Dr. Daniel Winer
Gastrointestinal pathologist and immunometablosim scientist, Dr. Daniel Winer, impressively balances clinical care and innovative research to best serve current UHN patients and those who may need care in the future.
​(Photo: UHN/Laboratory Medicine Program)

The infamous, "So what do you do?" question can stir an inner conflict in most. Even when the question is specific to profession, medical staff from UHN's Laboratory Medicine Program (LMP) may struggle to choose a definitive answer.

Between balancing clinical work and research, for LMP staff, the answer may just depend on the day.

'Bench to bedside'

In LMP, there are hundreds of different specialized laboratory professionals who practice clinically each day. Many of these same staff also dedicate huge portions of time outside of their clinical work to advance medical research and conduct innovative studies.

This type of juggling between research and clinical practice is one that many in LMP choose to embrace, as their clinical experience can often help steer research towards practical applications.

"'From bench to bedside' is a phrase we use a lot in LMP and our staff research is a great example of how we deliver innovation from our labs to our patients," says Dr. Runjan Chetty, interim medical director, LMP.

"Lab medicine is often considered an essential aspect of any study, and our medical and technical staff routinely contribute to and lead investigative studies, bringing clinical experience to the forefront of medical research."

Cardiovascular pathology and the study of stem cells

Dr. Michael Laflamme
Dr. Michael Laflamme, recent recipient of a University of Toronto Medicine by Design award, balances the clinical role of a pathologist and the research role of a regenerative medicine scientist all in a day’s work.
(Photo: Stefan Superina)

Cardiovascular pathologist Dr. Michael Laflamme, formerly a physician at the University of Washington, is one of the more recent medical staff to join LMP, and a true dual role member when it comes to research and clinical care. In addition to his role with LMP, Dr. Laflamme is the McEwen Chair in Cardiac Regenerative Medicine and a senior scientist at the Toronto General Research Institute (TGRI).

As a cardiovascular pathologist, Dr. Laflamme analyzes heart tissue and looks for abnormalities at cellular and tissue levels to diagnose disease.

As a senior scientist with TGRI, Dr. Laflamme dedicates his time to researching the use of pluripotent stem cells to repair damaged heart tissue.

He has developed widely-used protocols to guide the differentiation of stem cells into cardiomyocytes, which are heart muscle cells. This process involves mimicking the growth factors in normal heart development to stem cells in a laboratory setting.

Dr. Laflamme then transplants the cardiomyocytes into non-human research models, and studies the effectiveness of tissue regeneration and the electrical synchronization of heart muscle contractions. The goal of his work is to translate research in pluripotent stem cells and cardiomyocytes into a clinical trial to regenerate areas of damage after a heart attack.

Last year, Dr. Laflamme was awarded a $900,000 grant by the Ontario Institute for Regenerative Medicine to continue his research in stem cell-based heart regeneration, and just last month his collaborative team project to "improve the function, integration and safety of stem cell-derived cardiomyocyte transplantation" received a Medicine by Design Award from the University of Toronto.

Dr. Laflamme's project was one of 20 projects to receive funding from Medicine by Design, and funding for all projects combines to a total of $9 million per year for the next three years.

Gastrointestinal pathology and the study of the immune system

Dr. Winer at bench
With work to be done at multiple sites, Dr. Daniel Winer makes a quick visit to his lab in MaRs Discovery District and is then is back on his way to Toronto General Hospital to review some cases. (Photo: UHN/Laboratory Medicine Program)​

Endocrine and gastrointestinal pathologist, Dr. Daniel Winer, is another member of LMP who shares a dual appointment at TGRI, and is the first ever to be awarded a Canada Research Chair in Immunometabolism.

As a gastrointestinal pathologist, Dr. Winer specializes in the diagnoses and characterization of disease in the stomach, intestines, and pancreas. In addition to his clinical role at UHN, Dr. Winer also studies how the immune system influences metabolic disease, such as obesity and Type 2 diabetes, and has played a key role in establishing immunometabolism as a new field of medical research.

In 2011, Dr. Winer and his twin brother, Dr. Shawn Winer, were the first to show that both T cells and B cells of the adaptive immune system, which is one of two sub-systems to the overall immune system, play a key role in the onset of Type 2 diabetes. These findings steered Type 2 diabetes research in a whole new direction and suggests that metabolic diseases can be highly influenced by how our immune system responds to our body's metabolic changes.

The research conducted in Dr. Winer's lab involves the use of various mice test models including structured dietary conditions and modified immune systems that can alter the parameters of metabolic function. The lab then studies the effects of the different models and measures glucose and insulin levels and immune responsiveness. These findings are then translated to better understand how the human immune system affects metabolic disease.

In the past year, Dr. Winer received a Canada Research Chair in Immunometabolism, a Foundation Grant valued at more than $1.2 million from the Canadian Institute of Health Research, and an Early Researcher Award from the Ontario Ministry of Research, Innovation and Science.

The Early Researcher Award is one of 13 received by UHN staff and will help fund his lab's research in "novel immune mechanisms of obesity related insulin resistance and non-alcoholic fatty liver disease."

The award also requires a component of youth education, which will have Dr. Winer visiting Grade 8 science classes, teaching students about what cancer is at a cellular level and how lifestyle choices can help prevent its development.

"It's something I actually started doing about five years ago, and as much as I enjoyed it, I just didn't have the time," says Dr. Winer. "So I'm excited to start this type of outreach again and am hoping to make a positive impact not just in student's education, but their lifestyle as well."

LMP staff research as a whole

The medical, scientific and technical staff in LMP are highly involved with research initiatives at UHN, as well as those of many other international health organizations.

In addition to regenerative medicine and immunometabolism, LMP staff regularly make significant contributions in the fields of genetics, personalized cancer care, prostate cancer research, immunohistochemistry, hematology, neurology, biochemistry, and much, much more.

In the last year, UHN laboratory staff have accumulatively authored more than 100 papers, all of which is in addition to their clinical workload.

Though these aren't the double lives you may find in a comic book, LMP staff are certainly fighting every day to advance medical research and provide the best possible care for UHN patients.

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