Translating Research into Therapies

The human body is more than the sum of its organs. Yet for hundredsof years,medicine andmedical research have divvied up the totality of the person into diseases that are organ specific and characterized largely by their phenotypic presentation. These divisions are also reflected in the organization of academic medical centers and pharmaceutical research and development and even permeate the funding of biomedical research, with diseasecenteredNIH institutesandprivate foundations. This is understandable, and I am not suggesting that it should be eliminated because it is still a critical structure for delivering patient care. But in research, our understanding of the functioning of the body and the causes of disease has progressed beyond the phenotypic, and I would argue that the present structure has led to the curtaining off of one organ or disease from its brethren. An individual is the sum of their medical history, and having one disease can greatly alter the likelihood of having another. We know now that chronic inflammation also increasescancer risk (e.g., ulcerativecolitis and colorectal cancer) and is also a risk factor for obesity and neurodegeneration. These comorbidities can be explained in terms of common cellular and molecular pathways. We need to think of new ways to organize research into hubs informed by common themes—for example, the agingprocess or geneticmedicine—where physician scientists and basic researchers from different traditional disciplines can come together. In this way, we can begin to see behind the curtain that divides one branch of knowledge from another. Progress through Partnership