Author: Valentina Shakhnovich, MD on March 09, 2018
Growing Up in the Reverse Translation Paradigm
I obtained my medical training before any formal training in research. My observations (and frustrations) of variability in patient drug response is what sparked my interest in therapeutics research in the first place, and what continues to motivate me as an investigator and a physician-scientist. I think it’s fair to say that reverse translational research was innate to my academic up-bringing and is pretty much ingrained in me, which is why it was such a treat to organize the Reverse Translation issue for Clinical and Translational Science. Okay, it was a lot of work, but still, a treat. #PleaseKeepReading
The theme of reverse translation runs across the ASCPT Journal Family in March 2018. Interestingly, despite the different slants on therapeutics, inherent to the individual journal identities, all three journals took a similar, broad interpretation of the term reverse translation, with the patient at the center of this research paradigm. In the reverse translation paradigm, therapeutics research becomes a seamless, continuous cycle, in which patient experiences and clinical observations lead to a new testable hypothesis, which helps direct the next iteration of mechanistic research (whether benchtop-, EMR-, regulatory-, systems-, or model-based), which leads to the next clinical trial and the next patient experience, and so on.
As highlighted in the Reverse Translation issue of CTS, the beauty of reverse translation, unlike benchtop-to-bedside research, is that there is no such thing as experimental failure*; only expected or unexpected results and the inevitable variability in the human therapeutic response that needs further explanation and exploration.
I hope readers don’t think I took too much liberty with the definition or the scope of reverse translation, but I’m curious to hear your thoughts – please comment below!
*For those of you who missed my blog “My Experiment Failed: aka I Suck at Life,” I hate failure.
Figure 1 Reverse translation research paradigm. Republished with permission from Wagner, J.A. Patient-centered reverse translation. Clin. Pharmacol. Ther. (2017). https://doi. org/10.1002/cpt.902.
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