FEATURE — Spring 2004


Revolutionizing Medical Research and Patient Care

Expanding on the successes of the medical school's Genome Sequencing Center, Washington University is poised to transform health care. By creating and merging three new interdisciplinary research units into one expansive initiative—BioMed 21—the University is positioning its scientists to translate key genetic data into new treatments and, ultimately, prevention of disease.

by Judy H. Watts

Nearly everyone knows of some legendary soul who dined for a lifetime on the nutritional equivalent of chicken-fried steak slathered in gravy, chased with ice cream and pie; who exercised only with a foot on the gas or a thumb on the remote control—and who, nonetheless, lived to be 90, fundamentally healthy and mentally alert.

"The fact is, our genetic endowment controls much of what happens to us," says Larry J. Shapiro, executive vice chancellor for medical affairs; dean, School of Medicine; and the Spencer T. and Ann W. Olin Distinguished Professor of Pediatrics. "Some people, for example, are fortunate enough to have an extremely positive combination of genes that allows them to eat pretty much whatever they want and never suffer the ravages of heart disease. If we could identify these individuals in advance, we probably wouldn't have to try to intervene in their diets or put them on lipid-lowering agents. We could just let them live their profligate lives with impunity!"

At the University's press conference announcing BioMed 21 were (from left) Richard K. Wilson, director, Genome Sequencing Center; John F. McDonnell, chairman, Board of Trustees; Philip Needleman, associate dean for special research projects; Larry J. Shapiro, executive vice chancellor for medical affairs and dean, School of Medicine; and Mark S. Wrighton, chancellor.

At the same time, if scientists understood precisely which genes are involved in cardiovascular disease and other ailments—and how those genes act under various environmental influences—they could identify individuals at risk and begin to intervene. "At Washington University, we stand at the threshold of being able to do just that," says Shapiro. "With the vast amount of information available through the Human Genome Project and our tremendous institutional strengths—from genome sequencing to molecular imaging to bioresearch—we are poised to rapidly translate key genetic data into a lexicon that will allow us to design new drugs and strategies for treating human ailments in a much more efficient and meaningful way."

Quickly moving discoveries into clinical reality

The historical moment is a profound one for Washington University. At a time when scientific and technological advances—many pioneered at the School of Medicine—have brought humanity's dream of banishing disease and easing affliction closer to Earth than ever before, the University has developed a stunning research initiative to respond to the need and the promise. Because of its potential to redefine medical research and practice in the 21st century, the $300 million strategic plan is called BioMed 21.

BioMed 21's Three Research Units
To rapidly translate knowledge from the Human Genome Project into effective diagnosis and treatment of disease, BioMed 21 will establish three innovative, interactive University-wide research units:

Center for Genomics and Human Genetics
Enhancing the work of the Genome Sequencing Center (GSC), scientists will focus on, among other areas, detecting mutations in human DNA, assessing genes in healthy and diseased tissues, and producing animal models of human diseases. One research path: identifying new biomarkers, key proteins that might be used to tailor treatments to individual patients.

Center for Biological Imaging
Building on the University's breakthroughs and strengths in imaging sciences, researchers will seek to visualize structures that have molecular consequence, such as receptors for hormones, growth factors, and drugs—in real time and in living patients. Other inquiry will include distribution, binding, and action, and visualizing biochemical changes initiated within cells and within specific areas in organs related to disease or therapy.

Division of Clinical Sciences
Uniting many departments, the division will support patient-oriented research, train the next generation of clinical researchers with expanded clinical course work and opportunities for research experience in laboratories, help established specialists translate basic discoveries into treatments, expand facilities for clinical trials, and develop small-scale genetic sequencing facilities.

"BioMed 21 represents a new paradigm in basic and life-science research," says Chancellor Mark S. Wrighton. "This interdisciplinary initiative will reorganize biomedical research at Washington University around three central research units, which will be accessible to researchers on both campuses: the Center for Genomics and Human Genetics (CGHG), the Division of Clinical Sciences, and the Center for Biological Imaging." (See sidebar.)

"There are great opportunities for collaboration between biologists, physicists, chemists, engineers, psychologists, and computational scientists on the Hilltop and at the medical school in each of the three focus areas," says Edward S. Macias, executive vice chancellor and dean of Arts & Sciences.

