When someone is in respiratory failure, a ventilator takes over breathing to keep oxygen levels stable. However, this support can sometimes harm the lungs, diaphragm, brain, and circulation. New research from UHN shows that both too little and too much breathing effort while on a ventilator can be harmful for critically ill patients.
For patients on a ventilator, if the ventilator does most of the work, the diaphragm can weaken, and parts of the lung may collapse. The brain also becomes inflamed, leading to delirium and cognitive impairment. At the same time, excessive breathing drive—the body’s natural signal from the brain to breathe—results in high breathing effort which can injure the lungs and diaphragm, strain the heart, increase oxygen use, and cause distress. Keeping breathing drive and effort at a moderate level may help prevent these problems, especially in patients with severe lung injury.
However, current ventilator guidelines do not address breathing drive or effort, and their clinical impact on recovery has been unclear. To address this, researchers analyzed data from 1,186 adults who received mechanical ventilation at Toronto General Hospital’s intensive care unit (ICU) between June 2019 and April 2022. Daily measurements of breathing drive and effort were collected for up to 10 days, along with indicators of lung stress and oxygen levels.
The study found that both insufficient and excessive breathing drive and effort were linked to worse outcomes, including a higher risk of death and lower rates of leaving the ICU. Patients with low blood oxygen levels were particularly vulnerable to these effects. Overall, the findings suggest that how much a patient breathes on their own while on a ventilator can affect recovery.
This is the first study to report on the link between breathing drive, breathing effort, and patient outcomes. Monitoring these factors during ventilation could help detect risk early. Personalized ventilator support and other treatments to optimize breathing effort could significantly improve survival and recovery for these patients.
Dr. Jose Dianti, former postdoctoral researcher at the University of Toronto and current Physician at CEMCIC, Buenos Aires, is the first author of the study.
Dr. Ewan Goligher, Senior Scientist at UHN and Associate Professor in the Departments of Medicine and Physiology, is the senior and corresponding author of the study.
This work was supported by the National Sanitarium Association and UHN Foundation.
Dianti J, Lovblom LE, Iftikhar MA, Sahetya S, Telias I, Urner M, Del Sorbo L, Amato MBP, Slutsky AS, Brochard L, Ferguson ND, Fan E, Goligher EC. Association of respiratory drive and effort with mortality and time to discharge in patients on mechanical ventilation in Canada: a longitudinal, prospective, registry-based cohort study. Lancet Respir Med. 2025 Sep 19:S2213-2600(25)00297-8. doi: 10.1016/S2213-2600(25)00297-8. Epub ahead of print.
On World Science Day for Peace and Development, UHN announces the launch of the 2024–2025 Research Report: Driving Discovery, Delivering Impact. This report showcases TeamUHN’s goal of turning discovery into impact through collaboration, innovation, and a shared commitment to improving lives.
This year’s research report celebrates the transformative role science plays in shaping a healthier future. Highlighting advancements in regenerative medicine and AI-generated tools, the report explores how innovation is driving progress toward novel therapies, smarter diagnostics, and more. The report also emphasizes new approaches to making health care more accessible and inclusive. Central to these advances is the power of collaboration—demonstrating how partnerships across disciplines and institutions are fueling scientific progress.
Aligned with the 2025 World Science Day theme, “Trust, Transformation, and Tomorrow: The Science We Need for 2050," the report underscores how UHN’s research continues to shape a more sustainable and equitable future. Guided by our Research Strategic Action Plan, we are driving innovation through Transformative Experiences, Solutions Beyond Boundaries, and Alignment for Impact.
This year’s research report features research advancements, milestones, awards and other highlights from across UHN’s research spaces, including the following:
● UHN’s Research Strategic Action Plan, launched in spring 2025, aims to drive impactful, inclusive, and purpose-driven research and empowers teams to collaborate, accelerate innovation, and translate discovery into real-world solutions.
● Researchers at UHN are redefining care and bringing health care to communities through mobile health clinics.
● Scientists are engineering human heart tissue from human cells to study early cardiac development and have uncovered a role of cardiac immune cells.
● A new AI-driven tool, AnnoSpat (Annotator and Spatial Pattern Finder), was developed to identify different cell types and map their spatial position in tissues, helping scientists better understand how cells behave in tissues.
● UHN has introduced six Collaborative Centres, purpose-built hubs where scientists, clinicians, engineers, policy experts, and patients work together to address some of health care’s most complex challenges. Several Centres are building partnerships to expand their reach and impact.
