Institute for Translational Research in Biomedicine, Chang Gung Memorial Hospital, Taiwan
The Institute for Translational Research in Biomedicine (ITRBM) at Chang Gung Memorial Hospital in the southern city of Kaohsiung in Taiwan represents a new model for translational medicine. Commissioned in December, 2007 by Mr. Yung-Ching Wang (王永慶創辦人), the founder of the Formosa Plastic Group, and under liberal funding from the Chang Gung Medical Foundation (CGMF; 長庚醫療財團法人), the Center for Translational Research in Biomedical Sciences was officially inaugurated in February, 2009. In 2013, it was re-designated the ITRBM to elevate its organizational status in the CGMF because of outstanding performance. Under the directorship of Professor Samuel H.H. Chan (陳慶鏗教授), Ministry of Education National Chair Professor, the ITRBM aspires (1) to set an example on how translational research in a medical center should be carried out, and (2) to strive to be a center of research excellence with international repute.
Our Interpretations of Translational Medicine
As the brainchild of Professor Chan, the uniqueness of the ITRBM resides in his two interpretations of translational medicine. First, translational medicine is about solutions to health problems. If one subscribes to the philosophical connotation that medical research is for the betterment of humankind, then one should realize that there is no real demarcation between clinical (bedside) and preclinical (bench) research. This is because the only difference is that human subjects instead of animals, tissues or cells are employed in the studies. Nonetheless, governed by the same ethical principles and guidelines, all will reveal information in some aspects of biomedicine. Translational research in biomedicine therefore transcends the boundaries between bench and bedside research. It is the synthesis of ideas, technologies and research outcomes that are associated with a particular health theme.
Second, translational medicine is about communications. The word “translation” is most commonly defined as expression of words in another language. Its definitions can be extended to encompass expression in simpler language and uncomplicated interpretation. Translational research in biomedicine is therefore the presentation of knowledge gathered in a fashion that is amenable to non-experts. A molecular biologist is a non-expert when it comes to interpretation of the clinical ramifications of acute myocardial infarction; a cardiologist is a non-expert when it comes to interpretation of the intricate of DNA repair. Communication in simple, understandable language will therefore bridge the intellectual gap between laboratory scientists and clinical practitioners.
Our Philosophy and Goals
Stemming from these two interpretations of translational medicine, the governing philosophy of the ITRBM is that clinical and laboratory scientists must work together with an ultimate objective to tackle health-oriented problems. Under this philosophy, three fundamental goals of the ITRBM are (1) to foster a congenial environment where MDs and PhDs can interact freely in terms of generating meaningful research problems and solutions without the worry of availability of facilities, know-how or clinical significance; (2) to groom the next generation of investigators who are well versed in translational research and (3) to put ITRBM on the map. It should be emphasized that our research focus is towards solving health issues rather than towards patent applications, technical transfers or marketable products.
Our First 10-Year Strategic Plan (2009-2019)
A 10-year strategic plan (2009-2019) has been drawn to accomplish the aspirations and goals of the ITRBM.
(1) Provision of state-of-the-art research facilities and technical supports
The ITRBM has completed its Phase I stage of development that includes refurbishment of approximately 3,500 m2 of laboratory space; purchased, installed and tested over 3,000 pieces of equipment priced between USD 120 and USD 4,100,000. Phase II stage that began in 2014 is currently underway and entails refurbishment of the remaining 1,500 m2 of laboratory space, and procurement of additional equipment and upgrade of existing ones. When completed by 2018, the ITRBM will be endowed under one roof with state-of-the art facilities for physiological, biochemical and behavioral experiments at molecular, cellular, tissue and whole animal levels, which complement modern clinical facilities at Kaohsiung Chang Gung Memorial Hospital. In addition, an AAALAC International-accredited Center for Laboratory Animals provides excellent support for experimental animals, including genetically-manipulated mice. To befit translational research, compatible clinical and laboratory facilities are installed. For example, the presentation of images from the animal ultrasonograph or animal MRI and their analysis programs are compatible to those used in the medical center, making cross-interpretation between disease symptoms and phenotypes from animal models easily accessible.
