Translational research

Definitions of Translational Research

Translational research (also referred to as translational science) is defined by the European Society for Translational Medicine (EUSTM) as an interdisciplinary branch of the biomedical field supported by three main pillars: benchside, bedside and community. ^[1] The goal of TM is to combine disciplines, resources, expertise, and techniques within these pillars to promote enhancements in prevention, diagnosis, and therapies. Accordingly, TM is a highly interdisciplinary field, the primary goal of which is to coalesce assets of various natures within the individual pillars in order to improve the global healthcare system significantly.^[1]

Translational research applies findings from basic science to enhance human health and well-being. In a medical research context, it aims to "translate" findings in fundamental research into medical practice and meaningful health outcomes. Translational research implements a “bench-to-bedside”, from laboratory experiments through clinical trials to point-of-care patient applications,^[2] model, harnessing knowledge from basic sciences to produce new drugs, devices, and treatment options for patients. The end point of translational research is the production of a promising new treatment that can be used with practical applications, that can then be used clinically or are able to be commercialized.^[3]

As a relatively new research discipline, translational research incorporates aspects of both basic science and clinical research, requiring skills and resources that are not readily available in a basic laboratory or clinical setting. It is for these reasons that translational research is more effective in dedicated university science departments or isolated, dedicated research centres.^[4] Since 2009, the field has had specialized journals, the American Journal of Translational Research and the Translational Research (journal) dedicated to translational research and its findings.

Translational research is broken down into different stages, including two-stage (T1 and T2), four-stage (T1, T2, T3, and T4), and five-stage (T1, T2, T3, T4, and T5) schemes. In a two-stage model, T1 research, refers to the “bench-to-bedside” enterprise of translating knowledge from the basic sciences into the development of new treatments and T2 research refers to translating the findings from clinical trials into everyday practice.^[3] In a five-stage scheme, T1 involves basic research, T2 involves pre-clinical research, T3 involves clinical research, T4 involves clinical implementation, and T5 involves implementation in the public health sphere.

In a two-stage scheme, translational research includes two areas of translation. One is the process of applying discoveries generated during research in the laboratory, and in preclinical studies, to the development of trials and studies in humans. The second area of translation concerns research aimed at enhancing the adoption of best practices in the community. Cost-effectiveness of prevention and treatment strategies is also an important part of translational science.^[3]

Comparison to basic research or applied research

Basic research is the systematic study directed toward greater knowledge or understanding of the fundamental aspects of phenomena and is performed without thought of practical ends. It results in general knowledge and understanding of nature and its laws.^[5]

Applied research is a form of systematic inquiry involving the practical application of science. It accesses and uses some part of the research communities' (the academia's) accumulated theories, knowledge, methods, and techniques, for a specific, often state, business, or client-driven purpose.^[6]

In medicine, translational research is increasingly a separate research field. A citation pattern between the applied and basic sides in cancer research appeared around 2000.^[7]

Challenges and criticisms of translational research

Critics of translational research point to examples of important drugs that arose from fortuitous discoveries in the course of basic research such as penicillin and benzodiazepines,^[8] and the importance of basic research in improving our understanding of basic biological facts (e.g. the function and structure of DNA) that go on to transform applied medical research.^[9]

Examples of failed translational research in the pharmaceutical industry include the failure of anti-aβ therapeutics in Alzheimer's disease.^[10] Other problems have stemmed from the widespread irreproducibility thought to exist in translational research literature.^[11]