For the past two summers, Singh, a third-year medical student at the Max Rady College of Medicine, has focused on better understanding the sex-related differences in the development of rheumatoid arthritis.

The B.Sc. (Med.) program provides an opportunity for medical students to spend two summers – following their first and second years of the four-year MD program – immersed in research.

Under the guidance of her supervisors, Dr. Neeloffer Mookherjee, professor of internal medicine, and Dr. Liam O’Neil, assistant professor of internal medicine, Singh’s central hypothesis is that sex-specific immune differences shape preclinical rheumatoid arthritis and follow shared trajectories in both mice and humans.

Singh used a variety of tests to determine the changes in key biomarkers and to identify patterns associated with preclinical rheumatoid arthritis.

UM Today sat down with Singh to learn about her experience as a B.Sc. (Med.) student at UM.

How will the B.Sc. (Med.) research experience help you as a future physician?

I think it’s paramount. I think it gives me a critical lens to look through.  

In some cases, I’m not only looking at the individual patient, but I’m also considering a whole plethora of background information. For example, if a patient comes in and they need a certain medication, then I’m going to think, “What are the pros and cons to this medication? How will their specific situation change with this type of management?” 

Research has given me an appreciation for critical thinking. 

Has the B.Sc. (Med.) experience increased your interest in conducting research after medical school?  

I would say yes, but if you asked me last year, I would have said no. During my first summer, I had a lot of challenges because my experiments weren’t working. It was so frustrating, but this year, now that I got past the hurdles, I would say I can appreciate the process now.  

I would say once you get past the hurdles, it’s definitely worth it. 

What is something about research you didn’t know about until you took part in this program? 

I learned how impactful research is and how you can actually move the needle forward on different things.  

Even when you’re talking to clinicians, they will refer to specific studies. If you ask them a question like, ‘Why are we prescribing a certain medication?’ They will say, ‘Oh, this study has shown it has done this for this group of people, so it’s likely to be the result of that.’  

What has been your favourite aspect of the program?  

Coming into the program, I didn’t realize it would teach me the number of things that it has taught me. For example, I didn’t know I’d be learning how to code. Now, I feel very comfortable using the programming language R.   

What advice would you give a student thinking about pursuing a B.Sc. (Med.) degree? 

I would say if you’re on the fence about doing a B.Sc. (Med.), ask around about different supervisors and don’t just go with someone that would accept you. Be interested in what they’re doing. Go back and look at the different publications they’ve worked on.  

When you’re on the fence about deciding to do it or not, really interview the supervisor and see if it’s someone you’re interested in. Find somebody in the college who can nurture your passion for research because there is somebody. I promise you there is somebody.  

You will really get a lot of value out of the program. 

On March 13, the Government of Canada and Province of Manitoba announced funding of $2.4 million from the Canada Foundation for Innovation (CFI) and $2.4 million from Research Manitoba through the CFI – Innovation Fund Matching Program, totaling $4.8 million in strategic research infrastructure support.

“Research labs and facilities, like those being funded today, provide the foundation upon which Canada’s research leaders can make discoveries and drive innovation that will contribute to a better future for all of us,” said Roseann O’Reilly Runte, president and CEO of the CFI.

“We are proud to provide funding support for this innovative new multi-disciplinary research centre, showcasing Manitoba at the forefront of cutting-edge research to address global challenges,” said Jennifer Cleary, CEO of Research Manitoba.

It’s been reported that more than 20 per cent of premature deaths are linked to the detrimental effects of air pollution. By bringing leaders from different disciplines together, the AirSAFE research centre will provide evidence to develop new policies for improving air quality and human health. Researchers will be recruited to Manitoba to investigate why and how bad air is leading to diseases and limiting the effectiveness of therapies for these diseases.

“Congratulations to these researchers for receiving this investment to improve air quality policy and make the air we breathe safer for all,” said UM Vice-President (Research & International) Dr. Mario Pinto. “Building on the success of fundamental research at UM, the new AirSAFE facility will be a centre of excellence for interdisciplinary research that will be a leader in Canada and globally.”

This project is also made possible by various partners, including the Rady Faculty of Health Sciences, the department of internal medicine in the Max Rady College of Medicine, the Price Faculty of Engineering, CHRIM, SAFE Work Manitoba, the University of British Columbia, the Lung Association – Manitoba, and the Office of the Vice-President (Research and International) at UM.

