Dean's Report 2023

That’s because Popovic, who is also Director of KITE at the Toronto Rehabilitation Institute-University Health Network, believes successful researchers need to work with experts of other backgrounds to achieve successful results.   

“I’ve always been enthusiastic about bringing people together who have very different skill sets to work on the same project,” he says.  

“Researchers have a tendency to work in silos. It’s natural. If I’m an engineer, I focus on engineering. Medical doctors do the same thing. But the excitement and the new things happen when you are very uncomfortable. And the way to become uncomfortable is to work with people in varied fields, who share the same goal.” 

Take Popovic’s current work with Cindi Morshead, Professor and Chair of the Temerty Faculty of Medicine’s Division of Anatomy at the Department of Surgery. 

The duo are using electrical fields and electrical stimulation to multiply and move stem cells in the brain.  

The hope is that their work will create new methods of treating people who have experienced strokes, or traumatic brain injuries.  

“When you pool skill sets together, it’s not one plus one. It’s three or four,” he says. “Working with Prof. Morshead is a perfect example of that. She’s the best in working with stem cells. And I bring an engineering background with a knowledge of electrical stimulation and devices. We’ve come together to create new technologies. It’s only when you create these types of ecosystems of expertise that you come up with something exceptional.” 

Initially, Popovic’s own research started by focusing on treatments for people with spinal cord injuries. His work then grew to developing technological tools for people who had experienced strokes, and then extended again to research on developing therapies for people with traumatic brain injuries. 

Currently, in addition to his work on stem cells with Morshead, Popovic is also running a clinical trial. The trial will evaluate a therapy that stimulates facial muscles called Duchenne markers, to treat people with depression.  

Temerty Medicine is unique because of its relationships with hospitals through the Toronto Academic Health Science Network, he says. 

“From the Medical Sciences Building on campus, you are within a five-minute walk of some the best health care institutions in the world. What is exciting is that all of these hospitals have direct partnerships and relationships with Temerty. It’s one-of-a-kind,” he says. “With these relationships, you have access to patients and access to funding that other schools don’t have. It’s what makes Temerty a very exciting place.”  

Popovic points to the CenteR for Advancing Neurotechnological Innovation to Application (CRANIA). The centre — which develops devices to assist people with neurological conditions — opened in May 2021, launched by the University Health Network and the University of Toronto. 

“Physically, CRANIA is located at Toronto Western Hospital, where there are operating rooms and MRI systems, which are needed for these kinds of projects. But all the materials sciences and physiology work is done at U of T. This is the only centre in the world that has this kind of collaboration,” says Popovic.  

The results speak for themselves, he says. 

“You have design of neural prosthetics done by engineers, physiologists and computer scientists, then you cross the street and work with neurosurgeons, neurologists and physiotherapists, who can implant the device in the patient and test it with the patient,” he says. “It’s remarkable.”  

Ask a microbiologist or immunologist, on the other hand, and they are likely to share a more literal take on those words. In the nearly 170 years since Whitman wrote his poem, science has uncovered that humans do indeed contain multitudes — of tiny organisms that live in our bodies and affect health. 

Now, a new study from University of Toronto researchers is shedding more light on how the community of microbes in our gut contribute to a well-functioning immune system and defend against harmful pathogens. 

“The fact that there are these vast ecosystems of bacteria, fungi, viruses and other microbes living inside us really reshaped the way I see the human body,” says Pailin Chiaranunt, a PhD student in the Department of Immunology at U of T’s Temerty Faculty of Medicine and lead author of the study.  

Called the microbiome, this collection of microorganisms that live in and on our bodies plays a critical role in health and disease. Certain microbiome features — for example, whether there is more of one species or less of another — have been linked to a variety of health outcomes, from autoimmune and mood disorders to cancer risk and treatment response.  

After learning about the microbiome as an undergraduate student and then falling in love with immunology as a research technician, Chiaranunt became interested in how the microbiome and immune system interact with each other, particularly in the gut. This led her to U of T to pursue a PhD with Arthur Mortha, an Associate Professor of Immunology who studies the crosstalk between the immune system and gut microbiome. 

