Walter H.A. Kahr

Walter H.A. Kahr


MD, University of Toronto, 1994
PhD, University of Toronto, 1994
Postdoc, McMaster University, 1999-2002

Address The Hospital for Sick Children
PGCRL, Rm 19.9714
686 Bay Street
Toronto, ON M5G 0A4
Lab Kahr lab
Lab Phone 416-813-7654 ext 328019 or 328018
Office Phone 416-813-7977

I received my MD and PhD (Biochemistry) from the University of Toronto in 1994. Following post-graduate training in Internal Medicine at the University of Toronto (1994-1997), I completed a hematology fellowship in the Department of Medicine (1997-1999) and a post-doctoral fellowship in the Department of Pathology and Molecular Medicine (1999-2002) at McMaster University in Hamilton. During my post-doctoral fellowship I discovered that bleeding problems in patients with the rare inherited Québec platelet disorder arose from the abnormal expression of urokinase in their platelets. This information aided the effective treatment of this bleeding disorder. As a clinician-scientist at the Hospital for Sick Children I follow children with bleeding and clotting disorders. My research is focused on understanding the structure and function of platelets – the smallest cells in the blood – and how they develop from megakaryocytes, the largest cells in the bone marrow.

In the News

    Research Lab

    My lab is located within the SickKids Research Institute Program in Cell Biology on the 19th floor of the new PGCRL building located on Bay St. in downtown Toronto.

    Lab Members

    Fred G. Pluthero, Lab Research Project Manager
    Ling Li, Lab Research Project Coordinator
    Raizl Gruda Sussman, Post Doctoral Fellow
    Chien-Yi Lu, Graduate Student
    Richard Liu, Graduate Student
    Helen Yao, Graduate Student
    Yusef Al-Molieh, MSc Graduate Student – Candidate
    Ailing Pon, Research Student

    Research Description

    Blood Coagulation in Health and Disease


    Our research is aimed at understanding the development and function of blood platelets. These tiny, numerous cells initiate and co-ordinate blood clotting (i.e. hemostasis) at wound sites by adhering, aggregating and secreting a wide assortment of molecules. Platelets are also involved in the formation of arterial plaques and pathological clots such as the thrombi that cause heart attacks and strokes, major causes of mortality in the modern world. Many of our insights into the mechanisms of platelet development and function have come from studies of patients with inherited platelet disorders. Our particular interest is alpha granules, secretory vesicles that platelets use to transport and secrete several hundred different kinds of protein. We have identified several proteins and cellular pathways involved in the development of alpha granules in the cells that produce platelets, the bone marrow megakaryocytes.

    Blood Platelets in Health and Disease

    Each of us releases 100 billion platelets into our bloodstream every day. These tiny disk-shaped cells, only about 3 microns across, play vital roles as they patrol blood vessels for signs of injury. When they detect a breach they adhere, aggregate and activate formation of a clot that seals the wound and limits blood loss. Thus individuals lacking platelets or having dysfunctional cells experience abnormal bleeding. In addition to their key role in blood clotting, platelets are also involved in inflammation, immunity and wound healing, and in the formation of atherosclerotic plaques and pathological clots (i.e. thrombi) that trigger heart attacks and strokes. The many roles of platelets in health and disease are linked to their unique ability to store and release a wide range of biomolecules. These include a wide gamut of proteins stored within and released from secretory α‑granules, and studies of the development and function of these granules is a major focus of my research group.

    High resolution laser fluorescence microscopy of a human platelet shows actin near the cell membrane and the internal calcium store system that surrounds abundant protein-carrying alpha granules.

    Platelets and Megakaryocytes

    Platelets are produced by megakaryocytes, cells that develop within the bone marrow until they reach enormous sizes of up to 100 microns across. At that point they generate extensions that protrude into blood vessels and shed platelets into circulation by the thousands. We study megakaryocyte development in a variety of different ways using cells derived from humans and mice. This allows us to monitor gene expression, protein localization and trafficking, as well as the development of alpha granules, using advanced methods such as high-resolution fluorescence and electron microscopy. The ability to manipulate megakaryocytes in vitro has allowed us to study their development in detail, and examine aspects such as the trafficking of proteins destined for alpha granules, some of which are synthesized by megakaryocytes, while others are taken up from the bloodstream.

    Image of a cultured megakaryocyte (left, outer membrane in green) in the final stage of development when long extensions give rise to smaller anucleate bodies (right) that become platelets in vivo.

    Hereditary Platelet Disorders: Bedside to Bench and Back Again

    Much of the recent progress that has been made in understanding platelet production, structure and function has come from studies of hereditary conditions where one or more of these aspects are affected. Patients with arthrogryposis, renal dysfunction and cholestasis (ARC) syndrome have platelets that lack α-granules. In a series of studies we identified that the root cause of this defect is loss of one of two proteins: VPS33B and VPS16B, which we showed using yeast two-hybrid screens and mass spectrometry form a functional protein complex. Ongoing studies are extending this work in several directions, including determining the structure of the functional VPS33B/VPS16B complex.

    In another project we used classical genetics and platelet mRNA expression analysis to reveal the cause of gray platelet syndrome (GPS), where patients have platelets containing some alpha granule components, but normal granules fail to form. We found that GPS is caused by loss of function of NBEAL2 (neurobeachin-like 2), a large protein with several potential functional domains about which little is known. We have explored NBEAL2 function using Nbeal2-knockout mice that recapitulate many aspects of GPS pathology. These studies have allowed us to observe that loss of NBEAL2 function leads to impaired megakaryocyte development and affects their ability to package and retain protein cargo into alpha granules. Current studies are focussed on elucidating the cellular mechanisms whereby NBEAL2 facilitates maturation and stability of alpha granules.