Join us in celebrating a year of discovery and progress toward A Healthier World.
Click here to read the full report. Previous reports can be found here.
Watch the 2024–2025 UHN Research Report welcome message from Dr. Brad Wouters, Executive Vice President of Science and Research at UHN.
Heart disease is the leading cause of death for people on dialysis, yet few therapies have shown clear success in reducing that risk. Despite facing cardiovascular risks up to 20 times higher than the general population, individuals with kidney failure have had limited options to protect their heart health. Now, results of a new international study published in The New England Journal of Medicine offer a promising path forward.
The PISCES trial, also known as the Protection against Incidences of Serious Cardiovascular Events Study with daily fish oil supplementation in dialysis patients, was led by Dr. Charmaine E. Lok of UHN and the University of Toronto. The study followed 1,228 patients receiving hemodialysis at 26 sites in Canada and Australia. Participants were randomly given either daily fish oil capsules or placebo capsules and followed for 3.5 years.
The fish oil capsules contained omega-3 fatty acids, specifically EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid). These are natural substances found in fish that help reduce inflammation, prevent blood clots, and support heart rhythm. People on dialysis often have very low levels of these nutrients, which may increase their risk of heart problems. By taking fish oil, patients may be restoring a healthier balance in their bodies.
The results were striking. Patients who took fish oil had nearly half the number of serious heart-related events—including heart attacks, strokes, amputations due to poor circulation, and deaths from heart disease—compared to those who took the placebo. Even patients who had already experienced a heart event saw benefits.
“While other heart protective medications have been shown to be beneficial in the general population, they haven’t consistently reduced cardiovascular events in the hemodialysis population,” said Dr. Lok. “Fish oil supplementation is a simple, well-tolerated intervention that could have a meaningful impact.”
Importantly, the study found no increase in bleeding or other serious side effects, which was once a concern with omega-3 supplements. Blood tests showed that patients taking fish oil had higher levels of EPA and DHA, confirming that the capsules were absorbed and used by the body.
Further research is underway to better understand how fish oil works in patients receiving hemodialysis. But for now, the findings suggest that daily supplementation of specific omega-3 could be a safe and effective way to protect the hearts of people on hemodialysis.
Dr. Charmaine E. Lok, lead and corresponding author of the study, is a Senior Scientist at UHN and Professor at the Faculty of Medicine, University of Toronto. She also serves as Medical Director of the Hemodialysis Program at UHN.
This work was supported by the Heart and Stroke Foundation of Canada, Lawson Health Research Institute, Peter Munk Cardiac Care Innovation Fund, Kidney CARE Network International, the National Health and Medical Research Council, in-kind contributions from DSM (formerly Ocean Nutrition Canada), and operational support by UHN Foundation. The study also received a philanthropic donation from Mr. Alexander Epstein. This work was in part supported by a personnel award (Dr. Charmaine Lok) from the Heart and Stroke Foundation, Ontario Provincial Office.
Lok CE, Farkouh M, Hemmelgarn BR, Moist LM, Polkinghorne KR, Tomlinson G, Tam P, Tonelli M, Udell JA. Fish-Oil Supplementation and Cardiovascular Events in Patients Receiving Hemodialysis. N Engl J Med. 2025 Nov 7. doi: 10.1056/NEJMoa2513032.
On October 28, UHN’s Krembil Brain Institute, Schroeder Arthritis Institute, and Donald K. Johnson Eye Institute hosted the 2025 Krembil Science Jam: Spotlight on Discovery.
Now in its second year, the event brought cutting-edge science to life for an enthusiastic audience of over 130 attendees. Ten leading UHN researchers shared their latest research in dynamic, five-minute TED Talk-style presentations, offering insights into some of today’s most pressing health challenges. Speakers were introduced by host Mary Ito, whose wit and thoughtful questions kept the evening engaging. Topics ranged from Alzheimer disease and Parkinson disease to low vision, osteoarthritis, and mental illness:
● Dr. Mark Reed shared how a childhood fascination with fire led him to his pursuit of new drugs that could stop diseases in their tracks.
● Dr. Melanie Cohn discussed her application of economic principles to improve cognitive assessments for diverse patient populations with Parkinson disease.
● Dr. Heather Baltzer described how her team is co-developing a sensory-feedback thumb prosthesis with engineers at the University of Toronto.
● Dr. Ishrat Husain’s shared his work on bridging the gap between mental and physical health care
● Dr. Martin Ingelsson spoke about using precision medicine to develop immunotherapies that can treat neurodegenerative disorders like Alzheimer disease.
