Team:Lethbridge Canada/interviews


Dr. Trew
  • Michael Trew, MD, FRCPC, CCPE
  • Senior Medical Director, Addiction and Mental Health
  • Strategic Clinical Network
  • Alberta Health Services
  • Clinical Associate Professor
  • Department of Psychiatry
  • Faculty of Medicine
  • University of Calgary
  • Calgary, AB

Dr. Michael Trew has been practicing psychiatry in Calgary since 1983. His area of special interest is in the treatment of people with both psychiatric and medical illnesses including epilepsy, movement disorders, and HIV infection. More recently, he has been active as a medical leader within Psychiatry and has been very involved with the mental Health Shared Care Program. Dr. Trew was also an integral member of the Quality and Safety Portfolio of the former Calgary Health Region.

Yoyo: “…So as I mentioned we’re creating our hormone in E. coli, in a strain called DH5a – which is a non-pathogenic strain of bacteria created for just-in-the-lab use – as to make sure there is no pathogenic fear there. The ultimate goal is to produce natural oxytocin; a secondary goal is to possibly create a more stable form of the natural hormone, for research studies in the future. As of right now, oxytocin is synthesized artificially so there may be a difference between the natural syntheses of oxytocin vs. an artificial synthesis of oxytocin. We created two parts for this project, the first one being the Oxytocin-Neurophysin I construct. Basically since oxytocin, by itself, only has a half-life of 3-10 mins in the bloodstream, we have to add Neurophysin to it in order to stabilize oxytocin. And once we actually need oxytocin for research, studies or what-not, we employ NEC I, an enzyme, and what it does is cut our first construct right in-between the Oxytocin and Neurophysin so the result is oxytocin, the hormone, by itself.”

Dr. Michael Trew: “So what I’m aware of is that it is used for labour, for quite a while, in a clinical setting. Outside of that, it’s fairly limited in medicine at the current time. Its implicated in certainly a number of affiliation type things so I think there’s lots of curiosity about that but as you say some of the challenges are about: how do you get it to the right place in the brain, can you get it into the brain at all? Because of the blood-brain barrier (BBB) and it’s very short life in the blood stream before it gets metabolized. All of those factors make it a challenge for it to be successful in a treatment setting.”

Yoyo: “You pretty much got it right on point. So some of the secondary effects of oxytocin include improvements of human face-to-face recognition or interactions and that helps pick up on emotional cues to whoever they’re talking to. But that’s only part of the short terms effects that’s been observed so far. Some of the long term effects – of what we have, not too much research on it so far – it can cause isolation amongst groups because individuals tend to stay away from those who are different from them. So those are some of the pros and cons of oxytocin, as we know so far.”

Dr. Trew: “I was noticing there was some evidence with nasal sprays that there is some absorption into the brain itself, which usually bypasses the BBB. There’s always the question of ‘how practical is it other than for interesting experiments’. I guess that’s one of the challenges. Honestly, you need a good stable source of oxytocin in order to play in controlled settings.”

Yoyo: “So to start on a more general question, what are some of the biggest stresses Teenagers face daily?”

Dr. Trew: “I think that there is a number of stresses teenagers face now-a-days. Certainly some of the ones we observe are teens going through a time in their life trying to organize themselves in terms of self-identity with their relationship with fears and how that balance works out. One of the big development challenges is ‘what’s me vs. what’s the group?’ People in their teens are acquiring lots of information and knowledge when going to school, it’s a time where the brain is developing with regards to things we associate with decision making, the pre-frontal part of the brain continues to develop, so we see teens play with ideas about responsibility, social life and culture, asking questions – often philosophical – which is all tied into the parts of the brain. So part of the challenge is trying to make sense of it all, sometimes teenagers find that it is all overwhelming, they struggle with connecting all the pieces together. That’s associated with difficulties in terms of social support, that’s a problem. We also know it’s a time when teenagers do a lot of experimenting, it’s not uncommon to experiment with alcohol and drugs; one concern we have at the moment is that teenagers often over do things – drink in binges – which is not good for you – lots of evidence on that. Also getting into trouble drinking and driving, getting into fights, various other things while under substances. It’s them struggling with those questions, and sometimes not using their best judgements. So those are some of the things that strike me as daily stresses, maybe you can add on to that?”

Yoyo: “Do you think bullying is part of those stresses?”

Dr. Trew: “Absolutely. Bullying is part of that ‘how do you fit in the sense of yourself, society, and those around you’. And for some reason, if we’re the target of that behaviour, it’s quite overwhelming, often there’s shame associated with that. When you can’t reach out for assistance, sometimes we need to reach out further than friends and go beyond that, whether that’s beyond family, parents or other interested and concerned adults, help break out of that particular lock-in circle, that you could get caught up in. I think another dilemma is that if we go back a generation or two, it was difficult for bullying to happen other than face-to-face interactions. So it there was a bullying that gave you a hard time on the way home from school, you could avoid that. With the internet – sites like Facebook – there’s opportunities to bullying that’s brand new, and that’s added a new twist to your generation.”

