Skip to main content

Caroline Lamarche MD

Award:  KRESCENT New Investigator Award
Institution:  Hôpital Maisonneuve-Rosemont
Year:  2022-2025

Study title:  Immunotherapy in nephrology

Dr Caroline Lamarche is a clinician scientist and transplant nephrologist at Maisonneuve-Rosemont Hospital. She is an assistant clinical professor at the Université de Montréal. After her nephrology training at the Université de Montréal (2015), she completed a Master degree on the use of adoptive immunotherapy to treat/prevent BK nephropathy in kidney transplant recipients. She then pursued a post-doctoral fellowship with Dr. Megan Levings at the University of British Columbia on the use of chimeric antigen receptor (CAR) regulatory T cells (Tregs) to induce transplant tolerance. Her goal now as a new investigator is to bring immunotherapy to improve her patient’s care. 

Lay Summary
Purpose : The immune system is very important to protect us against infection, cancer and other invaders. However, in certain conditions it can become dysfunctional and lead to inflammation. After a transplantation, the immune system needs to be controlled so it will not recognize the new organ as an invader and attack it. Kidneys are very important to maintain balance in our body. In the last couple of years, we discovered that when kidneys do not work properly, the whole body is affected, including the immune system. Indeed, patients with failing or failed kidneys on dialysis have an increased risk of infection, cancer and have more inflammation, which increases the risks of heart disease. Regulatory T cells (Tregs) are a type of white blood cells that naturally work to control the immune system. They do not seem to work properly in patients on dialysis. There is more and more evidence we could use their natural ability to control the immune system to treat multiple diseases. They have mainly been tested in transplantation and in auto-immune diseases, where the immune system attacks the patient himself. My ultimate goal is to use Tregs to improve patient’s care in nephrology. My research program has 2 main themes: 1) Study Treg dysfunction (projects 1&2) 2) Do the first clinical trial using a patient own cells as a treatment in nephrology. Method: First, I will study Tregs in patients with kidney diseases on dialysis. Understanding how and why they do not work well in those patients is the first step. Ultimately, I would like to find a way to improve how they control inflammation and thus reduce cardiovascular risks (project 1). I was the first to describe a type of dysfunction in Tregs named exhaustion. I will continue to study this phenomenon and will test some potential treatments (Project 2). Finally, I will prepare the first clinical trial using the patient’s own cells to help kidney transplant recipients in Canada. The goal will be to inject cells to control a common viral infection after transplantation. This will pave the way to further studies using Tregs. Procedure: Most of my studies are done in a lab, where we cultivate human cells and study their behavior, describe them and study their efficacy. Some of the work will imply injecting human cells to mice. Finally, for the last project I will do a multicentric clinical trial. Outcome: I wish to increase the knowledge about Treg dysfunction and how to overcome this for the benefit of patients with kidney diseases. Relevance to patients: This work implies transition from basic knowledge to clinical treatment. I will try to bring as much discoveries to clinical use to decrease inflammation and hopefully cardiovascular disease, transplant rejection as well as a better control of infections after transplant.