● Dr. Valeria Ramaglia walked through her group’s investigation to catch the “criminal” responsible for memory loss in multiple sclerosis—the complement system.
● Dr. Anthony Perruccio discussed his family legacy of firsts at Toronto Western Hospital and his quest to reshape how osteoarthritis is understood and treated in Canada.
● Dr. Hance Clarke inspired with his bold vision to redefine how chronic pain is managed across Canada.
● Dr. Monica Daibert-Nido spoke about using biofeedback training and VR to retrain the brains of people with low vision.
● Dr. Christopher Kim shared ways to treat knee osteoarthritis, including robotic-assisted knee replacements and injectable cell therapies.
Attendees and presenters also had opportunities to network, creating a vibrant space for connection among donors, media, researchers, and supporters. Attendees left the event inspired by the shared mission of building A Healthier World.
For those who missed it, the Krembil Science Jam will be available to watch online soon, and you can listen to the Krembil Science Jam playlist here.
For the first time, presenters competed for research funding, thanks to generous sponsors:
● First Place ($100,000, Krembil Foundation): Dr. Mark Reed
● Second Place ($60,000, Krembil Foundation): Dr. Valeria Ramaglia
● Third Place ($40,000, Donald K. Johnson, OC): Dr. Melanie Cohn
● People’s Choice Award ($50,000, Give Back Health Innovation Foundation): Dr. Valeria Ramaglia
A new study from UHN’s Schroeder Arthritis Institute identified a potential biomarker—a measurable substance in blood that signals disease—for ulcerative colitis in patients with axial spondyloarthritis (AxSpA). This is a type of inflammatory arthritis that can cause chronic back pain in young adults. These findings may help make ulcerative colitis diagnosis easier and less invasive for people with AxSpA.
Research has shown that AxSpA and Inflammatory bowel disease (IBD) are closely linked. IBD is a group of conditions that cause swelling and inflammation in the digestive tract. Up to 10% of people with this form of arthritis also have IBD, and both conditions share genetic risk factors and immune connections between the gut and joints. Ulcerative colitis is a type of IBD that causes inflammation and ulcers in the colon.
While there is no cure for AxSpA or ulcerative colitis, treatment can manage symptoms and improve quality of life. For ulcerative colitis, early detection is important because treatment can heal the colon and prevent disease progression. Currently, diagnosing ulcerative colitis requires invasive techniques such as endoscopy and gut biopsy. A blood-based biomarker could offer a simpler, more measurable way to detect the disease.
Recent studies have identified an autoantibody—an antibody that mistakenly targets the body’s own cells—in patients with ulcerative colitis. This autoantibody reacts to a protein called integrin αvβ6, found in tissues throughout the body, including the gut. These anti-integrin autoantibodies are called AIAs, and until now, their role in AxSpA has not been studied.
Because AxSpA and IBD often occur together, the research team wanted to see if this same biomarker could help identify ulcerative colitis in people with this type of arthritis. They analyzed blood samples from patients with AxSpA—with and without IBD—as well as healthy individuals.
The results showed that patients with both AxSpA and ulcerative colitis had significantly higher levels of AIAs compared to those with AxSpA alone. The presence of AIA was also linked to a family history of IBD in these specific patients with both inflammatory diseases. Further analysis showed that the AIA test had moderate accuracy as a marker for ulcerative colitis in patients with AxSpA.
This is the first study to examine AIAs in people with AxSpA. The findings suggest that AIAs could serve as a useful diagnostic tool for detecting ulcerative colitis in patients with joint inflammation, potentially improving early diagnosis for those with overlapping inflammatory diseases. These findings also support further research on using AIAs as a general ulcerative colitis biomarker, especially in people with a family history of the disease.
Enoch Yau, a former graduate student in Dr. Inman’s lab at UHN, is the first author of the study and is currently a medical student at Western University.
Dr. Robert Inman is a Senior Scientist at Schroeder Arthritis Institute and a Professor in the Departments of Immunology and Medicine at the University of Toronto. He is the corresponding author of the study.
This work was supported by UHN Foundation.
Yau E, Chim T, Lim M, Inman RD. Anti-Integrin αvβ6 Autoantibodies as a Biomarker for Ulcerative Colitis in Patients With Axial Spondyloarthritis. J Rheumatol. 2025 Sep 15:jrheum.2024-1296. doi: 10.3899/jrheum.2024-1296. Epub ahead of print.
