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Helping People Breathe:

Nicolle Domnik strives to understand Chronic Obstructive Pulmonary Disease

July, 2017

by Natalia Mukhina

Dr. Nicolle Domnik

Banting Post-Doctoral Fellow Dr. Nicolle Domnik, Department of Medicine

“Conducting research is exciting because a researcher is the first person to make a new observation or discovery,” says Dr. Nicolle Domnik, a Banting Postdoctoral Fellow at the Department of Medicine.  This Post-doctoral Fellowship, Canada’s most prestigious and highest valued, supports world-class researchers across all disciplines, and Domnik is honoured to be among them.

Funded by the Canadian Institutes of Health Research for two years, Nicolle will examine Chronic Obstructive Pulmonary Disease (COPD) and how it affects lung function, especially during sleep. COPD ranks amongst the top five leading causes of mortality in Canada, causing about 800,000 deaths annually. “The primary cause of COPD is smoking,” explains Domnik, “and it is a fairly common disease with progressive and ultimately crippling symptoms.”

Over the course of the disease, individuals with COPD experience increasingly impaired airflow, worsening shortness of breath (known by the medical term ‘dyspnea’, meaning ‘air hunger’), and severe restrictions to daily activities.  All of these symptoms significantly deteriorate patients’ quality of life. “Patients with advanced disease often use supplemental oxygen to help their lungs compensate for inefficient mechanics and oxygen uptake into the blood stream. These patients frequently cannot bathe themselves without assistance, and find tasks like showering, dressing, or cooking exhausting,” Domnik says.

Many people with COPD have to retire prematurely. They can no longer work because of the debilitating symptoms and limitations of the disease. Obviously, COPD not only personally impacts the patients, but also affects their families and caregivers.

Nicolle Domnik sitting in a transparent chamber.

What particularly draws Domnik’s attention is the fact that many COPD symptoms are worst overnight and in the morning, especially right after waking up. Thus, in her research, Domnik seeks to understand what happens to patients’ breathing during sleep. “Most patients take their medications first thing in the morning and find they can’t start their day without them, despite the fact that once-daily formulations are meant to last for a full 24 hours. I’m interested in understanding what makes mornings so challenging. Would patients benefit from twice-daily formulations of medication? Or is there something inherently different about the circadian, or daily, changes in breathing in COPD that make patients susceptible to this pattern of symptoms?”

In searching for these answers, Domnik organizes her study into two related parts. First, she works with healthy individuals and patients with moderate to severe COPD to assess inherent difference between these groups’ breathing during sleep and in the morning. The second part of her research tests the effectiveness of using a bronchodilator (“puffer”) once a day versus twice a day. “I am testing whether an additional nighttime dose of medication improves lung function during sleep. If it does, why is that happening and how can we use that information to further improve treatment approaches? If it doesn’t – why not?” Such an angle of investigation enhances the practical value of her research and will help improve current clinical protocols for the treatment of COPD.

Domnik considers herself fortunate to be working with her colleagues at the Respiratory Investigation Unit and the experienced staff of the Sleep Disorders Laboratory at Kingston General Hospital. “The approaches that I’m able to use here in Kingston are unique and progressive, and differentiate us from other centres in Canada and internationally.”

I asked Nicolle to identify the top qualities that a successful researcher in her field needs to have. She listed them in a well-argued manner:

  1. Persistence. “We all hope to discover something truly significant one day, but the nature of research is that there is a huge amount of daily work interspersed with only a few ‘eureka’ moments,” Nicolle stresses. Persistence is crucial for moving forward on a project and dealing with what can sometimes seem like slow or challenging progress, which is normal for research.

  2. Openness and curiosity. A former participant of the 3-minute Thesis Competition, Domnik loves this contest as it provides the opportunity to learn about research in areas outside your own. “I remember, for example, Oluwatobiloba Moody, a participant from the Faculty of Law, who discussed the ethical and practical implications of pharmaceutical companies using indigenous knowledge from communities in Africa in formulating new drugs. I learned a lot of interesting things and was made to consider elements of research and discovery I hadn’t been exposed to before. Law may not be my area of research, but I deal with pharmaceuticals and their individual and community impacts on a daily basis,” says Nicolle. “It’s easy to become overly focused on one’s immediate research; however, I enjoy discovering just how much valuable knowledge is available outside of one’s direct area of study.”

  3. Critical thinking. “Good science comes from being able to accept what the data really are,” argues Domnik. “If your data look weird or unexpected, you have to ask yourself why. Were your assumptions wrong? Or was it something about how you structured your question or approach? The ability to ask questions, and reflect on yourself, your approaches and techniques creates a good researcher.” Nicolle believes teaching can strengthen this ability, especially when helping students who struggle with certain concepts. “While trying to explain them, you rethink your own knowledge and are forced to reconsider problems in different ways. In this way, teaching is extremely rewarding for researchers.”

With her previous work having dealt mainly with microscopes, cells, and reduced models, Domnik is now working in a different type of lab. She considers this new reality a motivating, but also very emotionally charged part of her research. “I now work with humans, who are all individuals with their own rich, complex and diverse lives. Sometimes it is challenging to balance experiencing the humanity with what you need to do as a scientist. Staying focused on your work, while letting yourself feel like a human being - for me, appreciation of both these elements is what leads to the best solutions.”