Translating “Translational Research”

Translational research is a catchphrase in biomedical circles these days. But if you’re confused about what the term really means, you’re not alone. 

It was 35 years ago when I first heard the term “translation” in a scientific context. It was about enabling basic research undertaken by the National Institutes of Health (NIH) to find its way into treatments for patients. Though that sounds pretty straightforward, I still have to explain it not only to the lay public but even to my colleagues. Why? One reason may be that translational research no longer just describes a process, but characterizes an entirely new discipline. 

A lot has happened since the 1980s, including the creation in 2012 of a new NIH institute—the National Center for Advancing Translational Sciences. This is one of the only NIH centers that is not disease-focused (unlike, for example, the National Cancer Institute or the National Institute of Mental Health). Its director, Dr. Christopher Austin, spoke at Einstein last fall and described NCATS’s mission: to “catalyze the generation of innovative methods and technologies that will enhance the development, testing and implementation of interventions that tangibly improve human health across a wide range of human diseases and conditions”

What Have You Done for Me Lately?
You might say, “Okay, that’s all well and good, but why should I care about translational research?” One answer is that industry, scientists and research agencies have all noted the alarming lack of innovative treatments being approved over the past several years despite strong overall research funding. Data suggest that the explosion in translational research in the past decade has caused it to outstrip its NIH funding. (See a recent paper by Dr. Lloyd Fricker.) This implies that the real problem may be a breakdown in the long road from the science lab to the prescription pad. 

“Translational research” can most simply be defined as investigation that is informed and framed by a robust understanding of human biology and disease. This all-encompassing approach thus bridges the spectrum from basic research to health outcomes. However, the terminology can be somewhat confusing because there are many types of translational science disciplines. One way to say it is that multiple translational sciences link together to make translational research happen. 

Science Silos
Translational research involves teams of investigators who have different areas of expertise. Our biomedical disciplines, such as “pharmacology,” “cardiology,” “cell biology,” “epidemiology” and “genetics,” can create artificial boundaries that are difficult to overcome. (See A. Casadevall and F. C. Fang, “Specialized Science,” Infection and Immunity, 2014.) These days, every scientist has become a superspecialist and may have trouble communicating, even with those in adjacent disciplines.

Translational research requires a special breed who are eager to work with and integrate disparate fields. In translational research, genetics may be as important as informatics for an epidemiologist, and “big data” are as vital for understanding a biological pathway as computer models are for health outcomes.

Valleys of Death
Translational research also brings us face to face with “valleys of death” that can hinder research as it advances through phases labeled T0→T1→T2→T3→T4. In this shorthand, T0 is basic scientific discovery; T1 tests discoveries in model animal systems; T2 spans the translation of knowledge from the lab into treatments for people; T3, or efficacy research, applies new interventions to larger patient populations; and T4, or effectiveness research, evaluates the methods used to affect healthcare for patients in real-life, community settings.

At the end of the day, what links all translational researchers regardless of their specific disciplines is their ability to foresee these gaps, and to think creatively about how to bridge them.

Engineering Solutions
Translational research is at a crossroads. While research funding is threatened by many of today’s societal and economic challenges, the research community must also take responsibility for its own shortcomings. The best way to advance translational research would be to better understand and address the gaps among disciplines, since that’s where teams of scientists will—as Tom Friedman would say—invent the future.