Dr. M. Cristina Nostro, Senior Scientist at UHN’s McEwen Stem Cell Institute, Associate Professor at the University of Toronto, and the Harry Rosen Chair in Diabetes Regenerative Medicine Research, has been honoured with the prestigious 2025 Till & McCulloch Award in Ottawa.
This award recognizes the most impactful publication in stem cell research by a Canadian researcher that year. This year, Dr. Nostro is recognized for her publication titled “Embryonic macrophages support endocrine commitment during human pancreatic differentiation,” published in Cell Stem Cell in November 2024.
This work is the first to utilize a co-culture of human embryonic stem cell (hESC) derived pancreatic beta-like cells and macrophages—a type of immune cell—to better model the environment in which pancreatic cells form during normal embryonic development. Dr. Nostro and her colleagues uncovered the key role of immune cells in the development and survival of endocrine cells of the pancreas. By leveraging this discovery, researchers can improve their models of the endocrine pancreas, make their results more reflective of in vivo processes, and hopefully bring the field closer to understanding and treating diabetes.
Dr. Nostro received the award surrounded by some of the best scientists, clinicians, bioengineers, and ethicists in stem cell and regenerative medicine, as well as representatives from industry, government, healthcare, and non-profit sectors from Canada and abroad.
For more details on this prestigious award and the Till & McCulloch Meetings, visit www.tillandmcculloch.ca.
The Government of Canada has announced the latest round of funding for the Canada Research Chair (CRC) program. Over $198 million will support 259 new and renewed CRCs.
Congratulations to the following UHN researchers who have received new or renewed funding through the CRC program:
● Dr. Mohit Kapoor, Tier 1 Canada Research Chair in the Mechanisms of Joint Degeneration (renewal). Dr. Kapoor is a Senior Scientist at UHN’s Schroeder Arthritis Institute and a Professor in the Departments of Surgery and Laboratory Medicine and Pathobiology at the University of Toronto (U of T). His research focuses on understanding osteoarthritis and how it damages joints, finding biomarkers for early identification of disease, and developing treatments to prevent or reverse the disease.
● Dr. Rama Khokha, Tier 1 Canada Research Chair in Adult Tissue Stem Cell Niches (renewal). Dr. Khokha is a Senior Scientist at UHN’s Princess Margaret Cancer Centre and a Professor in the Departments of Medical Biophysics and Laboratory Medicine and Pathobiology at U of T. Funding from this Chair will support research on tumour microenvironments and adult stem cell populations, their role in cancer, and the development of advanced lab models and genetic tools to study human cancers.
● Dr. Paaladinesh Thavendiranathan, Tier 2 Canada Research Chair in Cardio-Oncology (renewal). Dr. Thavendiranathan is a Senior Scientist at UHN and a Professor in the Department of Medicine at U of T. Funding from this Chair will support his research in improving prediction, prevention, and care for patients with cancer who are at risk of cardiovascular disease.
● Dr. Walter Swardfager, Tier 2 Canada Research Chair in Clinical Pharmacology of Cognitive Neurovascular Disorders (renewal). Dr. Swardfager is an Affiliate Scientist at UHN’s KITE Research Institute, a Scientist at Sunnybrook Research Institute, and Associate Professor and Associate Chair in Department of Pharmacology and Toxicology at U of T. His research focuses on the key molecules underlying how type 2 diabetes damages small blood vessels in the brain, increasing the risk of dementia. He is also studying whether new diabetes drugs can help protect brain health.
● Dr. Goldie Nejat, Tier 1 Canada Research Chair in Intelligent Assistive and Collaborative Robots (new). Dr. Nejat is an Affiliate Scientist at UHN’s KITE Research Institute and a Professor in the Department of Mechanical & Industrial Engineering. Funding from this Chair will support the development of a new generation of intelligent, collaborative robots to assist people who are living with dementia and other chronic conditions.
The CRC Program is a national initiative designed to make Canada a global leader in research. Through this program, the federal government has invested approximately $311 million annually to support world-class researchers across disciplines, enhancing academic excellence, competitiveness, and the training of future skilled professionals.
See here for a full list of results and here for the press release.
Research at UHN takes place across its research institutes, clinical programs, and collaborative centres. Each of these has specific areas of focus in human health and disease, and work together to advance shared areas of research interest. UHN's research spans the full breadth of the research pipeline, including basic, translational, clinical, policy, and education.
See some of our research areas below:
Research at UHN is conducted under the umbrella of the following research institutes. Click below to learn more:
