Paediatric Respiratory Diseases: An Interview with Dr. Theo Moraes
By: Arpita Parmar
Theo Moraes, MD PhD FRCPC
Staff Respirologist, The Hospital for Sick Children
Assistant Professor, Department of Paediatrics, University of Toronto
Dr. Theo Moraes is a Staff Respirologist at the Hospital for Sick Children, an Assistant Professor in the Department of Paediatrics at the University of Toronto, and an Associate Faculty Member of the Institute of Medical Science. Dr. Moraes leads a basic science laboratory at the Peter Gilgan Centre for Research and Learning at SickKids, and supervises three students.
I had the opportunity to sit down with Dr. Moraes, who shared his passion of being a clinician-scientist at the forefront of translational research.
Can you tell us about your education background and training?
I completed my undergraduate degree at Queens University—I was originally in biochemistry, but I transferred to life sciences. I then went to medical school at the University of Toronto, and after that, went back to Queens for my residency in paediatrics. I subsequently completed a fellowship in paediatric respiratory medicine at SickKids, a PhD through the IMS with Dr. Greg Downey as my supervisor, and post-doctoral training in immunology with Dr. Tania Watts.
What motivated you to pursue the dual role of a clinician-scientist?
I always had an interest in clinical medicine. After I got into medical school, I knew that I would want to be in paediatrics, because I love working with children. It wasn’t until I did my elective at SickKids that I became interested in academic medicine. I liked the energy and excitement of being in a dynamic center where things are always changing and new knowledge is being generated. Academic clinicians generally have additional responsibilities outside of clinical medicine. As such, I had to consider my interests carefully. I always liked mechanisms—trying to understand how things work. That is why I chose to pursue graduate training in a basic science laboratory. As a clinician-scientist I have a wonderful mix. I love seeing patients and having interactions with people. At the same time, I can also go somewhere else and think about how and why things work.
What is the main focus of your laboratory? Does it involve both basic science and clinical research?
The main focus is respiratory viruses; specifically, respiratory syncytial virus (RSV). RSV is the most common reason that babies [are] admitted to hospital and is a leading cause of death in infants around the world. We don’t have a great approach to managing RSV and there are no specific vaccines or therapies to impact the condition. As part of our work, we use primary human epithelial cell cultures that can be infected with RSV. This allows us to examine outcomes after RSV infection and see if our interventions are potentially useful. This model system can also be used to study other diseases, such as cystic fibrosis (CF), which our lab is also researching.
Could you tell us about significant research contributions that your team has made in your area of focus?
A few years ago, we were very lucky to collaborate with Dr. Richard Hegele. Together, we found that nucleolin is a cell-surface receptor for RSV; the receptor for RSV was something that was not known for many years. We are doing some work now to see if we can reduce RSV infection, by blocking or targeting that receptor. Additionally, Mike Norris, my PhD student, has completed some work examining how altering ion concentrations within the cell influences RSV infection. We hope that this will lead to more rational approaches to RSV and potentially other viruses.
Do you see the impact of your research in the clinical setting?
The work that we are doing with cystic fibrosis and epithelial cells is part of a major initiative here at SickKids. The Program for Individualized CF Therapy is a collaboration between Cystic Fibrosis Canada and the SickKids Foundation. This program has the potential to be a great resource for the CF community, Canadian researchers, and potentially international researchers.
The purpose of this program is to better rationalize therapies for individuals. Although many children with CF are treated with the same protocols, there may be an ability to refine therapies that better suit each individual. New studies show that CFTR modulating drugs will work for some patients but not others. Current thinking is that there may be individual factors which predict who is going to respond to different therapies. If we can better understand that, we can tailor therapies to individuals. Specifically, as part of bigger project, our lab can take cells from patients to make epithelial cell cultures. Our collaborators in the Gonska lab can then test CFTR function. We are still in the early stages, but [we] hope this will impact clinical care in the future.
What would be your best advice for someone interested in a career as a clinician-scientist?
Get advice from a clinician-scientist. There are lots of us out there, so find someone you can talk to. There are many different paths you can take to end up with this career. Talking to someone who has navigated the way will help you understand these paths and what may work for you. Mentoring in this way is important.