Cold truths from the world of virology

At the Research Matters Curiosity Shop people ask questions they’d like Ontario university researchers to answer. Recently, a visitor to the Shop asked: “Can we ever cure the common cold?” Research Matters tracked down Ana Sanchez, an infectious disease expert and instructor of medical microbiology at Brock University to get some answers.

Spoiler alert: It does not sound as though the facial tissue and cough medicine industries are in any danger.

Research Matters:    Why is it so hard to find a cure for the common cold?  
Ana Sanchez:    The first reason is because the disease is not caused by a single pathogen. There are more than 100 types of rhinoviruses that cause the symptoms we have come to know as the common cold. Then we have adenoviruses, coronaviruses and other groups that cause colds as well. Within each group, many variations can occur, providing different qualities to viruses, to which we must adapt and so our immune system can react appropriately . It would be a challenge to find a drug or vaccine that targets of them.

So, the diversity of the pathogens is, is the first challenge.

RM:     What else?
AS: Another challenge is that these viruses change a lot. They mutate. So even if we were to create a treatment it would be like a moving target.  It would be like the influenza, where we have to make new vaccines the time. Unless scientist find a special part of the virus molecule; a molecule that is common to an entire group and does not change much, the challenge will remain.

RM: Are viruses more challenging to treat than bacterial infections?
AS: For the longest time we were not able to create drugs to treat viral infections because scientists couldn’t identify a particular physiological aspect of a virus they could target. Bacteria are cells – living organisms with active metabolisms. They have membranes, cytoplasms, and nuclei we could decipher. We understand them better, which makes them easier to fight.

With viruses, we now know we’re not targeting live cells. Viruses are actually not “alive” although they carry a code for life. They don’t replicate by themselves, they don’t have metabolism.  They are the ultimate parasites and need to colonize a cell to do that, right?  So even when we may have drugs to inactivate viruses, because they live inside our cells, many time we end up damaging our own cells as well. As biotechnology advances, however, scientist are more able to conceive drugs or treatments to fight viruses off without causing too much damage to the patient.

Now, not viral infections are difficult to deal with. Some viruses, like hepatitis B are very stable, so it was possible to create a vaccine you can trust. It depends on the virus.

RM: Can scientists learn anything from the human immune system about curing colds?
AS: They could, but that’s really beside the fact. We get an infection, and our body successfully deals with it within a few days. We mount a strong cellular and antibody response and end up winning the battle.

But then we get another virus and another. There’s no end to the diversity of cold viruses.

RM: So, what’s the long-term prognosis for a cure?
AS: Curing the common cold is a terrible challenge. And remember that it is not really a severe disease. For most people, it is a nuisance. There’s a lot of people with the illness, but it’s not like influenza or other respiratory diseases that tend to be more serious. And even if there was a vaccine that worked for some cold viruses, it’s going to be hard to convince people that the vaccine works because they will get another cold from another virus and think, ‘Well this vaccine didn’t work well.’

RM: Is this just a never-ending battle, then?
AS: Each time there is a medical advance in virology – like the way we’re starting to better control HIV – we think we’re winning the battle against infectious agents. We have better drugs and people are living longer.  Then, boom, there’s something else.

Take Ebola. In the mid-1970s, Ebola became an issue for a period of time, and then we heard nothing for years. We thought maybe it was just a fluke. And then just comes back.

Of course, living a healthy life with good nutrition and good rest will improve your immune system to fight pathogens. And fighting pathogens (most of the time successfully) is something that we humans have been doing forever…

We are born with an immune system exactly because we need to fight these pathogens.  It’s there for a reason. But the other side is also always going to be there.