Yoyo: “Okay, so we mentioned how oxytocin improves face-to-face interactions. Do you think if we take oxytocin on a regular basis – let’s say once a day – do you think it could improve or possibly be used as a coping method against bullying?”

Dr. Trew: “That’s an interesting idea; I think I’d have to say I don’t know. It’s the sort of things that’s quite fascinating. A question that crosses my mind is that, is it going to be more helpful to the person who’s the victim – receiver of the bullying behaviour – or it might even be helpful to the one bullying to be more perceptive and be more impacting of the effects of bullying. That’s an interesting question; it’s something I haven’t thought of before. Any of these questions, it’s open to evaluation. And if it’s a good question we can say lets give it a try and see what happens, that’s what science is all about.”

Yoyo: “Could oxytocin be implemented into the school learning environment?”

Dr. Trew: “One of the challenges about oxytocin is getting it past the BBB, about how do you get a sustained oxytocin response over hours, or more perhaps. Certainly, when we are talking about learning and the effects of learning, you’re probably in need of something that works over some time – not 10, 15-30mins it’s not likely that will impact much. So part of the challenge is how do you maintain the effect over a long period of time. The particular inhibitor compound you’re working on, is that going to help maintain the effects of oxytocin within the brain over time? And if so, are there any side-effects? Not only are you extending the life of the hormone that you’re adding in, and it’s a neuromodulator that’s part of the brain already. So if there are going to be any side-effects, I don’t know, but that’s part of the bigger question. The only way to find out is to do some very careful observational studies.”

Yoyo: “So you mentioned side effects, are you referring to short term or long term side effects?”

Dr. Trew: “I think you got to look for both, at the moment we have some experience with oxytocin given to moms for delivery. From that perspective, a relatively short exposure for a few hours, that’s not really for the brain as for that procedure it doesn’t go in the brain itself. But for the rest of the body, it doesn’t seem to give any short or long term problems that we are aware of. So it looks to be pretty safe as of right now, at least for a few hours. Now that’s different from saying “Ok, we’re going to expose you to this a few hours a day over six months.” If you can succeed in getting it into the brain, by nasal sprays and such, does that give you any different profile side effects, and again, only time will tell. Certainly there will be indications given by animal experiments where they can put it directly into the fluid around the brain to see if there are any particular concerns as to physical effects. As far as any huge concerns, I’m not aware of them.”

Yoyo: “So you don’t think there is much trouble in regards to addictions or dependence to oxytocin?”

Dr. Trew: “The short answer at the moment is that it doesn’t look like the type of compound to give us any trouble at the moment. There are two or three things a type of compound that really gets us into trouble, those are the ones that have an effect on the reward circuitry. I’m not aware of oxytocin’s impact towards reward circuits, if my understanding turns out to be wrong, there might be some trouble. But again, from what we’ve seen so far, that is unlikely. I think we’re likely to be okay on that.”

Yoyo: “Lastly, do you have any questions for us?”

Dr. Trew: “No questions, this is a really neat project and congratulations to all of you and to the various people that are helping you do it. I think this is really neat, good on ya!

Yoyo: “Alrighty that was pretty much the interview. Thank you Dr. Trew for taking the time out of your day for this interview!

Dr. Trew: “My pleasure and if there’s anything else I can do or if you need to talk to me again just give me a call.”

Yoyo: “Great!”

Karen Sparkes
  • Karen Sparkes
  • Local High School Student Counsellor
  • Wajeay in Fort Macleod
  • G. R. Davis – Livingstone Range School Division
  • Family School Liaison Counsellor
  • Registered Social Worker
  • Fort Macleod, AB

Yoyo: “Brief intro: we’re making oxytocin this year, and what oxytocin is – I’m sure you know a little bit about it – it’s the love hormone. So one of the things commonly known for is during birth it’s supposed to dilate the cervix, and its involved in a positive feedback system so the more there is in the system the more it tells the brain to input more into the system. A secondary effect of oxytocin is if you engage in social interactions you produce oxytocin, it’s kind of tied in with the reward system mechanism. If you engage in social interactions – and you had a good time and produced oxytocin – you’d probably want more of that so you’d go out and socialize more, thus linking it back to the positive feedback system.

“So a little bit of how we plan to make oxytocin. The hormone itself – the natural version – only has a half-life of 3-10mins in the bloodstream. Really short. In order to stabilize it for studies or experiments we attach it to Neurophysin I. What Neurophysin I does is just stabilize the hormone, keeps it in check, so that it doesn’t decay as fast. So that’s how we store the hormone. If we want oxytocin by itself we have to make a second enzyme called NEC I – and what it does is just cut right in-between the Neurophysin I and Oxytocin hormone in order to get oxytocin by itself – to study, etc.

“So that’s a little bit of what our project is, any questions?”

Karen: “Neat! And do you have a hypothesis-type goal to your project?”

Yoyo: “Somewhat like what the goal of this project is?

