Winning the Race Against Organ Failure

With an aging population, researchers are investigating new ways for organs to repair and restore themselves before they shut down.

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The human body has an incredible ability to repair itself after injury, but its capacity for self-regeneration does have limits. And those limits are a source of frustration for kidney doctor Philip Marsden whenever he has to make a diagnosis of organ failure.

“It always frustrated me as a caregiver to talk to the parents of a child whose kidneys had shut down. ‘Why aren’t they healing properly?'” says Marsden.

Marsden works at St. Michael’s Hospital and is also a researcher at the University of Toronto’s Medicine by Design group. He hopes that one day we will understand organ development and repair so well that it will be possible to restore them using the same processes that happen after conception, when all the organs of the body form from a single egg.

“I’m a kidney transplanter, but at its heart I’m interested in what goes wrong with the organs in our body when they get injured,” adds Marsden.

“In kidney disease, the kidney is good at repairing, but not great; and sadly, here in Canada, there are thousands of patients waiting for organ transplants. Our goal is to get fewer patients needing a transplant by making their kidneys regenerate and fix themselves.”

The need will only grow as life expectancies continue to rise, as the risk of organ failure increases with age.

“Wouldn’t it be great to age in a healthy fashion where our organs don’t start to progressively shut down?” says Marsden. “That’s the challenge we have right now: that our ability to fix broken organs is catching up with us, and it’s a major challenge.”

Marsden’s goal is to eliminate the need for chemicals or organ transplants to treat organ failure. Instead his research looks at how organ systems can repair themselves from the ground up, just like they originally form in the embryo.

By looking to the earliest events in our development, it could be possible to age better, and to live longer and healthier lives.

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Dr. Philip A. Marsden is a clinician scientist and nephrologist at the University of Toronto and St. Michael’s Hospital. He is a professor in the Department of Medicine. His research is aimed at understanding the contribution of important endothelial genes to disease processes and novel aspects of how these endothelial genes are regulated. His 130 peer-reviewed papers have over 9000 literature citations in high-impact journals and address the molecular basis for serious diseases of the cardiovascular and renal systems. For instance, Marsden’s laboratory and collaborators described in 1992 the cloning, characterization and functional expression of the nitric oxide synthase that produces nitric oxide within endothelial cells. His work often targets cutting edge processes or molecular pathways regulating gene expression, for example he has recently focused on identifying epigenetic or chromatin-based pathways that are relevant to how endothelial phenotype is regulated in health and disease. 

Marsden has received several awards for his research from the Heart and Stroke Foundation (HSF), the Kidney Foundation of Canada, the Canadian Society of Atherosclerosis, Thrombosis and Vascular Biology and the Department of Medicine at the University of Toronto. He is a member of prestigious societies, such as the American Society of Clinical Investigation (ASCI)(1999), the American Association of Physicians (AAP)(2013), the Canadian Academy of Health Sciences (2013), and the Royal Society of Canada (2014). His has served on a number of editorial boards and research advisory committees. For example, he served as the only Canadian representative on the editorial board of the New England Journal of Medicine (2002-2014). He co-edits the major textbook in Nephrology. He is the Lisa Hofmann Chair in Translational Medicine at the University of Toronto and St. Michael’s Hospital. 

Marsden has held a number of leadership roles. He presently serves as the University of Toronto Departmental Division Director in Nephrology, a position he has held for 8 years. He also serves as the Vice Chair of Medicine, Research, in the Department of Medicine, a position he has held for the three years. He has contributed his research expertise to three Canadian Institutes of Health Research (CIHR) operating grant panels as well as the Kidney Foundation of Canada. He is currently funded by CIHR and National Institutes of Health. Over his career he has always championed group scientific interactions, in order to enhance science at the interface of clinical and basic concepts, and the value of scientific collaborations. He is especially proud that he has trained over forty graduate students and post-doctoral research fellows. He has advocated for trainees seeking careers as Clinician Scientists, has overseen a Clinician Scientist lecture series at St. Michael’s Hospital for over 10 years, and always taken high school students, multitudes of summer undergraduate students and co-op students who express interest in educational opportunities in medical research. 

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