Evidence of meeting #68 for Health in the 41st Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was nanotechnology.
A recording is available from Parliament.
11 a.m.
Conservative
The Chair Conservative Joy Smith
Good morning, ladies and gentlemen. I now call the committee together. Pursuant to Standing Order 108(2), we're studying technological innovation.
We have a special guest with us today. My grandson, Matthew, is here, sitting at the side.
11 a.m.
An hon. member
Imagine that.
11 a.m.
Conservative
The Chair Conservative Joy Smith
He wants to take in the committee. My daughter also is here today. She's just coming through the door. They're joining us for the health committee.
I would like to welcome everybody here today. I know that we have a very busy day. I want to tell our witnesses there's a possibility there could be bells ringing at some point. My apologies in advance for that, but if the bells ring, we have to go back to Parliament and vote.
We have some very prestigious people today. From the Public Health Agency of Canada, we have Dr. Frank Plummer. Of course, everyone is well aware of who Dr. Plummer is. He's made a huge contribution to our committee and to health in Canada.
By video conference, from Vancouver, British Columbia, we have Dr. David Huntsman, professor of pathology and medical director, Centre for Translational and Applied Genomics. By video conference from British Columbia as well, we have Dr. Marco Marra, director of the Genome Science Centre.
Can you hear me very well, Doctors?
11 a.m.
A voice
Yes, we can.
11 a.m.
Conservative
The Chair Conservative Joy Smith
Great.
We also have with us Dr. Warren Chan, professor at the University of Toronto. We're very pleased that you're with us.
A couple of other people will be joining us, I believe. Dr. Normand Voyer, professor, department of chemistry, from the University of Laval will be here shortly as well.
So we have a full house today.
Again, as you are aware, there are votes being set up right now, so I'm sure we'll have bells ringing before the end of committee. In advance, I would just like to apologize for the interruption, but we'll make a decision then on whether we'll be back, depending on how much time we have left.
I'm going to begin with the video conferences.
Dr. Marra and Dr. Huntsman, I know you're from two different organizations, but I'm going to start with Dr. Marra, from the BC Cancer Agency.
Can you begin, please, Dr. Marra?
11 a.m.
Dr. Marco Marra Director, Michael Smith Genome Sciences Centre, BC Cancer Agency
Thank you very much for the opportunity to address you today. I understand you're interested in hearing about the nature of our research: success stories, challenges, and recommendations.
I'll begin by providing a very brief history of the BC Cancer Agency Genome Sciences Centre, which is the entity I direct.
The Genome Sciences Centre was established by Doctors Victor Ling and Michael Smith in the late 1990s with a vision to develop technology to the point where routine decoding of cancer DNA would be possible. At the time I joined the effort, around 2000, there were something like a dozen employees. We went through a period of capacity-building and reputation-building over the next few years and the next punctuation mark in our development came, I would say, with the sequencing of the SARS coronavirus in collaboration with Dr. Frank Plummer, who is there with you today, and Dr. Robert Brunham at the CDC, and other folks too. Why that was significant in the context of our current work is that it established that DNA sequencing could reveal the enemy, if you will.
Capacity-building continued and in 2006 and 2007 we became one of four international early access sites for a new brand of machine, a new type of next-generation DNA sequencer. This DNA reader is capable of reading all the letters in the human genome at vastly increased rates. At that time, the price for a human genome was in the order of $75 million. Fast-forward to today. We are a leading international centre with the capacity to do something like 3,000 accurate human genomes annually and with world-leading computer infrastructure. Right now at our centre at the BCCA we have 60 teraflops of computer capacity operating, as well as 7,000 computer cores, and seven petabytes of disk space, with the cost of an accurate human genome now less than $5,000 and dropping.
In the last five or six years, we have seen the cost of a human genome sequence decrease from $50 million to $5,000 today, and around the world many have recognized the kinds of things that could be done with cheap and accessible DNA sequencing.
Today, principal investigators at the Genome Sciences Centre are involved in 392 projects, which total something like $590 million in research funding. Currently active are 110 projects valued at $248 million to the end of 2016, and 543 additional collaborations: 358 of those local, 83 pan-Canadian, and 101 international in scope.
Funding sources are a big deal. We spend between $20 million and $25 million a year, and we have to raise all but $1 million of that through grant applications, both Canadian and international. Our current funding distribution is 75% Canadian and 25% from the U.S.
Significant funders of our operation include Genome Canada, Genome British Columbia, CIHR, the National Institutes of Health, and the Canada Foundation for Innovation. This leads me to some of the challenges we face in the operation of our centre. Our centre is meant to be a highly collaborative entity, and in fact Dr. Huntsman, who is sitting here with me, and I work very closely together and will continue to do so as we use this kind of technology to unravel the mysteries of cancer.
