetus is Rh positive - her immune system might attack her baby. Potentially, this could lead to all sorts of complications in the development of the heart, lungs and brain. In some cases, it would lead to death in utero or life-threatening complications after birth. Chown contributed to the elimination of this threat by showing that the immune system was sensitized by the fetus bleeding into the mother, and by working with Dr. John Bowman and others to develop and test a serum called Rh Immune globulin, which was licensed in Canada in 1968 and used to prevent Rh disease. But the impact of his work extends beyond bedside neo-natal care. It broke ground for Manitoba's medical community because he was the first from the province to complete landmark research that led to the commercialization of a major new drug - work that ultimately laid the foundation for all research in the province to follow.

Chown obtained his medical degree from the University of Manitoba in 1922. He also trained as a pediatrician at Johns Hopkins, Cornell and Columbia universities before taking a position as a pathologist at the Children's Hospital in Winnipeg.

Dr. John Bowman

Dr. John Bowman played an important role in the development of Rh Immune globulin in Canada, a vaccine that was used to prevent Rh disease.

A physician and professor at the University of Manitoba's Faculty of Medicine, Bowman helped prove that Rh immune globulin could be administered to a pregnant woman to prevent Rh disease. The treatment could also be administered after pregnancy as a precaution against the woman's body developing an immune-response factor that could be passed on through breastfeeding to a newborn.

A founding member of the Winnipeg Rh Institute, Bowman worked with Dr. Bruce Chown to commercialize the vaccine, which is now marketed as WinRho SDF (The "Win" stands for Winnipeg). The drug is now sold in 35 countries by the Manitoba-based research firm Cangene.

Bowman and Chown not only helped form of one of Canada's largest life sciences firms, they set a course for future researchers in the province, demonstrating how a discovery could be commercialized for the benefit of people around the world.

Born in 1925, Bowman attended Gordon Bell High School and graduated with a degree in medicine from the University of Manitoba in 1949. In addition to his work as a researcher and teacher, Bowman also practised in the Pediatric Department at the Manitoba Medical Clinic. He died in 2005.

Dr. Allan Ronald

Two aspects of science make Dr. Allan Ronald's heart sing. One is making a scientific observation no one else has made, and subsequently having it confirmed by colleagues. The other is mentoring up-and-coming scientists to do the same. And his heart has had plenty to sing about over a career of more than five decades.

Born in Portage la Prairie in 1938, Ronald is a pioneer in the study of infectious disease and microbiology. Recently inducted to the Canadian Medical Hall of Fame, the professor emeritus first gained recognition for uncovering the reasons for recurrent urinary infections and developing effective ways of assisting women to manage this frustrating common illness. That was in the late 1960s and 1970s.

A few years later, he was at the forefront of research into sexually transmitted diseases. During the mid-70s when Winnipeg experienced an outbreak of chancroid, a sexually transmitted bacterial disease commonly found in Africa, his team stemmed the spread by finding a simple cure, using antibiotics.

That work led to an invitation to travel to Kenya to provide advice on how to treat the disease there, a place where it was much more widespread and problematic.

It was during his work in Kenya that Ronald found himself at the front lines of the HIV pandemic. Soon he became a leading expert on the disease in Africa and helped make game-changing discoveries as well as mentoring many leading lights in HIV research, like Drs. Frank Plummer and Keith Fowke - both now based in Winnipeg.

Among the many contributions he and his disciples have made to HIV research are the importance of sex trade workers in the spread of the disease and how circumcision prevents its transmission.

Dr. Frank Plummer

Many Canadians are familiar with Dr. Frank Plummer.

During the H1N1 influenza pandemic of 2009, the head of the Public Health Agency of Canada's National Microbiology Laboratory was frequently seen front and centre at news conferences on TV, informing the public about the outbreak of the potentially deadly flu.

In fact, whenever a major outbreak of infectious disease occurs in Canada or anywhere in the world, Canada's own version of the U.S.'s Centers for Disease Control is the "go-to" team in fighting it. And Plummer has been at the helm since its founding in 2000.

Although born in Winnipeg in 1952, the world-renowned infectious disease microbiologist did not cut his teeth here. He established himself as a brilliant scientist in Africa in the 1980s and 1990s. There, Plummer gained world recognition as a pioneering researcher in HIV, and was among the first to discover that some individuals had a natural immunity to the disease.

