Science Translational Medicine, a new companion publication to Science, represents the crystallization of several undercurrents that have been rocking biological research over the past few years. First is the uneasy sense that our approaches to the transformation of 50 years’ worth of remarkable advances in biomedical research into better cures, treatments, and preventative measures have not been as effective as they need to be to better serve society. Other worrisome symptoms include a growing avoidance of clinical research by promising young scientists and a decreased productivity in pharmaceutical and biotechnology companies. Why is this malaise occurring at a time of unprecedented opportunities for progress?
Fundamental research conducted with in vitro and in vivo models and assays has been enormously successful, in part because shared evolutionary pathways from the inception of life often dictate that seminal discoveries in one model system apply to all life forms, a reflection of the profound unity of biology. Yet direct translation is not the rule when it comes to applying knowledge gained from any one model to human disease biology. Often, promising approaches to disease characterization or treatment established in vitro or in animal models prove ineffectual in patients. This paradox illustrates the daunting intricacy and diversity of biological systems. Indeed, species-specific properties emerge from the intricate and still poorly understood mechanisms by which basic molecules interact to form molecular assemblies, organelles, cells, tissues, organs, and organisms. Scientists must devise new ways to reduce this complexity that allow us to achieve a higher level of understanding of integrated human biology, in an effort to translate basic biological knowledge into tangible advances for individuals and societies around the world. Creative experimental approaches, cutting-edge technologies, and innovative ways of conducting scientific explorations at the interfaces of established and emerging disciplines will be key if real progress is to be made. Interdisciplinary efforts among biological and physical scientists, with minimal institutional or disciplinary barriers between them, should be the rule rather than the exception.
Our country needs more and better translational research, both for the sake of our patients and because much of the research funding in the United States comes from the primary expectation of the American public that such scientific investigations will reduce the burden of disease. This is not to say, as many fear, that we should reduce our focus on basic research. On the contrary, I believe the opposite to be true, because one cannot effectively translate a language that is not understood in its primary form, and we are still a long way from achieving such mastery at the basic level. On the other hand, we cannot, as some argue, focus exclusively on basic research, because efforts to translate knowledge gained from experimental organisms will simply waste resources if scientists have not achieved a rich understanding of the fundamental properties of human physiology and pathophysiology. If we had used only a basic science approach, vaccines would still be a distant dream. The deciphering of complex systems requires a diversity of balanced approaches, the avoidance of dogmas, and the creation of varied opportunities for scientists to self-assemble freely and address these difficult problems as they see fit. Furthermore, insights gained in translational and clinical research often can help refine hypotheses at fundamental levels.
Without collaborations in all directions of inquiry, whether basic, applied, or clinical, scientists are likely to miss out on the opportunities for cross-fertilization and synergy inherent to the achievement of progress in a complex endeavor. If the science of translational medicine is to achieve its goals, a profound transformation is required, and the time for this reinvention is now. Never before have scientists had access to the remarkable tools that are available today and that allow rigorous translational investigations to be conducted. However, the creation of a redefined discipline of translational medicine will require the emergence of a new and vibrant community of dedicated scientists, collaborating to fill knowledge gaps and dissolve or circumvent barriers to improved clinical medicine. It is to aid in this reinvention effort, that Science and the American Association for the Advancement of Science have created their new interdisciplinary journal, which is intended to serve as the medium by which this emerging community will document its efforts and recognize its most brilliant minds and creative approaches, from wherever they come.