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Biomedical research enriched by patient input

June 14, 2022

While patients are often involved in shaping advanced clinical research, their voices are rarely heard in determining the direction of basic science. Dr. Rob Screaton, a senior scientist at Sunnybrook Research Institute (SRI), is leading the way in changing that.

Dr. Screaton, who studies cell biology as it relates to type 1 and type 2 diabetes, teamed up with colleagues, students, and people living with diabetes to review developments in pancreatic islet biology that occurred during the COVID-19 pandemic. Uniquely, the resulting scientific paper lists patient partners among the authors and includes a lay summary of the entire study.

Entitled “Islet Biology During COVID-19: Progress and Perspectives,” it was published recently in the Canadian Journal of Diabetes.

“There’s a movement across indications that patients should be involved at all levels of research, from the clinic all the way back to biomedical research. This makes perfect sense,” says Dr. Screaton.

The genesis for the project was a grant competition announced by the Canadian Institutes for Health Research (CIHR) to mark the 100th anniversary of the Canadian discovery of insulin.

This inspired a student discussion during a graduate islet biology class at the University of Toronto. The course, which was created by Dr. Screaton and colleague Dr. Erin E. Mulvihill, a scientist at the University of Ottawa Heart Institute, focuses on islets – clusters of cells in the pancreas that secrete hormones to maintain blood glucose levels. In particular, students study the inner workings of beta cells, which make and secrete insulin.

Students were curious about what research had been done in the field during the challenging first year of the COVID-19 pandemic. They scanned the scientific literature and found that more than 2,500 peer-reviewed articles had been published on pancreatic islet biology between March 2020 and July 2021. They decided to write a review.

Engaging patient partners

“One of the new CIHR requirements, at least new in the biomedical end of things, was we needed to demonstrate that we had engaged patients in our research plan,” says Dr. Screaton.

The team found there was little precedent in terms of how to do this.

Dr. Screaton reached out to Diabetes Action Canada, a Canadian SPOR (Strategy for Patient-Oriented Research) designed to involve patients in diabetes research projects. Seven patient partners took part in ensuring the language of the review was understandable and providing feedback on what elements were most valuable to them. A second round is now underway, with 14 patients involved.

He is developing a road map to guide other researchers on engaging patients in basic science. Dr. Screaton believes that the combination of scientists’ natural curiosity and patients’ lived experience is a magic blend that can lead to big, transformative science discoveries.

Tom Weisz, a retired chiropodist/podiatrist in Hamilton, Ontario, who developed type 2 diabetes 12 years ago, was one of the patient partners involved in the review. With his “omnicurious” outlook and volunteering spirit, he is thrilled to participate in basic research. “While I don’t need to know which organelles interact with the mitochondria, I’m grateful that work at the molecular level is being done. When you add in the patient perspective, I’m hopeful these discoveries will translate into treatments to make my life and the lives of others living with diabetes better.”

Comprehensive review

The team’s review paper is a comprehensive look at developments in islet biology during the first year of the pandemic. This includes research on how different cell types influence each other to affect insulin secretion. It also includes new tools such as a genetically modified pre-clinical model to determine whether beta cells are dividing, a modification to the “pancreas-on-a-chip” that will help researchers see islet cells releasing insulin, and the first-ever successful genetic editing of primary human islet cells using breakthrough technology.

The review also includes developments to improve transplantation of donor pancreatic islets, including a new way to “coat” or encapsulate transplanted islet cells to prevent immune attack by the host. Another is a development in using a patient’s own cells as stem cells.

Finally, prompted by observations that COVID-19 symptoms could be worse for people with obesity or diabetes, research included in the review examines how islets are directly affected by the virus.

“Despite the slow downs and closures related to the pandemic, some exciting stories in islet biology are coming through,” says Dr. Screaton. “We also learned what patients are excited about and what they are wary of. Now we can move forward on these developments.”

The review is available in the Canadian Journal of Diabetes.

Learn more about some of the work being done in Dr. Screaton’s lab.