In order to operate a centre such as ours and maintain the broad collaborative base that I think benefits us, and indeed the people who work with us, continued access to large-scale funding is absolutely essential. We applaud the existence of Genome Canada. We are encouraged that the Canadian Institutes of Health Research are also supporting genome science. We are grateful for access to the National Institutes of Health funds, which, over the years, have resulted in more than $135 million coming into B.C. for our operation. Without the CFI, the Canada Foundation for Innovation, we would have no access to leading-edge technology. We are truly grateful and thank all of these organizations for their continued support of genome science.
We would very much like to emphasize that a long-term commitment to keeping infrastructure current and at the leading edge is absolutely required for the success of large-scale activities like ours, and for success in the new era of personalized medicine.
CFI does an amazing job of making opportunities available, but we would like to recommend that the frequency of those opportunities be increased. In some instances, DNA sequence instruments may not compete with icebreakers for funding. We're less impressive than an icebreaker, I guess, but that's the kind of competition we find ourselves in sometimes.
This brings me to personalized medicine, which I was asked to comment on. As DNA sequencing costs have decreased, groups around the world have recognized the ability, or the imperative, to apply this technology to try to understand the molecular signatures in cancer and to develop more effective therapies.
We were one of the first in the world to publish, in 2010, our early observations on the use of DNA sequencing to treat a rare cancer. I'm pleased to report that we are engaged right now, in collaboration with Dr. Janessa Laskin here at the B.C. Cancer Agency, and Dr. David Huntsman and others, in an ongoing effort to more systematically apply the technology to try to understand—in poor-prognosis, treatment-resistant disease—how we might better use the resources of the health care system.
The project looks very much like sequencing DNA, finding mutations and other errors of the genetic code in the cancer, and then positioning those mutations and errors against existing drugs to try to find new drugs or new drug combinations that might benefit the patient. We think this is an entirely sensible thing to do, but it turns out that there are many roadblocks.
One of the biggest roadblocks for us is not the technological hurdles, but rather access to drugs. When we find a new drug combination that we think a patient should receive based on her molecular profile, that drug, in all likelihood, is not indicated for that condition. This leads to some roadblocks in trying to get new drugs for patients. In a discussion last night with an individual doing similar work in the United States, at an organization called TGen, it was interesting to note that they had experienced exactly the same stumbling blocks.
Perhaps this is something the committee would care to consider: in this era of personalized medicine, how do we make the latest drugs available to patients whose molecular profiles indicate that they might benefit?
That's the end of my comments. Thank you.
11:10 a.m.
Conservative
The Chair Conservative Joy Smith
Thank you very much, Dr. Marra. They are excellent comments. We've had some really good, new information this morning.
I'd now like to ask Dr. Huntsman to speak.
11:10 a.m.
Dr. David Huntsman Professor of Pathology, Medical Director, Centre for Translational and Applied Genomics; Director, OvCaRe, University of British Columbia
Thank you for the honour of speaking with you today. As Marco indicated, I work very closely with Marco and I, like many of you, wear several hats.
I run our ovarian cancer research team and we've managed to make huge progress in British Columbia in the understanding of this disease by having access to the infrastructure, which Marco and his colleagues have built. We've managed to find the mutations that drive and underpin several types of ovarian cancer, which has immediately led to new diagnostic strategies, and we're working on new treatments.
I also run the Centre for Translational and Applied Genomics, which takes our genomics discoveries and sort of beats them into clinically usable diagnostics, which we hope then to be able to translate and transfer to the laboratory communities not just in Canada, but internationally.
The last thing I'm involved in is the British Columbia personalized medicine initiative, which I'll come back to at the end. The personalization or individualization of disease control is something that is of great interest, because it's the only way we can move things forward at this point. Genomics is really the harbinger of high-content medicine. Our goal is basically to improve decisions. The vast majority of medical decisions are very much like putting on a blindfold and throwing a dart at a dart board. The people making the decisions don't have the information they need to make a refined choice for their patients.
As we move forward into more personalized medicine, we may wonder why genomics and also why cancer and microbiology? The reason that genomics is coming first is that DNA, as many criminals have discovered, is very difficult to destroy and nucleic acids are easy to study, and we can use digital technologies such as the amazing sequencing tools that Marco and his team have led in their implementation to decode cancers.
Everything we learn about how to use genomics could be applied to proteomics, metabolomics, and any other way of looking at biology in a deep and broad fashion.
