Penn State CTSI aims to push research findings to the people

Dna strands graphicAs a physician on the front line of the obesity and diabetes epidemics gripping the United States, Urs Leuenberger, M.D., professor of medicine in the Division of Cardiology at the Penn State Hershey Heart and Vascular Institute, has seen the disconnect between medical knowledge and reality. “We know an immense amount about many of the major health problems today, say obesity or diabetes, and we know a lot more than we did ten years ago or thirty or fifty years ago,” Leuenberger says. “So why is it that when we know so much more, the epidemic is getting worse?”

That is precisely the kind of question that the Penn State Clinical and Translational Science Institute (CTSI) will tackle over the next five years, thanks to a $27.3 million award from the National Institutes of Health (NIH). Penn State CTSI, a collaborative effort of the University, Penn State Milton S. Hershey Medical Center, and Penn State College of Medicine, joins a prestigious consortium of institutions that include Harvard, Johns Hopkins, Mayo Clinic, Yale, and the University of Chicago. In Pennsylvania, only the University of Pittsburgh and the University of Pennsylvania are also members.

“The CTSAs (Clinical and Translational Science Awards) support the innovation and partnerships necessary to bridge the traditional divides between basic research and medical practice,” NIH Director Francis S. Collins, M.D., Ph.D., said in announcing the latest awards. “The combination of resources and collaboration made possible by these awards is essential for developing and delivering new treatments and prevention strategies.”

Resources and collaboration are two of Penn State’s strengths in winning the CTSI grant. “Already, our Penn State Clinical and Translational Science Institute is bringing together researchers from across the University’s colleges, campuses, programs, and departments and fostering collaborative research,” says Harold L. Paz, M.D., CEO of Penn State Hershey Medical Center. “This CTSA funding award will add to this momentum and substantially increase our infrastructure for supporting translational research, expanding our ability to take scientific progress from the laboratory bench to the patient’s bedside.”

‘Translational research’ defined
“Translational research” is a phrase that has entered the health science vernacular in recent years, but what does it mean? Larry Sinoway, M.D., CTSI director and director of the Penn State Hershey Heart and Vascular Institute, explains: “There’s an expression that’s frequently used—‘from research bench to bedside’—but it’s actually more than that. It really means pooling the collective expertise of people from multiple disciplines to address a specific health issue and moving that knowledge into the places where people can benefit from it. And the process is bidirectional; so it also can be from the community—or the bedside—to the bench and back again.”

Adds Daniel Notterman, M.D., vice dean for research and graduate studies at the College of Medicine, “It’s very important to realize that translational research is not a special kind of research; it’s not like physics or biochemistry. It’s a process of research.”

Why Penn State
A history of collaboration is a key reason Penn State received this award, according to Sinoway. “Collaboration is a way of life here,” he says. “To get good things done in research, or any endeavor in life, requires teamwork; it requires groups of people taking one for the team, being very unselfish. That type of thing is seen more here I believe than virtually any place I’ve been.”

Penn State’s depth of research scientists across many disciplines along with the physical infrastructure to support them on both campuses figured prominently in the NIH’s selection, according to Notterman. “For example, developing new machine-human interfaces is of key importance in advancing medicine,” he says. “Penn State is uniquely poised to do that because of the strength that it has in neuro-engineering, in imaging (MRI) science, computer science and computer engineering. That’s certainly one great strength that synergizes with the strength of biomedical science at the College of Medicine.”

History of collaboration
The Penn State CTSI is actually a continuation of sorts of the General Clinical Research Centers at both University Park and Hershey, according to Leuenberger, who is also one of two associate CTSI directors. The Centers continued to function when NIH closed the program about four years ago and launched the CTSI grant program, which promised a little more money and a much bigger agenda, according to Leuenberger. “The idea is to remind researchers that the reason they are here is to do something that at least holds the potential to improve health,” he said.

The Penn State CTSI builds on the track record of the University Park and Hershey campuses working with each other despite the 99 miles that separate them. The diverse list of University players involved in the CTSI range from the School of Nursing and Colleges of Engineering and Information Sciences and Technology to the Social Science Research Institute and the Life
Sciences Greenhouse of Pennsylvania.

Penn State understands that distance is becoming less and less relevant as a limiter to collaboration, Sinoway says, especially when sophisticated technology effectively diminishes the distance. “Communication interaction is more a state of mind than it is a geographic issue,” he says. “There are people in many places in the world who don’t know the person who does research in the lab next to theirs. A big part of this grant is to break that down.”

Breaking down the silos and communication gaps among disciplines is critical, since the dynamic of moving a scientific discovery into the real world, where it can make an impact, requires many people with a host of different specialties. “There might be 10, 15, or 20 different professions involved in moving an idea from a hypothesis to first experimental testing, to broader testing and validation, and finally to the clinical application,” Notterman says.

“No one group of people can have all this expertise, so it becomes necessary for different disciplines to collaborate. At a place like Penn State in particular, we have different kinds of expertise arrayed across our campuses.”

The Social Science Research Institute at University Park, of which Susan McHale, Ph.D. is director, is a key component in bringing laboratory and clinical research to people who stand to benefit. “We know a lot about how to help people stay healthy, about how to prevent disease, about how to promote health,” McHale says. “What we are really bad at is getting people to behave in ways that are good for them, and social scientists are experts in what shapes human behavior and how to change it. That’s a huge role that we can play in the CTSI.” McHale is also an associate director of the CTSI.

Bringing research to market
The CTSI will also help create new opportunities for the Harrisburg-based Life Sciences Greenhouse of Central Pennsylvania, which has partnered with Penn State and the College of Medicine, along with Lehigh University in Bethlehem, to nurture start-up companies bringing life science discoveries to market, according to Mel Billingsley, Ph.D., president and CEO of the venture and professor of pharmacology at the College of Medicine.

Billingsley calls the CTSI “a really fast onramp to that bridge” from the laboratory to the public—a “bridge” that can cost $25 million to $50 million to commercialize a drug or medical device. “The CTSI completes the three-legged stool,” he says. “The University can develop the new technology, the Medical Center can do the clinical applicability study, and then if commercial space is willing to support it, the Life Sciences Greenhouse can help get the funding,” Billingsley says.

Apeliotus Vision Science Inc. of Hershey is one of the ventures that the Life Sciences Greenhouse has spawned. Gregory Jackson, Ph.D., associate professor of ophthalmology at Penn State Hershey Eye Center, is one of the company’s principal scientists developing a new cost-effective test for age-related macular degeneration. “This is an example of the type of company that the CTSI could help advance,” Billingsley says.

Collaborating with the community
Collaboration in the name of translational research extends into the community. This can involve organizations such as the American Heart Association or the American Cancer Society that are involved in trying to improve care for different types of diseases. Or it could be community groups, such as church groups that have an interest in trying to decrease disabilities and improve health care for a given town or region, Sinoway says.

Penn State CTSI is unique among the sixty consortium members because it is but one of a handful outside an urban center. Central Pennsylvania is a 27-county region comprising approximately 3.8 million persons, or 32 percent of the total Pennsylvania population. About 32 percent of the population in Central PA resides in rural counties, and 15 percent live in counties with few local health care resources and that are designated as impoverished, according to the 2000 U.S. Census 2000. Rural communities in this area range from small towns to the most geographically isolated areas.

“We will try to link and interact with small towns and rural environments so we can understand their health issues,” Sinoway says. “We need to work with the unique communities we serve to figure out what those problems are, then seek their input as we develop strategies to study those issues and improve health care in those communities.”

In other words, translating laboratory discoveries to where they can make a difference in the lives of the people we serve.

-by Richard M. Kirkner

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