Translational research

Translational research – often used interchangeably with translational medicine or translational science or bench to bedside – is an effort to build on basic scientific research to create new therapies,[1] medical procedures, or diagnostics. Basic biomedical research is based on studies of disease processes using for example cell cultures or animal models.[2] The term translational refers to the "translation" of basic scientific findings in a laboratory setting into potential treatments for disease.[3][4][5][6]

Definitions

Translational medicine is defined by the European Society for Translational Medicine (EUSTM) as "an interdisciplinary branch of the biomedical field supported by three main pillars: benchside, bedside and community."[2]

It is defined for school-based education by the Education Futures Collaboration (www.meshguides.org) as research which translates concepts to classroom practice.[7] Examples of translational research are commonly found in education subject association journals and in the MESHGuides which have been designed for this purpose.[8]

Translational research applies findings from basic science to enhance human health and well-being. In a medical research context, it aims to "translate" findings in fundamental research into medical practice and meaningful health outcomes. Translational research implements a "bench-to-bedside", from laboratory experiments through clinical trials to point-of-care patient applications,[9] model, harnessing knowledge from basic sciences to produce new drugs, devices, and treatment options for patients. The end point of translational research is the production of a promising new treatment that can be used with practical applications, that can then be used clinically or are able to be commercialized.[3]

As a relatively new research discipline, translational research incorporates aspects of both basic science and clinical research, requiring skills and resources that are not readily available in a basic laboratory or clinical setting. It is for these reasons that translational research is more effective in dedicated university science departments or isolated, dedicated research centers.[10] Since 2009, the field has had specialized journals, the American Journal of Translational Research and Translational Research dedicated to translational research and its findings.

Translational research is broken down into different stages, including two-stage (T1 and T2), four-stage (T1, T2, T3, and T4), and five-stage (T1, T2, T3, T4, and T5) schemes. In a two-stage model, T1 research, refers to the "bench-to-bedside" enterprise of translating knowledge from the basic sciences into the development of new treatments and T2 research refers to translating the findings from clinical trials into everyday practice.[3] In a five-stage scheme, T1 involves basic research, T2 involves pre-clinical research, T3 involves clinical research, T4 involves clinical implementation, and T5 involves implementation in the public health sphere. Waldman et al. propose a scheme going from T0 to T5. T0 is laboratory (before human) research. In T1-translation, new laboratory discoveries are first translated to human application, which includes phase I & II clinical trials. In T2-translation, candidate health applications progress through clinical development to engender the evidence base for integration into clinical practice guidelines. This includes phase III clinical trials. In T3-translation, dissemination into community practices happens. T4-translation seeks to (1) advance scientific knowledge to paradigms of disease prevention, and (2) move health practices established in T3 into population health impact. Finally, T5-translation focuses on improving the wellness of populations by reforming suboptimal social structures.[11]

In a two-stage scheme, translational research includes two areas of translation. One is the process of applying discoveries generated during research in the laboratory, and in preclinical studies, to the development of trials and studies in humans. The second area of translation concerns research aimed at enhancing the adoption of best practices in the community. Cost-effectiveness of prevention and treatment strategies is also an important part of translational science.[3]

Comparison to basic research or applied research

Basic research is the systematic study directed toward greater knowledge or understanding of the fundamental aspects of phenomena and is performed without thought of practical ends. It results in general knowledge and understanding of nature and its laws.[12]

Applied research is a form of systematic inquiry involving the practical application of science. It accesses and uses the research communities' accumulated theories, knowledge, methods, and techniques, for a specific, often state, business, or client-driven purpose.[13]

In medicine, translational research is increasingly a separate research field. A citation pattern between the applied and basic sides in cancer research appeared around 2000.[14]

Challenges and criticisms

Critics of translational research point to examples of important drugs that arose from fortuitous discoveries in the course of basic research such as penicillin and benzodiazepines,[15] and the importance of basic research in improving our understanding of basic biological facts (e.g. the function and structure of DNA) that go on to transform applied medical research.[16]

Examples of failed translational research in the pharmaceutical industry include the failure of anti-aβ therapeutics in Alzheimer's disease.[17] Other problems have stemmed from the widespread irreproducibility thought to exist in translational research literature.[18]

Facilities

In U.S., the National Institutes of Health has implemented a major national initiative to leverage existing academic health center infrastructure through the Clinical and Translational Science Awards. The National Center for Advancing Translational Sciences (NCATS) was established on December 23, 2011.[19]

Although translational research is relatively new, it is being recognized and embraced globally. Some major centers for translational research include:

Additionally, translational research is now acknowledged by some universities as a dedicated field to study a PhD or graduate certificate in, in a medical context. These institutes currently include Monash University in Victoria, Australia,[24] the University of Queensland, Diamantina Institute in Brisbane, Australia,[25] at Duke University in Durham, North Carolina, America,[26] at Creighton University in Omaha, Nebraska.[27] and at Emory University in Atlanta, Georgia,[28] The industry and academic interactions to promote translational science initiatives has been carried out by various global centers such as European Commission, GlaxoSmithKline and Novartis Institute for Biomedical Research.[29]

