Global Health Nexus, Summer 2002
Building a research engine designed to go the distance
Louis Terracio, Ph.D.
Associate Dean for Research
Two years ago I left my post as associate dean for basic sciences and Carolina Distinguished Professor of Developmental Biology and Anatomy at the University of South Carolina School of Medicine to come to NYU Dentistry. I came because Dean Alfano persuaded me that NYU Dentistry, long known for producing excellent clinicians, was in the process of creating a strong research engine capable of significantly advancing the knowledge base in oral health. He told me that the College was being transformed, both philosophically and physically, but I could not have imagined how far-reaching the changes would be.
Making Research a Priority and Sharpening its Focus
NYU Dentistry's research philosophy today is dramatically different from what it was 10 years ago. Research today is a priority, and because it is, all major decisions made at the College are considered not solely on their own terms but also in terms of how the decision will affect our ability to do research. Another major change is the redefinition of what it means to “do research.” In the past, people tried to be all things to all people, doing any kind of research they could in any way they could as long as they were doing research. Now, instead of a scattershot approach to research, we are electing to focus on specific areas. Oral cancer is one of those areas. From a public health point of view it is certainly a well-founded choice, because it is an area in which dentistry can have a major impact on general health. The oral cancer initiative is twofold: there is the epidemiology and health promotion aspect—oral cancer screenings and awareness campaigns—and the basic science investigations into the fundamental mechanisms of oral cancer.
In addition to a lack of focus, there was the problem of isolation. Not only at NYU Dentistry, but at other academic dental institutions as well, there were basic science research people doing fundamental research in cancer, cariology, or microbiology in their individual research labs, while clinical research people were off somewhere else working on xerostomia or other clinical conditions. They were independent entities. But in today’s market, research institutions can no longer remain competitive in that way. In order to be productive, groups of individuals must work together synergistically.
The Move To Translational Research
In addition to making research a priority and sharpening its focus, another key component of our research strategy is designed to foster interactions and collaborations among the world-class research faculty who have joined our ranks in recent years. Our objective is to build a bridge between the basic sciences and the clinical sciences in order to move fundamental basic science research into the clinic. This approach is called translational research—think of overlapping spheres—because it translates novel basic science findings into testable hypotheses for evaluation in clinical trials. Dr. Dianne Rekow, who recently joined NYU Dentistry, is responsible for implementing this philosophy.
NYU Dentistry will still conduct pure clinical research, such as studies on pain, implants, and whitening agents. And we will still have people doing research in very basic areas that may never be enacted in patient trials. But more and more will be translational research that begins in human or animal tissue experimentation and provides the groundwork to be translated into the clinical setting.
Many basic science researchers are already changing their orientation. Instead of thinking exclusively about fundamental mechanisms, they are also thinking about things that might be useful in the clinical setting five to ten years into the future. A major stimulus for this new kind of thinking comes from the revolution in bio-technology that arose from the human genome project’s exploration of our molecular selves. Simply put, things that people thought would happen far into the future are happening now.
We can expect that this new synergy among research orientations will look very much like the emerging model in biomedicine, where materials designed and tested at academic medical centers also move into clinical trials and practice there. This can easily be imagined at NYU Dentistry in terms of implant materials.
The Research Timetable
Our goal within the next five years is to double research productivity at NYU Dentistry and to see it thoroughly integrated into the fabric of the College. This will be achieved in three ways. First, the new Bluestone Center for Clinical Research will provide an optimal environment in which to conduct patient-oriented research designed to develop specific therapies. The results will be a tremendous boon to industry and ultimately to practitioners and patients. Second, basic science and translational research will be fully integrated approaches focused on producing specific clinical research hypotheses that can be tested at the Bluestone Center. Third, our epidemiology and health promotion activities will continue to expand. In short, we’ll have the whole gamut of research in important areas of dentistry being conducted at NYU Dentistry. The missing piece that we require is federal support for clinical research. We will begin to build the reputation of the Bluestone Center with contracts from corporations, and then pursue NIH-funded clinical studies, which are peer reviewed and judged to be among the highest-quality research it is possible to conduct.
In the short term, my goal is to continue to build an insfrastructure that facilitates research by giving faculty protected time from excessive paperwork and bureaucracy. And in addition to facilitating interaction among the major scientists at the College, we want to promote interaction with their colleagues throughout NYU, the United States, and the world in order to achieve bigger and better synergistic projects that are capable of improving oral health at the global level.