The recently announced grants from the Fall 2022 funding round went to faculty members in medicine, nursing and pharmacy.

“This outstanding result reflects the high calibre of our health researchers,” said UM Vice-President (Research and International) Dr. Mario Pinto.

“This funding will enable UM laboratory scientists to advance knowledge in areas such as cardiovascular health, spinal cord injury, rheumatoid arthritis, asthma, amyotrophic lateral sclerosis and Rett syndrome. Rady Faculty investigators will also conduct cutting-edge data research, as well as vital studies aimed at supporting mental health and well-being.”

The largest grant of more than $1.4 million went to a team led by Dr. Linda Larcombe, an associate professor of internal medicine, community health sciences and medical microbiology/infectious diseases.

Larcombe is an anthropologist whose research focuses on First Nations history, health and collaborative research. Her grant will fund a three-year project called “Connecting with cultural heritage: Land-based learning and healing through archeology in northern Manitoba.”

The study team will create and evaluate a land-based healing and cultural heritage program that will enable youth to explore archeological sites and artifacts reflecting the thousands of years of Inuit, Dene and Cree presence along the coast of Hudson Bay at Churchill, Man.

“We will determine if cultural heritage in land-based healing programming can contribute to wellness and leadership development of Inuit, Dene and Cree youth,” the researchers wrote.

Here’s a look at the other funded projects. More information on the studies and research teams is available here.

Dr. Harvey Max Chochinov, distinguished professor, psychiatry, Max Rady College of Medicine

Grant: $100,000 (one year)

In Chochinov’s study, health-care professionals will hold conversations with cancer patients, guided by the Patient Dignity Question: “What do I need to know about you as a person to take the best care of you possible?” The study will measure how this affects the experiences of both patients and care providers.

Dr. Ian Dixon, professor, physiology and pathophysiology, Max Rady College of Medicine; principal investigator, Institute of Cardiovascular Sciences, St. Boniface Hospital

Grant: $1,040,400 (five years)

Dixon’s project centres on proteins and processes involved in skin wound healing, with the goal of developing treatments to speed wound closure and reduce scarring. The study will investigate how age and sex affect dermal healing. It will also examine the healing of skin damage caused by chemotherapy and radiation.

Dr. Soheila Karimi, professor, physiology and pathophysiology, Max Rady College of Medicine; researcher, Children’s Hospital Research Institute of Manitoba (CHRIM)

Grant: $1,136,025 (five years)

Neural stem cell therapy has exciting potential for patients with spinal cord injury, but it currently faces the challenge that the cells die after they are transplanted. Karimi’s project will test an experimental treatment aimed at optimizing the use of neural stem cells for repairing spinal cord injury.

Dr. Jason Kindrachuk, assistant professor, medical microbiology and infectious diseases, Max Rady College of Medicine; Canada Research Chair in molecular pathogenesis of emerging viruses; researcher, CHRIM

Grant: $750,000 (five years)

Kindrachuk’s team will investigate the circulation and transmission of the monkeypox virus in wildlife in regions of Africa where the virus is endemic, as well as surrounding areas. They will also assess the potential impact of the virus on Canadian wildlife.

Dr. Lorrie Kirshenbaum, professor, physiology and pathophysiology, Max Rady College of Medicine; Canada Research Chair in molecular cardiology; director, Institute of Cardiovascular Sciences, St. Boniface Hospital Albrechtsen Research Centre

Grant: $853,931 (five years)

Kirshenbaum’s project builds on the growing evidence of a link between body-clock disruptions – like those experienced by shift workers and people with health issues such as sleep apnea – and cardiac dysfunction. He will investigate the relationship between circadian disruption and heart attack.

Dr. Lisa Lix, professor, community health sciences, Max Rady College of Medicine; Canada Research Chair in methods for electronic health data quality

Grant: $508,725 (three and a half years)

Lix’s study focuses on using anonymized health-care databases to construct personal and family disease histories for chronic illnesses, such as heart disease. Researchers will compare two methods for creating disease histories, using data from Manitoba and Denmark, and assess their value for predicting disease risk.

