Kaarina Kowalec

Kaarina Kowalec

Affiliated to Research

Tenured Associate Professor (U Manitoba), Affiliated Researcher (Karolinska Institutet)

Combines genomics, biostatistics, and epidemiology to advance precision medicine in neuro/psychiatric disease.

Visiting address: Nobelsvägen 12a, 17165 SOLNA
Postal address: C8 Medicinsk epidemiologi och biostatistik, C8 MEB I Lu, 171 77 Stockholm
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About me

  • I am a tenured Associate Professor at the Rady Faculty of Health Sciences at University of Manitoba and hold an Affiliated Research 
    position at the Karolinska Institutet. My research aims to identify precision medicine approaches to neurological diseases and psychiatric disorders by combining genomics, biostatistics, and epidemiology, to advance the outcomes of those affected by neurological and psychiatric disorders. Our work regularly involves an extensive network of Canadian, American, Swedish, and other International collaborators. I am funded by the Canadian Institutes of Health Research, US Department of Defense, US NIMH and the Consortium of Multiple Sclerosis Centres. We are a "dry-lab" focussed on computation and analysis, but collaborate with "wet-lab" groups internationally.


    During my postdoctoral and PhD studies, I held fellowships from the European Commission (Horizon-2020), and the Canadian Institutes of Health Research (CIHR), including the Marie Skłodowska-Curie Actions-Horizon 2020 European Fellowship (€180K) and the Government of Canada Banting Fellowship, with over 20 awards during my PhD alone, totalling over $960K in personal salary awards, and $1.8M in peer-reviewed operating and team grants. From 2017-19, I was a Postdoctoral researcher at the Karolinska Institute with Professor Patrick Sullivan and the KI-Psychiatric Genomics Institute to harness my collaborative, problem-solving abilities that I have developed during my doctoral training and apply them to the intricate issues faced today by the psychiatric community. My projects involved utilizing the Swedish National Register data, the Sweden Schizophrenia Study, and other psychiatric cohort studies.

Research

    • Theme 1: Epidemiology and genomics of poor outcomes in schizophrenia

    Schizophrenia (SCZ) is one of the top 15 leading causes of disability worldwide, with the average number of life years lost ~30 years. Those with SCZ are at 15-25 times higher risk for suicide, compared to the general population. It is currently estimated that ~200, 000 Canadians have SCZ. In 2004, the direct healthcare and non-healthcare costs related to SCZ in Canada were estimated at >$2B, and when considering additional losses, resulted in a total cost estimate of $6.85B. Features associated with poor outcomes in SCZ include childhood adversities (e.g. neglect), family history of psychiatric disorders, and SCZ genomic burden (the weighted sum of the number of SCZ genetic risk variants within each individual). There are currently no means of predicting, at first clinical presentation, who will experience a poor outcome in SCZ. Our overall goal is early detection of those at high risk for poor outcomes in SCZ, thereby triggering logical and effective interventions to mitigate the personal, social, and societal costs associated with severe SCZ. Our overarching translational goal is to develop valid and clinically useful models that predict crucial clinical outcomes for psychiatry and to implement the predictive models on a provincial and national scale.

    Projects:
    1. Investigating the association between accelerated DNA methylation age and mortality in SCZ. This work is published in Translational Psychiatry.
    2. Using population-based Swedish National register data and extensive genomic data to examine treatment resistance in schizophrenia (published in Molecular Psychiatry).​​
    3. Investigating the role of genetic variation in association with specific and all cause mortality in schizophrenia. This work is published in Translation Psychiatry.
    Theme 2: Epidemiology and genomics of poor outcomes in multiple sclerosis (MS) and other chronic immunoinflammatory diseases

    The prevention of poor outcomes, such as serious adverse drug reactions associated with MS therapies or the development of psychiatric disorders, is essential for those with MS and other chronic immunoinflammatory diseases. Currently, there are few clinically useful predictors of poor outcomes in MS. Variability in the genes that underscore drug biotransformation may be the key to identifying and predicting who is at greatest risk of serious adverse drug reactions and likewise, investigating the genes that underlie polygenic traits like psychiatric disorders, may also be important in investigating those at greatest risk for a psychiatric disorder. Findings from our cutting-edge work (published in Nature Genetics,  Neurology,  BMJ Open,  Expert Opinion in Drug Safety,  and MS and Related Disorders) could improve outcomes in MS and contribute to the future development of precision medicine approaches to MS and other autoimmune diseases.

