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Features May 2007: Volume 4, Number 2

Translational Treatment
By Scott LaFee

The primary goal of the new Clinical and Translational Research Institute (CTRI) at UC San Diego is to convert basic research into actual treatments and therapies for real people.

Awarded a five-year, $37.2 million grant earlier this year by the National Center for Research Resources, the CTRI's charge is to accelerate the practical application of laboratory discoveries, engage diverse communities in clinical research and train future generations of clinical and translational scientists.

How do we convert this ever-expanding wealth of basic research into actual treatments and therapies for real people? The newly established Clinical and Translational Research Institute may be the answer.

Virtually every minute of every day, a new scientific paper is added (on average) to the database of PubMed, the open index of biomedical abstracts published by the National Center for Bio­technology Information.

In 2009, that translated into 769,858 published papers cited in a single database—and that represents just a fraction of the medical community's scientific work and progress. Our knowledge of health and disease is growing exponentially, at rates unprecedented in the history of medical science. But even as our knowledge base deepens, we are presented with another challenge: How do we convert this ever-expanding wealth of basic research into actual treatments and therapies for real people?

That's the primary goal of the emerging disciplines of translational science and medicine and it is the particular mission of the new Clinical and Translational Research Institute (CTRI) at UC San Diego. Awarded a five-year, $37.2 million grant earlier this year by the National Center for Research Resources, the CTRI's charge is to accelerate the practical application of laboratory discoveries, engage diverse communities in clinical research and train future generations of clinical and translational scientists.

"This is a new kind of science that emphasizes bringing together investigators with diverse expertise," says Gary S. Firestein, M.D., professor of Medicine, dean of Translational Medicine at UC San Diego's School of Medicine and director of the CTRI. "It's collaborative in a way rarely seen before, with researchers not just working in isolation to understand the causes and courses of disease, but also pushing hard as a group to convert clinical research results into clinical practice. We want to move as fast as we can and short-circuit the long lag time from scientific discovery to practical application."

In the new paradigm, says Mike Ziegler, M.D., professor of Medicine and director of CTRI's Concept to Completion Program, participating researchers will have access to the latest technologies and techniques, a robust support system and some of the brightest minds in academia and industry. All intended to get good ideas into practice as soon as possible.

"The CTRI is transforming clinical research by providing guidance and support at every stage of research and development," Ziegler says, "from the initial idea to creating novel technologies to conducting clinical trials and moving these new treatments to the community."

Researchers are developing ways of monitoring the cardiovascular system with surface pressure monitors, ultrasound machines and electrical sensors, all of which are safer than standard methods now in use. "The CTRI will develop computerized data collection systems to integrate information from all these sources, providing a safe and thorough measure of cardiovascular performance," Ziegler says. "We plan to change medical practice by providing doctors with a picture of the cardiovascular system that's both more complete and safer."

Of course, smart practice means smart practitioners—scientists and doctors able to take maximum advantage of the newest and latest developments. For example, the institute will be able to draw upon the unparalleled resources of the San Diego Supercomputer Center, the California Institute for Telecommunications and Informa­tion Technology (Calit2) and the UCSD division of biomedical informatics.

The CTRI involves four professional schools of health sciences at two universities: the School of Medicine and the Skaggs School of Pharmacy and Pharmaceutical Sciences at UC San Diego, and the School of Nursing and School of Public Health at San Diego State University.

According to Dilip Jeste, M.D., professor of psychiatry and neurosciences and director of CTRI's education, training and career programs, there will be local and distance learning programs at various levels, from high school offerings to Ph.D. programs in medicine, clinical psychology, public health, pharmaceutical sciences, epidemiology and more. Postgraduate residencies, fellowships and faculty positions will be created.

"Clinical and translational science requires next-generation researchers to possess new and additional skills," Jeste says. "The CTRI will enhance existing programs like the Interdisciplinary Graduate Laboratory Research Training Program, and create new programs that focus on needs relevant to the future, such as the increasing utility of biomedical informatics.

"The growing emphasis on personalized medicine extends to education, too. Different trainees learn in different ways. They have different needs. Yet there is relatively little research about what constitutes and predicts successful training programs. In collaboration with education experts and using a new computerized evaluation system, we'll do this kind of outcomes research to see which types of programs work best."

Partners will include the UCSD Medical Center, the UCSD Rady School of Management, the Jacobs School of Engineering, including the new Institute of Engineering in Medicine and the von Liebig Center for Entrepreneurism and Technology Advancement, the Salk Institute for Biological Studies, the Sanford/Burnham Institute for Medical Research, the J. Craig Venter Institute; the La Jolla Institute for Allergy & Immunology; the Rady Children's Hospital Research Center, the Veterans Administration Medical Center in La Jolla and Palomar Pomerado Health System.

The public will be part of the process as well. Jeste says the CTRI will reach out through the general media and its own communications efforts to inform and educate. "Citizens today are constantly exposed to research results and news," says Jeste. "To make good decisions and choices, they must understand the science, the value of clinical investigations and, ultimately, what it all means to them."

Of course, only time will tell how the CTRI takes form and function. But one aspect may prove notably tangible. Plans call for a new 292,000-square-foot institute building to be erected adjacent to the Jacobs Medical Center, a 10-story, 490,000-square-foot facility slated to open on UCSD's east campus in 2016. The proposed CTRI building would include a connecting skyway to the new hospital—a symbolic and functional link between basic science and real-world medicine.

Scott LaFee is senior public information officer for research at UC San Diego Health Sciences. He previously covered science at the Union-Tribune.