Development and promotion in translational medicine: perspectives from 2012 sino-american symposium on clinical and translational medicine

Collaboration between academia and industry

How might we interact among stakeholders to optimally integrate health care delivery, academic research and the healthcare industry to improve the efficacy of truly translational medicine? What are the challenges?? In its simplest form, the solution lies in closer communication and integration among the various players, including product developers, academic researchers, healthcare providers and governments. There is a new model emerging to address this. Targeted drug development is one example of success in clinical and translational medicine. Several countries are now promoting the integration of their previously separated health and academic sectors. For example, in the U.K., Germany, Australia, Brazil, and Singapore, institutes have been established that create a strong link with industry and cut across various areas of science and medical practice. Meanwhile, academic institutions and government research centers are emerging as true partners with industry in the drug discovery and evaluation process. An example is the proposed National Center for Advancing Translational Science (NCATS) at the US NIH, which will become a key catalyst, integrator and leader to insure the interface of government, academic institutions and industry to promote translational medicine. In addition, pharmaceutical, biotech and other healthcare product developers are increasingly entering milestone-based funding agreements with academia and clinical investigators, sharing the risk of product development at a much earlier stage, in order to more rapidly move scientific discoveries to the treatment of patients and ultimately, commercialization.

Partnership business models

While there are various forms and structures of partnership business models, one that has proven successful has the product development organization (company) establishing a more integrated and flexible external network of academic experts. Such an example is Chorus, an autonomous division of Eli Lilly and Company[5], that is an early phase drug development group that cost-effectively advances candidate molecules from discovery through clinical proof of concept (PoC). In the seven years since its inception, Chorus has advanced two dozen molecules into development from discovery through early phase clinical study in patients. Another model calls for industry sharing its resources with multiple medical researchers and clinicians in Centers of Excellence (COEs), an example of which is the Shanghai Clinical Immunology Research Center[6], founded by Becton Dickinson & Co. (BD) and Zhongshan Hospital Fudan University. This COE allows researchers to share the most advanced and specialized laboratory equipment and clinical samples (Figure1). Another approach is to develop broad and flexible institution-wide collaborations, a representative of which is Pfizer’s Center for Therapeutic Innovation (CTI)[7], an entrepreneurial research unit at Pfizer dedicated to establishing global partnerships between Academic Medical Centers (AMCs) and Pfizer to focus on translational medicine. CTI laboratory staff includes Pfizer employees working side-by-side with leading basic and translational science investigators and post-docs from the AMCs. CTI established partnerships with 20 leading academic medical centers across the United States and supports collaborative projects from four dedicated labs in Boston, New York City, San Francisco, and San Diego. CTI received over 300 proposals from its first round of applications, and to-date has selected approximately 20 programs to initiate in partnership with the proposing PIs. Funded programs span a broad range of therapeutic areas, including oncology, inflammation, infectious disease, cardiovascular and metabolic disease.

From biobanking to precision medication

Dr. Gyorgy Marko-Varga, Professor of Lund University, described the biobanking facility in his hospital. To set up a specimen bank requires the collection of specimens while strictly following good clinical practice principles. The specimens collected have to be well identified and kept in strict environmental controlled facilities from the time of collection to the final storage[12]. Though the establishment of biobankis not easy, the benefit to clinical research is obvious such as promoting precision medication. Professor described his studies in individualized medication from screening drug delivery to gradual realization of precision medicine, thus ensuring patients the best and the most effective drugs in the early stage of diseases. We can obtain many specimens from biobank with related information that can be used in clinical translational research, thus realizing precision medicine which provides good prospects for establishing rational use of drugs, improving curative effects and reducing adverse reactions.

From bioinformatics to dynamic biomarker network

Some complex diseases are not caused by the maturation of single gene or single protein. It is an integration of networks, so we can’t diagnose these diseases depending only based on one or several genes and proteins. Numerous genetic and genomic datasets or proteomic datasets related to complex diseases have been made available during the last decade[13].

Dr. Ching-Wan Lam, Professor of the University of Hong Kong, described his studies of omics-based medicine. He explained the concept of metabolomics. Metabolomics can be defined as the field of science that deals with the measurement of metabolites in an organism and studies the physiological processes and reactions to various pathological stimuli. Metabolomic analysis can be translated into clinical medicine in terms of disease identification, early disease detection and screening through metabolomic analysis of human biofluids.

A number of methodologies and computational programs have been developed to integrate selected proteins into the knowledge-based networks via the combination of genomics, proteomics and bioinformatics[14]. Dr. Francesco Marincola, Chief of the Infectious Disease and Immunogenetics Section in the Department of Transfusion Medicine at the Clinical Center of the National Institutes of Health, reported his studies in finding network biomarkers in the metastatic cancer model. Bioinformatics analysis can provide a valuable molecular basis for systematic interpretation of the mechanism underlying metastasis where potential protein markers could be characterized[15].

The studies of these two professors made us have full confidence in the promotion of translational medicine in this field.

From internet of things to telemedicine

Internet of Things is one of the major communication advances in present time that links the internet with everyday sensors and working devices for an all –IP based architecture[16]. Internet of Things in Medicine is broadly recognized as a potentially important tool for transforming medical care and public health[17]. Internet of Things in Medicine includes many kinds of sensors within medical devices, combines the Internet of Things with the current internet, thus perfectly achieving the integration of hospitals, patients and medical devices and facilitating a totally new modern medical mode.

Telemedicine is the application of telemetry in the practice of medicine. To a comprehensive definition is in usage of exchanged medical information through electronic networks to improve a patient’s education, healthcare provider’s education, and patient care[18]. Dr. Chunxue Bai, Director of Shanghai Respiratory Research Institute, described his telemedicine mode to us--Cell Phone Based Remote Monitoring System for Lung Function. This invention can improve COPD management, asthma management and ICU ventilator management. It will let people diagnose diseases earlier, receive treatments earlier thus reducing the risks and even saving lives.

Our current complex health-care systems are fragmented, and their functioning, both in terms of efficiency and quality, are plagued by multiple discontinuities. But E-Health has the potential to ease transitions between the many settings and stakeholders of healthcare[19]. So, application of Internet of Things in Medicine is shall to be more benefit to people, it will be a developing trend in translational medicine in future.