    Projects:
    1. Understanding psychiatric comorbidity in chronic immunoinflammatory diseases using genomics​:  ​We published work modelling longitudinal depressive symptoms in IMID to understand their evolution and identify any associated factors (including polygenic risk scores), with the overall goal of identifying those at highest risk of higher depressive symptom burden. This work is published in General Hospital Psychiatry. We then followed this with an assessment of depression polygenicity in multiple sclerosis and this work is published in Neurology and an assessment of anxiety polygenicity in MS, published in ACTN. We also aimed to better understand the bidirectional relationship between multiple sclerosis and depression using Mendelian randomization and found no evidence for a causal role for this relationship. This was published in MSJ.
    2. Understanding factors associated with substance use disorder in those with inflammatory bowel disease and rheumatoid arthritis in Manitoba. These projects are now published in Inflammatory Bowel Diseases and ACR Open.
    3. Genomic variants associated with DMF induced lymphopenia in MS [GenDMF-MS]: Seeking to predict and ultimately prevent adverse drug reactions in people with MS. An international pharmacogenomic investigation of lymphopenia due to dimethyl fumarate in multiple sclerosis, funded by the National MS Society. The protocol for this work can be found here and the project is in the analysis stage.

Teaching

  • 2026

    • Course Coordinator, College of Pharmacy, University of Manitoba PHMD2012: Instructed 60 PharmD students in Pharmacogenetics (26 lectures of 60-minutes each).
    • Lecturer, College of Medicine, University of Manitoba BGEN7090: Instructed 7 students in Complex Trait Genetics (Two 1.5-hour lectures).
    • Lecturer, College of Medicine, University of Manitoba PHAC3000: Instructed ~50 students in Pharmacogenomics (Three 1-hour lectures).
    • Course co-coordinator,  College of Pharmacy, University of Manitoba PHRM7160/7170/7260/7270: ~20 graduate students in seminar course.

    2025

    • Course Coordinator, College of Pharmacy, University of Manitoba PHMD2012: Instructed 60 PharmD students in Pharmacogenetics (26 lectures of 60-minutes each).

    2024

    • Course Coordinator, College of Pharmacy, University of Manitoba PHMD2012: Instructed ~50 PharmD students in Pharmacogenetics (26 lectures of 60-minutes each).
    • Lecturer, College of Pharmacy, University of Manitoba PHMD2004: Instructed ~50 students in Critical Appraisal Pharmacotherapy Literature 1 (One 3-hour lecture)
    • Mentor,  College of Pharmacy, University of Manitoba PHMD4000: Instructed 6 fourth year PharmD students in a research project (12 weeks each).

    2023

    • Course Coordinator, College of Pharmacy, University of Manitoba PHMD2012: Instructed 35 PharmD students in Pharmacogenetics (26 lectures of 60-minutes each).
    • Lecturer, College of Pharmacy, University of Manitoba PHRM7102: Instructed 8 graduate students in Pharmacoepidemiology (One 3-hour lecture).

    2022

    • Course Coordinator, College of Pharmacy, University of Manitoba PHMD2012: Instructed 55 PharmD students in Pharmacogenetics (26 lectures of 60-minutes each).
    • Mentor, College of Pharmacy, University of Manitoba PHMD4000: Instructed two fourth year PharmD students in a research project (12 weeks each).

    2021

    • Lecturer, College of Pharmacy, University of Manitoba PHMD2012: Planned the course syllabus and pre-recorded 10 lectures to be given as part of the Pharmacogenetics course (60-minutes each).

    2020

    • Lecturer, College of Pharmacy, University of Manitoba PHRM3640: Instructed 55 undergraduate Pharmacy students in Principles of Biotechnology (8 lectures of 75-minutes each).

    2019

    • Lecturer, College of Pharmacy, University of Manitoba PHRM4470: Current Topics in Pharmacy (1 hour)
    • Lecturer, College of Pharmacy, University of Manitoba PHRM7260: Instructed 1 lecture of Pharmacy Graduate Student Seminar (1 hour)
    • Lecturer, College of Pharmacy, University of Manitoba PHRM3520: Instructed 55 undergraduate Pharmacy students in Scientific Literature Evaluation (5 lectures of 90-minutes each).
    • Lecturer, University of North Carolina-Chapel Hill and Karolinska Institutet: Instructed 20 researchers in R-Statistical Software tutoria
    • Teaching and Learning Certificate, University of Manitoba: Two-year program designed to develop the knowledge, skills, and reflective practice.

    2012-2016

    • Teaching Assistant, Department of Biochemistry & Molecular Biology, Faculty of Science, UBC: Instructed undergraduate weekly laboratory session; monitored and assisted student biochemical and molecular biology experiments; evaluated student assignments, examinations, and progress; consistently rated highly amongst third-year undergraduate students.

