[新知] Naturenews Special 轉譯醫療
Nature 有個轉譯醫學的「系列文章」
http://www.nature.com/news/specials/translationalresearch/index.html
有個約五分鐘的 Podcast 討論何謂轉譯醫學
我自行打逐字稿如下 (有很多問號是我聽不清楚的,有人聽懂可以補充)
(還是有寫好的啊!聽 Podcast 很累耶!^^||)
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If you work in Biomed, you already know the term translational research, but
what is it? Well it's designed to be a more effective way to convert basic
science into more of the things that really matter to patient, such as new
therapies. The new approach is the subject of a new special package of this
issue of nature, and we're joined on the line from New York by feature editor
Helen Pearson, who has put the package together.
Mike: Hi Helen
Helen: Hi Mike
Mike: So I suppose the only first question is what is translational research?
Helen: Well that is a good first question because you ask 10 people that
question you probably get 10 completely different answers. It's a fairly new
term actually only came to be commonly used off around 2000. But generally,
in the issue, we've taken to mean what's most relevant to our readers, so
it's taking discoveries which will be made in basic biomedical science such
as new drug targets and it's ensuring that they end up actually helping
patients. What it doesn't mean is that discoveries end up sitting on shelves
or just in the pages of a journal like Nature. So often translational
research is taken to be synonymous with bench to bedside, with a as if you're
going to take these basic biomedical discoveries and feed them into this
pipeline or black box and then out the end will pop this perfect drug. But
what most people are saying now is that it's much more cy??? process. So that
one thing for example that tests in human that's actually an experiment in
itself and you need to take result of that experiment even if it's a failed
clinical trial and learn from them and feed those results back to the bench.
Mike: So has that traditionally being a big disconnection between basic
research and applications? And is this the way trying to tackle that?
Helen: Historically, there hasn't really been a disconnect. So I think if you
went back 30 or 40 years you'll find that basic research and medicine really
went hand-in-hand and lots of people were trained in both discipline. But the
reason that this has become an issue is that biomedical research has changed
massively in the last 10 or 20 years so it used to be all about one
gene, one protein, one molecules and now it's all about all genes, all
proteins, all molecules, all the time. Just take the human genome project, to
mean, just say we have a list of virtually every drug targets thought to
exist. It's almost become overwhelming. So while being this explosion of
this quantity of information that's coming out, the problem is that there
hasn't been this eqaual explosion or increase in the ways to carry that this
basic information through into the clinic.
Mike: Man, as he said that it does sound fairly overwhelming, yeah, for
example, making sense of the whole human genome and its therapeutic
potential. Is there a right and a wrong way to do translational research
without it becoming all too confusing?
Helen: I don't think we can say at this stage that there is a right and a
wrong way because it is a fairly new effort. Many institutions are trying to
put in place ways to do it. For example at the National Institute of Health,
one of the focuses under director Elias Zerhouni has been to tackle
translational research and they investing are 500 million a year at the moment
to set up centers of translation across the US. And lots of people are watching
that effort with a lot of interest. And within each of those centers they are
going about different ways but generally involve training courses with people
who are comfortable with basic research and with clinical research. So it's
often about setting up infrastructure. But to say one way is better than next
I think it's too premature at this stage.
Mike: So you mentioned basic research there. Is your average basic research
are going to have to change their approach in order to preserve their
funding. And all basic researches at all was resentful about this movement.
Helen: I think there is a nervousness amongst basic researchers that the new
emphasis on translational research means that the pendulum has swung too far
toward application and away from what they like to do. I am not convinced as
much foundation to that. I think a lot of these effort are adding to these
money which is already going to basic research. And for example the effort by
the NIH is still 1 to 2 percent of the budget which is going on translation.
So, yes that there is that feeling of apprehension, but I don't think the
message that I heard from the people I interviewed is that we should be
scaling back from basic research. Most people still recognize that it's the
serendipidous discoveries that comp. ??? research which end up the best to
translate so we need to still support that, and that's what Zerhouni would
say too.
Mike: So how will we actually know whether or not translational research is
working in the XX? Are we going to stop seeing lots of biomed researchers is
becoming millionaires with their spin-off companies.
Helen: It's very difficult to measure. It's one of the question which people
who are dealing with translational research are scratching their heads over.
That's probably because drug development and diagnostic development is a
really long process. It takes 10 or 20 years. And most things that enter the
process will end up failing at some point. So lots of organizations are
saying how we're going to measure our success. And they might end up counting
the number of clinical trials they're doing or the amount of intellectual
properties they generated or the number of people they trained. But I think
it's almost the question we need to come back to in 5 or 10 years time and
then if the number of new drugs and products hasn't gone up then we need to
question whether this spoke (?) on translational medicine has been working.
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