The path from laboratory to bedside can take years — even decades.
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If you follow health and science news, it’s easy to get excited about the groundbreaking studies published on a regular basis. If you are a patient, it’s also easy to get discouraged when you realize those studies are just the start of a long process.
So why should you pay attention now? Because some of the discoveries that began as seeds years ago are bearing fruit now. Here are just a few examples poised to make a real impact on patient care in 2015 and beyond.
1. Go with your gut
From Greek yogurt to fecal transplants, gut bacteria are a hot topic these days. Is this just a fad? Definitely not. We are just now beginning to understand how the trillions of bacteria living inside us affect our health.
For example, Stanley Hazen, MD, PhD, a physician-scientist here at Cleveland Clinic, has shown compelling evidence that our gut bacteria influence the development of heart disease. Dr. Hazen and his colleagues discovered that when gut bacteria digest certain nutrients found in animal products (like red meat and eggs), a toxic byproduct called TMAO is formed. Measuring TMAO levels in the blood predicted fatal cardiac events better than traditional metrics, like cholesterol levels.
The good news for patients: A diagnostic test for TMAO is currently in development and should be available by the end of the year. This valuable tool will allow physicians to quickly assess which patients might benefit most from dietary interventions.
“Researchers hope to integrate medical calculators in a patient’s electronic health record, making it even easier for physicians to devise an effective treatment plan.”
Paul DiCorleto, PhD
Lerner Research Institute
2. Computing cancer risk
Your age, ethnicity, genetics, lifestyle — all of these factors and more affect your risk of developing cancer. For physicians, putting the pieces of this puzzle together to determine which patients need aggressive prevention strategies, such as early and frequent colonoscopies, presents a challenge.
Enter the calculator. Mathematical cancer prediction calculators, called nomograms, are now available to objectively predict your individual risk of cancer. For example, Michael Kattan, PhD, a researcher in the Lerner Research Institute, invented an online tool to help physicians decide when patients truly need colorectal screenings.
The tool, called CRC-PRO, accounts for multiple risk factors, which is more accurate than relying on a single risk factor, such as age. Clinicians can decide to screen high-risk patients before age 50. Doing so can save lives for younger patients who ordinarily would not have the screening until years later, when it might be too late.
Researchers hope to integrate medical calculators in a patient’s electronic health record, making it even easier for physicians to devise an effective treatment plan.
3. Just breathe
You may have heard that dogs can smell cancer, but physicians now have a more reliable source for “sniffing out” diseases. New technology measures organic compounds in the breath to detect a variety of diseases, including diabetes and early-stage lung cancer. So far, these noninvasive tools have had limited clinical use. But they are expected to become more widespread in 2015.
Physician-scientist Raed Dweik, MD, has shown their widespread applications. He and colleagues have successfully used patients’ unique “breathprints” to diagnose liver cancer, pancreatic cancer, lung cancer, pulmonary hypertension, heart failure, hepatitis, nonalcoholic liver disease, and obesity.
Much of the current technology used for breath testing is more suitable for research. The next step: Work is underway to develop portable devices for testing in a physician’s office.
4. New hope from vaccines
Sometimes results are driven by crisis. The Ebola epidemic in West Africa and recent U.S. scare have renewed focus on the need for a vaccine for at-risk individuals and frontline healthcare workers. Pharmaceutical companies are fast-tracking their programs, and promising Ebola vaccines are on the horizon. The most advanced of these vaccines—two developed by pharmaceutical companies GlaxoSmithKline and Merck—have been deemed safe and will enter Phase III testing in healthy individuals in West Africa next month.
You may not have heard of it, but the mosquito-borne Dengue virus sickens 100–400 million people each year. While not usually fatal in healthy individuals, infections can lead to deadly complications. A promising dengue vaccine has been developed and tested, and is expected to be submitted to regulatory groups in 2015. Experts expect commercialization later in the year.
But infectious diseases aren’t the only changes coming for vaccines. Although it won’t become available to the general public for several years, a Cleveland Clinic researcher’s breast cancer vaccine should meet a major milestone by the end of 2015 — initiating clinical testing in women.
Vincent Tuohy, PhD, showed the vaccine to be very effective in preclinical studies. It is designed to prevent triple negative breast cancer, the deadliest form of this disease — and the most common form occurring in women with high genetic or familial risk.
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