“The gut is probably one of the most dynamic ecosystems in the body because you essentially have the outside environment inside of you,” says Chiaranunt. “There’s a lot of work the immune system must do to maintain a balance between tolerating helpful microbes, food and other outside factors, and being able to mount an effective defense against pathogens like Salmonella that might show up.”  

In their study published in Science Immunology, the researchers turned their attention to macrophages, key immune cells whose job is to gobble up cellular debris and foreign microbes and kick start the immune response.  

Using mouse models, they first found that the transformation of monocytes, a type of white blood cell, into macrophages in the gut requires both a diverse microbiome and a host factor called CSF2. Then, in a series of elegant experiments, Chiaranunt and her colleagues identified the microbial factor driving macrophage development as ATP, a molecule that is universally used as energy currency across all forms of life. 

Their work also uncovered how microbial and host factors work together to support a robust immune environment in the gut: ATP produced by resident bacteria in the gut activates immune cells within a network of small, lymph node-like structures across the intestinal tract. These cells then produce the host factor CSF2 which spurs monocytes in the structures to become response-ready macrophages. 

The researchers further showed that the macrophages born from this pathway have high metabolisms and as a result, produce a lot of antimicrobial chemicals called reactive oxygen species. The abundance of these chemicals, in turn, contribute to the immune system’s ability to ward off microbial intruders in the gut.  

“That was a really cool finding because it suggests a new way in which microbial metabolism can directly impact immune cell metabolism,” says Chiaranunt, who recently defended her PhD thesis and is preparing to start a postdoctoral fellowship at the University of California San Francisco. 

While other studies have also found a link between the microbiome and macrophage development, this paper is one of the first to uncover how gut bacteria triggers white blood cells to become macrophages. The identification of CSF2 as a key contributor to that process also highlights the potential of CSF2-targeting treatments to modulate the immune response in people with autoimmune disorders and inflammatory bowel disease.  

“Our results bring us a big step closer to understanding the biochemical language spoken by the microbiota,” says Mortha. “Assembling a comprehensive dictionary for this language will help us to interpret when and why friendly and offensive messages are used by gut microbes to communicate with our immune system.”  

In addition to other members of Mortha’s lab, this study also included collaborators Slava Epelman, a clinician scientist in U of T’s Department of Medicine and at University Health Network, and Thierry Mallevaey, an Associate Professor of Immunology at U of T. Mortha, Epelman and Mallevaey are all members of the Emerging and Pandemic Infections Consortium, a U of T Institutional Strategic Initiative focused on developing innovative responses to infectious threats. 

As she planned her future over the past year, the 18-year-old turned to the Temerty Faculty of Medicine’s Summer Mentorship Program (SMP) to draw a clearer picture of her goal and how to make it a reality. 

The SMP gives high school students of African or Indigenous ancestry an opportunity to learn about health-sciences education at the University of Toronto. Over four weeks in July, participants explore medicine, rehabilitation sciences, pharmacy, dentistry, kinesiology, nursing, public health and social work — through hands-on activities, lectures and special projects. 

Students also receive a science credit they can apply toward their Ontario Secondary School Diploma.  

“The SMP gave me a new understanding of the research process and how various health professions help people,” says Tynes-McKenzie. “I enjoyed hearing from the speakers who gave open and honest insight into the work they do. There’s a sense of mystery surrounding a lot of fields, but to hear an insider’s perspective was valuable.” 

This year, the SMP welcomed 108 students, the largest in-person cohort to date. The program began in 1994 with seven participants, and since then about 1400 students have participated. Roughly one-quarter have gone on to pursue postsecondary education and careers in the health sciences or health-care professions. 

Some past participants have also returned to inspire new generations of young people. 

“The SMP played a pivotal role in shaping the way I thought about my future,” says physiotherapist Joanne Ukposidolo, a student in the program nearly 20 years ago who is now a program volunteer. “It opened up the world of health professions and allowed me to see the many different opportunities to explore. I want to give back to the community and guide students, help them see, navigate and execute on the endless career possibilities for them in health-care fields.”  

Though many program students come from Toronto and surrounding communities, some travel from other parts of Ontario and stay in student housing on campus. This summer, Temerty Medicine welcomed five students from outside the Greater Toronto Area, including two from the James Bay coast.  

