Nasal decolonization using photodisinfection therapy is a safe and effective strategy to minimize the risk of surgical site infections – Dr. E. Bryce

At one of Canada’s leading infectious disease and microbiology conferences, the AMMI-CACMID, Dr. Titus Wong presented data from his work on the MRSAid Quality Improvement Project at Vancouver General Hospital (VGH). Following the results from the abstract “Nasal Decolonization of Staphylococcus aureus with Antimicrobial Photodynamic Therapy (aPDT or photodisinfection)” and his work on this project, Dr. Wong was also nominated for the John Conly Innovation Academy Award.

The interim microbiology data from the yearlong Quality Improvement Project at VGH shows that MRSAid is safe and effective, with high patient compliance rates and an easy integration into hospital workflows. By performing universal nasal decolonization prior to surgery, the project team at VGH intends to decrease the number of surgical site infections (SSIs).

Annually, approximately 50,000 Canadian patients are affected by SSIs, causing the health care system more than 200 million dollars. In most cases, a patient’s body is weakened by surgery, making them extra vulnerable to developing severe infections. These infections are difficult to treat; hence it is so important to prevent patients from getting infected by applying universal decolonization of pathogenic bacteria.

We are very excited about the results at VGH so far and could not be more pleased with the awareness of MRSAid and photodisinfection in general at the AMMI-CACMID conference. Congratulations to Dr. Titus Wong on his nomination for his work on this Quality Improvement Project, the Ondine team is proud of this significant accomplishment!

After coming off a win at the Shamrock tournament in Scarborough, the ’99 or Peewee Unionville Jets select team took their first bus trip to an out of town hockey tournament last weekend. Destination…the ‘Rock’n Roll’ Tournament in Cleveland Ohio.  It was an exciting weekend as bands like the Red Hot Chilli Peppers were being inducted into the Rock & Roll Hall of fame.

Ondine sponsored Unionville Jets Pee Wee hockey team celebrates their gold medal

Not knowing what to expect, the Jets faced teams from Ohio, Pennsylvania, and even their local rival; Markham Select.  The players and coaches were truly inspiring as they faced the Stongsville Mustangs, perhaps the most talented and physical team they have ever faced, in a final gold medal game.  The Jets won the gold medal in a 3-0 win over the Mustangs and ended the tournament in very inspiring way.  After the final buzzer rang, the boys started singing the Canadian national anthem.

During his mouth examination, irregular cobblestoned mucosa of the entire right floor of the mouth was found (Figure 1). There were three areas each 1 cm in diameter of invasive firm nodules. Biopsies were then obtained and it was determined that the patient had invasive squamous cell carcinoma.  He was staged as a T3N0 superficial squamous cell cancer of the right floor of mouth and ventral tongue.

Left (Figure 1): Patient presents with squamous cell cancer of entire right floor of mouth and ventral tongue. Right (Figure 2): Six weeks post- PDT Treatment, area of tumor healed with normal mobile mucosa and without scar tissue

The patient’s cancer could be treated with a number of modalities including surgery or radiotherapy. Surgical resection would provide for a good cure rate but would likely leave the patient an oral cripple. Radiotherapy as well would have an excellent cure rate but the patient would have long-term xerostomia (dry mouth), which can cause difficulty in speech and eating. Photodynamic therapy is a minimally invasive outpatient treatment that has been found in Phase II clinical trials to provide at least the same cure rates as surgical or radiotherapy for superficial oral carcinomas.  As all of these treatment options provide for the same cure rates, it was important to discuss the various treatment options with the patient including each treatment’s risks and benefits. This way the patient could decide which treatment they would prefer to undergo for their cancer therapy.  Importantly, PDT treatment does not eliminate the options for other therapies should there be a recurrence of disease. This patient chose to undergo photodynamic therapy treatment.

Photodynamic therapy works by applying a photosensitizing agent to the affected site and activating it with a laser light. Photofrin was injected intravenously at a dose of 2.0 mg/kg over a 5 minute period as an outpatient procedure.  Approximately 48 hours after the injection, the patient underwent general anesthesia and intubation. The tumor of the right floor of mouth, mandible and ventral tongue was measured using a small ruler. The area to be treated included the actual tumor and at least 5mm of normal appearing tissue.  In this case, the area to be treated was measured to be 6×4 cm. Normal tissue of the tongue and cheeks and left floor of the mouth were protected from light administration using moist surgical gauze sponges.