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Bathroom talk

Sharon Oosthoek | April 16, 2015

Alex Mihailidis is known as "the talking bathroom guy" for his research into computerized devices designed to help those with dementia live more independently in their homes. The University of Toronto biomedical engineer created a bathroom with sensors to detect when someone standing idly at the sink has forgotten how to wash their hands. The sensors trigger a gentle voice that leads them through the process of turning on the tap and using the soap. And if they need extra help, there is a video screen in front of the sink to demonstrate proper technique. Mihailidis's bathroom adapts to the user so that if it's their habit to take 30 seconds to lather up, it will wait 30 seconds before prompting them to rinse. He has put his bathroom through a series of rigorous tests at the Toronto Rehabilitation Institute's mock apartment, set up for studying assistive technologies in the home. People with mild to moderate Alzheimer’s disease living in long-term care homes in Toronto came in to help, showing that they are able to complete 25 per cent more of the required steps with the bathroom's prompts. Testing is crucial, says Mihailidis. Anywhere from 70 to 90 per cent of assistive devices are abandoned after a short period of use. Often it's because designers haven't deeply considered users' abilities, education and cultural or social backgrounds. Mihailidis is just wrapping up a research project to understand how these factors affect people's use of assistive technologies. The project relies on questionnaires, focus groups and interviews with caregivers. "Technology is the easy part" His resolve to get it right comes from a chance meeting years ago, with an engineer whose wife had Alzheimer’s disease. The man talked about how both he and his wife were embarrassed when he had to help her in the bathroom. He said he wished there was some device that could prompt his wife to use the toilet and sink, and give her back her dignity. "That kind of stuck with me," says Mihailidis. "Technology is the easy part. I mean it may take us a few years to perfect it. But what we really need to understand is how this technology affects people's lives." Mihailidis is also working on an interactive robot that can help people with dementia complete daily tasks such as making a cup of tea. Unlike the bathroom technology, which stays put, the robot can follow someone into the kitchen. Preliminary tests at Toronto Rehab show people with dementia are willing to interact with the robot and follow its prompts. Mihailidis's team — keenly aware that our population is aging ­— is encouraged by these results. "We are still in the research phase. These are complex technologies," says Mihailidis. "But our goal is have people use these technologies in their home to keep them living there independently as long a possible."

Healing gardens

Araina Bond | April 13, 2015

Nathan Perkins is dedicated to improving people’s health, one woodland path at a time. “Connecting with nature is incredibly important for health and wellbeing,” says the associate professor at the University of Guelph’s School of Environmental Design and Rural Development. His work is part of a body of research that demonstrates the powerful benefits that come from interacting with natural environments. In fact, studies show even a five-minute walk outdoors can lower blood levels of the stress hormone cortisol. Whether it’s as complex as a walk through a labyrinth or as simple as being able to move a chair to a place in the sun, research shows that a vital part of happiness and healing involves being in a healthy environment. While there are many studies that link nature – even something as simple as gardening or caring for a house plant – with good physical and mental health, Perkins has seen the effects first hand. He recalls keenly how a staff member at a health centre he helped design once told him: “What a huge difference this design makes for our clients. They are self-medicating on nature!” Perkins also works with schools and other institutions, and he’s designed projects on three continents. While each is different, they are all about finding the best ways to connect people with nature. His first major project was working with Guelph's Homewood Health Centre, a psychiatric hospital with programs for helping patients deal with addictions. “I was their designer in residence,” he says. “It was the highlight of my academic career.” Participatory design crucial to project Since the historic Homewood Health Centre houses a daycare where Perkins’ own children attended, the beautiful grounds are also an opportunity for stimulating interaction. “The clients got so much joy from watching the kids play in the gardens,” he says. “But the children also learned that people with addictions and mental health issues are just regular people.” Perkins explains that environments that inspire wellbeing are about more than just beautiful flowers. He believes in a process of participatory design from beginning to end. Patients and staff at Homewood, for example, were not only consulted throughout, but were also involved in long-term initiatives such as the herb garden and nature trail. “We all need a pilgrimage experience, a contemplative meditative space. It can be as simple as having chairs that people can move to create their own space,” he says, pointing out that in many institutions such as hospitals, chairs are bolted to the floor. Perkins has published several studies showing the benefits of involving staff, patients and even visitors in the design process. In designing institutions, he says, so much of the process is focused on long term cost-saving measures. “That’s how you end up with windows that don’t open,” he explains. “I’m a big believer in windows that patients can open. If you can’t have that, it could be something as inexpensive as putting a bird feeder outside the window.” Perkins notes that research shows small changes, such as having a hospital room with a view, can lead to shorter stays and less pain medication. In fact, he still treasures a letter sent by one former patient with addictions issues thanking him for the woodland trail he’d designed. She said it gave her hope and helped her heal. “I want to change the world,” says Perkins, and there is little doubt that he is on the right path.