Temerty Medicine’s Office of Access and Outreach and Office of Indigenous Health are working to spread the word about the SMP to Indigenous learners in particular, in remote, northern communities.  

Last winter, the Faculty was one of several Ontario medical schools invited by the Weeneebayko Area Health Authority to visit communities in the James Bay coast region. Temerty Medicine staff Lindsey Fechtig and Renée Huntley visited the area to share information about the SMP and STEAM Design, an experiential learning program for high-school students from equity-deserving groups who want to help solve health-care system issues. 

Fechtig and Huntley hope to make the trip an annual event, to help encourage more young Indigenous people to take part in the SMP and other programs at Temerty Medicine. 

A related initiative, SMP Discover, allows students who have completed the SMP to continue their learning through additional community-building experiences, internships, mentorship opportunities and online workshops. 

Students in U of T and other undergraduate programs can also join Community of Support, which provides information about, and help with, the medical school admissions process as well as other experiences for learners from under-represented groups. 

“We have strong partnerships, not only with our Office of Indigenous Health, First Nations House and health-professions faculties at U of T, but also with the Ministry of Education, several local school boards and many community organizations,” says Ike Okafor, who founded and leads the Office of Access and Outreach. “We’re thankful to our partners and thankful for the unwavering support in inspiring and transforming our participants’ futures.” 

For Tynes-McKenzie, her time in the SMP is now a memory, but she has a sharper focus for her future and is in the first semester of a medical sciences program at Western University. She is equipped with a new network of contacts in health care, she says, and is more excited than ever about her plan to apply to medical school and a new dream of becoming a neurosurgeon or cardiologist. 

A new initiative called the Enhancing Teacher Performance (ETP) program is designed to help educators at the Temerty Faculty of Medicine sharpen their teaching skills.  

The program was launched by the Centre for Faculty Development in the fall of 2022, to help faculty members enhance their teaching effectiveness in clinical and laboratory settings. One-to-one coaching is complemented by customized learning activities, simulated teaching encounters and debriefing, targeted workshops and curated resources. 

Sev Perelman, a Professor in the Department of Family and Community Medicine who has been teaching for many years, became one of the ETP program’s first participants after he received some negative learner feedback. 

“We can all fall into habitual behaviour patterns. Some might be helpful, but others may not be,” Perelman says. “The ETP program helped me evaluate my teaching approach. I’m developing more empathy for learners, which took on new importance after I did the program. The coaching, role-playing, and everything I learned helped me change my mindset and the way I check in with and provide feedback to trainees. The experience was profound and impactful.”    

Professor Latika Nirula, Director of the Centre for Faculty Development, says that some participants register for the ETP program after discussing mentorship with their departmental chairs, while others are referred to address performance concerns raised by learners or departmental leaders.  

The idea, she says, is to support lifelong learning and encourage a growth mindset among educators. 

“Some of these faculty members have won awards for teaching at other points in their career,” says Nirula, who is also the program’s lead and one of its coaches. “That just shows how important it is to continue working to refine one’s process. The environment is changing, and people’s personal needs and approaches can change, too. New evidence emerges all the time to show us how to best support medical education. We may all need to adapt over time.”  

The program is open to all faculty members who wish to register, regardless of how long they’ve been teaching. The program is designed to be flexible and to allow faculty members to join at any time. It can take participants three to six months to complete a personalized plan, depending on their own schedules and when workshops are offered.  

Once they’ve completed the program, faculty may continue to support their own ongoing development by engaging with the centre’s extensive programming as general centre members for free. 

As Temerty Medicine works toward promoting wellness, resilience and respect within the learning environment, the ETP program offers each participant a plan tailored to meet their individual goals and work context. Coaches also consider student feedback and any skills the teacher may want to focus on. 

“It’s around the faculty shifting practices that aren’t working,” Nirula says. “Our learners feel more empowered to share concerns about their experiences in the teaching environment. We want faculty to embrace that feedback and create spaces for more effective dialogue. Constructive feedback needs to go both ways.” 

Nirula also hopes to expand and diversify the pool of coaches, which currently stands at three, as the program attracts more participants.  

Having channeled negative feedback into positive changes, Perelman credits the ETP program with helping him foster a more supportive relationship with his students and says he hopes more of his colleagues will benefit from the program, too.