Using a Nd:Yag pumped-dye laser (Laserscope) at 630 nm wavelength, light was delivered to the tissue bed.  The light treatment was performed at 75 J/cm² and 150 mW/cm². Light was delivered for a period of 500 seconds. In addition, the three areas of tumor invasion were treated.  This light treatment was performed at 100 J/cm fiber length at a fluence rate of 400mW per cm fiber length.

On completion of treatment, the patient received Decadron (an anti-inflammatory medication) intravenously to reduce tissue edema. With Photofrin^R PDT, when normal tissue is exposed to the 630 nm light, the limited amount of Photofrin^R in the normal tissues will be activated resulting in tissue edema. This reaction occurs immediately so that by the end of the light illumination the tissue edema is maximal.  Therefore, the patient was observed in the recovery room for 2 hours post treatment in order to ensure that the airway was stable.   After two hours of airway observation, with a normal airway, the patient was discharged to home with oral pain medications.  He was instructed to avoid daylight outside for 30 days, standard room light exposure causes no problems. He was instructed to proceed with a normal diet as tolerated and there are no voice use restrictions.

Tumor response was evaluated at 1 week, 1 month and then every 3 months thereafter.  At one week, the selective tumor necrosis is noted.  Multiple biopsy specimens of the treated area were obtained 6 weeks after treatment that demonstrated a complete histopathologic response (Figure 2).  Remarkably, the area of tumor resolution healed in with normal mobile mucosa without scar tissue.  As well, the submandibular ducts remained patent and fully functional.  The only area of scar was where the invasive tumor nodules had destroyed the collagen matrix of the tissue.  This patient has remained free of disease for over 5 years.

Polymicrobial biofilms, many of them antibiotic resistant, have been significantly implicated in the etiology of this chronic indolent disease process and its associated inflammatory processes.  Preclinical studies we have conducted demonstrate the effectiveness of photodisinfection to selectively photoeradicate a broad spectrum of biofilm micoorganisms, including antibiotic resistant S. aureus, P. aerugenosa and fungal species, without causing injury to tissue or mucosa.

Sinuwave Technologies Corp has developed light administration devices that would allow for “in office” treatment of chronic sinusitis patients.  This is designed as a painless, repeatable therapy that can be performed with only topical nasal anaesthesia. This unique treatment modality is expected to undergo human trials in the second half of 2012 in Canada. To learn more about  www.sinuwave.com

Leonie Markhorst, Communications Extraordinaire

It is with great pleasure that we add Leonie Markhorst to the Ondine family. As our new Marketing Coordinator, Leonie is responsible for managing the projects and internal communications that will help bring Ondine’s technology to even more patients and healthcare providers.

A Dutch native, Leonie graduated from Utrecht University with a Bachelors degree in Communications. At age 19, she founded a successful online jewellery business before beginning her career as an Internal Communications Specialist for a large global organization. There, she was responsible for the operational tasks within her department, managed corporate events for up to 1,500 attendees, and acted as an advisor to line management. In 2011, she moved from the Netherlands to Vancouver to pursue bigger opportunities.

In her spare time, Leonie enjoys fashion, interior design and dance. She is fluent in three languages and is a contributing editor for a renowned online fashion magazine. The Ondine team is extremely pleased to have Leonie join us, and we cannot wait to get her started on some very exciting projects!

Donald W. Black with Leanne Carlson

Ondine Biomedical Inc. wishes to congratulate Donald W. Black, a long time friend and supporter of our company. Don has been awarded the Queen Elizabeth II Diamond Jubilee Medal, recognizing his lifelong contributions to his peers, community and country over the past sixty years. Don is the recipient of other prestigious Canadian honours, including the Order of Canada, the Queen Elizabeth II Silver Jubilee Medal, and the Saskatchewan Order of Merit.

Don was born, raised and educated in Regina, where he has spent the majority of what has been a successful, distinguished, and diverse career. Don is currently the Chair at Greystone Managed Investments and Greystone Capital Management, the investment firm whose success he is largely responsible for.  Throughout his career, Don has been actively involved in the community, leading many charitable organizations including the CNIB “That All May Read” National Capital Campaign, the United Way of Regina Leadership Giving Campaign, the Tomorrow Fund, and the RCMP National Heritage Center.

Don Black is a generous man, quick to smile and never misses the opportunity to make a positive impact on the people and world around him. His friends at Ondine are very proud of this extraordinary man and wish to congratulate him on this well deserved recognition.

