|Year : 2016 | Volume
| Issue : 1 | Page : 1-2
Translational medical science
John FB Morrison
Emeritus Professor, Institute of Integrative and Comparative Biology, University of Leeds, Leeds, United Kingdom
|Date of Submission||27-Apr-2016|
|Date of Acceptance||09-May-2016|
|Date of Web Publication||2-Jun-2016|
John FB Morrison
Emeritus Professor, Institute of Integrative and Comparative Biology, University of Leeds, Leeds
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Morrison JF. Translational medical science. BLDE Univ J Health Sci 2016;1:1-2
The birth of a new multidisciplinary journal of medical and clinical sciences is to be celebrated: Congratulations to the team behind this venture. The stated objectives of the "BLDE University Journal of Health Sciences" encompass advances in fundamental and applied science, and the clinical, social, and ethical issues involved. The journal intends to report on drug discovery from the laboratory bench to their introduction into healthcare, and in so doing, it will support interaction between scientists and doctors. Educational resources will also play a central role in translating laboratory findings into the clinic, and clinical research will support and inform the scientists in their objective to confront and conquer the major healthcare problems of this century.
While the freedom of researchers to do curiosity-led science should always be preserved, governments tend to support research that addresses major medical challenges or reduces the costs of healthcare. Worldwide, there are many common problems: The challenges of aging populations and diseases such as diabetes, cardiovascular disorders, cancer, or neurodegeneration to mention just a few. Physiology and pharmacology have a long history of contributions that addresses these issues, and the increased life span of many populations can be attributed at least in part to the success we have had in treating cardiovascular diseases, reducing the incidence of strokes, heart attacks, cardiac failure, and other related disorders. We can be proud that the discoveries of the last 50 years have provided a modern pharmacopoeia that has provided safe solutions to many common medical problems. The methods used in making these discoveries are just as valid this century as they were during the last.
In the 21 st century, the language of molecular genetics has become relevant universally and is central to future studies of biology and medicine. It ushers in an era when personalized medicine is possible. Pharmacogenetics can, for example, identify genes that determine whether an anticancer drug will work effectively, or be metabolized to an inactive compound. Ethnic variations in the responses to drugs such as antihypertensive agents or warfarin can also be explained. Moreover, there is new understanding of diseases in which familial tendencies are common. The "nature" of disease, i.e., the inherited component is being explained and stands to benefit individuals with specific genomes.
However, some of the most common medical problems worldwide appear to relate more to "nurture" lifestyle, toxic environments, infection, etc., and the effects of "nurture" on diabetes and neurodegenerative diseases are two such areas.
Neurodegenerative diseases represent a considerable challenge, and it is fascinating that some of the gaps in knowledge are being addressed by the development of new techniques that cross the traditional boundaries. For example, the problems of early recognition of Alzheimer's disease and of methods for clearing beta-amyloid from the brain are being investigated using a variety of techniques. These include molecular genetics, protein folding, axoplasmic transport, glymphatic system, immunology, a variety of imaging modalities, as well as early psychological assessments, to name just some of the major approaches.
Anticholinesterases had limited success in treatment as cholinergic projections from the basal forebrain nerves degenerated. Other neurones appear to be saved despite the dementia. Not only is the cortex thinned but also the axonal projections across the midline in the corpus callosum are diminished. Together these indicate that the longer axons connecting different functional areas within the cortex also degenerate. It is no wonder that brain function deteriorates so markedly when the whole network becomes disconnected.
At a cellular level, inclusion bodies, lewy bodies, neurofibrillary "tangles," accumulations of beta-amyloid or synuclein, etc., characterize neuronal degeneration and these features are shared with a variety of other disorders such as Parkinson's disease, motor neurone disease, and multiple systems atrophy. Some authorities have recently pointed to the importance of axoplasmic transport and pathological changes in the neurotubular system as a commonly described feature of neuronal degeneration in the central and peripheral nervous systems. This system is known to clear substances such as beta-amyloid from the interior of the axon, using neurotubules as the track along which molecular motors can carry materials in either direction. In Alzheimer's disease, the presence of neurofibrillary tangles indicates disruption of the neurotubules, a consequence of hyperphosphorylation of tau protein which stabilizes the beta-tubulin meshwork. Comparisons can also be made with peripheral neuropathies including diabetic neuropathy where there are also dilated axons and accumulations of materials that indicate the existence of a "traffic jam" within the axons; and changes in axoplasmic transport have been observed in experimental diabetic neuropathy.
These contrasts, between the languages of different scientific disciplines and between the presentations of potentially related diseases, are familiar enough but serve to indicate the need to translate and integrate within the medical sciences using a multidisciplinary approach. As new technologies yield different views on the same basic disorder, there is a need to constantly reinterpret their meaning and the consequences within different disciplines (indeed the borders between the classical disciplines have largely disappeared). As nature or nurture induce changes in gene expression, signaling pathways, and cellular or tissue mechanisms, the final arbiter has to be their effects on the whole organism and the human population. The gaps in knowledge need to be addressed in the light of discoveries of all areas of medical science and clinical surveys of outcomes as new technologies or treatments are introduced.
Many authorities support the view that a multidisciplinary approach, sometimes called "translational medical science" is an efficient way of transferring new discoveries and knowledge from the laboratory into initial clinical testing. Translational science is a two-way process and will be enhanced by education and international collaboration between scientists and clinicians: Both must be aware of the advances in laboratory breakthroughs and of clinical outcomes. Crossing the boundaries and filling in the gaps should be aided by education and the media, including new medical publications. Translating and communicating advances within this new journal based on university setting and with an international panel of scientists and clinicians on its editorial boards are to be valued and promoted. Hopefully, the bringing together of minds will provide solutions relevant to the prevention and treatment of disease.
Hence, my message is "Translate, Integrate and Communicate!" and please take advantage of the potential of this new journal. We wish the "BLDE University Journal of Health Sciences" every success; and on a personal note, I feel very happy to see this initiative happening in India, where I feel I have many friends.