The Canadian Institute for Health Research (CIHR) presented this highly competitive award to Dr. Lange in recognition of the translational research program he has developed, focusing on The Development of Novel Therapeutic and Preventative Strategies for Kidney Stone Disease. This award will allow Dr. Lange and his research team to continue diligently working on their novel research towards improving the treatment and prevention of kidney stone disease.

Novelty of Research Program: Currently, no basic science or translational research program dedicated to developing novel treatment/preventative options for kidney stone disease (KSD) exists across the country, making the research program at The Stone Centre at VGH the first of its kind in Canada. The novelty of Dr. Lange’s independent research program is further illustrated by the approach taken to develop innovative treatment/preventative strategies for KSD. To date, the majority of research in this area is driven by clinicians and focuses on improving surgical interventions or diagnostic tools in an attempt to decrease the incidence of KSD. While some progress has been made in improving these aspects, the incidence continues to climb. This is mostly due to the fact that current approaches do not address specific mechanisms associated with the failure of treatment and preventative strategies.

Dr. Lange deems that a paradigm shift in research is required to generate innovative and efficacious treatment/preventative options. As such, his research program focuses on identifying and targeting specific molecular mechanisms that have remained unconsidered. Specifically he is focusing on improving the functionality of ureteral stents, which are the most abundantly used treatment to maintain some urine flow in the presence of an obstructing stone, or following surgical intervention to remove the obstructing stone while the ureter heals. Currently, ureteral stents are associated with significant complications in at least 80% of stented patients including infection, encrustation and discomfort associated with the fact that overall ureteral function is significantly impaired with a stent in place and minimal urine flow occurs due to gravity and pressure changes in the filling bladder. The end result is residual pressure buildup and expansion of the kidney. In this context, Dr. Lange’s independent research program studies molecular mechanisms that drive ureteral dysfunction associated with obstruction and indwelling ureteral stents and focuses on the development of novel stent coatings to prevent device-associated infection and encrustation. In addition, he is studying mechanisms that drive recurrent KSD in an attempt to develop novel therapies to prevent disease recurrence. In this context, he is studying the role of the intestinal microbiome in recurrent KSD as dietary oxalate is a major source of oxalate in the body.

We would like to give a special thank you to the members of the Stone Centre Advisory Group for their support and guidance in our research!

Sullivan Research Day was an all day educational program hosted at the Paetzold auditorium at VGH on June 21, 2016. This event featured various lecturers that were invited to talk about their respective research in the field of urology. These lectures included presentations from Doctors, residents, fellows, and students in a variety of topics such as clinical research, cell plasticity and treatment resistance, genomics and bioinformatics, metabolism, and novel diagnostics and therapeutics as they pertain to various cancers.

One of the Stone Centre’s very own students – David Choy – was selected to present his ongoing metagenomics research project at this prestigious event.

Here is a short brief on the presentation…

“The Relationship between Bacterial Enzyme Pathways in the Gut and Metabolic Imbalances in Kidney Stone Patients”

Introduction: In kidney stone disease (KSD), patients suffer from excess absorption/production of oxalate that combines with calcium in the kidney to form calcium oxalate stones. In this study,  we want to find out how the bacteria in the gut microbiome use their metabolic enzymes to regulate oxalate and other metabolites in and across the gut.

Methods: Fecal samples were collected from 17 patients with calcium oxalate kidney stones and their non-stone forming healthy spouses. DNA is extracted from the fecal samples and shotgun-sequence using Illumina HiSeq and the NexteraXT metagenomics library kit. The DNA sequences were then aligned to five gene databases to obtain meaningful annotations. The DNA was also sequence specifically for 16s_rRNA genes to identify the bacteria present.

Results: Metagenomics sequencing results show that patients and controls had different prevalences of genes involved in glyoxylate, butyrate, and vitamin metabolism. These pathways play a role in oxalate and calcium regulation because glyoxylate is a precursor for oxalate in hepatocytes, butyrate promotes the integrity of the colonocyte gut lining and therefore absorption of ions across the gut, and vitamin metabolism regulates calcium absorption respectively. These observations are further supported by 16s_rRNA data that showed controls had a higher prevalence of butyrate-producing bacteria of the Lachnospiriceae and Ruminococcaceae family. Additionally, we found that patients did not have any Oxalobacter formigenes (a well-known oxalate degrading bacteria) in their gut while most controls did.

Conclusions: These results suggest that bacterial enzymes play a role in regulating the absorption, degradation and secretion of oxalate in the gut whether by directly degrading oxalate or by affecting other metabolites. Further study may uncover targets in bacterial enzyme pathways for treatment of metabolic disorders like KSD.