Dr. Suresh Mishra, professor, internal medicine, Max Rady College of Medicine

Grant: $100,000 (one year)

Mishra will explore the role of cholesterol in the body’s production of steroid hormones. He aims to develop new ways to treat altered steroid hormone levels, which can lead to infertility and illnesses such as inflammatory diseases.

Dr. Neeloffer Mookherjee, professor, internal medicine; researcher, CHRIM

Grant: $100,000 (one year)

Mookherjee’s team will look at differences in how rheumatoid arthritis (RA) develops in males and females. In addition to using a mouse model, her team will study human samples from close relatives of RA patients, who may show changes in their blood before the appearance of clinical RA symptoms.

Dr. Christopher Pascoe, assistant professor, physiology and pathophysiology; researcher, CHRIM

Grant: $100,000 (one year)

Pascoe’s project aims to better understand how diabetes in pregnancy increases the risk of asthma in offspring. He will examine how maternal diabetes increases the twitchiness of airway smooth muscle in the lungs of offspring, and whether a specific enzyme co-ordinates changes in this muscle.

Dr. Mojgan Rastegar, professor, biochemistry and medical genetics, Max Rady College of Medicine; researcher, CHRIM

Grant: $990,675 (five years)

Rastegar has been working for more than 10 years to understand the pathobiology of Rett syndrome, a severe neurodevelopmental disorder in young children. This study will investigate the molecular and cellular abnormalities of the brain in this syndrome. The goal is to pave the way for therapeutic strategies.

Dr. Emily Rimmer, assistant professor, internal medicine, Max Rady College of Medicine

Grant: $307,530 (three years)

Rimmer’s project is a pilot study in preparation for an international randomized controlled trial of therapeutic plasma exchange as a treatment for septic shock. The researchers see potential for this treatment to save lives by removing harmful substances from the blood and replacing missing blood components.

Dr. Zulma Rueda, associate professor, medical microbiology and infectious diseases, Max Rady College of Medicine; Canada Research Chair in sexually transmitted infection – resistance and control

Grant: $100,000 (one year)

Rueda’s team will look at the incidence and impact of methamphetamine use and concurrent sexually transmitted and blood-borne infections in people living with HIV in Manitoba and Saskatchewan. One of the study’s goals is effective knowledge-sharing among people living with HIV, service providers and communities.

Dr. Geoffrey Tranmer, associate professor, College of Pharmacy

Grant: $100,000 (one year)

Tranmer will focus on edaravone, one of the few drugs approved to treat amyotrophic lateral sclerosis. In its current form, this medication has many limitations. Tranmer’s team plans to develop improved versions of edaravone and test them in order to optimize the drug and prepare it for advanced clinical trials.

Dr. Sonia Udod, associate professor, College of Nursing

Grant: $450,000 (three years)

Udod’s research will examine how health system leaders have adapted in response to the pandemic. She aims to determine how leaders can build their own and nurses’ psychological health and well-being to ensure a healthy workforce and organizational resilience at hospitals during and after the COVID-19 crisis.

Dr. Roberta Woodgate, distinguished professor, College of Nursing; Canada Research Chair in child and family engagement in health research and healthcare; researcher, CHRIM

Grant: $776,475 (five years)

Woodgate’s youth-centred, mixed-methods study aims to understand the impacts of COVID-19 on the mental health and well-being of Manitoba youth who have come of age during the pandemic. The findings will inform recommendations to improve services and supports for this population.

Grant: $100,000 (one year)

Woodgate’s team will also conduct a youth-centered, arts-based longitudinal study that will result in the creation and evaluation of a toolkit. This toolkit, co-created by youth, will be designed for use in schools to foster social connectedness and optimize youth mental health and well-being.

“I’m humbled,” said Dr. Vidyanand Anaparti, a research associate in the department of internal medicine at the Max Rady College of Medicine. “I’m honoured my research made the list.”

But this isn’t the first time Anaparti’s work has made the annual list highlighting research breakthroughs in the area of arthritis. Anaparti’s findings have been featured on the list for 2019 and 2020. 

The research that most recently made the list began 12 years ago, when samples of synovial tissue were collected from the knees of 17 patients with early rheumatoid arthritis. Synovial tissue is a connective tissue that surrounds joints. It’s where rheumatoid arthritis begins, Anaparti said.  