Cancer and microbiology will always come first and this is why I think Dr. Plummer is here with us, because these are the two diseases where you can remove diseased tissue and you can actually look at the genome of the entity that is causing a problem—cancer or some micro-organism—and study it as being separate from the host. We're learning things in cancer that we hope will be applicable across medicine.
The discoveries we're making and the things that are coming into the clinic should improve both cancer control in terms of cancer susceptibility and also, as Marco suggested, treatment, a trial of on-the-fly whole genome sequencing to help patients, one patient at a time. But this is a very special project and it's strange. Even though this is something that we're all invested in and we're trying to figure out how to use the information, it's hard to argue that our genome sequence, as in our full genomes, won't be some kind of base part of our health care records in 20 years' time or so. How are we going to get there? If health care in Canada is going to keep up with the rest of the world, we'll have to find a way.
We don't have to do this just in tertiary care settings. If we're really going to make a difference, we have to make a difference where most decisions are made, that is, even though we may start in cancer clinics and other academic enterprises, we have to move this process into primary care. And this is where the BCPMI comes in, where we realized in British Columbia that although we look for successes in the diseases we study as individuals, the challenges we face are shared across the whole of medicine, such as some of the ethical, legal, and social challenges of changing the way health care is done.
Genomics isn't the only underpinning; bioinformatics is the other. And if we're going to use information to improve clinical decisions, we have to improve the informatics not just in research centres, but also in decision tools in primary care as well. This is going to take a culture shift, but also a major change in the way we educate all types of health care practitioners.
At this point I would also like to echo my gratitude to the Canada Foundation for Innovation, in particular, because if not for their initial investments into the Genome Sciences Centre, none of the fantastic work that has happened in British Columbia over the past few years would have been able to occur.
Also, I suggest that we have to not just fund the infrastructure but also fund the projects—which have to be peer reviewed— that are going to use these infrastructures, such as the continued support of CIHR. If we are going to improve our health and also have a healthy economy, these are key things that we are going to have to accomplish.
Lastly, I would like to echo Marco's last comment. If we are going to personalize cancer care and personalize the care of other decisions, we have to rethink the way that evidence is perceived in making the decisions to approve drugs. The large phase III clinical trials, which were the mainstay of approvals over the past few decades, will not work for personalized medicine because we're shrinking things down into n = 1 treatment opportunities. There's nowhere you can do a phase III trial to assess that.
In every part of the pipeline from basic genomics through to validation, through to implementation in laboratories and clinics, into regulatory bodies, we are all going to face challenges. I think the potential benefits for our patients and the health of the nation—if we embrace these challenges and start supporting teams that are taking avant-garde approaches to restructuring around high-content, personalized medicine—will be massive. There's an opportunity for Canada to be an international leader moving forward. I know Marco and I are both really excited about the possibilities of participating and playing a leading role in that process.
At this point, I will be happy to end. We can both address any questions you may have.
11:20 a.m.
Conservative
The Chair Conservative Joy Smith
Thank you very much, Dr. Huntsman. We very much appreciate the collaborative approach you are both taking and your very insightful comments.
We will now hear from Dr. Frank Plummer. Of course you know he's the chief science officer and the director of the National Microbiology Laboratory.
Welcome again, Dr. Plummer.
11:20 a.m.
Dr. Frank Plummer Chief Science Officer, Scientific Director General, National Microbiology Laboratory, Public Health Agency of Canada
Good morning, ladies and gentlemen. It's a pleasure to be here. I thank you for the opportunity to talk to you today about how we use technologies.
We live in a remarkable time when it comes to technological advancements. Within the lifespans of most of us, we've gone from marvelling at a man on the moon, to people living on a space station; from computers that filled huge rooms, to having the world in the palm of our hand; and from the discovery of DNA, to being able to sequence a whole genome of an organism in a very short period of time.
To further illustrate this point and the rapidity of progress, in 2003, the genetic fingerprint or sequence of the SARS coronavirus was done in collaboration with the B.C. Genome Sciences Centre and the BCCDC , in less than two weeks, which was a remarkable feat at the time. By 2009, when we were in the middle of the H1N1 epidemic, it took us just a couple of days to sequence the pandemic H1N1 virus, and it would be even faster today.
These tools are extremely important in our ability to respond to infectious diseases. By various estimates, there have been between 35 and 50 newly discovered viruses and bacteria over the last 40 years. Some of the things we worry about a lot today, such as E. coli 0157, HIV, and so on, we didn't know about when I started medical school. These are all either newly discovered or new to humans. We have every reason to believe that more and more of them will be discovered. The rate of these new diseases happening is about one a year or so.