“At first, we tried to look into how the effects of oxytocin would affect individuals with mental illnesses; how artificial doses of oxytocin would affect the brain. If you have possibly schizophrenia or autism – general lack in social functioning – you could possibly use it to gain a better experience while socializing with others. However, since that involves lab rats and such – which we weren’t able to get access to – we went a different route. Now, we’re aiming for a cheap way to produce natural oxytocin. Some of the things others have done before are synthesizing artificial oxytocin, which may be different from a naturally synthesized hormone. What we can do after we produce our hormone is compare natural vs. artificial. Also, for later on, others can use the constructs we’ve made to synthesize the hormone naturally.”

Karen: “Cool, sounds really nice!”

Yoyo: “To start on a more general question, what are some of the current biggest stresses teenagers face daily?”

Karen: “Teens as in 13-18, 13-21 years old? Biggest stresses right now include social inclusion, making important life-long decisions – which at the moment don’t seem like big decisions – but there are so many now. Especially with the education teens can get now – they're bombarded with “this is important”. Soon they are confused as there’s just too many.”

Yoyo: “You mentioned fitting into society – do you think bullying is part of that?”

Karen: “Of social inclusion? Absolutely. And of our perception of bullying too, our society have shifted over the last few years.”

Yoyo: “What do you mean by perception of bullying?”

Karen: “Bullying and with social media, influenced a person’s perception of bullying – especially with respect to if you are feeling included or excluded. So what used to be maybe a range of normal teenage behaviour has suddenly – in the last 5-6 years – has suddenly evolved into a form of total social exclusion or inclusion. So that perception of being bullied becomes 100 times more than without social media.”

Yoyo: “Could you say that bullying in the past has been more face-to-face interactions whereas now it’s more through technology or devices.”

Karen: “Absolutely.”

Yoyo: “In terms of bullying, do you think oxytocin is an appropriate coping or treatment method?”

Karen: “…It’s hard to answer because is oxytocin related to a positivity quotient?”

Yoyo: “If you engage in face-to-face interactions, oxytocin enhances your ability to pick up on emotional cues which allows you to respond appropriately to those social cues picked up.”

Karen: “Okay. I don’t know whether or not, to be honest. Because – speaking from my experience – about how it’s portrayed in the media, it makes everyone happy, if that’s so, then great!”

Yoyo: “Do you think there would be a huge difference between healthy individuals to those mentally challenged?”

Karen: “What do you mean by mentally challenged?”

Yoyo: “For example, someone who has autism or schizophrenia.”

Karen: “Oh, tough question. I think for autism, yes, from what I remember for autism – there’s a big impact in the Amygdala, and that’s the emotional center, so I think that it might help with autism. But schizophrenia would be different. But honestly, I think those who have depression would benefit the most from oxytocin. Because would that not be the antidote to somebody with depression? Because depression is somebody with ruminating – they have problems with their serotonin levels, problems with oxytocin levels supposedly. And there a lot of teens with depression!”

Yoyo: “With all those stresses on them?”

Karen: “Yes. The other factor with teens and depression over the last couple of years is the lack of Vitamin D teams are getting. Since they are spending their time indoors, especially in this region, you’d have to be a farm worker to get enough vitamin D. So with lower levels of vitamin D it’s pretty well documented that it leads to depression. I mean it’s a common perception that the more social a person is, the happier they are, but that’s not necessarily true.”

Yoyo: “Do you think there is any risk with addiction or dependence with oxytocin?”

Karen: “Why not? I think there would be, especially if it makes you feel happy. One of the common things with oxytocin – the love hormone – is that when people come down from that feeling they’d crave it. They have troubles in their relationship because it’s not good enough – “well you’re not the same person you are anymore” – when really it’s the hormone that was talking. And they are on high all the time – “you look good, you’ve lose weight, you have tons energy, you’re always feeling good” and when you settle back into your normal life, then who wouldn’t crave that? Who wouldn’t want to go back to that nice feeling? I think it would be very addictive.”

Yoyo: “Now that we’ve gone through this interview, do you have any questions for us?”

Karen: “One of my questions would be – maybe more general – would something like oxytocin be able to regulate emotions? Can it be used in emotional regulations? With teens. It’s a really big question but it was something I thought of while you were talking – just something that might be useful.”

Yoyo: “I guess it would depend more on the person and how they react to different things. I suppose I can’t make a generalized statement to everyone that takes oxytocin. Maybe someone will react more radically to events while on oxytocin, purely based on their ‘normal’ behaviours. Yeah, it’s a very general question so I’m not sure I can give a specific answer.

“Anyways, thank you for doing this interview with me!”

Karen: “Yeah, you’re welcome! Sounds very interesting!”

Mike Spear
  • Mike Spear
  • Director of Corporate Communications
  • Genome Alberta
  • Calgary, AB

Additionally, we had an interview with Genome Alberta's Mike Spear regarding our recent endeavors. Genome Alberta is a publicly funded, not-for-profit organization which is dedicated to publishing information on genomics, proteomics, bioinformatics and bioethics research in Alberta. Our conversation centered around the composition of our team, the science behind our project, and the potential impact of our project. The interview has yet to be published, but we look forward to its release.