    2011-2012

    • Laboratory Instructor, Biology Program, Faculty of Science, UBC: BIOL 140 Laboratory Investigations in Life Science: Instructed weekly laboratory sessions and preparatory sessions to enable students to participate in the scientific process; facilitated discussions with students and recorded student progress; assessed student work (assignments, written work, exams) and kept accurate records of student attendance, participation, and marks.

    2008-2009

    • Problem-Based Learning Facilitator, Rady College of Medicine, Department of Medical Microbiology, University of Manitoba

Articles

All other publications

Grants

  • Canadian Institutes of Health Research (CIHR)
    1 April 2026 - 31 March 2031
    In Canada, schizophrenia is a mental health condition that can lead to disability and early death. Researchers have used large databases to find genetic factors that contribute to our understanding of how schizophrenia works, however none of these studies included people from Manitoba and very few from Canada. We want to create a Manitoba-specific study to understand schizophrenia, where we will invite people with schizophrenia to participate by providing a blood sample. We will also collect medical data, and link to other data sources that are already available such as that from medical records and or other government sources. This is unlike any other study in Canada, because Manitoba has unique medical data available, where it covers most of a person's life, from birth to the end of life. These large databases that link genetic and medical data for conditions like schizophrenia are uncommon globally, but we also have access to a similar study in Sweden. Accessing this Swedish data can help to compare our findings from Manitoba with an outside country that is like Canada. Our goal is to provide a better understanding of schizophrenia in Canadians, compare with that of the Swedish study, and perform research to understand how genetics play a role in schizophrenia. To achieve these goals, we have three main aims: (1) create the Manitoba Schizophrenia Study, (2) examine if there genetic differences between those with and without schizophrenia, and compare this to individuals from Sweden and (3) investigate whether any genetic factors play a role in antipsychotic drug prescribing. The results from this project will create a highly coveted and novel resource for schizophrenia researchers in Canada, support new knowledge to improve our understanding of schizophrenia and may lead to new insights into the condition and potential targets for better treatments.
  • Polygenicity of Brain and Physical Reserve in Multiple Sclerosis
    Congressionally Directed Medical Research Programs
    1 September 2025 - 31 August 2027
    Background: This project directly addresses two FY24 MSRP focus areas: (a) identifying correlates of disease progression in MS and (b) understanding mechanisms contributing to MS etiology and disease course. Aging is a key determinant of physical impairment progression in MS, making it crucial to identify an individual's "reserve," which is the capacity to resist or delay such impairments. Brain reserve, represented by intracranial volume (ICV), reflects an individual's neurobiological capital and ability to tolerate MS-related pathology. Physical reserve refers to the ability to resist disease-related physical decline. Unfortunately, the contribution of reserve to MS-related impairments is poorly understood, especially regarding the genetic contributions. This proposal aims to fill this gap by characterizing and evaluating polygenic scores (PGS) – cumulative genetic loads for traits like brain volumes and aging-related diseases – to brain and physical reserve in MS. By using PGS as stable genetic factors from birth, we can identify novel mechanisms and potential therapeutic targets, excluding reverse causation._x000D_ _x000D_ Hypothesis/Objective(s)_x000D_ Specific Aims: We aim to identify whether aging associated PGS are correlates of MS disease progression. Our objectives are to (1) Validate the association between ICV PGS and brain reserve in PwMS, (2) Examine the association between PGS for aging-related traits and brain atrophy in MS and (3) Investigate the link between PGS for physical reserve in MS. We hypothesize that the PGS for ICV will be associated with brain reserve in people with PwMS, as observed in non-MS populations. We also hypothesize that PGS for aging-related traits will be associated with greater physical reserve in PwMS, manifesting as lower physical impairment for a given degree of brain atrophy._x000D_ _x000D_ Study Design: We will utilize five well-characterized cohorts from Canada, USA, Sweden, the UK and the global MS-PATHS network, comprising a total of 1,800-4,900 PwMS. Data will be pooled using random-effect inverse-variance weighted meta-analysis. For Objective 1, we will validate the association of the ICV PGS with head size-normalized ICV using quantile regression, adjusting for covariates such as genetic ancestry, age and sex. For Objective 2, we will construct a generalized linear model to predict physical function (z-score Timed-25-foot walk) based on brain volume, adding each PGS sequentially to determine its contribution to physical reserve._x000D_ _x000D_ Innovation: This research is among the first to assess whether PGS developed in large non-MS populations can predict brain reserve in PwMS. Additionally, by examining the genetic burden of aging-related traits in relation to physical reserve, this study could identify aspects of reserve that are potentially modifiable, offering new insights into MS progression._x000D_ _x000D_ Impact: The proposed research will generate new knowledge about the biological factors influencing reserve and the risk of physical impairments in MS, potentially leading to novel therapeutic targets. Improved understanding of reserve could enhance the ability to identify PwMS at high risk of accelerated physical decline, guiding more personalized and effective use of disease-modifying therapies. This is particularly important as even the most effective therapies currently available do not fully prevent disability progression in MS.