Congratulations David!

For more information on the metagenomics project please visit our ongoing clinical research page!

Dr. Lange was featured in an article “The art of standing out amongst your peers” from the Schulich Medicine and Dentistry at Western University:

When Dirk Lange, PhD’08, was just about to graduate from Schulich Medicine & Dentistry’s Department of Microbiology and Immunology, he recalls speaking to a visiting professor about how to move forward and find great success in his career. The professor encouraged him to find a niche area in research that he could become the leading expert in.

Eight years later, Lange is the Director of his own basic science research program in the University of British Columbia’s Department of Urological Sciences, and has been recognized as one of the biggest up-and-coming researchers in the field of urology. We sat down with Lange to discuss his current role, and whether or not he would pass along the same advice he once received to current trainees in the Department of Microbiology and Immunology.

For full article click here.

The second annual Stone Centre event was held at the Paetzold Health Education Centre  on June 23, 2015.

With over 100 participants ,   this event featured educational talks from the Stone Centre’s Doctors, as well as research engagement and participatory hands on learning. The audience was composed of past and current patients at the Stone Centre as well as family members, friends, and community guests.

000000000000000000000000000000000000000000000000000Educational talks on kidney stone epidemiology, diet and prevention, and research strives to improve prognosis kick started the event, followed by two patient perspectives and an interactive session. Guests were then given the opportunity to mingle with each other and with health care providers to ask any further questions and/or participate in current research studies.

As part of the interactive session the dietitians held hands on dietary advice session with visual presentation. There was also a ureteroscopy simulator that was run by the urology residents where guests had the opportunity for hands on feel of a kidney stone removal procedure. At the general stone disease information and research booths guests could learn more about clinical and laboratory research projects (including a video presentation of the research laboratory), have conversation with the research team, and pick up brochures and pamphlets for more information.

Judith Andrew and Lynn Tomita are registered dieticians at the Chronic Kidney Disease Clinic. At the event they presented a talk on diet and how it affects the chances of developing stones. They stressed the importance of  a healthy diet and went over thorough dietary recommendations on fluids, sodium, fruits & vegetables, protein oxalate and calcium.

Following the success of the 2015 Stone Centre event, the Stone Center team here at VGH has decided to start a focus group. The focus group will serve as a tool to further our efforts in bridging the gap between doctor and patient perspectives.   Making sure that patients’ needs and concerns are listened to and met is a top priority for the Stone Centre team. In bridging this gap we hope to raise our standards of care, focus our research efforts and decrease the amount of stress that patients have when dealing with their stone disease. We are currently in the recruitment process and are looking for potential candidates.

Overall this years’ event was larger and even more informative than last year! Thanks to generous help from the Stone Centre team and donors for refreshments and door prizes we were able to make this event happen. For a list of our donors please see a list below. If you missed out this year, please do not hesitate to contact us for more information and future patient engagement initiatives including our patient focus group and fundraiser, via phone: 604-875-4111 ext. 62421, or email: olga.arsovska@ubc.ca.

Charitable Donors: 

https://www.choicesmarkets.com/

https://www.safeway.ca/

http://www.nestersmarket.com/

kinsfarmmarket.com

www.saveonfoods.com/

http://livehappywater.ca/

http://vancouverwateradventures.com/

http://cafeami.ca/

https://www.davidstea.com/

http://www.broadwaywineshop.ca/

We need you: Great opportunity to help with our fight against kidney stones!

The Stone Centre Focus Group will further our efforts bridging the knowledge gap between physician care and patient priorities, while improving future research strives. We are currently in the recruitment process and are looking for volunteers.

The focus group will give the Stone Centre team input on kidney related issues from a patient perspective. Making sure that patients’ needs and concerns are listened to and met is a top priority for the Stone Centre team. One of our goals is to be supportive of including patients to guide their own care. We aim to raise our standards of care, focus our research efforts, and minimize the effects of this disease.

The focus group will meet once a month for a 1-1.5 hour long session, starting in early fall 2015. These sessions will involve respectful and inclusive group discussions centered on improving prognosis and prevention of kidney stone disease. We are looking for individuals who are willing to share their personal experiences with stone disease and work together with our team to find solutions. The group discussions are entirely confidential. Light refreshments and snacks will be provided during group meetings.

Ideal candidates are good communicators and listeners, as well as enthusiastic and optimistic about treating and minimizing their stone disease. We encourage everybody who is interested to apply as we are looking for a diverse group.  This will allow the focus group to cover the full spectrum of kidney related issues.

Those who are interested in joining the focus group or for more information can contact us at the office 604-875-4111 ext. 62421 or email: kristina.pavlovic@ubc.ca.