Having studied under Dr. Allan Ronald, he soon took over a leading role in fighting HIV's spread. His work fighting the disease continues today, funded by leading national and international organizations, including the Bill & Melinda Gates Foundation.

Plummer describes his team's success as a case of being in the right place at the right time mixed with an ability to look at the problem from a different angle. Early on, for example, most experts agreed HIV was a male disease, but Plummer and his team proved otherwise.

"We were the first on the ground in Africa when HIV became recognized as a problem," he says. "And we thought outside the box, not ascribing to conventional wisdom at the time." His work has led to many new discoveries that will one day lead to an HIV vaccine.

Plummer, who graduated from the University of Manitoba's Faculty of Medicine in 1976, says he is indebted to those who came before him here in Winnipeg, scientists such as Ronald and Dr. Henry Friesen - who helped bring the national disease lab to the city. "I inherited the National Microbiology Laboratory, and together we have made it the best or as good as any disease research lab in the world."

Dr. Henry G. Friesen

Dr. Henry Friesen is considered one of the godfathers of medical research in Manitoba.

In addition to making groundbreaking discoveries, Friesen was also one of the original founders of the Manitoba Health Research Council and helped transform the nature of medical research in this country as an architect and champion of the creation of the Canadian Institutes of Health Research - the leading funding provider for health research in Canada.

Born in Morden, Manitoba, in 1934, Friesen is best known for his research on hormones of the pituitary gland, an olive sized structure at the base of the brain. In the 1970s, he uncovered the identity and role of a pituitary hormone called prolactin.

Initially, the scientific community scoffed at the idea that prolactin existed in humans, let alone that it might affect female infertility. But Friesen proved them wrong. After developing simple tests to measure blood levels of prolactin he found a connection between high levels of the hormone and infertility.

His work eventually revealed that many women with high levels of prolactin who were infertile had small tumours of the pituitary gland that produced too much of the hormone.

Friesen went on to collaborate with neurosurgeons and drug companies to pioneer treatment of patients with pituitary tumours and elevated prolactin levels. Either surgical or drug therapy effectively eliminated the tumours, normalized prolactin levels and cured the disorder, enabling hundreds of thousands of women around the world who were infertile to become pregnant.

Drs. Leslie & Noralou Roos

When Drs. Leslie and Noralou Roos were at the Massachusetts Institute of Technology in the 1960s, they could have hardly foreseen they'd become trailblazers in the world of health care.

The married couple both got PhDs in political science - about as far as one can imagine from health care. In their graduate program, they were offered training in using computers.

When they arrived in Manitoba in the 1970s and discovered that every physician visit and every hospital admission generated computerized records for the whole population, they told Manitoba Health: tell us what you want to know and we'll figure out how to use the data to find answers.

Ever since, the Rooses have been at the forefront of analyzing health-care data. They have pioneered new ways to use information collected by not just the health-care system but by education and social services. Noralou was quoted once: "I've never met a data set I didn't want to work with."

In 1991, they were involved in founding the Manitoba Centre for Health Policy, at the request of then provincial health minister Don Orchard.

It was a time when the health-care system was in a state of flux. Budget cuts had forced the closing of almost a quarter of the hospital beds in Winnipeg, and the government wanted to know the effects on care. So the Manitoba Centre went to work. "There were headlines suggesting people would be dying in the streets if they couldn't get into a hospital," Noralou Roos says.

What they found was counter to the conventional wisdom at the time. Instead of more people dying and having complications, or being unable to get into hospital, access to high-quality care had actually not been substantially affected. It was the first major step toward making systematic data analysis an integral piece of policy planning for health-care delivery in Manitoba.

Independent from the government, the Manitoba Centre for Health Policy - now led by Dr. Patricia Martens - provides policy advice for many of the big issues that challenge the health-care system, such as wait times and the effectiveness of dollars spent on programs.

But the scope of what the Rooses created extends beyond Manitoba. Ontario, British Columbia, Alberta and Quebec all have major centres working with government data generated by the health-care system. More recently, both the United Kingdom and Australia have sought the Rooses' advice as part of their commitment of millions of dollars for setting up their own centres that use administrative data for health research.

The Rooses have worked with leading researchers in clinical epidemiology, health economics, health services research, population health, child development and knowledge transfer.

Wave: November / December 2012

About Wave

Wave is published six times a year by the Winnipeg Health Region in cooperation with the Winnipeg Free Press. It is available at newsstands, hospitals and clinics throughout Winnipeg, as well as McNally Robinson Books.

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