In the same way fate seems to keep knocking on Carolyn’s door, she felt the benefits of her determination first-hand. After the crash, Carolyn was taken to Vancouver General Hospital (VGH), the first major institution to roll out Ondine’s technology. Like all patients undergoing surgery, she was zapped clean by Ondine’s laser.

Ondine Biomedical Inc. is a proud supporter of the mission and goals of the PanAmerican Photodynamic Therapy Association. Launched last month, the Association’s purpose is to galvanize the basic science and expertise of photodynamic therapy in the Americas. This will help encourage the study and practice of PDT in the treatment of animal and human diseases.

Many of you may not know that photodynamic therapy has been around for centuries. In fact, the earliest recorded treatment using a photosensitizing agent and a light source occurred in ancient Egypt over 3,000 years ago. Vegetable and plant substances were used as photosensitizers and sunlight was used as the light source. Patients suffering from skin diseases such as vitiligo had the photosensitizers topically applied to the damaged area, and the resulting photochemical reaction restored their tissue to a healthier state. In some cases, it even helped repigment their skin to its normal color.

Today, photodynamic therapy is clinically used worldwide in a number of applications – cancer, macular degeneration, gum disease, infection control, and acne. The antimicrobial application of PDT, commonly known as “Photodisinfection,” is Ondine’s platform technology and is used in all of our products. It is therefore critical that we lend our support to groups such as the PanAmerican PDT Association, which aim to help further the study, education and practice of PDT techniques in disease.

Ondine is a proud supporter of the PanAmerican PDT Association, and is very excited to see how they will move the field of PDT forward. After all, this technology has saved lives. To read these stories, please visit the PanAmerican PDT Association website.

The family then turned to photodynamic therapy (PDT), a treatment proven to be effective in killing cancer. Connah’s treatment consisted of taking a pill containing a photosensitizing agent and then activating this agent with light. A powerful reaction was then initiated, which killed the cancerous cells while preserving the surrounding healthy tissue. Amazingly, after ten months of PDT  treatment, ten of Connah’s eleven tumours have now disappeared. “This is the one miracle in my entire career,” said Connah’s GP, Dr. Eamon Jessop, “He’s doing incredible well, it’s staggering.” To hear Connah’s story, please watch the video below:

Connah from Matt Hunt on Vimeo.

Miracles really do happen. On Thursday October 27^th, Carolyn Cross (our CEO, Chairman, and dear friend) survived a deadly plane crash. On a chartered flight headed to Kelowna, Carolyn knew something wasn’t right when the pilot told passengers there was an oil leak and they were returning to the airport. “I looked at his hands and they were shaking, trembling,” Carolyn said in an interview from her hospital bed, “At that moment I knew we were going to die.” Carolyn then calmly took out her phone and began typing out farewell messages to her three young kids, “Something that they would remember me by, that I could have peace that I had said my goodbyes.”

Seconds later, Carolyn’s plane crashed on a busy road about 900 meters short of the runway. “We crashed and I immediately looked outside because I was at a door window and it was full of flames outside. So I couldn’t go out. It smelled full of gasoline….I went to get up and I could not walk. It was as if I had no legs, as if they were blown off. And I thought of my children, and God and the universe gave me the energy and I got up to the door. I said I don’t know what I am going to do now because I can’t get out of the plane, my legs, I can’t get out of the plane.”

“There were four people that pulled me out and carried me to safety even though the plane was in flames. It smelled of gas. And then they went back for more. And people were shouting “the plane’s going to blow, it’s full of gas, we smell gas” but they went back in. It was amazing.”

On Friday morning, the day after the plane crash, Carolyn held a conference call with all of us at Ondine. From her hospital bed, she told us about the plane crash, about her cuts, bruises, and broken bones. She told us how thankful she is of the everyday heroes that pulled her out of the plane crash, and she told us about her passion behind this company. “I survived this plane crash for a reason, and one of them is to put our technology on the map. I am more dedicated to PDT than ever.”

Our thoughts and prayers go out to the family of Luc Fortin, the courageous pilot whose gallant efforts saved the lives of passengers onboard that flight. To those everyday heroes that helped pull Carolyn and other passengers out of the burning plane, we can’t thank you enough. “I laid in bed last night understanding how lucky I am,” Carolyn said, “I am alive because of these people. I want them to know how brave they were.” If you are one of these heroes, or know of them, please contact us at cchew@ondinebio.com.