Subcommittee on Neurological Disease Committee on Nov. 2nd, 2010

[Kirsty Duncan, Liberal, Etobicoke North, ON]

How do you feel about tracking our vets, an initial telephone interview looking at health and military service--and perhaps twice-yearly interviews afterwards--and looking at specific research regarding types of treatment in order to better support vets?

[David Cameron]

That makes good sense. It also enables the opportunity to perhaps identify the contributing or triggering factor that has initiated the ALS. If there's a commonality--for example, environmental--the more information we have, the more statistical data out of Veterans Affairs, the better off we will be.

[The Chair, Conservative, Joy Smith]

Thank you, Mr. Cameron.

[Nigel Van Loan]

May I just add one comment to that, Madam Chairman?

[The Chair, Conservative, Joy Smith]

Please go ahead.

[Nigel Van Loan]

We as a society are working very closely with Veterans Affairs in Charlottetown with the appropriate people, both research and medical, to make sure that our knowledge is shared with them in terms of how they might progress the care and support of veterans.

[The Chair, Conservative, Joy Smith]

Thank you, Mr. Van Loan.

We'll now go to Mr. Brown.

[Patrick Brown, Conservative, Barrie, ON]

I'd like to follow up on some of the questions I'd asked before.

The $350 million: what would that do in terms of the percentage of research not being reached? Would that mean that it's 25/75, or would that dramatically change the scope of things?

[David Cameron]

I think it would make a dramatic difference, simply because if you divide the $600,000 or $700,000 into the $350 million, it will generate a significantly larger body of research and knowledge. I know that we have finite dollars....

I haven't done the analysis that would respond directly to that question.

[Patrick Brown, Conservative, Barrie, ON]

Down the road, if it's possible to do that, it would be interesting to know what it means. When we're looking at making pitches and presenting ideas within our various caucuses, I think it would be very interesting to know how much more research should be done and what that means for organizations like yours.

There's another thing I wanted to ask about. This is the neurological disorders subcommittee, and the reason we're looking at each of these subsets is that we believe there are a lot of commonalities and that it's important for us to understand that better. What do you view are the commonalities between the major neurological disorders? When you invest in research in one, how does it benefit our understanding of the brain in general?

[François Gros-Louis]

Neurological diseases involve neurons, and there are different types of neurons. We think that for all neurodegenerative diseases—for example, ALS, Alzheimer's, Huntington's—the same kinds of degenerative pathways are involved but different neurons are involved.

In ALS, it's motor neurons that are degenerating. In Alzheimer's, it's memory cells that patients are losing. In Huntington's, the neurons are of a different type. In multiple sclerosis, it's myelin that's degenerating. But we think the pathways are kind of similar.

One example is the immunization therapy we're developing with ALS. This approach was also used with Alzheimer's disease, where they went into a clinical trial with a vaccine for Alzheimer's. The clinical trial was stopped because some of the patients developed adverse effects. That's why, before going into a clinical trial with immunization in ALS, we will look carefully at what happened during the Alzheimer's disease trial and not repeat the same problem they had.

[Patrick Brown, Conservative, Barrie, ON]

Do you find there's a lot of sharing of knowledge amongst the various neurological groups? Is that happening in Canada?

[François Gros-Louis]

Yes, it's happening in Canada, for sure. During the national meetings of the Canadian neuroscience society--they organize a meeting every year--there is a lot of sharing of information.

[Patrick Brown, Conservative, Barrie, ON]

There is something else I'm interested in. A year ago I lost my grandmother to Alzheimer's. I remember asking the doctor at the time about Alzheimer's. I was surprised at how much we didn't know about it and how little understanding there was of the brain when it came to Alzheimer's.

I guess that's my concern with neurological disorders: what basis are we starting from? For instance, I went to the CIBC Run for the Cure, and they talked about the tremendous progress in breast cancer research, comparing the life spans and the survival percentages. What basis are we starting at here? What have we learned in the last 20 years? What progress are we making, and what opportunities are there for progress? Have we had successes? Are we optimistic about successes?

I know those are general questions, but....

[François Gros-Louis]

Yes, we are really optimistic. It's very difficult to study neurological diseases. It's difficult to get brain biopsies. Nobody wants to give them, so we are developing animal models, cellular models, to study those diseases.

The technology is there. We have various animal models that help us a lot to study the biology of the disease. Over the past years we have begun to understand which biological defects lead to those diseases.

[The Chair, Conservative, Joy Smith]

Thank you very much.

Monsieur Malo.

[Luc Malo, Bloc, Verchères—Les Patriotes, QC]

Thank you, Madam Chair.

I will continue along those lines. In reply to a question posed by Ms. Hughes, Mr. Gros-Louis said that it is important for him and young researchers to generate interest in the research they are conducting. I would like to provide you with an opportunity to explain the research you are involved in, and to explain why it is pertinent, interesting and promising. Therefore, I am simply asking you to expand on what you told my colleague, Patrick Brown, and explain to us why passive immunization, based on various models used to treat Alzheimer's, may be promising in the case of amyotrophic lateral sclerosis.

[François Gros Louis]

The passive immunization that we are developing is based on the administration of monoclonal antibodies, antibodies specific to a protein called SOD1. A small number of patients possess mutations of this gene. It is believed that administering these antibodies to patients will eliminate the protein's toxic effect.

As we know, the majority of ALS cases are sporadic. Recent, unpublished studies have shown that sporadic patients can acquire malformations of this protein even if there is no mutation in the SOD1 gene. Environmental toxins can cause misfolding of the protein's tertiary structure and create toxicity. The treatment we are developing could be used with patients who do not have a genetic mutation, which represents the vast majority of people suffering from ALS.

[Luc Malo, Bloc, Verchères—Les Patriotes, QC]

This scientific procedure that you have developed is just one being studied internationally. Is the community of researchers studying ALS focusing, for the time being, only on this alternative, or is other research on other advances being conducted elsewhere in the world? Are researchers from all over the world talking to one another in order to come to a better understanding of ALS?

[François Gros Louis]

Yes, there are a number of collaborations with various research groups around the world. For example, with regard to immunization, there is currently a collaboration with a Boston group with a view to humanizing the antibodies identified. Antibodies have been developed in mice. Going directly to clinical trials with patients would be a bad idea because they would develop rather adverse immune reactions. Thus, we have to humanize these antibodies. Some groups in the United States have specialized in this technology. We are actively working with them to carry out this research. There are also other proteins involved, not just the SOD1 protein I mentioned. Other genetic mutations have been identified, other abnormal proteins have been found in ALS patients. A great deal of research is currently being conducted on this subject.

[Luc Malo, Bloc, Verchères—Les Patriotes, QC]

Have you established a timetable? For example, earlier you said that clinical trials are not being carried out in order to avoid repeating the mistakes or encountering the problems observed with Alzheimer's. Nevertheless, do you know approximately when this will take place?

[François Gros Louis]

It is very difficult to say. I am not directly involved in the clinical translation. The post-doctoral supervisor looks after that aspect. It is very difficult to establish a precise timetable.

[Luc Malo, Bloc, Verchères—Les Patriotes, QC]

Are there specific obstacles that have already been identified?

[François Gros Louis]

Yes, first patients have to be recruited. It may be very difficult to get them to agree to participate in the research project. It is a new technique and some patients may have concerns. Furthermore, the antibodies may have no effect or the effect may be moderated. There is also the issue of antibody delivery, of how to inject the antibodies. Will intravenous injection have to be done via intrathecal injection directly into the nervous system in order to be effective? We do not presently have the answer to such questions.

[The Chair, Conservative, Joy Smith]

Thank you, Monsieur Malo.