Fall 2012
Growing a clinical research enterprise

synapse: University of Nevada, Reno School of Medicine

James Kenyon, Ph.D.

Photo by Matt Lush.

Mentoring junior scientists a key component

By Anne Pershing

Clinical research is finding practical medical applications for the pure science done in laboratories so they can be applied to patients.

It can be as basic as conducting clinical trials within a physician's office; an activity the University of Nevada School of Medicine is looking to grow under the umbrella of creating a clinical research enterprise.

"The conspicuous mission currently missing from the medical school is a robust clinical research program," said Thomas L. Schwenk, M.D., dean of the medical school.

"Clinical research is the type that affects the actual practice of medicine, the type of research you see on TV and hear about on the radio… the type of research that brings patients to the School of Medicine to receive the most advanced care."

He added that growing and supporting the development of a clinical research program is one of his highest priorities.

"That is why the Nevada IDeA Network of Biomedical Research Excellence program, led by physiology and cell biology professor, Dr. James Kenyon, is so important."

The Nevada INBRE has had success gathering together the various components of clinical research and serves as a model for establishing such relationships across other departments at the School of Medicine.

According to Schwenk, the INBRE program provides the infrastructure and support to mentor and develop trained faculty and staff members, create the systems that design and conduct clinical research trials, collect and store data and provide analytical expertise.

"It is also a way that many physicians and patients can get involved in research and contribute to improve medical care," he said.

He added that the other exciting news contributing to the school's success in this endeavor is generous support received from Jennifer and Phil Satre and the Redfield Foundation.

"The former gift will support clinical research development in general and the latter supports research that improves the health of children. The Satre and Redfield gifts are so precious and special, and give us the confidence and support to forge ahead with the development of strong programs that will improve the health and health care in Nevada," said Schwenk.

And Kenyon, who received his Ph.D. in physiology and biophysics from the University of Vermont, is also pleased with the support from the Satres and the Redfield Foundation.

"If we're going to be a player in the clinical research area, we need to get our game up," he said.

He went on to say that the clinical enterprise is an exceptional opportunity for both students and faculty.

"We have a duty to fulfill our mission to provide good health care for the people of Nevada. Patient care and research need to be more active. That's our goal. We're also working to mentor faculty members," he said.

He explained that as the principal investigator of the Nevada INBRE project, he obtained the approximately $14 million, five-year INBRE (renewable in 2015) grant to develop a statewide biomedical research network extending from Nevada's community colleges through the University of Nevada School of Medicine where the emphasis is on developing clinical research. A key component of the network is a mentoring program to develop early career researchers, such as Dr. Alex Keene of the University of Nevada, Reno biology department.

"A specific goal of the INBRE is to create a network of early career scientists across Nevada and to provide them with a range of training and mentoring activities. As a current mentor to Dr. Keene, I have made sure that he has been included in the network and the INBRE-sponsored activities."

Some of those activities include Keene's participation in a professional grant writing workshop and working with the University's grants co-op.

"The co-op group gathers together scientists, ranging from graduate students to experienced principal investigators, to discuss developing grant proposals and the process of grant review and funding at the National Institutes of Health. I will also ensure that Dr. Keene will be linked to the resources for clinical and translational research being developed by the Mountain West Consortium, a regional consortium to develop clinical research" said Kenyon.

Kenyon pointed out that the INBRE Bioinformatics Core developed a HIPAA-compliant, secured, web-based database used by Dr. Doina Kulick to develop "Live Well", an innovative web-based tool.

"Live Well enables primary care physicians to counsel their patients on diet and exercise and gives their patients a tool to monitor and improve their lifestyles. Dr. Kulick's approach is highly innovative. The initial data are encouraging and will be used to justify a more extensive study," he said.

Kulick, director of the School of Medicine's Wellness and Weight Management Clinic and an associate professor of internal medicine and nutrition, explained that the newly-created Live Well program "is a translational research pilot study funded by the INBRE that studies the effect of an innovative dietary counseling program on diet and cholesterol."

She added that a healthy diet is the foundation of preventing and treating diseases including coronary artery disease, cancer, stroke and diabetes. National data show that only 10 percent of Americans eat a healthy diet. According to the USDA, healthier diets could prevent at least $87 billion per year in medical costs, lost productivity and lost lives.

"Meanwhile, data from the 2010 National Ambulatory Medical Care Survey show that during visits to primary care physicians, only 11.7 percent documented any type of counseling for diet or nutrition, down from 13.5 percent in 2006," she said.

Kulick pointed out that the counseling intervention using Live Well is low cost, low intensity as it requires only two five-minute sessions of physician-patient interaction, and most importantly, can be delivered during the routine physician office visits.

This streamlined approach allows physicians to make nutrition an integral part of the treatment of chronic diseases.

"This very encouraging pilot study needs to be reproduced at a larger scale in order to validate these preliminary data. Together, we will seek future funding to further this translational research project. The ultimate goal of our research is to improve the health care of patients in our community," she said.

Kenyon added that the Live Well program is exceptional because the National Institutes of Health had earlier determined that basic science results were not impacting public health. They are now distributing research dollars emphasizing more funds for clinical research which led to INBRE grants.

"We're also working on other programs through INBRE," said Kenyon, indicating that he is developing a more robust clinical research enterprise at the School of Medicine.

"Right now, we're working on a partnership with the UC Davis Clinical and Translational Science Center on a program for our medical residents where they can receive training in an intense week-long clinical research camp in Sacramento.

"In addition, we're working on a program for our medical students to study and conduct research at UC Davis. Sascha Horowitz, a third-year medical student, entered the program in July and will study sleep in burn patients at the UC Davis Medical Center and Shriners Hospital for Children. The training she receives will earn her a master's degree in clinical research."

INBRE also reaches out to help other institutions like the University of Nevada, Reno; the University of Nevada, Las Vegas and state community colleges that are currently limited on biomedical research.

"We've had some success with this approach and it's become quite strong as the students get training and exposure to mentoring and labs to direct them toward biomedical research," Kenyon said.