See also

References

  1. ↑ Mahla RS (2016). "Stem Cells Applications in Regenerative Medicine and Disease Therapeutics". International Journal of Cell Biology. 2016 (7): 19. doi:10.1155/2016/6940283. PMID 27516776.
  2. 1 2 Cohrs RJ, Martin T, Ghahramani P, Bidaut L, Higgins PJ, Shahzad A. "Translational Medicine definition by the European Society for Translational Medicine". New Horizons in Translational Medicine. 2 (3): 86–88. doi:10.1016/j.nhtm.2014.12.002.
  3. 1 2 3 4 Woolf SH (January 2008). "The meaning of translational research and why it matters". JAMA. 299 (2): 211–3. doi:10.1001/jama.2007.26. PMID 18182604.
  4. ↑ Reis SE, Berglund L, Bernard GR, Califf RM, Fitzgerald GA, Johnson PC (March 2010). "Reengineering the national clinical and translational research enterprise: the strategic plan of the National Clinical and Translational Science Awards Consortium". Academic Medicine. 85 (3): 463–9. doi:10.1097/acm.0b013e3181ccc877. PMC 2829722. PMID 20182119.
  5. ↑ Science Careers Staff (2011). "Careers in Clinical and Translational Research". Science. Retrieved March 24, 2018.
  6. ↑ Agency for Healthcare Research and Quality (2017). "Translating Research Into Practice". www.ahrq.gov. Retrieved March 25, 2018.
  7. ↑ Burden K, Younie S, Leask M (October 2013). "Translational research principles applied to education: the mapping educational specialist knowhow (MESH) initiative". Journal of Education for Teaching. 39 (4): 459–463. doi:10.1080/02607476.2013.801216.
  8. ↑ Younie S (2016). "Mapping Educational Specialist knowHow (MESH)". International Teacher Education Knowledge Mobilisation Summit: a framework for UNESCO SDG4 2030. London: Whitehall.
  9. ↑ "What is Translational Science". tuftsctsi.org. Tufts Clinical and Translational Science Institute. Retrieved 9 June 2015.
  10. ↑ Pober JS, Neuhauser CS, Pober JM (November 2001). "Obstacles facing translational research in academic medical centers". FASEB Journal. 15 (13): 2303–13. doi:10.1096/fj.01-0540lsf. PMID 11689456.
  11. ↑ Waldman, Scott A.; Terzic, Andre (2010-10-01). "Clinical and Translational Science: From Bench-Bedside to Global Village". Clinical and Translational Science. 3 (5): 254–257. doi:10.1111/j.1752-8062.2010.00227.x. ISSN 1752-8062.
  12. ↑ "What is basic research?" (PDF). National Science Foundation. Retrieved 2014-05-31.
  13. ↑ Roll-Hansen N (April 2009). Why the distinction between basic (theoretical) and applied (practical) research is important in the politics of science (PDF) (Report). The London School of Economics and Political Science. Retrieved November 30, 2013.
  14. ↑ Cambrosio A, Keating P, Mercier S, Lewison G, Mogoutov A (December 2006). "Mapping the emergence and development of translational cancer research". European Journal of Cancer. 42 (18): 3140–8. doi:10.1016/j.ejca.2006.07.020. PMID 17079135.
  15. ↑ Tone, Andrea (2009). The Age of Anxiety: the History of America's Love Affairs with Tranquilizers.
  16. ↑ Ashutosh Jogalekar (November 26, 2012). "The perils of translational research". Scientific American Blog Network.
  17. ↑ Golde TE, Schneider LS, Koo EH (January 2011). "Anti-aβ therapeutics in Alzheimer's disease: the need for a paradigm shift". Neuron. 69 (2): 203–13. doi:10.1016/j.neuron.2011.01.002. PMC 3058906. PMID 21262461.
  18. ↑ Prinz F, Schlange T, Asadullah K (August 2011). "Believe it or not: how much can we rely on published data on potential drug targets?". Nature Reviews. Drug Discovery. 10 (9): 712. doi:10.1038/nrd3439-c1. PMID 21892149.
  19. ↑ "Новости Мюнхена и Германии". CTSA Web.
  20. ↑ "Clinical and Translational Science Awards Program Hubs". www.ncats.nih.gov. National Institutes for Health. Retrieved 31 March 2016.
  21. ↑ "Maine Medical Center Research Institute attracts top scientists, licenses discoveries". www.mainebiz.biz. Mainebiz. Retrieved 17 June 2015.
  22. ↑ "Translational Research Institute". www.scripps.edu. The Scripps Research Institute. Retrieved 17 June 2015.
  23. ↑ UC Davis Health System, Clinical and Translational Science Center. "UC Davis Clinical and Translational Science Center: About Us".
  24. ↑ "Translational Research – PhD and Graduate Certificate". www.med.monash.edu.au. Monash University. Retrieved 17 June 2015.
  25. ↑ "MPhil in Translational Research". www.di.uq.edu.au. University of Queensland Diamantina Institute. Retrieved 17 June 2015.
  26. ↑ "Clinical and Translational Research". medschool.duke.edu. Duke University. Retrieved 17 June 2015.
  27. ↑ "Center for Clinical and Translational Science". medschool.creighton.edu. Creighton University. Retrieved 14 July 2015.
  28. ↑ "Certificate Program in Translational". Emory University. Retrieved 4 Jan 2018.
  29. ↑ "Novartis". World Pharma News.
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