The classic view of the translational scientist is a physician-scientist who is engaged in basic discovery, clinical research, and patient care. These the combined experiences and discoveries in each phase of research can accelerate translation. However, no one individual can span the full spectrum of translational sciences. Thus, well-integrated team science is critical to the successful bridging of the sciences that we call translational medicine. Contemporary translational research involves using a team-based approach to 1) formulate research questions based on clinical observations, 2) test these questions in the laboratory, 3) test the clinical efficacy and safety of laboratory-inspired interventions, and 4) test the effectiveness of therapeutic interventions in the community. The concept of personalized medicine truly spans all stages, from discovery to implementation. This translation, when it is operating ideally, results in interventions that make a difference in the lives of patients.
The Department of Medicine has strategically developed teams of scientists focused on discovering pathways of disease, identifying targets to intervene in disease, and translating those targets into therapeutic advances. An example of this is the intentional collocation of scientists in newly renovated space on the 9th floor of the Clinical Sciences Building who are focused on diseases that result in inflammation and fibrosis of organs.
Within this group is the Center of Economic Excellence in Inflammation and Fibrosis. Dr. Feghali-Bostwick is the Kitty Trask Holt Endowed Chair for Fibrosis Research and focuses on fibrosis in the lung secondary to systemic sclerosis. Dr. Don Rockey leads efforts to discover and target pathways of fibrosis in liver disease. Finally, Dr. Lynch Schnapp leads a team focused on idiopathic pulmonary fibrosis. Each team consists of basic and clinical scientists and clinicians focused on treating patients with fibrotic diseases. Dr. Betty Tsao is the Richard M. Silver Endowed Chair for Inflammation Research. Her work is focused on genetic factors that lead to lupus or more severe lupus. Her work is integrated into the MUSC Lupus Erythematosus (MUSCLE) translational research group. This group exemplifies translational research in that it regularly meets with one basic, three translational, and four clinical (two pediatric) researchers. Weekly meetings (including study and data coordinators) are held to formulate research questions, refine study design, review study operations, and perform feasibility studies for new trials. The group collaborates on single center and multi-center basic and clinical investigator-initiated studies and industry clinical trials.
Other teams are taking known discoveries and determining how to best implement them in the clinical and community environments to increase their effectiveness. This branch of translational research studies patient, provider, community, social, and system factors that can influence the patient’s disease course as much as the choice of a medication for treating chronic conditions. Dr. Leonard Egede, the Director of Center for Health Disparities Research, leads a team that studies interaction of psychosocial factors, race, and ethnicity and health outcomes. These factors can influence the course of the patient’s disease as much as many medical intervention.
All the above examples are not inclusive of the breadth of team translational sciences in the Department of Medicine. However, they serve as examples of how team science can break down the barriers between basic, clinical, and community research to make a difference.