UAB's Research PillarsBy Charles Buchanan
Cancer: Already a national leader in discovering and developing novel cancer treatments, UAB will investigate the continuum of disease from its smallest scale—the genetic and molecular basis—to the largest—affected populations and their environments. “Building scientific teams in each area who communicate with each other will help us understand cancer in its broader context and have a bigger impact on prevention and treatment,” says UAB Comprehensive Cancer Center director Edward Partridge, M.D. “We can measure so much and end up with a billion data points,” adds Mary-Ann Bjornsti, Ph.D., chair of the Department of Pharmacology and the Newman H. Waters Endowed Chair of Clinical Pharmacology. “This approach provides a framework for refining and analyzing that information so that it’s meaningful.” Energetics, the relationship among physical activity, diet, and cancer development, also will be a focus. UAB researchers “are beginning to understand the molecular basis of obesity, but there’s room for tremendous growth and activity,” Partridge says. The center also will strengthen its translational therapeutics, investing in the phase 1 clinical trials facility and experts in imaging and stem cell- and T cell-based therapeutics. “On average, we get two or three new discoveries into clinical trials each year,” Partridge says. “We want to double that.”
Cardiovascular Biology and Diseases: The first item on UAB’s cardiovascular to-do list—the recruitment of Sumanth D. Prabhu, M.D., to direct the Division of Cardiovascular Disease—has been completed. Now work is under way to create a comprehensive cardiovascular center that will unite clinicians and researchers across campus. Additional faculty recruitment will target the “rising stars” poised to lead the field. “We want their ideas and innovations in our fertile collaborative environment so that we stay on the cutting edge for research and care,” says Steven Pogwizd, M.D., director of the Center for Cardiovascular Biology and the Featheringill Endowed Chair in Cardiac Arrhythmia Research. UAB will build on its existing programs in electrophysiology, heart failure, cardiometabolics, vascular biology, and imaging, while exploring new areas such as stem cell biology and novel approaches to drug development, device therapy, and interventional cardiology. “This approach will enable us to focus on high-risk, innovative projects and make us more competitive for large-scale grants,” says John Chatham, D.Phil., director of the Division of Molecular and Cellular Pathology. “We have the expertise and the patient population. There’s no doubt we can be a national leader in developing new approaches to heart disease.”
Diabetes, Obesity, and Metabolism: UAB’s location at the epicenter of the diabetes and obesity epidemic means discoveries here can have a major impact, says Anath Shalev, M.D., Comprehensive Diabetes Center director and the Nancy R. and Eugene C. Gwaltney Family Endowed Chair in Juvenile Diabetes Research. A top priority is preventing the loss of insulin-producing beta cells, the key to any diabetes cure, Shalev says. Beta cell research will be strengthened and expanded to include investigators in other specialties, increasing the number of scientists pursuing innovative ideas. Metabolic signaling, crucial to obesity and diabetes development, will be another focus, with studies aimed at defining potential novel therapeutic targets. New research relationships with UAB’s centers in neuroscience, nephrology, ophthalmology, cardiovascular care, and other specialties will address the major diabetes complications, which take a very high human—and an increasing financial—toll. “Diabetes is such a complex disease that an interdisciplinary approach is critical to any chance of making a significant advance,” Shalev says.
Immunology, Autoimmunity, and Transplantation: As Americans live longer and face health problems that are more chronic than acute, understanding the immune system is essential, notes Robert Kimberly, M.D., director of the Comprehensive Arthritis, Musculoskeletal, and Autoimmunity Center and the Howard L. Holley Research Chair in Rheumatology. “Immune mechanisms—defense against microbes as well as tissue repair and inflammation—are central to human health,” influencing conditions ranging from rheumatoid arthritis and inflammatory bowel disease to atherosclerosis, multiple sclerosis, and cancer. New scientific and clinical collaborations—supported by research and drug discovery funds—will explore the genetic basis of immune response. One model will apply human genomic knowledge to animal models to study variations in response, which could “change the way we specialize therapies to individual patients,” says Casey Weaver, M.D., pathology professor and the Wyatt and Susan Haskell Endowed Professor for Medical Excellence. “In the future, we may be able to preemptively retune their immune response, preventing them from ever expressing a particular disease.” UAB also will expand investment in its gnotobiotic facility, which studies how gastrointestinal bacteria shape the immune system; findings could point to new avenues for treating disease. In addition, the new Comprehensive Transplant Institute will coordinate services for multiple organs, reflecting its important clinical role at UAB.
Infectious Diseases, Global Health, and Vaccines: UAB’s pioneering research and clinical care helped change the course of HIV treatment, and today it faces the same opportunities with several other emerging diseases, says Michael Saag, M.D., director of the Center for AIDS Research. Against hepatitis C, UAB will become a clinical-trial and treatment center, adapting its successful approach to HIV. Both diseases have similar treatment roadmaps—and hepatitis C is curable, Saag says. For tuberculosis (TB), a growing global health threat, UAB will build a research program with international reach, aimed at developing new therapeutics to cure the infection and fight drug-resistant strains. “A new TB drug with a new mechanism for action hasn’t been created since 1970,” Saag says. A host response program will focus on developing new vaccines for viral, bacterial, and fungal infections—which will become more important as more patients undergo lifesaving transplants or other procedures that suppress their immune systems and increase their vulnerability to infections. In HIV, UAB will strengthen its efforts to develop a cure and vaccine while investigating protocols to better identify infected patients, link them to care, and retain them in care.
Neuroscience: There’s a simple reason why UAB will direct more of its efforts toward neurodegenerative diseases—such as Alzheimer’s and Parkinson’s disease—and cognitive/memory disorders. “They’re closely related to aging,” says David Standaert, M.D., Ph.D., Comprehensive Neuroscience Center director and Department of Neurology chair. “As the population ages, we’re going to see more of these diseases.” These specialties, along with glial biology/neuro-oncology, are also particular strengths for UAB, he says. Twenty-one new faculty members will be recruited to conduct research and clinical care in the three focus areas; at the same time, the CNC will provide seed support for interdisciplinary multi-investigator research projects with the potential to earn NIH grants and develop into breakthrough patient therapies. Other initiatives will build up UAB’s programs in pain research and epilepsy. “The neurosciences are an exciting and rapidly expanding area of biomedicine,” says David Sweatt, Ph.D., chair of the Department of Neurobiology and the Evelyn F. McKnight Endowed Chair for Learning and Memory in Aging. “There are immense opportunities for developing novel treatments and expanding our basic understanding of how the brain makes the mind.”
Imaging: A new advanced imaging facility will add powerful technologies for research and clinical care and develop imaging-analysis expertise among faculty and students.
Genomics and Proteomics: A Personalized Medicine Task Force will lead UAB’s integration of genomic and proteomic research and education into clinical care.
Informatics: An upgraded electronic medical records system will be able to add genomic data for personalized medicine.
Biorepositories: UAB’s DNA and tissue banks, crucial to biomedical research and translational breakthroughs, will be linked and expanded.
Center for Clinical and Translational Science (CCTS): UAB’s NIH-funded CCTS, which links the laboratory bench with the patient’s bedside, will develop the phase 1 clinical trials facility and match basic and clinical investigators to advance their research.
Outcomes and Health Care Effectiveness Research: Data collection, research, and training programs will expand, promoting evidence-based practice of innovative care.