Why are these threats increasing? There are a number of reasons, including ecologic changes that make it possible for carriers of infections such as mosquitoes to inhabit new areas. We have dengue hemorrhagic fever, for instance, in Florida, for the first time in many years. There are also human demographic and behavioural changes: people becoming more concentrated in cities and moving away from an agricultural subsistence life; people moving into previously unsettled areas; and globalization, where the incubation time for most, not all, infectious diseases is less than the time it takes to get from point A in the world to point B.
We also have rapid growth in technologies, including health technology, which in spite of the improvements that they bring to our health also present new threats sometimes. And there is microbial adaptation and change; these bugs change much faster than we can change.
Infectious agents are an excellent example of Darwin's theory of evolution; it happens in a very short period of time with them. They are innately designed to adapt for survival by constantly evolving to beat human interventions. They have sex lives. They exchange genetic material, giving them new properties we haven't seen before.
We are kind of like the Red Queen in Through the Looking Glass. We need to run faster and faster to stay in the same place, to stay ahead of these threats. One of our biggest challenges in the public health realm of infectious diseases is to try to anticipate what's going to happen next. You can't really anticipate the specifics of it, but you have to be ready for pretty much anything.
I'll talk about five tactics that we use within the Public Health Agency and beyond to try to deal with these threats.
Tactic 1 is the rapid detection and alerting of infectious diseases. The Public Health Agency of Canada has a number of tools at its disposal for that, including some we developed ourselves to fill existing gaps. An important one is the Canadian network for public health intelligence, or CNPHI, as we call it. It's a secure, web-based system that compiles information from various surveillance platforms and issues alerts to users. We can use information, such as over-the-counter sales of antidiarrheal medication to detect aberrations. It doesn't tell you what is happening exactly, but it tells you that something is wrong. This was developed by the agency staff, and we currently have more than 4,000 public health officials across the country using it on a daily basis.
These tools also help us to determine the existence and extent of an outbreak through recognition of related cases across jurisdictions. This was used extensively during our response to the XL Foods E. coli issue a month ago or so.
Tactic 2 is rapid containment at source. Sometimes it's not possible to send the specimen to the lab, so we've developed a strategy for sending the lab to the specimen. Sometimes it's more expedient to send our people, with the necessary technology, to the site of an event rather than sending samples into the lab.
We've developed two very unique mobile laboratory systems. The first is a lab on a truck. This is a high-tech level 3 infectious disease laboratory that can travel to sites such as the Vancouver Olympics, and the G-8 and G-20 in Ontario, to monitor for acts of bioterrorism. Some of the work we do includes air sampling and testing of suspicious packages at such sites.
The other lab is kind of a lab in a suitcase, about 13 pieces of luggage that can be checked on a passenger flight. We respond to diseases such as Ebola in Africa. We recently had a team in the Democratic Republic of the Congo responding to an Ebola outbreak.
This is technology that has been adapted by our staff so they can safely work on specimens that may contain these agents. It allows the provision of rapid diagnostic tests at the site of outbreaks in the remotest areas of the world. This unit has been deployed to Angola, the Democratic Republic of the Congo, Congo, Kenya, Iran, and various other places.
It's really revolutionized the way the World Health Organization responds to an outbreak. You can imagine that getting a turnaround for a diagnostic test in two hours instead of two weeks, which was previously the case, makes a big difference to what you do on the ground in these situations.
Tactic 3 is using viruses to fight viruses. Our lab in Winnipeg is using the latest genetic engineering technologies to create new ways of developing vaccines. We're working on HIV vaccines and universal flu vaccines, but our most significant breakthroughs have been with two Ebola vaccines. In both cases we've used another virus, a virus that's harmless to humans, to deliver Ebola proteins and Marburg proteins to the body, basically fooling the immune system into thinking it's seeing the real virus and resulting in pretty robust immunity.
We're working with the private sector to commercialize these vaccines, which will have potential application for preventing biological warfare and responding to epidemics and accidental laboratory exposures.
Tactic 4 is using high throughput machines to understand genetics. Understanding the genetics of a virus as well as those of hosts, such as humans, helps us to identify further recurrences of the same outbreak, to create vaccines and treatments, to understand where the virus or bacteria originated, and in the case of a host, to understand how people become infected and why some people are susceptible when others are not.
This strategy was used extensively during the listeria outbreak in 2008, and also more recently with the XL Foods E. coli outbreak.
I've mentioned the technology we have in place for rapid genetic sequencing of viruses and bacteria. To complement that, we need capacity in what's called bioinformatics, which Dr. Marra and Dr. Huntsman have already referred to.
It is easy to generate large amounts of data these days, but understanding it is a huge challenge. We have a cutting-edge bioinformatics group that can analyze massive data sets using more than 1,200 central processing units and 250 terabytes of storage—not quite up to what Dr. Marra described, but pretty good.
