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BOOK REVIEW
Year : 2011  |  Volume : 134  |  Issue : 2  |  Page : 241-242

Principles of translational science in medicine:From bench to bedside


Moving Academy of Medicine & Biomedicine, 13, Swastishree Society, Ganesh Nagar, Pune 411 052, India

Date of Web Publication10-Sep-2011

Correspondence Address:
M G Deo
Moving Academy of Medicine & Biomedicine, 13, Swastishree Society, Ganesh Nagar, Pune 411 052
India
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Source of Support: None, Conflict of Interest: None


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How to cite this article:
Deo M G. Principles of translational science in medicine:From bench to bedside. Indian J Med Res 2011;134:241-2

How to cite this URL:
Deo M G. Principles of translational science in medicine:From bench to bedside. Indian J Med Res [serial online] 2011 [cited 2020 May 25];134:241-2. Available from: http://www.ijmr.org.in/text.asp?2011/134/2/241/84763

Martin Wehling, editor (Cambridge University Press, Cambridge, UK) 2010. 382 pages. Price: US$ 99.00

ISBN 978-0-521-88869-1 (hardback)

This multi-authored book edited by Professor Martin Wehling, starts with a section on introduction and definition of this somewhat ill defined branch of clinical research. The book has sections dealing with issues such as target identification and validation, biomarkers, early clinical trial design, pharmaceutical toxicology and translational science biostatistics. The final chapter describes a few success and failure stories.

The first section discusses various dimensions of the concept highlighting NIH roadmap of interdisciplinary research involving various branches of biosciences including Bioinformatics and Nanomedicine. It also addresses the issues of the scope and limits of translational research in biomedicine. There is also a discussion on "secondary translational sciences" which really provides socio-economic angle relevant to any patient oriented new developments. These issues certainly are important to policy makers. However, the notion of "secondary translational sciences" plays little role in scientific research. No one can predict socio-economic implications of a discovery. The authors rightly state that translational science is a more inclusive and broad-based term than "Translational Medicine". However, the confusion around the precise meaning of the term has remained more or less unresolved.

Section on Target identification and validation describes briefly the new "Omics" technologies such as genomics, proteomics, metobonomics, etc., with colour illustrations. These technologies, which permit simultaneous study of numerous targets on a small chip, would become integral essential components of future biomedical research especially in new drug development. There is discussion on problems in standardization, reliability and reproducibility of the "omics" technologies. Since multiple targets would be involved it is necessary to study inter-relationships of these targets and their implications to translational medicine. Obviously for limitation of space this chapter is broad-based sometimes lacking in details. There is a separate section on pharmacogenetics in which genomic technology would play a crucial role. It should also have application in investigation of individual and broad-based drug toxicology. There is a much needed chapter on tissue banking.This section is a good attempt to describe the "omics" sciences and should be useful especially for the beginners in the field.

The section on Biomarkers defines importance of this emerging field in translational or patient oriented research. With the ethical problems faced in animal experimentation and also growing realization that the results of the animal studies have several limitations when applied to humans, human based surrogate markers will be increasingly employed in clinical and translational research especially in drug development. There are special chapters on biomarkers in cardiovascular disorders and oncology. It also includes use of imaging as a biomarker. This is very important in view of new developments such as PET and PET CT that could now be used to study in vivo alterations at the molecular level. There are chapters that discuss importance of "Imaging Biomarkers" in psychiatry research which currently suffers from lack of objective laboratory tools. An important feature of imaging technologies is that these are non-invasive and, therefore, highly suitable for longitudinal studies. This is perhaps the best section and in fact the main strength of the book.

The section on Early clinical trial design describes the conventional clinical phases especially drug development. Phase I is the first stage in human trials and the dose to be used is based on preclinical studies decided by a set of guidelines of drug controlling authorities such as FDA. The issue of making the "go or no go decisions" at various phases is also discussed. The concept of microdosing needs to be seriously considered. The main issue here is how the regulatory agencies would respond to such an approach, as it is compounded by the fact that first dose may result in long lasting changes that may affect response to subsequent doses.

Recording of adverse effects is a mandatory component of any new drug development that includes the preclinical and clinical toxicity. Classical approach is to study both macro- and microscopic alterations in tissues in relation to dose of the trial drug. An important section in the book which deals with pharmaceutical toxicity (Section V), discusses the issue of use of biomarkers as early indicators of toxicity as compared to the conventional approaches.

Statistics is an integral part of clinical trials. This chapter deals with its special role in translational science. One issue in statistics is how to interpret the alteration observed in validated multiple targets. The last section describes a few examples of successful and unsuccessful translational research projects.

Medical ethics, designing of a clinical protocol, data analysis and management which are integral part of the any clinical or translational studies have received very scant attention. This is one weaknesses of the book that could be a distraction to the beginners in the field. The major emphasis of the book is on biomarkers in translational/clinical research. Overall, the book should be a good reading for those interested in the field of biomarkers in relation to translational research.




 

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