World Hepatitis Day - July 28, 2013

Highlighting Canadian Research

Dr. Naglaa Shoukry
Associate Professor, Department of Medicine, University of Montreal
Director, Viral hepatitis Research Group, CRCHUM

Twenty percent of patients infected with the hepatitis C virus (HCV) spontaneously clear the infection, and Dr. Naglaa Shoukry's goal is to understand why. The Université de Montréal (UdeM) researcher, who recently completed a year-long sabbatical at the Center for the Study for Hepatitis C at The Rockefeller University in New York, has been trying to answer this question for a large part of her career. Her most recent work, published in the June 2013 issue of PLOS Pathogens and partially supported by CIHR, examined the differences at the cellular levels between patients with acute resolving HCV and those with persistent infection, and found that individuals who fail to clear the virus possessed a defect in a specific subset of CD4 T cells; involved in the adaptive immune response and production of IL-21 known as Th17 cells. In contrast, patients with acute resolving HCV develop strong Th17 responses that correlate with an expansion of these CD4 T cells and elevated plasma levels of IL-21. This work suggests a potential therapeutic use for IL-21 in HCV infection, as it could enhance immune responses to other interventions such as vaccines.

This project builds on research that Dr. Shoukry conducted early in her career. A pharmacy graduate of Cairo University, she received her PhD in Immunology from McGill University in 2000. The recipient of a CIHR/Health Canada Fellowship, Dr. Shoukry joined Dr. Christopher Walker's lab at the Children's Research Institute in Columbus, OH for her post-doctoral training. Her interest in hepatitis C infection inspired dually by the HCV problem in her native Egypt, and by the tainted blood scandal in Canada, it was during this time that she established the essential and complimentary roles of CD8 and CD4 T cells in HCV infection, using a chimpanzee model. This work clearly demonstrated that the elimination of CD4 T cells in non-human primates affected viral clearance.

Upon joining the Université de Montréal Hospital Research Centre (CRCHUM) in 2005, Dr. Shoukry established a translational research program focused on HCV, studying various issues of viral immunity in a cohort of high-risk injection drug users. This cohort, the only one of its kind in Canada, is the source of most of the patient samples that Dr. Shoukry uses in her research.  Dr. Shoukry and her colleague Dr. Julie Bruneau from the Department of Family Medicine at UdeM and the CRCHUM are currently investigating viral clearance in repeatedly infected individuals, to better understand the degree and type of protection conferred by previously cleared HCV infection. This information will be beneficial for the development of an effective vaccine against HCV. Development of such a vaccine is a high priority, according to Dr. Shoukry. Building upon infrastructure established with prior CIHR support, she and her colleagues, as part of a team led by Drs Michael Houghton and Lorne Tyrrell at the University of Alberta, recently received funding from Alberta Innovates – Health Solutions for a project aimed at the development of a vaccine for use in humans. Dr. Shoukry believes that vaccination is the key to eradicating hepatitis C infection. Although current treatments are highly effective, there are over 170 million people infected with HCV worldwide, and many of them do not have access to, or cannot afford, these treatments. The problem is more critical in developing countries and among marginalized populations such as Aboriginal peoples. Effective and affordable treatment access, including vaccines, will be needed to fully eradicate this chronic disease.

In addition to maintaining her research lab, Dr. Shoukry is a mentor in the National CIHR Research Training Program in Hepatitis C (NCRTP-HepC). She has received 8 grants from CIHR as a Principal Investigator, and has additional funding from the Fonds de recherche du Québec – Santé (FRQS; through the Reseau FRQS-SIDA et maladies infectieuses) and the Canadian Liver Foundation. She has published extensively in peer-reviewed journals, including 26 articles on hepatitis C.