In fact, this technology is so advanced that the Centers for Disease Control and Prevention in the U.S. came to us when they needed assistance in analyzing the genomes of cholera bacteria from the outbreak in Haiti.
Tactic 5 is using systems biology to understand infectious diseases. I mentioned the genetics of a host a moment ago. When we talk about hosts, usually we're talking about humans. Understanding our own biology and the interactions between biologic systems has provided a wealth of information related to understanding infection by pathogens such as HIV and influenza.
The agency has done considerable work in this field. We're hoping it will lead us to the key that stops the HIV pandemic altogether. There's a lot of hope being placed on drugs for HIV these days. Drugs are very important, but I don't believe we'll solve the problem with drugs. We need the vaccine.
These are some of the key tactics we use to stay ahead of outbreaks. I would like to talk a bit about some other ways in which technology is advancing public health.
We hear so much about social media these days and the impact it can have on opinions and the course of events. This technology presents, too, an opportunity along with a threat. New health threats arise because of these kinds of technologies. For instance, it has helped to promote the spread of sexually transmitted diseases. But social media can also be used for health promotion, for intervention, and potentially early warning purposes. During the H1N1 pandemic, the Public Health Agency used social media in its efforts to reach out to people through such tools as Facebook and Twitter.
With the time we have today, I've only been able to touch on some of the latest technologies using a few examples. From what you've heard, though, I think you'll agree that in a highly technical field where innovation is essential, the Public Health Agency is at the cutting edge of using these kinds of tools for public health.
Thank you.
11:30 a.m.
Conservative
The Chair Conservative Joy Smith
Thank you very much, Dr. Plummer. As usual, it was a very helpful and insightful presentation for our committee.
Now we'll go to Dr. Warren Chan.
I understand, Dr. Chan, you have a PowerPoint presentation. Are you all set to go?
11:30 a.m.
Conservative
The Chair Conservative Joy Smith
All right.
I must say to the committee, before Dr. Chan starts, that I've combined the two, genomics and nanotechnology, and we are now going into the nanotechnology part. I did that because, as you know, the bells are going to ring, and I wanted to make sure our presenters had a chance to give all of their information.
My apologies in advance for having to combine the two topics, but it was necessary to do that.
Please begin, Dr. Chan.
11:30 a.m.
Professor, University of Toronto, As an Individual
I'd like to start off by thanking the committee for inviting me here to talk about nanomedicine and nanotechnology.
I'd like to start off by describing that nanotechnology is essentially an enabling technology that allows you to do different types of applications. We see nanotechnologies in making faster computer chips and thinner screens, as well as in the treatment and diagnosis of diseases.
Right now Canada doesn't have a major focus in nanotechnology research and development, compared to a lot of different developed countries in the world. To give you an example, right now, 16% of all publications that come out of Singapore have some aspect of nanotechnology. South Korea, China, and all the countries in Asia are actually putting a lot of emphasis on this.
In terms of the application of nanotechnology to medicine, the big driver in that particular space is actually the U.S. They started a cancer nanotechnology program about 12 years ago, which has now spun off seven cancer nanotechnology centres, and continue to produce new types of companies and clinical trials for new types of drugs.
I thought I'd spend this 10 minutes talking about what nanotechnology is, and why it's important. I want to describe that because nano now has become an interesting buzzword. You see it in tons of movies, always relating to villains trying to change some structure or something to become more villainous, right? Nanotechnology is a very interesting and growing research field.
The first thing I want to define is what nanotechnology is. There are actually three or four definitions out there. The U.S. has one, Japan has one, and the U.K. has one. The one I like is the British Standards Institution's definition, which essentially refers to nanotechnology as the intentional design, synthesis, characterization, applications of structures, devices, and systems by controlling size and shape in the 1 to 100 nanometre range.
To give you a perspective of what that size range means, if you look at the diameter of your hair, that diameter is 1 to 10 micrometres. Nanotechnology is about 100 to 1,000 times smaller than the diameter of your hair. It's very important that we work with materials in this size range, and the real reason is that you can tune the properties of the material. In the traditional method, if you want to make a new material, you have to start off with a synthesis and you basically have to make a new compound each time you want to make something with a new property.
The unique thing about nano is that in order to make the material with a unique property, all you have to do is change the size or the shape of the material. Something that is very small versus large; they have very different properties, but the method of manufacturing is exactly the same. It allows you to have a lot of raw materials.
I'm showing here the real crux of nanotechnology, and this is what drove the U.S. to put about a billion dollars in this for various applications. A good example is gold. All of us have gold jewellery and it looks yellowish, right? But if you look at gold at the nano scale, it's not yellow, it's actually red. The colour is actually different tints of red as you start changing the size of the material.