    Recently the expertise of my group and others solved a mystery concerning a patient with a puzzling set of symptoms involving platelets and the immune system. We discovered the root of these problems was loss of expression of ARPC1B, a component of the Arp2/3 complex that generates branched actin filaments in blood cells. This work received considerable media interest and was recognized by the inaugural Janet Rossant Research innovation Prize, and it has stimulated further exploration of ARPC1B deficiency by us and others. A novel technical aspect of this project was the generation of gene knockout human megakaryocyte precursor (imMKCL) cells using CRISPR/Cas9 gene editing, which were used to model megakaryocyte development in the absence of ARPC1B function.

    Fluorescence (left) and scanning EM (right) imaging of normal platelets spreading on fibrinogen (top) and platelets from a patient lacking ARPC1B (bottom) show a striking difference in the ability of the deficient cells to spread and form adherent lamellipodia via actin filament branching.

    Awards & Distinctions

    1999-2001 — Medical Research Council/HSFC Post Doctoral Fellowship Award
    2001-2002 — Heart and Stroke Foundation of Canada Post Doctoral Fellowship Award
    2006-2009 — Heart and Stroke Foundation of Ontario, Phase II Clinician Scientist Award
    2017 — Platelet Journal Cover Competition-Winner for 2018
    2018 — The Janet Rossant Research Innovation Prize, The Hospital for Sick Children, Research Institute

    Courses Taught

    BCH449H Medical Biochemistry
    BCH374Y1 Research Project in Biochemistry
    BCH473Y Advanced Research Project in Biochemistry


    View all publications on PubMed

    Germline mutations in ETV6 are associated with thrombocytopenia, red cell macrocytosis and predisposition to lymphoblastic leukemia.
    Noetzli L, Lo RW, Lee-Sherick AB, Callaghan M, Noris P, Savoia A, Rajpurkar M, Jones K, Gowan K, Balduini C, Pecci A, Gnan C, De Rocco D, Doubek M, Li L, Lu L, Leung R, Landolt-Marticorena C, Hunger S, Heller P, Gutierrez-Hartmann A, Xiayuan L, Pluthero FG, Rowley JW, Weyrich AS, Kahr WH, Porter C, Di Paola J.
    Nature Genetics. 2015 Nov 3; 47(5),535–538.  Read

    FlnA binding to PACSIN2 F-BAR domain regulates membrane tubulation in megakaryocytes and platelets.
    34. Begonja AJ, Pluthero FG, Suphamungmee W, Giannini S, Christensen H, Leung R, Lo RW, Nakamura F, Lehman W, Plomann M, Hoffmeister KM, Kahr WH, Hartwig JH, Falet H.
    Blood. 2015 Jul 2;126(1):80-8.  Read

    Platelet production: new players in the field.
    Pluthero FG, Kahr WH.
    Blood. 2016;127(7):797-9.  Read

    A high-throughput sequencing test for diagnosing inherited bleeding, thrombotic, and platelet disorders.
    33. Simeoni I, Stephens J , Hu F, Deevi SV, Megy K, Bariana TK, Lentaigne C, Schulman S, Sivapalaratnam S,Vries MJ, Westbury SK, Greene D, Papadia S, Alessi MC, Attwood AP, Ballmaier M, Baynam G, Bermejo E, Bertoli M, Bray PF, Bury L, Cattaneo M, Collins P, Daugherty LC, Favier R, French DL, Furie B, Gattens M, Germeshausen M, Ghevaert C, Goodeve AC, Guerrero JA, Hampshire DJ, Hart DP, Heemskerk JW, Henskens YM, Hill M, Hogg N, Jolley JD, Kahr WH, Kelly AM, Kerr R, Kostadima M, Kunishima S, Lambert MP, Liesner R, López JA, Mapeta RP, Mathias M, Millar CM, Nathwani A Neerman-Arbez M, Nurden AT, Nurden P, Othman M, Peerlinck K, Perry DJ, Poudel P, Reitsma P, Rondina MT, Smethurst PA, Stevenson W, Szkotak A, Tuna S, van Geet C, Whitehorn D, Wilcox DA, Zhang B, Revel-Vilk S, Gresele P, Bellissimo DB, Penkett CJ, Laffan MA, Mumford AD, Rendon A Gomez K, Freson K, Ouwehand WH, Turro E.
    2016 Jun 9;127(23):2791-2803.  Read

    Loss of the Arp2/3 complex component ARPC1B causes platelet abnormalities and predisposes to inflammatory disease.
    Kahr WH, Pluthero FG, Elkadri A, Warner N, Drobac M, Chen CH, Lo RW, Li L, Li R, Li Q, Thoeni C, Pan J, Leung G, Lara-Corrales I, Murchie R, Cutz E, Laxer RM, Upton J, Roifman CM, Yeung RS, Brumell JH, Muise AM.
    Nature Communications. 2017 Apr 3;8:14816.  Read

    NBEAL2 (Neurobeachin-Like 2) Is Required for Retention of Cargo Proteins by α-Granules During Their Production by Megakaryocytes.
    Lo RW, Ling Li L, Leung R, Pluthero FG, Kahr WH.
    Arteriosclerosis, Thrombosis, and Vascular Biology. 2018 Jul 26;38:2436-2447.   Read

    The endoplasmic reticulum protein SEC22B interacts with NBEAL2 and is required for megakaryocyte α-granule biogenesis.
    Lo RW, Li L, Pluthero FG, Leung R, Eto K, Kahr WHA
    Blood. 2020 Aug 6;136(6):715-725.  Read