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CTSA workshops to pursue NIH initiative by Mary Helen Yarborough Public Relations MUSC is bridging the divide between scientific research and clinical care through a bold new initiative that promises to partner various areas of research and produce outcomes for the benefit of direct patient care.   In launching the Clinical and Translational Science Awards (CTSA) program, a roadmap initiative established by the National Institutes of Health (NIH), MUSC leaders have described the CTSA program as the most significant strategic opportunity facing academic health centers in the last 50 years.   By engaging in this initiative, MUSC joins the ranks of a handful of top research hospitals ready to benefit from increased federal funding opportunities for collaborative and applied research between clinicians and scientists.   At the core of the initiative is the realization that basic, translational and clinical investigators along with clinical practices, networks and industry must be brought together to improve the understanding and treatment of human disease.   At a Town Hall meeting April 25, MUSC President Raymond S. Greenberg, M.D., Ph.D., announced MUSC’s CTSA programs, that will involve each of the six colleges and their deans, and teams of top researchers and stakeholders that will assure that what is developed in the labs will be known by clinicians, and then applied in clinical settings.   “The CTSA is the vehicle that the NIH is using to shape the future of clinical research, so it is critical that we position ourselves to compete successfully,” Greenberg said. “Clinical and translational work is among the highest priorities at the Medical University and we see great opportunities with this new program to build upon our established successes.”   The program’s primary focus is to ensure that MUSC and other health care facilities across the country develop and use the best possible science and translate the critical discoveries more rapidly into improved therapies  for patient care.   “Given the great disparities in health within the population of South Carolina, our focus appropriately enough, will be on many of the conditions that contribute to these disparities,” Greenberg said.   For example, the Centers for Disease Control and Prevention (CDC) ranks South Carolina first in the nation for stroke-related deaths, ninth in diabetes-related deaths and prostate cancer deaths, and 18th in heart-related, disease-related deaths, as well as 25th in overall cancer-related deaths.   Meanwhile, MUSC’s leadership in health disparities research is evidenced in the design implementation and coordination of numerous NIH-supported centers and initiatives, according to CTSA program co-director Kathleen T. Brady, M.D., Ph.D., professor of psychiatry and director of MUSC’s General Clinical Research Center (GCRC).   So that MUSC research is shared and translated statewide, part of the CTSA program will include collaborating with other teaching hospitals across the state and ultimately across the nation.   “We will also reach out to partner with colleagues across the state of South Carolina, amplifying the impact of what we might be able to do on our own,” Greenberg explained.   At the CTSA work group launch on April 21, Perry Halushka, M.D., Ph.D., CTSA co-director and dean of the College of Graduate Studies, met with an assembly of MUSC’s who's who, including deans, professors, and top researchers.   The meeting was the first of what will be many to come during the next six months as work groups will be formed, and teams will pore over how best to accomplish the school’s new mission, that Halushka called, “a mandate.” The entire CTSA program planning is slated to be complete in about 18 months.   “There’s nothing sacred anymore in terms of what we do with research,” Halushka said. “All six colleges will have representatives, and these are all with clout. We’re not talking about minor changes. We are talking about major changes that will cross institutional boundaries.” CTSA program in action MUSC has not waited on the CTSA program plan to be fully developed and implemented before basic, clinical and translational science researchers collaborate on findings and delivery.   Examples of clinical/translational research at MUSC include: cardiovascular translation research that is seeking to identify changes in myocardium enzymes in the progression of heart failure; addiction research that is identifying new ways to treat and cure cocaine addiction; groundbreaking research on cancer, lupus, hypertension and even age-related hearing loss. NIH roadmap NIH’s Elias A. Zerhouni, M.D., announced the program last fall as a way to spur the transformation of clinical and translational research in the United States, so that new treatments can be developed more efficiently and delivered more quickly to patients.   “We are truly at a crossroads in medicine,” Zerhouni said in a Oct. 12 statement. “The scientific advances of the past few years, such as the completion of the Human Genome Project, dictate that we act now to encourage fundamental changes in how we do clinical research, and how we train the new generations of clinician scientists for the medical challenges of this century.”   The program gives research institutions more freedom to foster productive collaboration among experts in different fields, lower barriers between disciplines, and encourage creative, new approaches that will help us solve complex medical mysteries, according to Zerhouni.   “Ultimately, patients will be better served because new prevention strategies and treatments will be developed, tested, and brought into medical practice more rapidly.”   The grants will encourage institutions to propose new approaches to clinical and translational research, including new organizational models and training programs at graduate and post-graduate levels. In addition, they will foster original research in developing clinical research methodologies, such as clinical research informatics, laboratory methods, other technology resources and community-based research capabilities. Potential benefits to patients include: new medical monitoring devices that they can use in their own homes; improved methods for predicting the toxicity of new drugs in specific individuals; and a seamless and safe experience for those who participate in clinical trials.   NIH plans to award four to seven CTSAs in 2006 for a total of $30 million, with an additional $11.5 million allocated to support 50 planning grants for those institutions that are not ready to make a full application. NIH expects to increase the number of awards annually so that by 2012, 60 CTSAs will receive a total of approximately $500 million per year.   For the purposes of this initiative, NIH is defining clinical research as studies and trials that involve human subjects. Translational research is to include two segments of the research continuum. The first is the process of applying discoveries made in the laboratory, testing them in animals, and developing trials and studies for humans. The second concerns research aimed at enhancing the adoption of best treatment practices into the medical community.   NIH expects to make initial awards by the fall.     Friday, April 28, 2006 Catalyst Online is published weekly, updated as needed and improved from time to time by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, catalyst@musc.edu. Editorial copy can be submitted to Catalyst Online and to The Catalyst in print by fax, 792-6723, or by email to catalyst@musc.edu. To place an ad in The Catalyst hardcopy, call Island papers at 849-1778, ext. 201.