The three research arms of BioMed 21 are interrelated and mutually supportive; CGHG's genetics and genomic contributions to understanding abnormalities' underpinnings may accelerate as the imaging center pursues techniques allowing investigators to visualize not only molecular structure but also function dynamically over time. And creating a scientific and physical infrastructure at the Division of Clinical Sciences will move basic discoveries rapidly into clinical reality.

BioMed 21's starter hit-list includes Alzheimer's disease, cancer and infectious diseases, diabetes, obesity, Parkinson's, and neuropsychiatric, cardiovascular, and autoimmune diseases.

"Eventually we can begin to intervene in a positive way to prevent illness from appearing," says Dean Shapiro. "The power of genomic medicine is ultimately preventative."

Assembling the brightest people

A search has already begun for additional faculty members in many areas, including patient-related research and imaging. "First and foremost, these people must be doing highly creative, highly innovative science at the leading edge of their particular field," says Shapiro. "We're also looking for people who can capitalize on working in interdisciplinary teams. We'll make senior appointments as well, but we will really be focusing on young people on the ascending limb of their scientific-discovery careers and periods—and identifying the best and the brightest."

Approximately 50 Ph.D., M.D., and M.D./Ph.D. students will also enroll under BioMed 21 to train within the new paradigm.

Supporting a grand initiative

BioMed 21 is expected to spark industry partnerships, create jobs, and in other ways help make St. Louis a thriving center not only of plant and life sciences but of biotechnology and biomedicine. Support comes from federal research grants, gifts, and internal resources. The medical school's renowned Genome Sequencing Center (GSC), directed by genetics Professor Richard K. Wilson, recently received a three-year grant for more than $130 million from the National Institutes of Health. Investigators will sequence the genes of nonhuman species, compare the codes with the human genome, and so learn about the complex genetic interactions that regulate human health.

"Eventually we can begin to intervene in a positive way to prevent illness from appearing," says Dean Shapiro. "The power of genomic medicine is ultimately preventative."

What Chancellor Wrighton has described as "transforming gifts" from friends of the University will immeasurably enhance the search for the collegial faculty powerhouses who will mentor BioMed 21's new students and catalyze research. Those gifts include a previous Danforth Foundation gift providing a $30 million endowment to stimulate research, of which $6 million will endow eight Danforth Foundation Career Development Professorships for young faculty members. Four professorships within BioMed 21 will be endowed through a $6 million gift from John F. McDonnell, chairman of the University's Board of Trustees, and the JSM Charitable Trust. Another major gift established the Philip and Sima K. Needleman Professorship for a senior person who will play a leading role in the new Division of Clinical Sciences. Philip Needleman, a University trustee whose numerous research contributions to patients' well-being include the design and development of Celebrex (a new type of arthritis drug), is associate dean for special research projects.

Building new structures—and excitement

At the hub of the Medical Campus' patient-care facilities—the hospitals, the Center for Advanced Medicine, and Siteman Cancer Center—will rise a new $150 million, 250,000-square-foot BioMed 21 translational research facility (at far left in artist rendering).

A vigorous building program will accommodate the new interdisciplinary teams and growing basic and clinical research programs. The first hammers will sound next to the GSC as a $13.5 million reconstruction gets under way to enhance interactions among basic researchers, clinicians, and the GSC. Then a $150 million, 250,000-square-foot BioMed 21 translational research facility will rise in stages at the hub of the Medical Campus' patient-care facilities: the hospitals, the Center for Advanced Medicine, and Siteman Cancer Center. Next door will be the new Farrell Learning and Teaching Center, an important element of BioMed 21; near that, a facility to expedite the development of mouse models for human diseases will thereby speed research and testing.

Best of all, this momentous time in the life of the University is teeming with the excitement of infinite possibility. The energy is evident in the comments of University officials, department heads, and faculty on both campuses. Speaking on behalf of his colleagues on the Hilltop and the Medical campuses, Shapiro sums up "the buzz around the place" since BioMed 21 debuted: "People are really excited; they're proud to be part of an institution that isn't just sitting back and waiting for the next good thing to happen but is going forth to chart new territory! It's exciting, and it's part of the wonderful tradition of this institution."

Then, in a comment that suggests something of the interdisciplinary research experience itself, Shapiro sums up his own feeling: "It is extremely energizing to be around such a group of creative and committed people."

Judy H. Watts is a free-lance writer based in Santa Barbara, California, and a former editor of this magazine.