A Modest Proposal: Scientist Clinician Jamboree

24 October 2013 by Lowell Goldsmith - JID Jottings, posted in Uncategorized

Two articles in Science Translational Medicine (Sept 25:  Wolk et al, 2013; Clark, 2013) triggered a stream of consciousness response and lead to this proposal. There are not enough productive jamfests between clinicians and scientists to keep advancing research. The articles related to skin TH17 cells in psoriasis producing IL-29 (a gold cytokine on the cytokine hit parade); Il-29 triggers production of several antiviral proteins, whose abbreviations are well known to their friends but not others. This research was stimulated by the clinical observation, known forever (meaning before I trained), that patients with atopic dermatitis often have disseminated herpes simplex infections, while patients with extensive psoriasis do not. This old (no, very old) observation now may have a scientific basis. Why did it take decades to perform this research? The most obvious reason is that methodology in cell and molecular science needed to reach a certain stage just to perform the studies. The other, more subtle, point is that no one thought of, or had funding and a group on which to test, such a hypothesis.  A German group gets the gold ring for these findings.

Just as interesting is the accompanying perspective by Rachael Clark, reviewing several aspects of the skin’s immunological response. In addition to scientific detail are the author’s remarks about whether mouse models will be completely applicable to human disease. This was the topic of a previous post in this space (January 15, 2013) which yielded many comments from our readers. Dr. Clark is in Boston, home of the Red Sox, and she uses an analogy that mouse studies  bring us to third base but may not be sufficient to bring the runner home for understanding human disease. I realize this may not be the most international sports model and would appreciate a soccer analogy to complement the baseball one.

Thus, my idea:  there is a need to bring physicians and laboratory scientists together to brainstorm and be creative. This could be at local (institutional), national, or international levels, to share what each group of individuals knows and what they need and desire to know. This should be an ego-free zone, for most productivity. National clinical and/or scientific societies can convene the meetings and set ground rules. Sure, involve industry. The need for rapid progress is too compelling to let the naysayers overrule the usefulness of this proposed jamboree. I hope our commenters will refine and continue these discussions.

 

REFERENCES:

Wolk K, Witte K, Witte E, et al (2013) IL-29 Is Produced by TH17 Cells and Mediates the Cutaneous Antiviral Competence in Psoriasis. Sci Transl Med 5:204ra129

Clark RA (2013) Human Skin in the Game. Sci Transl Med 5:204ps13

 

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