College of Nursing
University of Utah
Historically, basic medical research
focused on gaining knowledge of the world around us, such as understanding
mechanisms of disease, or biologic response to disease. Research was performed
to better understand the world around us, and was not necessarily aimed at
gaining applicable knowledge for curing disease, defining best practice, and
promoting health. This paradigm has shifted over the last half century and
translational research has emerged. See a historical biography. Translational research is broadly defined as a
multidisciplinary research that aims to bridge the gaps between basic medical
research and its application at the bedside or in the community. Researchers
and scientists in medical translational research now aim to improve patient
outcomes and promote health within this new context.
The idea of translational science was
first printed in 1974 in the New England Journal of Medicine,1
and in 2006, the NIH put
out a statement about the importance of bridging the gaps between basic
research and clinical practice.2 This
promoted the development of specialists in translational science, as well as
the development of journals dedicated to promoting this type of research.
The Journal of
Translational Science, published an image outlining the gaps in research.3
The translational gaps identified have
been used to describe the stage or type of translational science being done. Click for
more info.
This has set the model
for the “T” phases of translational health research:
T1 Research
linking basic scientific discoveries to human application.
T2 Research of clinical practice and safety.
T3 Research linking lab research to population research to provide more meaningful results.
T4 Evaluation of “real world” treatments.
T2 Research of clinical practice and safety.
T3 Research linking lab research to population research to provide more meaningful results.
T4 Evaluation of “real world” treatments.
Image retrieved from: https://flic.kr/p/xUgGXR on august 7, 2017.
Only five years ago, the NIH
established the National Center for Advancing Translational Science (NCATS). Their mission is to bring together multidisciplinary researchers that
can link research to clinical practice and improve patient outcomes more
efficiently than in the past. Just this
week they awarded a 12-million-dollar grant to researchers at Dartmouth who will be tackling lung cancer and
precision medicine in a multifaceted approach. Their study will include identifying
genes that are linked to lung cancer and validating current biomarkers for lung
cancer for screening in patients. Finally, they will work to integrate this
data with patient environmental exposure and population risk assessments to
better screen and identify those at risk of lung cancer.
While
the concept of translational research has evolved, it has become an integral part of
discovery in relation to patient centered outcome and public health research. For the interested reader, Translational Research publishes many translational studies.
One such study about circulating tumor cells (CTC’s), helps to bridge the gap
between bench research done identifying ways to screen for CTC’s and clinical
care by reviewing the types of CTC detection screenings tested. Further, they
review the advantages and disadvantages of each test as well as the clinical
implications. While there is still work to be done in this field, this paper
serves to provide a resource to providers with up to date information for
treating patients with advanced cancers. Additional translational studies are
discussed here on nature.com.
Of course
there are critics of translational research, The perils of translational research. These criticisms are mainly focused
in two areas. First, that it detracts from basic research finds which provide
the “raw” materials for translational science. This is an important
consideration when looking at where research dollars are allocated each year.5
Secondly, critics point to a lack of reproducibility. This, however, could be said about
many types of research, and requires the fastidiousness of every researcher.
There are many opportunities for researchers interested in
this type of research, including funding. Bill and Melinda Gates have outlined
some of these on their foundation website. This is an exciting time to be in
research, and many opportunities are available for specialized
training in this area.
Useful links for further investigation
and support:
NCATS
program overview and initiatives:
University of Utah Center for Clinical and
Translational Science
NIH
Training Translational Research Training
References:
1.
Wolf, S. (1974). The real gap
between bench and bedside. New
England Journal of Medicine, 290(14),
802-803. doi:10.1056/NEJM197404042901411
2.
Woolf, S. H. (2008). The meaning
of translational research and why it matters. JAMA, 299(2), 211-213. doi:http://dx.doi.org/10.1001/jama.2007.26
3.
Drolet, B. C., & Lorenzi, N.
M. (2011). Translational
research: Understanding the continuum from bench to bedside. Translational Research.
doi: http://dx.doi.org/10.1016/j.trsl.2010.10.002
4.
Cambrosio, A., Keating, P.,
Mercier, S., Lewison, G., & Mogoutov, A. (2006). Mapping the emergence and development
of translational cancer research. European Journal of Cancer. doi:http://dx.doi.org/10.1016/j.ejca.2006.07.020
5.
Fang, C. F., & Casadevall, A.
(2010). Lost in translation-basic science in the era of translational research. Journal of Infection and
Immunity, 78(2), 563-566.
doi: 10.1128/IAI.01318-09
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