If you have something that's very small—for example, one atom or three atoms—the colour of that material looks white, so you can't tell the difference. But if you have something that's very large, 19 atoms to 26 atoms for example, it looks red. You can't tell the difference. At the 1 to 100 nanometre size range, you can change the colour of your material by changing the size, so something that is 6 atoms might appear blue, something that is 12 atoms may appear green, something that is 19 atoms will appear red.
If you have your gold jewellery, if you make it bigger and bigger, it still looks yellow. But if you start shrinking to the nano scale, it looks red, more red, sometimes orange or green, depending on the size of the gold you're working with.
The unique aspect of nano is the tunability and creation of large amounts of raw materials for a variety of applications. As I mentioned, you can tune the optical properties of material, tune the magnetic properties of material, and tune the electrical properties of material. That's why nanotechnology is very commonly used to make better electronics, because these are all electronics-related.
I have an example of five different vials of what are called quantum dots. These are nano crystals made of cadmium and selenium. They were initially made in the 1970s by the former Soviet Union as a way to create more energy for bombs and for biowarfare, but what ended up happening is that all the new Christmas lights that you might buy at Walmart have quantum dots in them. The new LCD screens from Samsung now contain quantum dots because they give better resolution. This is what this is starting to move to.
These five vials are the exact same materials, cadmium and selenium. The only difference is that the green is three nanometres and the red is six nanometres; that is the only thing we've done. The reason that at that size you have tunability is that you force the electrons to behave in a certain way. That is the crux.
If you look at the gold particles shown on the right of this slide, they look like loose spherical particles under a microscope. It is basically a hard metal that you chip, so it looks like a small size.
The next picture shows what scientists can actually make of nanomaterials now. You can see that you can make little structures. These are called nano rice, a nano star, nano cubes. Whatever shape you can see with your eyes on the global scale, you can make in the nano scale now. It took 20 years to perfect strategies to make these particular materials. Because you make them in different shapes and sizes, you can now tune the physical properties of the material. Again, there are a lot of different raw materials.
In the last seven or eight years there has been a focus on nanotechnologies to solve some of the medical needs at this point. I'll give you some examples.
The way you can think about it is that nanotechnology is essentially an enabling tool to solve some of the issues associated with cancer therapeutics and diagnostics as well as to detect infectious disease. It's also starting to evolve into vaccine developments and is being used for cardiovascular detection. I'll explain how it's being used.
It has a broad range of applications. Many interesting researchers are trying to make what are called theranostic agents: can you make a nanostructure, inject it into the body, detect the disease, and as it detects the disease slowly release the drug to try to treat the disease? It is based on the ability to detect and sense the local environment in order to tell it what to release and how to treat the system. This is a new concept that's starting to come into play.
As I mentioned, the big push in nanomedicine from the U.S. government, in the late part of the 1990s and early 2000s, was to establish what is called the cancer nanotechnology program. What they believe is that with nanotechnology you can detect the cancer as it begins. It's the concept of early detection: the quicker you can detect a cancer, the greater the chance of survival. Once the cancer starts moving around your body, it's very difficult to find. You want to detect it before it starts moving around, because once it starts spreading, it's like finding a needle in a haystack. It is everywhere in your body, and even if you treat one cancer at one site, another site may start to spring and grow.
The other application that cancer nanotechnology focuses on is targeted therapy. You can actually design these structures to carry the drug so that it can specifically only go to the cancer site and not to a healthy site. One of the problems of chemotherapeutics is that you're flooding your body with poison and hoping that the poison will kill more of your disease cells than your healthy cells. That's why you have all the side affects associated with chemo. But if you can trap everything in a nanostructure, protect it, and cause it to only release at the disease site, you basically will remove the exposure of the healthy tissues.
The third part is to try to improve surgical precision. When you try to remove a tumour, if two cancer cells survive, they can grow again. In some work being done at Rice University, they can take particles that produce heat, target a tumour cell, and then basically shoot a laser right at that spot to try to burn off the tumour at that site.
But there are two challenges in getting this to work. One is the delivery challenge. How do you actually get to the site? What is the proper size and shape? At this size range, below 100 nm, the particles can travel within your body, but how do you control the delivery process? There is also the toxicity of these materials: some of these materials are made of metal, and that becomes an issue.
The second aspect is nanotechnology diagnostics and how to simplify the diagnostic process. Here is a slide illustrating a strategy in which we can take beads, load them with nanomaterials of different colours, and make bar codes out of them. We all go to the grocery store: the bar code scans the product, allowing the store to monitor inventory of that particular product. Can we do the same thing with diseases? We can enable these molecular-scale bar codes to scan for different kinds of genetics, scan for different kinds of proteins associated with diseases. This allows you to then detect the disease not just by using one protein or one gene, but maybe a series of proteins or a series of genes to tell you that you have some disease.
