The power of collaboration: Basic and clinical researchers explore the mysteries of Inflammatory Bowel Disease

Thursday, October 25, 2012
Photo Cathy Streutker and Stephen Girardin
Profs. Cathy Streutker and Stephen Girardin

“I tell my students, ‘This is how a pathologist wins the Nobel Prize.’ They were going against everybody and they couldn’t get their research published,” Professor Cathy Streutker, Director of Surgical Pathology at Toronto’s St. Michael's Hospital explains. She continues, “It was the collaboration between a gastroenterology fellow who needed a project and a pathologist who kept observing an unusual bacterium that led to this incredible discovery.”

Inspiring her students, Prof. Streutker describes the remarkable collaboration between a young gastroenterology fellow and a senior pathologist in the early 1980s. It was the partnership between the Australian gastroenterologist Dr. Barry Marshall and the pathologist Dr. Robin Warren that created a paradigm shift in our understanding of gastritis and peptic ulcers: they were not caused by stress but rather by the bacterium Helicobacter pylori. Remarkably, the duo had found a cause and cure for a serious condition that affected millions worldwide; in 2005 they were awarded the prestigious Nobel Prize in Physiology or Medicine.

While collaboration in research is common, it is the unique combination of basic and clinical research that sets the Department of Laboratory Medicine and Pathobiology (LMP) Professors Stephen Girardin and Streutker apart. Since 2010, the pair have been investigating the role of immune modulators and how they affect inflammatory disorders such as Crohn’s disease, a painful and often debilitating condition affecting more than 100, 000 Canadians. More specifically, they are studying the role of Nod-like receptors (NLRs) and how the defective function of these receptors might contribute to an individual's susceptibility to the disease. If they can better understand the role of these receptors, then the disease can potentially be controlled.

To date, their research has led to four papers in journals such as Infection and Immunity, Gastroenterology and, in 2011, they published “Identification of an innate T helper type 17 response to intestinal bacterial pathogens” in Nature Medicine.

In her work with the highly regarded Prof. Girardin, Prof. Streutker’s expertise in histology (the study of tissues) is essential and she often alters the scoring schema of a project to make the research more accurate and relevant. The samples are collected from Prof. Girardin’s laboratory, made into slides at the Toronto Centre for Phenogenomics and then sent to Prof. Streutker for blinded review. At the end of a project, Prof. Streutker provides crucial material for the pathology portion of the paper.

Prof. Girardin describes the unique partnership, “The knowledge of being able to score mouse models is pretty rare. It’s hard to find people with this expertise so we were lucky that she wanted to develop her research. It was a win-win situation."

Prof. Streutker agrees, “I have been pushing residents to build their research portfolios. You don’t get senior author papers but you get co-author in very good journals. How else am I going to get into Nature Medicine? It’s not going to happen unless I’m collaborating with someone at Stephen’s level. It’s been a great opportunity for me to work with him and I really appreciate the trust that he has in me to do the job.”

It’s clear that the duo's approach has a transformative effect on students such as Prof. Girardin’s PhD candidate Stephen Rubino. Rubino explains, “When you’re a clinican you’re trained to be a really good observer. Cathy’s really good at observing what is normal and what is diseased. What is really good about researchers is that we question a lot. We don’t just observe but we go deeper into the mechanisms and ask ‘how’ or ‘why.’ If you can combine those two aspects - the observational abilities and the questioning - you get groundbreaking research.”

This unique combination of observational and questioning skills illustrates the diversity and power of the department. Referring to the inspirational Marshall and Warren collaboration and her own approach, Prof. Streutker explains, “It’s a great example of how if you keep thinking about what you’re looking at, sometimes you get remarkable and unexpected results.” With this open-minded approach, perhaps the future holds yet another seismic shift.