Subcommittee on Neurological Disease Committee on Nov. 23rd, 2010

[Bruce Ireland]

I can certainly talk about Ontario, and I think other regions are certainly working on it. They probably haven't got it to the stage yet where we are, but in Ontario we've had consultations. The Ontario government announced start-up funding for a new Ontario brain institute last week—

[The Chair, Conservative, Joy Smith]

Wonderful.

[Bruce Ireland]

— and our NHCC committee has been working very closely with that.

I think, from the point of view of a Parkinson Society Canada model, we are using that to work with our regional partners from British Columbia to St. John's, Newfoundland, to do the same kinds of things with their provincial governments.

[The Chair, Conservative, Joy Smith]

Yes. Once you have that one model, if one province does it, it's kind of like a domino effect, I find.

[Bruce Ireland]

Absolutely.

[The Chair, Conservative, Joy Smith]

You know, “You're doing it, and you're real good. Well, we're better. Guess what we're doing?”

[Bruce Ireland]

Exactly.

[The Chair, Conservative, Joy Smith]

It reminds you of school sometimes.

[Bruce Ireland]

Absolutely.

[The Chair, Conservative, Joy Smith]

But good for you.

I just wondered about that.

Now we'll go to Mr. Brown.

[Patrick Brown, Conservative, Barrie, ON]

One question I'm always interested to ask, and I know there's always a hesitation to be optimistic on this, is what type of progress are we seeing when we look at the money that's been invested? When we go back to our ridings and people ask about government investments, we always hear people wanting to know if these investments are going towards successful causes.

So when we talk about the $72 million that has been invested since 2000, and if we're going to make a pitch to grow beyond that and make a pitch that we need to see a greater envelope with CIHR, are there examples you can share with us that we can be hopeful there's elementary progress and exciting new ideas? Could you sort of help paint us a positive pitch?

[Dr. David Grimes]

Yes, I think there are definitely a lot of success stories out there. I still cringe when people say we're going to have a cure for Parkinson's in five or ten years, because nobody knows. Nobody knows which area it's going to come from. I think you have to be very open to different ideas.

If you look at some of the trials that are starting up on different compounds, there's a whole new wave of treatments that are starting to get into clinical trials. I think you heard a little from my colleague Michael Schlossmacher last week about things like alpha-synuclein in the brain. We now have the ability to recognize and identify compounds that will affect alpha-synuclein levels in your brain, so we're now trying them out in people. This is something nobody dreamed of five years ago. If we can give somebody a compound that directly decreases the amount of this abnormal protein that's accumulating in people's brains, is that going to work? Well, it's certainly exciting, but we don't know yet.

I'm doing a clinical trial right now where one line of evidence in some mice identified that it looks like there's a problem with calcium homeostasis, a calcium problem in the main energy cells in the brain. You do a big drug screen because you've identified this brand new pathway, and it turns out there's a blood pressure pill that's already on the market in the United States that affects this very particular receptor. So we're now trying this out on people. Can we change how the energy cells part of the brain are working by giving a compound?

This was only discovered three years ago, and we're already trying it on people, because we now have the technology to screen drugs that are already on the market and see if they already have an effect. Instead of waiting 20 years to go through all the safety data for all the different things that could potentially go wrong with a drug, let's screen the 10,000 drugs that are already on the market and that might have an affect on this brain process.

There's no question that we're better. There's no question that we have made a lot of improvements. There's no question that we've identified new pathways that we can test new compounds in.

So we're doing a much better job, but as I said, do we have the answer yet? No.

[Patrick Brown, Conservative, Barrie, ON]

Do you have a comment, Chris?

[Chris Sherwood]

Yes, and I hope I'm not taking too much time.

When you ask about “success”, I would ask what does success mean? If we think about it in terms of pursuing a cure, that's great--except that, as I always like to say, life is a sexually transmitted disease that ends in death. Everybody is going to die. So what does success mean for somebody living with Parkinson's now, where a cure really may not be an option?

I think that's really part of the answer to your question. Success for them isn't necessarily anything other than being cared for well, and what does that look like? How do you then make sure that the outcomes for someone coming to terms with their dying process, which is what it is, are as good as they could be, and what does that mean for them? Because that is where all of us are going.