What is being worked on now is to convert this technology into a hand-held device so that you can actually use it at the point of care, so that when you're infected it's all automated. You can essentially push a button and within an hour can say whether you have disease A, B, or C. On my final slide, I use malaria as an example, in which there is one strain that is very deadly and one that is not.
Within the next few years, there is going to be a lot of emphasis on translation and diagnostic devices. In vitro hand-held devices are going to be commercialized in the next few years in terms of development and patient care. With regard to the in vivo application, there's going to be a lot more work required, but probably, in about the next 10 to 15 years, it will be in play in order to inject into the body and be able to detect diseases or treat diseases.
With that, I'd like to thank you. That's my overview of nanotechnology at this point.
11:40 a.m.
Conservative
The Chair Conservative Joy Smith
Well, Dr. Chan, my goodness, that was amazing. Thank you so much for your presentation today.
We will now hear from Dr. Voyer.
11:40 a.m.
Dr. Normand Voyer Professor, Department of Chemistry, Université Laval, As an Individual
My presentation is going to be in French, but I am willing to answer questions in English and French.
11:45 a.m.
Professor, Department of Chemistry, Université Laval, As an Individual
I would first like to thank...
11:45 a.m.
Conservative
11:45 a.m.
Professor, Department of Chemistry, Université Laval, As an Individual
That is fine, thank you.
I would first like to thank the members of the committee for inviting me to present part of my research work that, as you can see, is geared to the construction of bio-inspired nanostructures designed to kill bacterial or cancer cells.
I am a chemist and I thank
...Dr. Chan for the beautiful introduction...
on nanotechnology. So I won't have to redo it.
As chemists, we build molecules from scratch. We want to build nanoscale molecules to kill bacterial and cancer cells.
Why do we want to do that? Right now, the greatest threat on the planet—and Dr. Plummer talked about it at length—is that there are more and more bacteria resistant to current chemotherapy. An increasing number of cancers are resistant to the drugs currently being used in clinical settings. If we do not come up with new developments and discover new therapeutic agents with new modes of action, we are going to have a serious problem on our hands in coming years. It will be more difficult to counteract bacterial infections, viral infections and infections of all sorts, in addition to the problems with increasingly resistant cancers.
My area of research is promising in that respect. The new solution to combatting this scourge is called nanochemotherapeutics. As Dr. Chan said, when you develop nanoscale substances, their physical, chemical and biological properties are completely different from compounds that do not have nanometre dimensions.
Nature has been using nanotechnology for hundreds of thousands of years because it develops viruses, which are real nanorobots, as well as nanoscale toxins and proteins that have incredible properties. One of those properties is to alter the membrane of our good cells, which causes a great level of toxicity.
To better understand my area of research, you need to try and imagine that every human being is made up of billions of small cells. Bacteria are unicellular organisms, but humans have billions. The integrity of those cells is maintained by what is known as the cell membrane. It is a thin little layer, a type of Saran Wrap that keeps the cell intact. So when you manage to puncture the membrane of cancer cells or bacterial cells, they die. As a result, some toxins and substances secreted by the bacteria are able to break this membrane and kill cells.
At our lab at Laval University, our approach is to try to mimic these proteins, to design and synthesize nanostructures or nanoscale compounds that have the properties to mimic natural toxins that attack and puncture the membranes. We want to target the cells that need to be destroyed, meaning the cancer cells and bacterial cells that are increasingly resistant.
The benefit of using this technique is that it will bring us one day to a group of nanochemotherapeutic agents, as an extension of today’s conventional chemotherapeutics. These tools will potentially be universal therapeutic agents for all bacteria and viruses since their mode of action is innovative. Actually, this type of mechanism will induce no resistance.
As an example, let me show you a prototype. As our inspiration, you see a protein on the left with green bows and small purple bubbles. This protein is secreted by bacteria and it is a toxin that destroys the red blood cells. If you are infected by the bacteria and this toxin is in your blood, it will destroy your red blood cells and you will die.
We have used this protein as an inspiration to create—as you can see on the right—nanostructures, three to four nanometres in size, that will be able to puncture the membrane of undesirable cancer cells. To date, we have managed to show their activity in killing cancer cells, as well as bacteria.
