Integrated research for applications in public health

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Agência FAPESP* –By Washington Castilhos

Agência FAPESP – Translational medicine aims to speed the transfer of knowledge produced at the bench for application in clinical investigation and public health. In other words, the idea is to establish a connection between the creation and application of knowledge, integrating researchers in both basic and clinical fields for greater benefit to the population.
 
A historic landmark in translational medicine occurred when the U.S. National Academy of Sciences Institute of Medicine began to hold symposia to discuss the importance of clinical investigation to have the capacity to transform knowledge from basic research because developments obtained through clinical investigation were not sufficient to do this with the necessary speed or efficiency.
 
As a result, the scientific community began to discuss the fact that clinical trials in the country had not advanced as much as basic biomedical research. Later, in 2003, the U.S. National Institutes of Health (NIH) began promoting the reengineering of clinical investigation and creating a program to finance the organization of translational medical centers at universities as one of its targets. Today, there are approximately 60 centers.
 
“The objective was to stimulate the formation of multidisciplinary teams and create a culture of proximity between the basic research area and clinical trials and to ensure that knowledge resulting from basic research – which was considered useful in clinical trials – reached the patient. The challenge was also to apply the knowledge produced at universities to public health,” explains Eduardo Moacyr Krieger, professor emeritus at Universidade de São Paulo’s Ribeirão Preto Medical School.
 
Krieger, who is vice-president of FAPESP, an organization for which he also served as president for 14 years, coordinated the Symposium on Translational Medicine held on November 29 at the Brazilian Academy of Sciences.
 
Although the term is new, the practice and idea of translational research is not. Eduardo Krieger cited the creation of Silicon Valley in partnership with Stanford University during World War II as an example of how rapidly knowledge can be transferred from a university to the private sector to meet demand for military technology.
 
“Medicine was slow to do this,” he observed, citing the discovery of angiotensin-converting enzyme (ACE) inhibitors, drugs used to treat arterial hypertension, as an example.
 
“It took 10 years of basic research before the results were applied to medicine,” said Krieger, a top specialist in the field of cardiovascular physiology, which focuses on researching the mechanisms of the regulation of arterial pressure.
 
“Today, the speed with which research at the bench is conducted and knowledge reaches application has changed fundamentally. The university communicates its knowledge to industry or industry comes to get it,” he observed.
 
Eduardo Krieger, who created the Translational Cardiology Program at InCor (the Heart Institute), which is the most important translational medicine group in Brazil, believes that one milestone in this area is FAPESP’s support through its Thematic Projects, which give incentives to multidisciplinary research involving professionals from different origins.
 
“USP also created a Research Support Program to stimulate multidisciplinary projects and promote the integration of thematic subjects,” Eduardo Krieger commented.
 
“In the public area, the Ministry of Health created the National Network of Clinical Research, which brings together 35 university hospitals and initially provides funding for hospitals to create an infrastructure for clinical trials. The major universities are also creating their own centers – in Porto Alegre, Finep funded the construction of buildings for clinical trials,” he added.
 
At the moment, Eduardo Krieger coordinates a Thematic Project in which he studies biomarkers of the evolution of patient treatment to determine whether a patient is responding well or poorly to a given treatment.
 
The researcher also coordinates a Health Ministry and CNPq Project to investigate the percentage of Brazilians who are resistant to hypertension therapy and to determine which are the four best drugs administered under Brazil’s Unified Health System. The objective is to transform results from clinical research into measures for public health. “This is one of the objectives of translational medicine,” he said.

<p><b>By Washington Castilhos</b><b><br />
</b></p>
<div><b>Agência FAPESP</b> – Translational medicine aims to speed the transfer of knowledge produced at the bench for application in clinical investigation and public health. In other words, the idea is to establish a connection between the creation and application of knowledge, integrating researchers in both basic and clinical fields for greater benefit to the population.</div>
<div> </div>
<div>A historic landmark in translational medicine occurred when the U.S. National Academy of Sciences Institute of Medicine began to hold symposia to discuss the importance of clinical investigation to have the capacity to transform knowledge from basic research because developments obtained through clinical investigation were not sufficient to do this with the necessary speed or efficiency.</div>
<div> </div>
<div>As a result, the scientific community began to discuss the fact that clinical trials in the country had not advanced as much as basic biomedical research. Later, in 2003, the U.S. National Institutes of Health (NIH) began promoting the reengineering of clinical investigation and creating a program to finance the organization of translational medical centers at universities as one of its targets. Today, there are approximately 60 centers.</div>
<div> </div>
<div>“The objective was to stimulate the formation of multidisciplinary teams and create a culture of proximity between the basic research area and clinical trials and to ensure that knowledge resulting from basic research – which was considered useful in clinical trials – reached the patient. The challenge was also to apply the knowledge produced at universities to public health,” explains Eduardo Moacyr Krieger, professor emeritus at Universidade de São Paulo’s Ribeirão Preto Medical School.</div>
<div> </div>
<div>Krieger, who is vice-president of FAPESP, an organization for which he also served as president for 14 years, coordinated the Symposium on Translational Medicine held on November 29 at the Brazilian Academy of Sciences.</div>
<div> </div>
<div>Although the term is new, the practice and idea of translational research is not. Eduardo Krieger cited the creation of Silicon Valley in partnership with Stanford University during World War II as an example of how rapidly knowledge can be transferred from a university to the private sector to meet demand for military technology.</div>
<div> </div>
<div>“Medicine was slow to do this,” he observed, citing the discovery of angiotensin-converting enzyme (ACE) inhibitors, drugs used to treat arterial hypertension, as an example.</div>
<div> </div>
<div>“It took 10 years of basic research before the results were applied to medicine,” said Krieger, a top specialist in the field of cardiovascular physiology, which focuses on researching the mechanisms of the regulation of arterial pressure.</div>
<div> </div>
<div>“Today, the speed with which research at the bench is conducted and knowledge reaches application has changed fundamentally. The university communicates its knowledge to industry or industry comes to get it,” he observed.</div>
<div> </div>
<div>Eduardo Krieger, who created the Translational Cardiology Program at InCor (the Heart Institute), which is the most important translational medicine group in Brazil, believes that one milestone in this area is FAPESP’s support through its Thematic Projects, which give incentives to multidisciplinary research involving professionals from different origins.</div>
<div> </div>
<div>“USP also created a Research Support Program to stimulate multidisciplinary projects and promote the integration of thematic subjects,” Eduardo Krieger commented.</div>
<div> </div>
<div>“In the public area, the Ministry of Health created the National Network of Clinical Research, which brings together 35 university hospitals and initially provides funding for hospitals to create an infrastructure for clinical trials. The major universities are also creating their own centers – in Porto Alegre, Finep funded the construction of buildings for clinical trials,” he added.</div>
<div> </div>
<div>At the moment, Eduardo Krieger coordinates a <b><a href="http://www.bv.fapesp.br/en/auxilios/2126/bench-clinical-trials-development-biomarkers/" target="_blank">Thematic Project</a></b> in which he studies biomarkers of the evolution of patient treatment to determine whether a patient is responding well or poorly to a given treatment.</div>
<div> </div>
<div>The researcher also coordinates a Health Ministry and CNPq Project to investigate the percentage of Brazilians who are resistant to hypertension therapy and to determine which are the four best drugs administered under Brazil’s Unified Health System. The objective is to transform results from clinical research into measures for public health. “This is one of the objectives of translational medicine,” he said.</div>
<div> </div>