Dr. Zachary Kaminsky is the newly appointed DIFD Mach-Gaensslen Chair in Suicide Prevention Research at The Royal’s Institute of Mental Health Research.
In 2014, Dr. Zachary Kaminsky published a study that connected the dots between changes affecting a particular gene, SKA2, and increased suicide risk. Excitingly, biomarkers in the blood show these changes.
After publishing the study, Kaminsky received hundreds of emails from parents whose children died by suicide. Some had samples of their child’s blood, and they wanted him to test them for the suicide biomarker. Legally, he couldn’t.
“These parents wanted to know that there was something about their child’s biology that made them vulnerable,” Kaminsky says. “They wanted a reason why. Unfortunately, I couldn’t give them that, but maybe someday we can.”
Work remains to be done to create a clinically useful test, but Kaminsky is determined to see the day when something as simple as a blood test saves lives that would otherwise be lost to suicide. He speaks of it becoming a reality in a matter of years with enough focus and funding.
“We have a chance with biomarkers to do good in the very near future, I think,” Kaminsky says. “That’s my life’s goal — to see some of the biomarkers identified in my lab being used to save people.”
The hope is that by identifying people who are at risk, they can get the help they need quickly — perhaps before they even realize they’re suicidal.
Suicide is a research question
Imagine that every year, ten Boeing 747s full of Canadians fell from the sky, leaving no survivors.
That human loss is equal to what actually does happen every year in Canada due to suicide. It leaves few of the living unscathed. And even though we’ve been developing new and better treatments for many mental illnesses, suicide rates remain unmoved. We need research to tell us more.
That’s why, in 2014, DIFD and the Mach-Gaensslen Foundation created the Chair in Suicide Prevention Research at The Royal’s Institute of Mental Health Research.
“Seeing the Chair in Suicide Prevention Research come to fruition at The Royal brings us great hope — hope that other families can avoid the horrific despair of losing someone to suicide,” said Luke and Stephanie Richardson on behalf of DIFD, which provided $1M of community-raised funds to create the chair.
The Mach-Gaensslen Foundation, which supports research in cardiology, oncology, and psychiatry in Canada, contributed another $1M.
The new chair’s job is to figure out how to reduce Canada’s suicide rate — a challenge that requires a very specific type of person.
“People aren’t used to knowing the future.”
Kaminsky’s father was clinical directory of psychiatry at Johns Hopkins.
“I grew up hearing stories around the dinner table about the people my father helped,” Kaminsky remembers. “I was never far from the fact that there were a lot of people out there in need.”
Years ago, Kaminsky applied to medical school. He realized research was a better fit for him and changed his career trajectory, but the drive to help people never went away. He just sees research as a way to do it on a massive scale.
Kaminsky is a molecular biologist who studies epigenetics. Almost all human cells have the same DNA, but a cell in the heart isn’t the same as a cell in the brain or skin.
Genetically, they’re the same. Epigenetically, they’re not. Genes get turned on and off, manipulated by epigenetic factors. Kaminsky studies these factors on a molecular level. Epigenetics wasn’t always the
plan, though.
“I met the love of my life, who was a Canadian, and I needed to get up to Toronto,” he remembers. “I needed a visa and likely would have taken any lab position.”
The decision was lucky in more ways than one — the love of his life is now his wife, and he got a job in Dr. Art Petronis’ epigenetics lab at the University of Toronto. Here, he became convinced that epigenetics holds a deep well of hope for mental health research.
"Despite new and better treatments for many mental illnesses, suicide rates have remained unmoved. We need to know more about suicide, not just how often it happens but why it happens. That’s why the DIFD-Mach Gaensslen Chair in Suicide Prevention Research is so important. This is the beginning of a new era in suicide prevention research and one that we think will have far-reaching effects."“Psychiatric diseases are complex, with features that standard genetic and environmental theories can’t account for,” Kaminsky says. “But, this can all be explained, at least broadly, by the theory that epigenetic dysregulation is accounting for disease.”
In 2010, Kaminsky had finished graduate and postdoctoral training in Toronto, and returned to Baltimore to establish a new epigenetics lab at Johns Hopkins. The work paid off — by 2014, his research identified a biomarker indicating high risk of postpartum depression, and another indicating high suicide risk.
“People aren’t used to knowing the future,” he says. “They’re used to waiting for symptoms, and then acting
on them.”
A blood test for suicide risk
Kaminsky’s new role as Suicide Prevention Research Chair at The Royal gives him the opportunity to focus hard on his discoveries related to suicide.
The research also helps take away the stigma of suicide.
“Epigenetics and the DNA have the power to make mental illness real in a way it hasn’t been before.
It’s in the biology,” Kaminsky says. “Many people have been saying that, and I’m here to make that choir one voice stronger.”
The SKA2 discovery is promising, but many questions remain. Plus, for a blood test to accurately identify high suicide risk, it needs to be able to test for a panel of biomarkers — not just one. But Kaminsky thinks other markers, other epigenetic factors, are out there waiting to be identified. He’s planning a huge search for them, and the stakes are high.
“Most people who have seen their doctor within a couple months prior to a suicide attempt are not deemed at risk,” he says. “It’s getting missed.”
Ordering a test would make a doctor’s job much easier, especially in emergency rooms. If care providers knew who needed help, they could provide life-saving support quickly. “If my research is saving lives and helping people, I’ll have satisfied the chair. I’m not going to be satisfied unless I do that.”