  • Canadian Institutes of Health Research
    1 April 2025 - 31 March 2030
    Over 90,000 people have multiple sclerosis (MS) in Canada. Each person's experience with MS is different. These differences are likely caused by a mix of factors. Examples of some of these factors are a person's sex, gender, age, ethnicity, and if they live in a city or not. Together, these factors contribute to a person's diversity. Past MS research has not included people who are very diverse even though some diversity factors can put a person with MS at a disadvantage for their health. Currently, researchers are unsure which diversity factors put people at the greatest health disadvantage. This in turn limits access to the right types of support and care. Our long-term goal is to improve health in people with MS who have not been included in past research. We will take three steps to reach our goal. First, we will develop ways to test how biological factors including genetics, age and sex, contribute to health outcomes in people with MS. Second, we will recruit 500 diverse people with MS to look at how a person's biology, lifetime experiences, and environment impact their health outcomes. We will look at the outcomes of quality of life and ability to live independently. Third, we will find and test ways to best support people with MS who experience health disadvantages because of their experiences and environments. During our work we will involve people with MS, health care providers, advocacy groups, and health care decision makers. Working with a big team will improve our chances that our findings will be meaningful and helpful for people with MS, regardless of what diversity factors they experience.
  • Brain Canada Foundation
    1 April 2024
    Reserve is someone’s ability to tolerate age-related changes and disease-related insults to their brain without developing symptoms. How reserve contributes specifically to multiple sclerosis disease is unknown. There are two types of reserve: “Brain reserve” which is like an individual’s “hardware”, and “cognitive reserve” which is your “software”. Whether differences in someone’s DNA contribute to reserve have not been considered. To address this, we seek to understand where DNA or genetic differences play a role in brain and cognitive reserve in multiple sclerosis. Our first goal is to understand factors associated with brain and cognitive reserve in multiple sclerosis that could be used to advance treatment and care. Our second goal is to better understand how multiple genetic differences influence the volume of brain over time. This may help with identifying who with multiple sclerosis may benefit the most from therapeutics.
  • Canadian Institutes of Health Research
    1 April 2024 - 31 March 2025
  • Capitalising on our differences: A gathering to better understand and advocate for Early Career Health Researchers in Canada
    Canadian Institutes of Health Research
    1 January 2023 - 31 December 2023
  • Canadian Institutes of Health Research
    1 January 2023 - 31 December 2023
  • Precision Genomics Suite
    Canada Foundation for Innovation
    22 November 2022
    Neurogenomics, Pharmacogenomics, Precision Medicine Automated preparation of samples for precise genomic analyses
  • Psychiatric Disorder Genomic Risk Scores as a Correlate of Disease Activity and Progression in Multiple Sclerosis
    Congressionally Directed Medical Research Programs
    15 July 2020 - 14 July 2024
  • Enhancing CAN-AIM capacity to respond to drug safety and effectiveness queries
    Canadian Institutes of Health Research
    1 September 2019 - 31 August 2022
  • Canadian Institutes of Health Research
    1 September 2019 - 31 August 2022
  • Identifying Clinical, Demographic, & Genomic Risk Factors for Treatment-Resistant Psychiatric Disorders
    Canadian Institutes of Health Research
    1 April 2018 - 3 January 2019
  • Canadian Institutes of Health Research
    1 April 2018 - 3 January 2019
  • The Drug Safety and Effectiveness Cross-Disciplinary Training (DSECT) Program
    Canadian Institutes of Health Research
    1 November 2015 - 28 February 2022
  • Canadian Institutes of Health Research
    1 November 2015 - 28 February 2022
  • Canadian Institutes of Health Research
    1 July 2014 - 30 June 2019
  • Genotype specific approaches to beta-interferon therapy in Multiple Sclerosis
    Canadian Institutes of Health Research
    1 May 2011 - 31 October 2014
  • Canadian Institutes of Health Research
    1 May 2011 - 31 October 2014

Employments

  • Associate Professor (tenured), University of Manitoba, 2025-
  • Assistant Professor, Genetics, University of Manitoba, 2019-
  • Affiliated to Research, Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, 2025-2027

Degrees and Education

  • PhD, Genetics and epidemiology, University of British Columbia, 2016
  • MSc, Viral genetics, University of Manitoba, 2011
  • BSc, Microbiology, University of Manitoba, 2008

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