Fix that leaky pipe

Sharon Oosthoek | April 9, 2015

There was a time when mould in your house — even so-called toxic black mould — was considered a mere aesthetic problem. "Until 1988, it was assumed if mould grew in a building, it was just ugly and not much of a health hazard," says David Miller, an expert in fungal toxins and allergens at Carleton University. "That assumption was absolutely wrong." Miller's research has been instrumental in changing our understanding of how mouldy homes harm our health, and in creating building codes and government policy to lessen those effects. Mould is a colloquial term for fungi that grow on things such as food and damp building materials. When it reaches a critical mass on the wall or a cold corner of a house, bits of the fuzzy stuff break off and become airborne or collect in dust. These fragments contain toxins and proteins, some of which are allergens, and all of which are small enough to travel deep into the lungs. People living or working in damp and mouldy buildings are at increased risk for asthma and respiratory problems such as colds and flu. Miller helped establish this link by honing techniques for assessing exposure in a way that is relevant to our health. In partnership with a large clinical lab, he works with blood samples from people already known to be allergic. This means their blood contains antibodies produced in response to various allergens, including those from mould in their homes and workplaces. Miller then uses these antibodies to "mine" for allergenic proteins produced by mould. He does this by extracting proteins from the most common species of fungi that grow on damp building materials. These are then purified on a special gel that also separates them. Next he spreads a dilution of the antibodies over the gel. "If there is a protein that the antibody recognizes, it will stop there and stick," he says. This tells him that the proteins from building samples come from moulds that have an adverse affect on our health. Don't forget to ventilate Such research is especially important in Canada, where children — whose developing immune systems make them vulnerable — spend about 90 per cent of their time indoors. That's a problem, given that between 10 and 30 per cent of homes in North America have moisture issues leading to mould growth. Part of the reason for this, says Miller, is we began to better insulate our homes in response to the 1970s' energy crisis. That's a good thing for reducing energy and greenhouse gas emissions. But for a long time we didn't pay enough attention to proper ventilation, giving mould a damp breeding ground. "A typical family of four emits two to seven kilograms of water every hour from things like cooking, cleaning, showers and faulty venting on clothes dryers," says Miller. "If it isn't vented properly, the water goes into the fabric of the building." Thanks to the work of Miller and others, we now better understand the risks. This has led not only to building codes requiring better ventilation, but also to public education campaigns encouraging people to repair leaky pipes, use kitchen and bathroom exhaust fans and make sure clothes dryers are properly vented. "Changing building codes requires evidence. Making public policy requires evidence," says Miller. "That's where I've tried to make my contribution."

Let the voting begin: ...

Sharon Oosthoek | April 8, 2015

Did you know the anti-blackout suit, which gave Allied pilots the advantage in the Second World War and later enabled space travel, was designed here in Ontario? Or how about evidence used in the canonization of the first Canadian-born saint, or the development of the colour motion picture process Technicolour? Yep, all advances made here in Ontario. On April 1, the Research Matters team launched a fun-online campaign at www.yourontarioresearch.ca to highlight the 50 game-changing discoveries made in this province’s universities over the last 100 years. The list includes well-known ones — insulin and the Group of Seven, anyone? It also includes discoveries with less profile, but just as much impact. Check out our top picks and see for yourself. As hard as it was for people here at Research Matters to narrow down the list to 50, the big challenge is now up to you to vote for your favourite discovery. Voting began April 1 and will continue all summer at fairs and public events as the game changers go on the road with the Research Matters’ Curiosity Shop. The public’s top-five favourites will be announced in the fall. Of course, measuring the impact of university research can be a personal matter — for some people it might be about how a certain discovery in medicine saved their mother's life. For others, it may be how it led to public policy that created new possibilities for peace and democracy. My personal favourite? As an enviro geek, my vote goes to techniques pioneered in Ontario for assessing water quality, contaminant transport, climate change and changing wildlife stocks in critically-important ecosystems. I'm proud of our home-grown discoveries and I hope you are too. Let this be an opportunity to delve deeper into research that matters to you. Be sure to keep up to date on twitter – you can find us at @OntarioResearch and use the hashtag #researchmatters. Check out the full list of game-changing discoveries at http://yourontarioresearch.ca/ and vote for your favourite.