What does success mean for those people?

[Patrick Brown, Conservative, Barrie, ON]

I certainly imagine that success is trying to make that process more bearable for those who are living with Parkinson's, to improve their quality of life.

On that same note, last week when we had Greg McGinnis here, he said his greatest fear wasn't about what he is going through, it's about the fact that he's heard all these stories about how it gets passed down in families and that his son is going to get it. I guess one element of success is that if we invest $144 million in the next decade instead of $72 million, can we move the yardstick forward?

On that note, what do we know about the passing down of this disease? Greg mentioned this last week. Is there anything we've learned on that front about it being shared within families?

[Dr. David Grimes]

I think that's one of the real success stories in Parkinson research. Had you asked a Parkinson doctor 15 years ago if Parkinson's was inherited, they would have said no. At conferences, some of my senior colleagues were laughed at because they suggested there was a strong genetic component to Parkinson's. Now it turns out there are at least eight different genes that we can currently test for that cause Parkinson's disease.

The trouble is that there's a whole bunch of issues there--i.e., who should we test, why should we test it--but there's no question that there are genes that cause Parkinson's disease that we didn't know about. The first one was discovered in 1997, so this is relatively new information.

[Patrick Brown, Conservative, Barrie, ON]

How was that discovered?

[Dr. David Grimes]

It was through doing genetic studies in families. This is identifying and narrowing down what the region--

[Patrick Brown, Conservative, Barrie, ON]

Was that discovered in Canada?

[Dr. David Grimes]

It was a joint discovery between an Italian group and an American group, who identified the first gene. The second gene, actually, was one called parkin. It just turns out that we hired, here in Ottawa, the researcher who just discovered that.

So this is definitely increasing.

[The Chair, Conservative, Joy Smith]

Thank you.

Mr. Malo, I'll give you five minutes. We're going to go into committee business at 10:30 a.m.

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

Thank you, Madam Chair.

Dr. Grimes, you may continue.

[Dr. David Grimes]

This whole area of genetic research in Parkinson's is one that, again, we didn't know about 15 years ago. This is where the major strides are being made in terms of developing better models. We need better models in Parkinson's; we can't test everything in people, and using some of these genetic things that we had no idea existed 15 years ago and putting these abnormal genes into mice and in flies and in fish and figuring out what happens to them--this is where we've been making these more recent discoveries. This is where we really have been getting to the point now where we're turning these discoveries into treatments that we're trying in people.

We talked about diagnosis and the struggle for people when they have to see me, whom they've never seen before, and have to rely on me telling them they have Parkinson's, believing what I have to say versus having a test.

Some of the basic research in this whole discussion of biomarkers is one that we desperately need in Parkinson's, but we're definitely making progress. The first gene I mentioned, alpha-synuclein, my colleague has the potential to measure in your blood and spinal fluid. Part of his work is funded by Parkinson Society Canada, and he's looking at can we have a measurement and can we accurately predict who might have Parkinson's and can we use some of these biomarkers and follow progression that we desperately need.

So yes, there are definitely success stories. I'll just maybe tie back to an earlier question. Yes, the Parkinson Society has been key for funding pilot studies. The funding base that Parkinson Society Canada has is relatively small for the amount of work that needs to be done. Researchers apply to Parkinson Society Canada to fund their ideas. The success rate is considered not too bad; you have a 50% success rate. The trouble is going to the next step. I think this is where the CIHR has run into big trouble; there are so many scientists out there who say, “No, I'm not staying up until 3 o'clock in the morning and writing a proposal to the CIHR when I have a 16% chance of having it funded.”

So we have a bunch of great ideas, and we have some pilot money that we can get, but how do we carry those ideas forward? If your success rate is so low, there are a lot of frustrated scientists out there saying, “I'm just not doing this any more. This is crazy.”

That's a big problem.

[The Chair, Conservative, Joy Smith]

You have another minute and a half.

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

I would simply like to say that I want to give the witnesses an opportunity to comment further because we have almost reached the end of the committee session.

So I am giving them the floor.