In the next slide, I am showing you a short film. You can see the same nanostructure going through a blood vessel. You see the red blood cells in the background. At the bottom you see the start of a leukemia cancer cell. The nanostructure will detect the presence of this cancer cell. Next, it will incorporate itself into the cell membrane to create a port that will allow excess sodium ions to enter. In so doing, the sodium ions will disrupt the internal biochemistry of the cancer cell. The cancer cell will die by itself through a mechanism called apoptosis. I will not get into the details, but it is a mechanical process that makes it possible to puncture the membrane of the cancer cell, thereby killing it.
Clearly, this is not going to happen overnight. How long do we think it will take until this type of nanostructure can be used clinically? We are talking about approximately 10 to 20 years. Right now, we are talking about very rudimentary trials. Work needs to be done. We need to prepare analogs, to gain a full understanding of how the mechanism of action works and to improve selectivity in killing undesirable cells, not the healthy cells in our bodies. We also have to determine the safety profile, the therapeutic dose, the efficacy and so on.
Why should the Government of Canada support this type of work? Nanomedicine, which includes nanodiagnostics—that was talked about at great length earlier—and nanotherapeutics, involves technologies with huge potential that can revolutionize the way we diagnose and treat patients. That will facilitate very early diagnosis, meaning
bedside monitoring, point of care.
Clearly, it will also lower healthcare costs and improve quality of life.
But the main reason why the government must fund this work, which is too risky for the industry, is so that, one day, we will be able to see our research work come to fruition in Canada. Actually, the industry does not have the money needed to study and develop technologies that will reach their full potential in 10 to 20 years. That will be very expensive and the industry does not have those types of resources. It is up to university researchers and those who conduct basic research in universities to develop those new approaches. Subsequently, companies will be able to build on them and develop concrete applications.
I would like to conclude by thanking granting agencies, specifically NSERC, which has always supported my research work.
I will be happy to answer any questions you may have.
11:50 a.m.
Conservative
The Chair Conservative Joy Smith
I thank you very much for your insightful presentation. It has been an amazing morning in terms of the presentations we've had here.
The bells haven't been rung yet, so I'm going to go straight ahead. I apologize in advance for when they ring, if they ring.
Dr. Plummer, I understand you have to leave at 12:15 p.m. I wanted to make the committee aware that Dr. Plummer has to leave at 12:15, so any questions for him should be asked before then.
Dr. Marra and Dr. Huntsman, I understand you are with us until 12 noon. Are you able to stay a few more minutes for some questions?
11:55 a.m.
Professor of Pathology, Medical Director, Centre for Translational and Applied Genomics; Director, OvCaRe, University of British Columbia
Ten minutes or so more. The fact is he'd be late for the next meeting.
11:55 a.m.
Conservative
The Chair Conservative Joy Smith
Great. You're all probably getting together for lunch. If you weren't in B.C. and Dr. Plummer in Ottawa, I might say you were simply ducking out for lunch, but I don't think that's the case.
We're going now into Qs and As because we have the rare opportunity of asking some very learned people about things the rest of us don't have knowledge of.
I'll begin with Ms. Davies.
11:55 a.m.
NDP
Libby Davies NDP Vancouver East, BC
Thank you very much, Chairperson.
I hope I can ask some learned questions. I didn't think I would ever be at a health committee where we'd be talking about Christmas tree lights and how they function. That was very interesting.
It's a bit overwhelming, I have to say. I've been keeping notes and trying to keep up with all of your presentations. I feel as though we've had an hour's crash course in genomes, and nanotechnology, and so on. I absorbed a little bit, I have to say, and I know there are a ton of questions.
What I'm thinking about, though, is this. When we have this incredible research that's going on in various stages—and in some instances Canada is plowing ahead, which is terrific—the issue that keeps coming back to me is what challenges we face in making these incredible new technologies accessible to people.
I think it was Dr. Marra who mentioned the whole issue of personalized medicine; that, for example, access to some of these new drugs, based on personalized medicine and the research you're doing, will change the way we do clinical trials because we'll be down to a micro level. We've just had Dr. Chan tell us about his nanotechnology, and we're talking about 10 or 20 years from now.
The question I have, because we are doing this study, is what is it that we need to be prepared for in advance in terms of applications for what you're researching now? It sounds like we have a bit of a handle on some of it now, but for some of the information you presented, the timeline is much longer. It would be terrible to see a situation where we have made advances and yet we don't have the capacity, in terms of clinical trials or approvals or even accessibility for patients, to actually roll it out, and we end up with a big gap.
I don't know if this is a field that any of you get into. Maybe you're just at the front end, and somebody else does the other end, but you could address that and give us some ideas about what we need to focus on, as a committee, because we'll be writing a report. What is it that we need to prepare for, in terms of policy considerations, for how your research will actually apply and help people in the future? Would any of you like to address that?
11:55 a.m.
Conservative