Peter SeniorPeter Senior, MD/PhD

Office:     2000 College Plaza
Mail:        8215 112 Street, Edmonton AB T6G 2C8
Phone:     780-407-1480
Fax:         780-407-6933
Email:      petersenior@ualberta.ca

 

 

 

 

Current Position

Associate Professor, Department of Medicine Division of Endocrinology

 

Research Area

My research interests fall in to three areas:

  • Clinical Islet Transplantation: evaluating type 1 diabetic subjects before and after islet transplantation, and the impact of islet transplantation and immunosuppression on diabetes complications, particularly renal function and diabetic nephropathy;

 

  • Diabetic Nephropathy: through the Northern Alberta Diabetic Nephropathy Prevention Clinic, the feasibility and effectiveness of delivery of preventative diabetes care in communities using local paramedical staff is being evaluated in regard to renal and cardiovascular outcomes; and

 

  • Clinical Diabetes: I am a co-investigator in the ACCORD trial testing the effectiveness of intensive glucose, lipid and blood pressure control to prevent cardiovascular events in type 2 diabetes.

 

Current Research Activities

Clinical Trials in Islet Transplantation

My major focus has been in evaluating the impact of clinical islet transplantation on clinical and metabolic outcomes, particularly in terms of microvascular complications and the deleterious effects of immunosuppression. Detailed assessment of transplant outcomes has been an integral part of evaluations of the success, or otherwise, of clinical trials of new strategies to improve islet transplant outcomes. These studies have included both local investigator-initiated studies as well as playing a lead role in multi-centre studies funded by the National Institutes for Health (CIT 04/07, CIT 06).

 

Recent studies explore the ability to regain insulin independence following combined therapy with proton pump and dipeptidyl peptidase type 4 inhibitors which in animal models have been shown to prevent islet apoptosis, promote differentiation of ductal cells into beta cells and prevent rejection of islets.

 

Another major focus is to develop clinical, metabolic and molecular tools to identify the earliest stage of graft dysfunction as a necessary first step for intervention studies to prevent graft loss and maintain long-term insulin independence.

Community Prevention of Cardio-Renal Complications of Diabetic Nephropathy

Multifactorial interventions to reduce blood pressure, blood glucose and lipid levels have been demonstrated to reduce cardiovascular and renal events in patients with diabetic nephropathy, and to reduce mortality. However, the use of proven therapies in clinical practice is often sub-optimal. We have established rural community clinics using paramedical staff to deliver multifactorial interventions for people with diabetic nephropathy. Initial publications describing the effectiveness of the clinics and exploring factors associated with success or lack thereof in individuals have been published. Future and ongoing studies seek to examine its cost-effectiveness, to compare clinical outcomes with matched diabetic and non-diabetic controls living in the same communities, and to explore factors associated with improvements in risk factors and barriers preventing success.

Clinical Trials in Diabetes

The ADI has established a clinical research unit where I am the PI on a number of pharmaceutical trials of new agents to treat diabetes and/or its complications. I also collaborate with colleagues in nutrition on several clinical trials looking at body composition, bone health and vitamin D status as well as metabolism in people with Type 2 diabetes using our whole body calorimeter

 

Human Studies

 

  • Islet Transplantation studies
  • Caspase
  • Sernova Pouch
  • NN2211-3619

 

  • Investigator Initiated. Vitamin D supplementation and bone health in adults with diabetic nephropathy. 2011 – ongoing. Open for recruitment. Co-PI Dr Diana Mager, contact Stephanie Schwindt
  • GSK: A Randomized, Double-Blind, Placebo-Controlled Multicenter Phase II Study to Evaluate the Safety and Efficacy and Dose Response of 28 Days of Once-Daily Dosing of the Oral Motilin Receptor Agonist GSK962040, in Type I and II Diabetic Male and Female Subjects with Gastroparesis. March 2011 - ongoing
  • ToleRx/GSK DEFEND-2: Durable-Response Therapy Evaluation For Early- or New-Onset Type 1 Diabetes. Sept 2010 - Mar 2012 (study complete)
  • Boehringer Ingelheim: Trial 1245.36:  A phase III, randomised, double-blind, placebo-controlled, parallel group, efficacy and safety study of BI 10773 (10 mg and 25 mg administered once daily) as add on to pre-existing anti-diabetic therapy over 52 weeks in patients with type 2 diabetes mellitus and renal impairment and insufficient glycaemic control. Sept 2010 - March 2012 (study complete)
  • Pfizer:  A phase II, randomized, double-blind, placebo-controlled, parallel-group, multi-centre study to evaluate the efficacy and safety of once-daily administration of a phosphodiesterase 5 inhibitor (PF-00489791) in adults with Type 2 diabetes and overt nephropathy. Protocol A7331011. Dec 2010 – Nov 2011 (withdrew – 0 patients randomised)

Other Activities and Affiliations          

 

  • Medical Director Clinical Islet Transplant Program
  • Medical Director Diabetic Nephropathy Prevention Clinics
  • AHS Strategic Clinical Network for Obesity Diabetes & Nutrition Core Committee
  • Canadian Diabetes Association Clinical & Scientific Section Executive
  • ADI Clinical Director for Diabetes Research
  • Attending Physician Diabetes and Endocrinology, University of Alberta Hospital
  • Associate Editor, Diabetic Medicine
  • Canadian Journal of Diabetes National Editorial Board
  • Collaborative Islet Transplant Registry Publications and Presentations Committee
  • CIT Metabolic Sub-committee

 

Biography

Dr. Peter Senior completed his medical school and Internal Medicine residency at the University of Newcastle-upon-Tyne in the United Kingdom, and in 2002 received his PhD in “Aspects of Cell Membrane Function in Type 2 Diabetes” as an RD Lawrence Fellow of the British Diabetic Association.

