April 8, 2016

Last summer, Charles Berniqué suffered from what doctors initially thought was an extreme case of food poisoning after a birthday lunch out with his wife. His esophagus had burst, and a giant infection was taking over his body.

“I thought when I got home I could walk it off, but it wasn’t the case,” Berniqué said. His wife got him back in the car, and he was swiftly admitted to hospital.

Once in the care of medics, what started out as a treatment for possible food poisoning rapidly turned into a rescue mission for something else entirely: septic shock.

Berniqué, a 73-year-old grandfather of five from Hawkesbury, Ont., would become one of the first patients last summer to receive a new and experimental stem cell treatment for septic shock at The Ottawa Hospital. The hospital’s ongoing clinical trial, which will involve nine patients in total, is the first in the world to use stem cell therapy to treat cases of septic shock, an often fatal infection found in intensive care units.

“When you look back at where I started and how sick I was, it’s just a miracle,” Berniqué said. “The hospital here was just amazing. The people are so, so helpful. At all levels.”

Septic shock can start with something as simple as a bacterial infection. Patients’ organs begin to fail because their immune system goes into overdrive to fight the infection and their entire body becomes inflamed. The body’s reaction can be too much for many older people or those with weakened immune systems. There are currently no known remedies beyond fighting the symptoms.

There are more than 100,000 cases of septic shock a year in Canada. The infection can have a 20 to 40 per cent mortality rate and their treatment costs Canadians $4 billion annually.

In hospital last June, Berniqué was placed into an induced coma to help combat the septic shock. His wife, Maureen Berniqué, who wanted to give her husband the best chance for recovery, consulted with specialists and decided with close family to participate in the hospital’s stem cell trial involving a new treatment called Cellular Immunotherapy for Septic Shock. CISS was used to help Berniqué in addition to traditional treatment.

Within 24 hours of the decision, Berniqué received a dose of 30 million mesenchymal stem cells delivered intravenously. Mesenchymal stem cells have unique properties that modify the immune system and promote tissue healing rather than just produce new cells. The stem cells used by Berniqué were given by an anonymous Ottawa donor.

In the three months following the treatment — and despite a number of medical complications from the septic shock — Berniqué slowly recovered and is now back at home and working part-time.

Before Berniqué, the research had showed promise early on. Dr. Lauralyn McIntyre and her team of researchers at The Ottawa Hospital Research Institute found the stem cells performed the way they had predicted in animal tests.

“We had very compelling pre-clinical data, that this may work very well,” said Dr. Duncan Stewart, executive vice-president of research and senior scientist at The Ottawa Hospital.

The early stages of the research showed survival rates tripled when the treatment was used on animal models that had conditions similar to septic shock.

“We were incredibly impressed with the magnitude of the response in terms of being able to prevent inflammation, being able to reduce organ injury and improve survival in all animal models,” said Stewart.

Another surprise in the animal model research was that the cells also helped clear the bacteria that was attacking and infecting, and may even have encouraged tissue healing. “(Stem cells) helped the body get rid of bacteria even though they were reducing inflammation. So, that was really interesting,” said Stewart.

Stem cells play the role of “building blocks” in our bodies. They grow in our bone marrow and most organs, and can be thought of as tiny self-contained cell factories that develop into other cells that grow into what makes up useful things such as hearts, blood, bone and muscles. Medical science has created ways for us to share stem cells with each other — like we do blood — so their reconstructive properties can be used.

Certain kinds of stem cells have been used to treat illnesses such as leukemia, bone marrow deficiencies and aplastic anemia. In the case of Berniqué, this was the first time stem cells were involved in treating a widespread infection.

CISS is an Ottawa-grown treatment. Each step of the way, researchers, scientists and donors from Ottawa have contributed to the results. McIntyre began work on this method in 2012.

Once researchers were able to pinpoint the cells required, they turned to anonymous donors in the Ottawa area. The donated material was then cultivated and grown at a stem cell manufacturing centre at The Ottawa Hospital, where the treatment was performed.

Jennifer Ganton, a spokeswoman for The Ottawa Hospital, cautioned that the trial is in its early stages, but said the research shows promise. She said doctors hoped the stem cells helped fight back Berniqué’s large bacterial infection, but don’t yet know if the cells played a role in healing him.

“We can’t make any claims about how (mesenchymal stem cells) are working in humans until we finish the trial,” said Ganton. “However, the results have been promising enough that we have received funding to start scaling up our stem cell production for a larger trial.”

Stewart sees this use of stem cells as a technology that could turn the medical industry on its head.

“We’re working hard to start a larger trial next year, and it looks like things are falling into place for that,” Stewart said. “If those results were very definitive, within three to five years, there might be a compelling need to offer this therapy.”

As for the Berniqués, they are happy Charles is home again with their dog, Google. It took about six months after his initial emergency in June for his life to completely go back to normal. In January, he received word he doesn’t need to return to the hospital until next year. He said he’s grateful to have a chance to potentially be a part of medical history.

“If people come out of this like I have, it’s amazing. It’s something that’s needed,” Berniqué said.


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