As with any advance in human health, scientific discoveries must be translated into practical applications. Scientific breakthroughs typically begin at “the bench” with basic research, and then progress to the clinical level, or the patient's “bedside.”
Researchers are increasingly aware that this “bench-to-bedside” approach to translational research must be a two-way street, an exchange of information. Basic scientists provide clinicians with new tools for use in patients, and clinical researchers make observations about the nature and progression of disease that often stimulate basic investigations.
However, barriers between clinical and basic research, along with the complexities involved in conducting clinical research, have traditionally made it hard to translate new knowledge to the clinic – and back again to the bench.
The National Institutes of Health (NIH) and numerous pharmaceutical companies have channeled billions of dollars into basic research, and have realized that their return on investments is lower than anticipated. Translational research often is seen as the missing component, though organizations dedicated to translational research do exist (such as the Center for Clinical and Translational Studies at the University of Texas).
Through the Clinical and Translational Science Award Program (CTSA), the NIH recently created a national consortium that includes 39 centers in 23 states with an annual funding commitment of $500 million by 2012. Though still young, the program was designed to shorten the time required to translate research results into therapies.
In an editorial in Science Magazine, 13 leaders of a diverse range of organizations wrote a collective editorial entitled “Translational Careers”. The editorial’s authors share a deep interest in clinical and translational research, and express a collective commitment to the development of an effective clinical and translational research workforce.
The editorial is positive about the potential of the CTSA program, but cautions against an overreliance on federal design and an under-reliance on support systems necessary for this kind of a program.
“People are the prerequisite for success,” they write. “We need an array of innovative investigators whose expertise spans all the disciplines of basic discovery and medical science. As a counterpoint to federal efforts, our private, nonprofit organizations have addressed the human capital need in robust ways, training and funding physicians and other clinical scientists, and piloting models for interdisciplinary graduate training involving biologists, physical and computational scientists and engineers, as well as a wide range of clinical and public health professionals."
The editorialists argue that beyond the rigorous research education essential for all scientists, translational scientists who will work at the frontiers of discovery and clinical science must possess a wide variety of practical and logistical skills.
"They must understand the processes by which discoveries turn into therapies, as well as the evolving role of private industry." the group writes. "They must navigate the regulatory environment surrounding human-subjects research, work in teams and share the rewards of their work, and defer financial rewards while spending years in extra training to gain this knowledge. Existing investigators must learn new skills, but we must also attract new people and facilitate productive interactions among them.
“If it fulfills its potential, translational research will lead to better health for people. But translation is not one-way; the insights gained at the bedside, and from clinical and population-based studies, will spawn hypotheses, enabling scientists to probe the mechanisms of disease in new ways and ultimately enriching basic biology. Therefore, strengthening the support systems for those who will accomplish this multidirectional translation can only be good for science,” the group finishes.
Prize4Life finds this thoughtful editorial particularly relevant to the ALS field. We fully support the CTSA initiative, and, in keeping with our mission and our current projects, we are also conscious of the need to create a vibrant and supportive arena in which researchers can work effectively and cures for diseases such as ALS can be developed.