 

Between 1999 and 2002, Dr. Senior completed his specialist training in Diabetes and Endocrinology in Newcastle.

 

In September of 2002, he joined the University of Alberta as an Islet Transplant Fellow working with Dr. James Shapiro.  He joined the Faculty of Medicine and Dentistry in the Division of Endocrinology at the University of Alberta in 2003. He is the co-director of the Northern Alberta Diabetic Nephropathy Prevention Program. He became the medical director of the Clinical Islet Transplant Program in 2007, where he is actively involved in the clinical and metabolic assessment and follow-up of islet transplant patients.

 

Dr. Senior’s research interests include clinical islet transplantation, hypoglycemia, diabetic nephropathy and health care delivery. He has been an investigator in a number of clinical trials in both diabetes and islet transplantation including large multicentre studies (e.g. ACCORD) as well as smaller scale phase II/III studies and JDRF funded investigator-initiated trials.

Dr. Senior has authored more than 50 publications in peer-reviewed journals as well as 7 book chapters. He is associate editor of the journal Diabetic Medicine and on the editorial board of the Canadian Journal of Diabetes. He is also a member of the Executive of the Clinical and Scientific Section of the Canadian Diabetes Association.

 

Research Goals

 

The major focus of my research activities is to directly improve the lives of people with diabetes by:

  •  by improving the safety and effectiveness of islet transplantation
  • improving the delivery of health care to people with diabetic kidney disease
  • developing and testing new treatments for diabetes and its complications in clinical trials

This can be challenging in several areas.  Finding suitable volunteers for clinical trials can be difficult. Ensuring co-operation and collaboration with local diabetes clinics and health care services is vital but may be harder to achieve than would be anticipated.

 

Major Achievements

 

  • Department of Medicine, Jonathan B Meddings Clinical Innovation Award 2011
  • European Renal Association Travel Award 2006
  • Capital Health Regional REACH Award for Innovation nominee for Diabetic Nephropathy Prevention Clinic, 2005
  • University of Alberta Hospital REACH Award for Innovation for Diabetic Nephropathy Prevention Clinic, 2005
  • Dept of Medicine Research Day Post-Doctoral Fellow Presentation First Prize, University of Alberta, 2003
  • RD Lawrence Fellowship 1996-1999. Three-year full time research fellowship awarded by the British Diabetic Association.
  • Pfizer Academic Travel Award 1998-1999.

 

Select Publications

 

Barton et al Improving Outcomes in Clinical Islet Transplantation: 1999-2010. Diabetes Care 35:1436-1445, 2012: 1436-1445

 

Elizabeth R. Seaquist, Denise Bonds, Dale Childress, Mark Feinglos, David Goff, Michael Miller, Vasilios Papademetriou, Kevin Peterson, Peter Senior on behalf of the ACCORD investigators. The impact of recurrent hypoglycemia and hypoglycemia unawareness on mortality in the ACCORD study.  Diabetes Care 2012; 35: 409-414

 

Gamble JM, Hoang H, Eurich DT, Jindal KK, Senior PA. Patient Level Evaluation of Community-Based, Multifactorial Intervention to Prevent Diabetic Nephropathy in Northern Alberta, Canada. Journal of Primary Care and Community Health 2012; 3: 111-119

 

Koh A, Imes S, Kin T, Dinyari P, Malcolm A, Toso C, Shapiro AMJ, Senior P. Supplemental Islet Infusions Restore Insulin Independence after Graft Dysfunction in Islet Transplant Recipients. Transplantation 2010; 89: 361-5

Peter A Senior, Marilyn Zeman, Breay W Paty, Edmond A Ryan, AM James Shapiro. Changes in Renal Function After Clinical Islet Transplantation: four year observational study. Am J Trans 2007; 7: 91-98

PA Senior, BW Paty, SM Cockfield, EA Ryan, AMJ Shapiro. Proteinuria Following Clinical Islet Transplantation Resolves When Sirolimus is Substituted by Tacrolimus. Am J Trans 2005; 5: 2318-2323

PA Senior, RC Welsh, CG McDonald, BW Paty, AMJ Shapiro, EA Ryan. Coronary Artery Disease is Common in Non-Uremic, Asymptomatic Type 1 Diabetic Islet Transplant Candidates. Diabetes Care 2005; 28: 866-872

 

Trainees

Name

Level

Dates

Stephanie Schwindt

Masters

2011 - present

Zaina Albalawi

Post-doc

20012-present

Jonathan Yau

undergraduate

2011

Jennifer Jacquier

Post-doc

2009-2010

Holly Hoang

Post-doc

2008-2009

Salsabeel AlAnsari

Post-doc

2007-2009

Angela Koh

Post-doc

2007-2008

Waleed AlBaker

Post-doc

2006-2007

Jennifer Bailey

Post-doc

2006-2007

Sarah Kwong

Post-doc

2005-2006

Sheila Jessa

undergraduate

2005

Marianna Corrales

Post-doc

2005

Markus Walter

Post-doc

2005

Eman Al-Fadhli

Post-doc

2004

Marilyn Zeman

Post-doc

2003-2004

 

Website Links of Interest

 

Clinical Islet Transplantation Program

twitter: @islettx