Fifty years of research at the Janeway Children’s Hospital

To the Editor,

This year marks the 50th anniversary of the Dr Charles A. Janeway Children’s Hospital in St. John’s, Newfoundland and Labrador (NL). This occasion allows us to celebrate the over three generations of children who have received care there. It is also an opportune time to reflect on the successful research that has been conducted at the hospital. Early in the Janeway’s history, through its connections with Memorial University of Newfoundland, clinicians and researchers identified the need to conduct local paediatric research. Since then, the hospital’s staff and faculty have produced hundreds of research publications on a wide range of children’s health topics. Early research pioneers include Dr M. Kutty, who studied lipoprotein metabolism; paediatric radiologist Dr Benvon Cramer; and Drs Wayne Andrews, James Friel and Khalid Aziz who conducted neonatology research. Based on her work in the 1970s with a small group of children with unique dysmorphology, Dr Penny Allderdice and her team were the first to identify the genetic conditions related to chromosome 3 duplication q21, which came to be known as Allderdice syndrome (1). Several other genetic conditions have been identified through work at the Janeway and Memorial University, including arrhythmogenic right ventricular cardiomyopathy which affects about 1500 people in NL who have a gene that puts them at high risk for sudden cardiac death (2), and Dr Paul Dancey’s work in helping to identify and treat deficiency of the interleukin-1-receptor antagonist, the discovery of which illustrates the importance of careful clinical observation in fostering innovation (3).

The Janeway community continues to explore the unique patterns of disease found in our part of the country. Work by the Janeway Diabetes Team found that NL has one of the highest rates of type 1 diabetes worldwide, and that rates have been increasing steadily over a 20-year period (4,5). Similarly, work led by one of our paediatric residents, Dr Lorine Pelly, found high rates of autism spectrum disorder in certain parts of the province (6). Both of these studies have spawned further work into these complex conditions.

Not all of the history of research at the Janeway has been positive. During the 1980s and 1990s, Dr Ranjit Chandra was one of the leading researchers at the hospital. But concerns were raised by one of his research nurses, Marilyn Harvey (R.N.), that Dr Chandra was publishing articles on studies that had not been completed. Further investigations led to the BMJ and other journals retracting his publications and the subsequent loss of his Order of Canada (7,8). With the ever present pressures on researchers to publish, this incident reminds us of the need to hold ourselves always to the highest scientific and ethical standards in conducting children’s health research.

In 2011, with funding and support from the Janeway Hospital Foundation, the Colonel Harland Saunders Foundation, the Faculty of Medicine of Memorial University and the Eastern Health regional health authority, the Janeway Pediatric Research Unit (JPRU) was established. The JPRU serves as a nexus for paediatric health research being conducted in NL and strengthens the hospital’s partnership with the university. Having this infrastructure in place, along with the continued financial support from research funders, especially the Janeway Hospital Foundation, has allowed for more research activity to be conducted than in any other point in our history.

The future of paediatric research in NL looks bright. Having the infrastructure in place and a growing community of local researchers, including a positive and energetic group of paediatric residents, medical students, graduate and postgraduate students pursuing their own projects, we hope to continue improving children’s health in NL and beyond and to serve as an example of what a relatively small paediatric hospital can accomplish through a commitment to high-quality children’s health research.