Dr. Elena Netchiporouk
Assistant Professor - Department of Medicine
The incidence of autoimmune diseases affecting the skin and/or internal organs is rising steadily, but at a rate that cannot be explained by genetics alone. This argues for the importance of environmental causes in disease initiation and, possibly, progression. Pollutants and microorganisms (e.g., viruses) may directly damage our cells and elicit production of auto-antibodies by our immune system against our own cells. My research program focuses on understanding the interaction between environment and autoimmune diseases affecting the skin, specifically chronic urticaria and systemic sclerosis. While both are autoimmune in nature, they are completely different with respect to their clinical presentation and prognosis, which makes them ideal to study in parallel.
1. Clinical and translational research on chronic urticaria, mastocytosis and antiviral role of anti-IgE monoclonal antibodies.
a. Hypothesis: Infection may be responsible for triggering CSU and inducing short-lived autoreactive antibodies. This work focuses on xenobiotic RNA identification in adult CSU patients鈥� derived skin and sera samples using Dual RNA Seq technique. This work is funded in full by Contract Academic Staff operating fund, Canadian Dermatology Foundation and Novartis Pharmaceuticals. As part of this work, I have established the adult chronic urticaria registry at the MUHC and recruit patients into the longitudinal registry and biobank for the above mentioned study on biweekly basis.
b. I have established the adult mastocytosis registry (MASTER) where I recruit patients biweekly. So far, I have recruited 20 patients into the MASTER study. Analysis of comorbidities and complications (e.g. osteoporosis) is being performed, longitudinal data will inform on prognosis and clinical and laboratory biomarkers.
c. Hypothesis: Omalizumab, an anti-IgE monoclonal antibody has demonstrated in vitro and in vivo antiviral activity. I have obtained funding from the Minist猫re d鈥櫭塩onomie et Innovation to conduct a Phase IIb adaptive design clinical trial across multiple sites in Quebec and Ontario to test effectiveness and safety of omalizumab in hospitalized patients with COVID-19 infections. ERB has been approved at the MUHC, pre-approved by Clinical Trials Ontario, approved by Health Canada. Omalizumab is being donated by Novartis. Study coordination is being done as fee for service contract by CATCO Clinical trial platform. Patient recruitment will start by mid-May, 2021.
2.聽Translational and epidemiologic research in scleroderma (Systemic Sclerosis (SSc)) and morphea
a. Hypothesis: SSc and morphea share the common fibrosis pathway, but differences accounting for variable prognosis exist. This work focuses on studying the expression profiling of 3 different sclerodermoid conditions, the SSc, morphea and sclerodermoid GVHD with specific focus on Th17 and Th2 signaling pathways. This work is funded by Contract Academic Staff operating fund, Eli Lilly Inc and Sanofi Genzyme.
b. Hypothesis: SSc/morphea cases distribution in Quebec is not random and may account for environmental and/or occupational triggers. Geographic mapping of SSc/morphea cases in Quebec will be done using administrative databases. This work is funded my Association des M茅decins Sp茅cialistes du Qu茅bec and Contract Academic Staff grant. Along similar line of work, while awaiting RAMQ data, I have analyzed and published (accepted in Current Oncology) a mapping manuscript on gastric carcinoma in Canada (Canadian Cancer Registry data), my team collaborated with Dr. Litvinov on melanoma mapping analysis (CIHR grants) and I am finalizing the data analysis for psoriasis mapping in Quebec to correlate with social deprivation and marginalization index (RAMQ data shared by Dr Rahme).
c. Canadian-MOrphea REgistry (C-MORE). Hypothesis:Subsets of morphea, such as linear, deep and pansclerotic types are less likely to spontaneously resolve, are associated with more severe quality of life and extacutaneous involvement than plaque morphea. Linear facial morphea in adults is less likely to be associated with extracutaneous sequella as opposed to adults given that bony structures are fully formed in adults. Given significant gap in morphea research, development of a national registry will enable us to better study pathogenesis, clinical features, prognosis and elucidate prognostic biomarkers in this rare disease. I am the Principal Investigator and founder of C-MORE which includes 39 physicians across 8 provinces. I have obtained in-kind funding from SkIN Canada (CIHR funded entity) and obtained ERB for the province of Quebec to start patient recruitment and biobanking.
3.聽Montreal Derm FilEZ
a. I have developed an interactive dermatology education platform targeting 1) dermatology residents/ primary care physicians and 2) patients and general public using table format summaries and question banks. The medical professional part has been completed, pending uploading to the website this winter. A randomized controlled educational trial assessing the utility of this tool to improve long term retention of dermatology knowledge by 海角社区 and Laval University dermatology residents at 3-months is being conducted.