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Infectious disease research requires big picture, collaborative approach
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Infectious diseases have always imposed a heavy toll on human populations. Infectious bacterial, viral and parasitic pathogens have collectively decimated populations, created widespread panic and fear and severely impeded economic development and growth in many countries throughout the world, as is evident with the current Ebola outbreak.
Despite significant advances in the fields of medicine and science during the last century, there remains a staggering number of infectious diseases, including malaria, HIV/AIDS, tuberculosis and others, that continue to defy science and remain a scourge on humankind. Thirty-three million people currently live with incurable HIV/AIDS, 40% of the world’s population is at risk for malaria, and approximately 30% of the world is infected with TB. More than 16% of deaths worldwide result from infectious diseases, nearly 4 million by these three diseases alone.
“Why?” begs fundamental biological questions; answers to which will require research organizations to facilitate the creation of collaborative teams that are committed to pursuing an integrated approach to biological research. This approach is necessary to unravel the mysteries that shroud the complex biological processes and interactions between these pathogens and their human hosts.
John Aitchison
Louie Coffman
By exploiting the newly emerging capabilities of systems biology — the comprehensive study of interacting biological components — and increasing collaboration between researchers, we can accelerate the pace of progress toward the development of vaccines and drugs to prevent and treat the deadly infectious diseases that kill more than 14 million people every year.
Why has progress to stop these diseases been so slow?
Pathogens command extraordinary advantages over their human hosts. These advantages have enabled them to hide in host cells to elude immune surveillance and disable and take control of immune system cells to ensure their viability and develop resistance to therapeutic drugs.
More than 200 years ago, armed with little more than keen observational skills and extraordinary resourcefulness, Edward Jenner discovered that people could be protected from the smallpox virus by inoculating them with material related to the smallpox virus. The medical science of vaccination that emerged from his remarkable work has since spared considerable human suffering and saved millions of lives.
In the 200 years since Jenner’s discovery, billions of dollars have been spent on vaccine research and the human immune response. This work has advanced the science of vaccination well beyond what Jenner might have imagined and has profoundly impacted medical science. But despite these advances, we still have no vaccine for malaria or HIV/AIDS and other emerging infectious diseases. For these diseases, the classical approach to vaccine development, based on Jenner’s discovery, has not worked.
Looking ahead, developing the means to prevent, treat and cure these infectious diseases will be dramatically hastened by a deep scientific understanding of pathogen biology, the human immune system and the interactions between them. Improved knowledge of the complex interplay between pathogens and their host will enable a rational and calculated approach to develop vaccines and drugs to prevent and treat infection.
Solving the mysteries of how pathogens and the immune system interact will require an interdisciplinary approach that incorporates the technical and conceptual innovations that are embodied in systems biology.
Despite the fact that biological processes are deeply and inseparably integrated and related, until now they have been “reduced” for study part by part, in isolation. But years of research has generated detailed information about the interactions of molecular components of complex systems. This information is beginning to be synthesized by systems biologists to characterize the emergent properties of complete biological systems.
Systems biology is the study of “emergent” properties, which are the product of interactions between a system’s constituent parts. Like the plot line of a book, which cannot be comprehended by dissecting a book word by word, emergent properties are elusive. Advancing our understanding of the interactions between pathogens and the host response, where the war between the two is waged, is a major challenge. But the answers we need require study of the interactions between pathogens and the immune system in overall context, not the separate, individual study of singular components.
In this same collaborative spirit, in order to solve these problems, specialists must work together. There is considerable evidence that groups of diverse, independent actors collectively are smarter, able to solve problems better and faster than expert individuals acting alone. It is inescapably true that “no one is as smart as all of us.”
The widespread adoption of collaborative teams in scientific study will require research organizations to examine their operating model. While it is popular for organizations to claim they are “collaborative,” and that collaboration is a “core value,” few organizations are home to great groups of the caliber that rallied to work on the Manhattan Project to end World War II; that invented the microchip that launched the digital revolution; or that put a man on the moon.
Sadly, most organizational claims of collaboration as a corporate value are specious. This is because collaboration is a bottom-up, emergent property of groups. Collaboration cannot be ordered or mandated. All that organizations can do is establish the initial organizational and physical conditions that are essential for the assembly and emergence of collaborative work.
In order to better drive innovation and discovery, research organizations must first establish an ambitious goal. The goal must stretch well beyond what is possible to what can only be imagined and thus present opportunities to create new knowledge, break new ground and learn, such as to unravel the mysteries of the pathogen-host interface. This goal will require, per Anthony S. Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, that we “do better than nature.”
This goal must pique interest among individual team members, but the organization as a whole must demonstrate belief and commitment to its pursuit.
In addition, the attraction of the right mix of people is vitally important to building a research model that will successfully solve these deadly and complex infectious diseases. Effective multidisciplinary teams must comprise members who individually possess strong technical skills, collaborative “human” skills and conceptual skills that enable them to acknowledge their role and expected contribution to the effectiveness of the group.
A visionary leader also is essential to identify the diverse mix of talent and skills necessary and establish the culture and climate conducive to making critical scientific breakthroughs. The group needs multidisciplinary scientists, technologists (some of whom are thinkers and others tinkerers), inventors and innovators. All must feel safe to venture into new territory, beyond their comfort zones, engage in free exchange, confident enough to teach and humble enough to learn.
Finally, research organizations must design physical spaces that create opportunities for scientists to interact informally and formally with colleagues. Space layouts, traffic patterns and placement of people within a workspace demonstrably impact group productivity. Accommodating individual and interactive work styles is likewise important.
To alleviate the suffering inflicted by these diseases, modern medical science will have to “do better than nature,” an ambitious goal that requires the creation of collaborative teams that are committed to pursuing an integrated approach to biological research aimed to unravel and understand the complex interactions between pathogens and their human hosts.
Research organizations must commit to employing the emerging capabilities of biological research and encouraging the formation of collaborative groups to accelerate the pace of progress toward the development of vaccines and drugs to prevent and treat infectious diseases — ultimately saving the lives of more than 14 million people every year.
For more information:
John Aitchison, PhD, is scientific director and professor at Seattle Biomedical Research Institute, a nonprofit research organization focused on infectious diseases.
Louie Coffman is senior vice president and chief operating officer of Seattle Biomedical Research Institute.
Disclosure: Aitchison and Coffman report no relevant financial disclosures. For more information, visit www.seattlebiomed.org.