Translational medicine forms a bridge between clinical and basic research. It is an umbrella term for ‘translating’ preclinical research findings to everyday clinical practice and patient care, thus going from bench to bedside.
Translational medicine involves experiments that facilitate a better understanding of the development of diseases within basic research, the discovery of pharmaceutical points of attack, effect studies applicable to human therapies, the biological study of human diseases and new improvements in treating human diseases. It also includes non-human or non-clinical studies, which can even form the foundation for new clinical applications and drug development trials in clinical phases 1–3 (as Maria Sznol, a member of the Journal of Translational Medicine editorial board, has observed).
Like translational thinking, establishing a link between theoretical and clinical potential, that is, between the potential for basic research and patient care, is unique not only in Hungary, but also in Central Eastern Europe.
History of translational medicine
An approach based on translational medicine does not represent a new system. It is rather a return to the roots – naturally, rethought for the 21st century. In the 1950s, clinical systems were structured such that clinical studies, patient care and theoretical research were all done in the same place and members of research teams worked in all these areas. Developments in the decades that followed and the specialization of research areas led to a separation of clinical research (e.g. internal medicine and surgery) and theoretical studies (e.g. biology and molecular biology in particular). It was this separation of types of research that brought about one of the greatest challenges in medicine in the late 20th century. In a number of cases, those engaged in the two types no longer speak the same language. Despite the fact that billions of dollars are spent on theoretical and pharmaceutical research, the number of products/drugs in patient care has not risen. According to an oft-cited statistic, only a tiny proportion of the several thousand candidate drug molecules, that is, about a thousand molecules, reach the preclinical phase.
Interwoven with the clinical and basic research system, the translational model seeks clear answers to questions that have arisen in clinical patient care, thus leading to a tangible improvement in population health.
Advantages of translational medicine
One of the main advantages of the system is that the clinical questions can be transformed to basic research studies and after that, basic research findings can be transformed into clinical applications and shared with the various clinical/therapeutic areas quickly and effectively.
Clinical medicine should be divided into two main categories: general and translational medicine. The central work of general medicine is to provide basic care and graduate training, while translational medicine – besides the good care - engages in clinically-oriented studies (thus increasing scientific output), pharmaceutical phase trials (to discover new therapies and grow institutional income) and postgraduate training (to raise the number of PhDs and other academic degrees). Patients are only affected by translational medicine if they undertake to participate in a clinical study (based on the National Institutes of Health (NIH) model).
Another feature of the system is its multidisciplinary nature; that is, it facilitates theoretical and clinical research in particular medical specialties in coordination with various fields (IT, mathematics, clinical research, theoretical research and management).
In order to maximize the output, the main pillar of translational medicine comprises (1) the registration system, which covers all the clinical areas and is expanded through the appropriate IT communication infrastructure, and (2) the biobank which is linked to it. These systems are set up and maintained with data entered and mutually shared in accordance with strict legal and ethical principles. It is thus possible to make a sufficient number of cases available for ongoing clinical studies and provide solid evidence to better understand and treat particular diseases and to boost the scientific value of future publications.
The most outstanding centres for translational medicine, where the translational approach to medicine was first institutionalised, are the National Institutes of Health (NIH) and the Harvard Clinical and Translational Science Centre. Today, centres like these can also be found in Cambridge and Oxford. They represent the world’s greatest research potential, with studies published in the most significant scientific journals.
Since Hungary and Central Eastern Europe do not play a role in this domain yet.
The implementation of translational medicine in Hungary aims to change this situation.