An elaborate management system has been instituted to maximize the technical supports and ensure proper handling and maintenance of the facilities. Regular training sessions have been carried out on major equipment. However, unlike the common practice in many core facilities, the fundamental philosophy is not to perform any task for any user, but to train and educate potential users to become experts in their own right.
(2) Encouragement of scientific and clinical interactions
State-of-the-art facilities notwithstanding, the quality of biomedical research resides in employing the most appropriate and sensitive methodology in addressing the scientific issues at hand. In addition to their individual research endeavors required to establish their national or international standing as a scientist, PhDs at the ITRBM routinely provide consultations to MDs on the best methods to answer a mechanistic question. Likewise, MDs provide inputs to PhDs on the validity of, for example, a new animal model based on whether the stipulated phenotypes are actually manifested by patients with the targeted disease. Furthermore, because of their diversified scientific backgrounds, interactions among the PhDs have led to broadening of their research horizons. It is not uncommon for a cell biologist to expand his/her work to animal models; or for a behavioral scientist to incorporate molecular biology into his/her studies. Not to mention that a combination of all the above scenarios is an encouraged practice. In the end, this is a win-win situation for both the clinical and laboratory scientists.
(3) Recruitment criteria
We fully recognize that, despite its obvious benefits, not every MD or PhD subscribes to the practice of carrying out his/her research endeavors in an interactive manner. To avoid unbecoming predicaments, subscription to this philosophy is taken seriously in our recruitment exercise. In addition, appointments are made based not on where and under whom the candidates were trained, but on their potentials to thrive as an independent and nationally or internationally competitive biomedical researcher. As a tradition, our new recruits are not expected to join the research team of senior MDs or PhDs.
(4) Provision of financial support
The principal concern on selecting research projects at the ITRBM is whether the study is of clinical significance, with no restriction on specific diseases. Beyond that, funds for man-power and supplies are not an issue, and facilities are already available. The practice is to make use of grant application as a means to solidify the scientific problems to be solved; and more often, to put the know-how of clinical and laboratory scientists together to provide comprehensive answers. Members of the ITRBM are also encouraged to seek external funding; a matching fund amounting to 50% of the grant is awarded as an enticement. Despite the massive financial investment, the orientation of research projects is always towards solving a health problem rather than towards a marketable product.
(5) International and national exposure
Several plans are put into place to allow members of ITRBM to have broad international and national exposure. In addition to one expenses-paid international meeting per year funded by the CGMF, PIs can use their matching funds to attend international and national meetings. We also bring the international and national community to Kaohsiung in the form of visits and seminars. On those occasions, our visitors or speakers are invited to have an informal exchange with our members in the absence of the two chair professors. This practice is deemed beneficial to our younger colleagues because they and the visitors can speak freely and openly on all subjects without inhibition. In addition, since 2010, ITRBM sponsors two annual meetings, one on Frontiers in Translational Medicine, and one on Translational Circulatory and Stem Research, both again include eminent speakers from abroad and Taiwan.
Our Second 10-Year Strategic Plan (2019-2029)
When ITRBM was inaugurated in 2009, the mandate was to serve as a new model of translational research in the CGMF and become a premier research institute. To continue the momentum engineered during our first decade, a 10-year strategic plan for 2019-2029 has already been approved by the Steering Committee (決策委員會). Our goal is to follow the original mandate and continue its current momentum and competitiveness. As a natural course of maturation, ITRBM further plans to broaden its horizons by expanding the diversified expertise in the Institute to solve innovative but more demanding health-related puzzles with societal impacts that we envisage will dominate the next decade in Taiwan and around the globe. Three research themes, which highlight current frontiers in contemporary biomedicine, are selected as the research focus of ITRBM. They are: energy metabolism in health and disease, immune response to challenges from internal and external environments, and diagnostics/therapeutics application in clinical medicine. These research themes are put forward at the backdrop of three major advantages loftily established in our Institute during our first decade. These include (a) advanced technology platforms that encompass bioinformatics and molecular imaging for research from cell to experimental animal to human; (b) a handsome array of disease models that allow for mechanistic studies using genomics, cell or molecular biology and systemic physiology/pathophysiology approaches; and (c) clinical application that extends outcomes from preclinical research and technology platforms to address clinical issues.