After the synovial tissue was collected, the patients’ clinical data was gathered over 12 years and the scientists discovered that the patients could be placed into two groups. One group of patients had significantly high levels of matrix metalloproteinase (MMP) and the other group of patients had low levels. MMP is a group of enzymes that break down proteins found in spaces between cells in tissues. The enzymes were responsible for tissue degradation of synovial tissue and increased inflammation, Anaparti said.  

The research team observed that people with high MMP responded well to treatment, had lower joint inflammation and a reduction in swollen joint count than those who had low MMP levels. The study was published in Frontiers of Medicine last year.

“We can predict by analyzing the genes expressed in the tissue biopsy of an individual who will respond to treatment better and who will resist treatment,” Anaparti said. “We need to collect more samples and conduct more studies to validate our model, but this is definitely a big start and a step closer to a precision medicine based approach to treating rheumatoid arthritis.”

Dr. Siân Bevan, chief science officer, Arthritis Society Canada, said that one in five Manitobans has arthritis and it’s time to transform how we understand and treat this disease.

“By revealing new insights about the molecular features and outcomes of people with rheumatoid arthritis, this research could help tackle the common problem of patients going through trial-and-error cycles before finding the best treatment for them,” Bevan said.

This research will not only benefit patients but the health-care system as well, Anaparti said. The system will save money because patients won’t be on treatments that don’t work for them, he said.

“My sincerest congratulations to Vidyanand on this important accomplishment,” said Dr. Hani El-Gabalawy, professor of internal medicine and immunology at the Max Rady College of Medicine, who is Anaparti’s supervisor along with Dr. Neeloffer Mookherjee, professor of internal medicine and immunology. “The basic and translational research he has undertaken at the Manitoba Centre for Proteomics and Systems Biology provided new insights into how the early molecular and cellular patterns found in the inflamed joints can predict the outcomes of rheumatoid arthritis up to 15 year later.”

The interdisciplinary team is one of only four research groups in Canada to receive funding from CIHR’s Human Immunology Research Teams grant, an initiative to study autoimmune diseases with the goal of improving the knowledge of the human immune system.

“We’re delighted to receive this CIHR funding, but we also recognize the challenges ahead in undertaking such an interdisciplinary project,” said Dr. Hani El-Gabalawy, professor of medicine and immunology and Endowed Rheumatology Research Chair, Max Rady College of Medicine.

The project, titled Prediction and prevention of rheumatoid arthritis in First Nations People, has three aims. The first aim is to improve biomarkers in predicting whether someone will develop rheumatoid arthritis.

El-Gabalawy, the project’s principal investigator, said that rheumatoid arthritis “starts before it starts.” Meaning that before someone develops sore, stiff or swollen joints, and a diagnosis can be made by a doctor, the person has biomarkers in their blood that show their immune system isn’t functioning properly, he said.

The biomarker could be present for up to 10 years before the person develops any symptoms, El-Gabalawy said. However, not everyone who has these biomarkers will develop rheumatoid arthritis. So part of what the research team is trying to do with this first aim is to find better ways of predicting who will develop rheumatoid arthritis.

The project builds on team members’ previous research that showed that rheumatoid arthritis is very common in some First Nations families. El-Gabalawy said that the disease can be particularly damaging and resistant in First Nations people.

Aim two of the project will be a randomized clinical trial in First Nations communities to see whether the combination of turmeric, omega-3 and vitamin D can reduce the risk of rheumatoid arthritis based on biomarkers developed through the first aim. In support of this approach, team members’ previous research showed that this combination of supplements helped prevent inflammatory arthritis in mice.

Co-investigator Dr. Dylan Mackay, an assistant professor in the department of community health sciences and a clinical trialist with the George & Fay Yee Centre for Healthcare Innovation, said that if the results of the trial are favourable, it could mean that treatment costs could be reduced or avoided with the trio of affordable supplements.

“Some of the modern rheumatoid treatments are incredibly expensive,” said Mackay, who is a lead on the clinical trial. “Finding lower cost alternatives that maintain the health of people would be fantastic.”

Researchers will screen about 1,500 people to find under 200 people with biomarkers to be eligible for the study.

