GRAND FORKS — Whether it’s a deeper understanding of Alzheimer’s disease or cancer, scholars at the University of North Dakota School of Medicine and Health Sciences are working to more rapidly bring medical discoveries to doctors and the patients they care for.
To do that they need to bridge the gap between purely scientific researchers and clinical professionals. The School of Medicine (SMHS) has been emphasizing work in the area of translational research, which aims to “translate” scientific research into practical treatments. That work is being done through the Dakota Cancer Collaborative on Translational Activity, a clinical translational research center (CTR), that pairs in teams doctors and researchers.
“One of the things we're doing is through the CTR, we're trying to fund some of that bench-to-bedside stuff,” said Marc Basson, senior associate dean of medicine and research. “We specifically don't fund individuals, we fund clinician/non-clinician teams, and that's by design. It's unique to our CTR.”
Doing so creates a forum for researchers who have a specific idea to reach out to a medical practitioner, and ask if it has merit. It’s a way of keeping science on track toward a cure, or the generation of a new medical device or piece of equipment. It’s an idea that works both ways. Doctors, who may not be in a position to carry out a study on their own, or have the technology to do it, can bring their ideas for laboratory research to the SMHS.
“Building those teams I think has been very helpful,” Basson said.
The idea of a CTR center isn’t new, and work in similar paradigms is being done across the nation. Basson said five years ago that was not the case at UND, and the idea to engage in translational research came to the fore to encourage “crosstalk” between scientists and doctors. The SMHS has managed a doctoral program in clinical and translational science since 2016. A multimillion dollar gift from a former SMHS researcher has established an endowed chair in translational research. The position is expected to be filled next year.
Researchers at the Dakota Cancer Collaborative center are working to develop innovative cancer treatments across North Dakota and South Dakota. The CTR center is funded through a National Institute of Health grant, which is in the process of being renewed, with an expanded scope of illnesses to investigate. Researchers there are also able to study COVID-19, because of the national impetus to address the virus.
Still a lengthy process
But the idea of quickly advancing treatments to patients doesn’t mean researchers cut corners. It can take years to develop a new drug. Basson said seven to 10 years is normal, and it isn’t unusual for researchers to spend 15 years on a potential medicine. The translational partnerships established at the SMHS mean researchers don’t have to publish their findings and hope a clinician picks up the torch and sets up a clinical study. They can broach the idea themselves.
Joshua Wynne, dean of the SMHS, said mRNA coronavirus vaccines are his favorite examples of translational research ushering in a breakthrough. Research on mRNA vaccines had been going on for years, he said, but when the pandemic hit it took a remarkably short time to translate them into the Moderna and Pfizer-BioNTech vaccines.
“From the time the first person was identified with (COVID-19) until a vaccine was put in the arm of a patient, was less than a year,” said Wynne. “That has never happened in the history of the world.”
Both Wynne and Basson stressed the rigorous nature of bringing a new treatment to a patient. It starts in the lab, with researchers understanding the science behind an illness and what could treat it. From there, any treatment proposal goes through multiple approval processes.
Basson outlined the scope of how that is done, for a concussion study he is working on with Essentia Health in Fargo. The idea is to see how hyperbaric chambers can be used to treat people who don’t completely recover from concussions, between 10% and 20% of those who suffer them, he said. The proposal has to be approved at institutional review boards at both Essentia and SMHS, then needs U.S Food and Drug Administration approval to use oxygen and the chamber in ways for which they are currently not authorized. When that happens, the review boards need to sign off on the plan again, not to mention anyone who wants to be involved with the study.
Wynne said scholars don’t shy away from the thorough vetting process, that it is necessary for both safety and faith in new treatments.
“We're not looking to take any shortcuts, on the contrary we want to do it in a robust way so that the public has confidence in the new discoveries,” Wynne said.
Much of the translational research happening at the SMHS involves cancer. Other research involves Alzheimer’s disease, and a potential method of early detection. Colin Combs, a SMHS professor and chair of basic sciences, said the pathology of that disease shows up in a person’s intestines, and is not just localized in the brain. He’s looking at tissue samples from other organs for a connection, one that would allow for earlier treatment, if those signs show up more quickly than in the brain.
“That's one of the things that we're hoping to do that's fairly new is to show that it isn't only affecting the brain, and that maybe what's going on in these other organs can give us some insight into how to improve the conditions in the brain,” Combs said.
UND and the SMHS aren’t working alone. They have partnered with all major medical providers in the state, including Altru, Sanford Health, Essentia Health and Trinity Health. Universities involved include UND, North Dakota State University and the University of South Dakota.
Those partnerships also extend to rural and Native American health care providers, because clinical trials in those communities have traditionally been underrepresented, Basson said.