The National Institutes of Health has awarded one of 12 Clinical and Translational Science Awards (CTSA) for 2007 to a team based at the University of Chicago Medical Center. These awards, together with 12 CTSAs awarded in 2006, form the core of an NIH effort to build a national consortium of select centers that will "transform how clinical and translational research is conducted," ultimately enabling researchers to provide new and better treatments more efficiently and quickly to patients.
To improve human health, according to the NIH's Roadmap for Medical Research, scientific discoveries must be translated into practical applications. Such discoveries typically begin at the bench with basic research -- in which scientists study disease at a molecular or cellular level -- then progress to the clinical level, or the patient's bedside, and ultimately to widespread adoption as standard clinical practice.
This award to the University of Chicago provides more than $22.6 for a series of such translational projects. It will bring together basic scientists from the biological, physical, behavioral and social sciences, physician-scientists from the medical school, and faculty from the schools of public policy, social service administration, and business. And it will put all those researchers in close contact with the residents of the South Side of Chicago.
Together, they will conduct basic, translational and clinical research; speed the transition of new knowledge from laboratory bench to patient bedside; push the boundaries of personalized medicine; and improve the health of the community. "Through collaboration and leadership, these sites are serving as discovery engines that can rapidly translate research into prevention strategies and clinical treatments for the people who need them," said Elias Zerhouni, MD, director of the National Institutes of Health. "The CTSA consortium also represents our investment in the future as it prepares the next generation of clinical researchers to meet tomorrow's health care challenges." The University of Chicago was selected for its expertise in translational research and its eagerness to cross boundaries. The University has a long history of extensive collaborations among faculty from different disciplines, strong and productive relationships with institutional partners such as Argonne National Laboratory and the Illinois Institute of Technology -- which will also be partners in this project -- and robust and expanding community engagement.
"The ambitious, ultimate goals of this program are to train scientists and health care providers at the University and in our community to determine the molecular underpinnings of disease or disease predisposition in any individual patient," said Julian Solway, MD, Walter L. Palmer Distinguished Service Professor of Medicine and Pediatrics and principal investigator for this project.
"We intend to develop, test, implement, and make readily available to residents in our community personalized therapies directed toward those underpinnings, which might be different among individual patients, and to do this in a way that is rigorous, valid, efficient, ethical, and respectful of our community's needs and values."
"The translation of biomedical discovery into effective, deliverable, and personalized therapies for diverse populations with common, complex disorders is a daunting but tremendously important task," said James Madara, MD, Chief Executive Officer of the University of Chicago Medical Center, University Vice President for Medical Affairs, and Dean of the Division of the Biological Sciences and the Pritzker School of Medicine at the University of Chicago.
"Few cures for common health problems have emerged from strategies that ignore personalized needs," Madara said. "We believe this reflects not only the complexity of the disease processes but also the extreme heterogeneity of patient populations and the corresponding heterogeneity of successful approaches for diagnosis and treatment. The many strengths of the investigators and residents within the University of Chicago community encourage us to meet this challenge head on."
One objective of the CTSA program is to eliminate barriers: between academic disciplines, between laboratory and clinical research, and between scientists, doctors and patients. To reach that objective, the program will bring residents of the many diverse neighborhoods surrounding the University into the research process.
The 1.1 million residents of the South Side of Chicago form a diverse but, in many cases, chronically underserved population. The community has high rates of hypertension, diabetes, asthma and other complex diseases. Ten to 15 percent of adults are physically disabled. Fifteen to 20 percent of all births to neighborhood residents are premature. Area residents over age 35 are three times more likely to be hospitalized for complications of diabetes.
Through partnerships between the University and its Medical Center, other health care providers on the South Side -- including Access Community Health Network and Advocate Healthcare -- the CTSA will attempt to overcome these health disparities by improving access to medical care, and raising the standards of care for all those on the South Side.
The University already is home to three separate centers focused on understanding and alleviating health disparities: the NIH-funded Center for Interdisciplinary Health Disparities Research, the CDC-funded Center for Health and the Social Sciences, and the Robert Wood Johnson Foundation-funded Finding Answers: Disparities Research for Change.
"The CTSA grant will enable us to take great strides forward together," said Solway.
The national CTSA initiative grew out of a commitment by the NIH to re-engineer the clinical research enterprise, one of the key objectives of the NIH's "Roadmap." CTSA applicants were encouraged to create an academic home for clinical and translational science.
For this purpose, the University of Chicago created the Institute for Translational Medicine (ITM). Under Solway's direction, the ITM will operate across academic departments to generate new methods, tools and systems of discovery. The ITM will also interface closely with the committee on clinical and translational science, which will offer a novel curriculum in clinical and translational research.
The specific objectives of the ITM are to:
- Prepare physicians and scientists for careers in translational research.
- Create a seamless career path for young faculty seeking translational investigator status.
- Encourage high school, college, and allied health professions students to seek careers in translational research.
- Provide state-of-the-art resources for translational research, including access to expertise n clinical trial design, biostatistics, epidemiology, ethics, informatics, and regulatory issues.
- Provide comprehensive medical ethics training for current and future clinical and translational researchers.
- Provide a "home" for collaboration between departments and cooperating institutions.
- Enhance communication among investigators.
- Define the key genetic determinants of common, complex disorders.
- Utilize a "systems medicine" approach to treat common, complex disease.
The Medical Center is also preparing to launch a multi-faceted Urban Health Initiative (UHI), which will engage the community in developing clinical and community research agendas; involve community organizations in that research; accelerate the translation of health knowledge and expertise into and out of our community; and strive to reduce health disparities.