The third aim will look at the experience of First Nations people as they progress through the clinical trial from start to finish. Amanda Fowler-Woods, a PhD candidate in the department of community health sciences, Max Rady College of Medicine, said that there have been clinical trials done with Indigenous people before but this would be the first-ever study to gather their experiences.

“We want to know if Indigenous peoples are feeling like research is still not being done in a good way, because if you look at history, that makes perfect sense,” said Fowler-Woods, who is a lead on the third aim. “Our peoples weren’t treated well. Scientific experiments were done on Indigenous peoples, not with them. And the results of that have been traumatic, so this is an opportunity to actually get constant feedback on what we are doing good, and what we are not doing good on.”

Fowler-Woods said that this is also a chance to build a framework for how to combine Indigenous methodologies with quantitative research so scientists are not only doing research with First Nations people but they’re taking care of their spirits, and protecting and honouring who they are.

“It excites me that the communities will feel respected, and they’ll start to see that there’s a possibility that research is actually working to help,” Fowler-Woods said.

El-Gabalawy said that one of the things that thrills him about this project is that it brings seasoned scientists – like Dr. Aaron Marshall, head of the department of immunology, Dr. John Wilkins, professor of internal medicine and director of the Manitoba Centre for Proteomics and Systems Biology, and Dr. Neeloffer Mookherjee, associate professor within the departments of internal medicine and immunology – together with up-and-comers like Fowler-Woods, Mackay, Dr. Liam O’Neil, assistant professor of internal medicine, and Dr. Vidyanand Anaparti, a post-doctoral fellow in the Max Rady College of Medicine.

“I’m excited because this project leverages lots of different expertise at the University of Manitoba,” Mackay said. “I’m glad that CIHR recognized that and funded the project.”

This support, through the Canadian Institutes of Health Research, will help Canadian researchers study the full spectrum of health issues affecting the lives of Canadians.

While visiting the university, Eyolfson highlighted the $9.7 million in funding that will go to researchers in Manitoba.

Eyolfson highlighted the work of Dr. Josée Lavoie, a University of Manitoba researcher who works on kidney health care in rural and remote Manitoba First Nation communities. Manitoba First Nations have the highest documented prevalence and the second highest incidence of end-stage kidney disease in Canada. Canadians living in rural/remote locations and requiring care experience significant barriers. Dr. Lavoie will receive $1.5 million to support her research.

“These investigators are all leading experts in their fields. This recognition through the highly competitive CIHR project grants program is testament to the high impact of their research and the investigations these funds will support,” said Dr. Digvir Jayas, Vice-President (Research and International), University of Manitoba.

Other announcements are happening across the country to highlight the diversity and strength of Canada’s health research community. The total amount of funding announced by Minister Petitpas Taylor is $372 million.

U of M projects funded:

Lavoie, Josée G., Community Health Sciences, $1,575,900
Kidney health care in remote Manitoba First Nation communities

Karimi-Abdolrezaee, Soheila, Physiology & Pathophysiology, $1,059,525
Therapies for spinal cord injuries

Driedger, S. Michelle, Community Health Sciences, $864,450
Fostering trust through joint clinical decision making

McKenna, Sean A., Chemistry, $784,125
Investigating the regulatory role of RNA-G4 helicases

Fowke, Keith R., Medical Microbiology, $772,650
Reducing HIV target cells in the female genital tract

Dhingra, Sanjiv, Physiology & Pathophysiology, $749,700
Preserving stem cells in the heart

Hatala, Andrew R., Community Health Sciences, $745,875
Participatory health with Indigenous youth in Canadian cities

Azad, Meghan, Pediatrics & Child Health, $742,050
Breast milk and allergic diseases

Mookherjee, Neeloffer, Internal Medicine/Immunology, $661,725
Regulatory mechanisms in the control of asthma

Murooka, Thomas T., Immunology, $573,750
Understanding how viruses are transported from one cell to another

Sibley, Kathryn M., Community Health Sciences, $443,700
Ensuring health research is incorporated into everyday practice

Slater, Joyce, Food & Human Nutritional Sciences, $393,976
Building Evidence to Inform Policies and Programs for Food and Nutrition Security in Manitoba Youth

Riediger, Natalie D. Community Health Sciences, $359,551
A proposal for introducing a pop beverage tax to combat diabetes

Total amount: $9,726,977