Walmart and groceries

Paul Fraumeni | March 11, 2015

A little more than one year ago, Shelley Broader, CEO of Walmart Canada, announced her chain was moving fully into the grocery business. Walmart’s Canadian stores had added full grocery lines to some of its larger outlets, but Broader’s plan was to inject $500 million into expanding the number of Walmarts that offer groceries. Canada seems to have a full complement of grocery stores already, with Loblaws, Metro, Sobey’s, Longo’s, Costco and the discount stores related to some of these chains. Are we at the point of market saturation? We asked Professor David Soberman for his thoughts. Soberman is a professor of marketing and the Canadian National Chair of Strategic Marketing at U of T’s Rotman School of Management. Q. Almost all Walmarts will soon offer a full line of groceries. Don’t we have enough grocery stores already? No. The simplest explanation for why Walmart is entering the grocery market is that the population of Canada is growing, so we would expect there to be an increasing number of grocery stores. A lot of people perceive this as being a massive increase to the number of chains but if you go back 20 or so years ago you had IGA, Food City, A&P, Dominion, and Loblaws. The bottom line is that even in those days we had five or six chains. Q. So it’s more about the product line, not the number of chains? Right. The focus today is on combining a variety of product lines that used to be offered in separate stores. One-stop shopping is the key now. People used to separate their grocery shopping from other shopping. So you might go to a mall to do Christmas shopping, for example, or to buy clothing or school supplies for your children. But for your groceries, you would have to make a separate trek to the supermarket. Now, it’s all being combined. That’s the main reason Walmart is expanding into groceries. They already carry household products and clothing. Potentially this can put Walmart in a bit of a pickle because they have something like 400 stores but half of them don’t really have complete grocery sections. Now they are ramping that up so that the majority of their stores include the full grocery section. The idea is that when people think of going grocery shopping they’ll actually go to Walmart. Q. How do grocery stores distinguish themselves? Don’t they really all offer pretty much the same products? No, I think they do actually create distinct images. Sobey’s, Loblaws and Metro all have discount stores, so that enables them to compete by reaching different audiences. And even the discount versions, like FreshCo, No Frills and Food Basics, each offer a somewhat different approach from each other in the discount sector of grocery shopping. But the gold standard is Loblaws. They’ve created very much their own image with their pioneering efforts in private labels, with President’s Choice and No Name, and the collection of products they’re offering. That approach has really helped them to create differentiation. Q. What about the higher-end grocery stores, like Pusateri’s and McEwen? Do they make a difference to the overall grocery industry? This is called segmentation. In cities like Toronto, Vancouver, Calgary or Montreal you have a certain segment of the population, maybe 5 or 10 percent, who are high-income earners who like to spoil themselves with exotic foods or imported items that cost a bit more but that offer different tastes and experiences. This is not the sort of thing sold en masse by a Sobey’s or Metro because the turnover isn’t there and these kinds of products are not part of their model. In contrast, the objective of a Pusateri’s or a McEwen is precisely to allow shoppers to find the exotic foods or imported items that cannot be found elsewhere. They charge a higher price so they don’t need the volume of a prototypical supermarket: as long as a specialty grocer like Pusateri’s has a steady flow of customers, the business model is viable. Whatever big city you go to you’ll see these types of stores. In London, England, you see Fortnum and Mason and in Paris, you see Fauchon which is the same sort of shopping experience, for wealthier people who want special jam or imported escargots imported from a certain region of France. But these grocery stores don’t have a negative influence on the business of the larger chains.   A longer version of this story was originally published by the University of Toronto. It has been edited for clarity, accuracy and brevity, and is republished here with permission. 
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