Processes, Dynamics and Problems in Translation: a Comparative Study of Stem Cell Innovation in the UK
Abstract
The means by which 'science' is translated into clinical utility/practice has recently attracted a new degree of attention from government, healthcare policy-makers and the public. This is especially apparent within stem cell innovation, where improving both provision for and efficiency in translation are seen as vital for the development of stem cell therapies. The UK is currently investing large sums of money in stem cell science: understanding and improving translation in respect to stem cell innovation has become a priority. The empirical research specified within the proposed programme of work responds to this need.
Translation is not simply a case of transferring scientific knowledge from the research-base into the clinic. In practice, translation is neither linear nor unidirectional, but instead involves complex and evolving interaction between scientific, clinical, commercial and other groups. Emphasis will be placed on characterising the dynamics within and between these constituencies in order to understand how 'networks of translation' are built, how they function and where problems arise. The research will map translation in two different therapeutic contexts at the forefront of stem cell innovation in order to generate an evidence-based model of the processes, dynamics and problems of stem cell translation.
The study focuses on the haematopoietic stem cell (HSC), the first known and best characterized stem cell population, which to date remains the only stem cell routinely used in the clinic. Under the rubric of HSC transplantation, the HSC has become a therapeutic mainstay within cancer medicine. Recently, changing understandings of HSC plasticity have also placed the HSC at the forefront of regenerative medicine, where it is being recast as a potential treatment for various prevalent debilitating diseases, such as cardiovascular diseases. The established tradition in transplantation medicine, together with its emerging position in the vanguard of regenerative medicine, renders the HSC a compelling subject for the study of translation.
Current research suggests two patterns of HSC innovation. HSC transplantation in cancer therapy is characterised by incremental change and is driven largely by the public sector. In contrast, the highly innovative and emerging paradigm of regenerative medicine is driven in part by the private sector and is engendering novel forms of public/private collaboration.
Key aims
To characterise and understand the factors that underlie the problems and difficulties with translation, and those that foster effective translation
To map and characterise the 'networks of translation' associated with these very different innovation environments
To cast light on how translational activities differ between different innovation environments
To develop policy relevant insights into the processes of 'translational activities' in stem cell innovation
To generate evidence-based models of translation that will aid the development of both 'best practice' within stem cell translation and an infrastructure conducive to stem cell innovation
Case Study I
This centres on HSC transplantation in contemporary cancer medicine, especially the haematological cancers. These therapies are continually evolving in light of scientific advances which are yielding benefits to patients. This case study explores translational activities in this innovation environment which is characterized by continual and incremental change within an established therapeutic paradigm.
Case Study II
This examines translation in the context of HSC-based regenerative medicine - an innovation environment that is highly novel, risk-laden and fraught with uncertainty. Phase I clinical trials using HSCs to treat CVD have recently been initiated in the UK and will form an early focus within the proposed research.
Contacts
Dr Alison Kraft
Outputs
Poster
http://www.york.ac.uk/res/sci/posters/kraftfellowship.pdf
Publications
In preparation:
‘New light through an old window: What’s new about translation?’
Working draft – submission imminent
‘The cancer stem cell: A new concept for an “old” disease’
Working draft – due for submission August 2008 as contribution in a book following from the ‘Emerging Diseases’ Workshop, Hamburg, February 2008
‘Blood and Brain: Adult stem cells – a Comparative study’
Working title of a joint paper with Dr. B. Rubin, University of Basle
Papers
February 2008: ‘The cancer stem cell: A new concept for an “old” disease’, FSP BIOGUM, University of Hamburg
April 2008: ‘Manhattan Transfer: Blood, radiation and the birth of stem cell biology’. Research Colloquium, "Naturwissenschaften im historischen Kontext", Institut fű r Zeitgeschichte, University of Vienna .
Forthcoming:
August 2008: 4S/EASST, Rotterdam
December 2008: ‘Brown Bag Series, SATSU, University of York
December 2008: History of Cancer Workshop