By Mark Lebwohl, MD, October 01, 2015
We’ve all seen it happen before our eyes. A study is funded to examine a particular disease, and researchers end up discovering the pathogeneses for another disease. It’s a common process in therapeutic discovery, and while it may not be what was intended by those who funded that research, it’s undeniably remarkable. So there is no denying that medical research funding is an extremely high priority for the entire medical community. This is an important message for those who control medical research appropriations in our country. As such, it’s a message that I recently took to Capitol Hill.
In August, I teamed up with Dr. Stephen Katz, director of the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), to educate several members of Congress about the past and future value of medical research. We met with Reps. Charlie Dent (R-Pa) and Chuck Fleischmann (R-Tenn.), and Sens. Dick Durbin (D-Ill.), Jack Reed (D-R.I.), and Bill Cassidy (R-La.) and I must say, they were all extremely receptive to the importance of research in skin disease.
Dr. Katz and I pointed out that just in the last decade, research has led to new treatments for conditions like psoriasis that have had a tremendous impact not only on psoriasis patients, but patients with other severe diseases like rheumatoid arthritis, Crohn’s disease, ulcerative colitis, sarcoidosis, and a host of others. But these treatments didn’t start with a clear research path. Dr. Katz pointed out that this work started in NIH-funded basic science labs that discovered a molecule called cachectin that was first detected in animal cancer models. Now, years later, that molecule is called tumor necrosis factor (TNF) and we now know that it plays a major role in the development of a number of diseases including psoriasis. Who would have ever thought that this finding in laboratory mice would lead us to treatments for psoriasis? Dermatologists were certainly at the forefront of developing biologics that targeted TNF alpha for the treatment of psoriasis, and those treatments have subsequently been used for many other diseases as well.
I also discussed a personal interest of mine, a condition called pseudoxanthoma elasticum (PXE) in which patients develop calcification of elastic tissue, leading some patients to develop myocardial infarctions at an early age and to develop a form of blindness that affects mostly elderly people. Dermatologists were able to find the cause of PXE thanks to work that was funded by NIAMS. That work is now helping us find a treatment which may have implications not only for PXE, but also for atherosclerotic vascular disease. There is a lot of reason to be excited about that work that was funded by NIAMS.
Unfortunately, Congress is operating under tight fiscal constraints. As you may recall, the Budget Control Act of 2011 resulted in cuts to research funding by 5 percent (sequestration). Overall, however, over the last 10 years, funding for the NIH has dropped by more than 22 percent when adjusted for inflation. However, there is a glimmer of hope. This summer, the House passed the 21st Century Cures Act, which would provide $8.75 billion in additional mandatory funding for the NIH and $550 million for the FDA. The Senate is working on its own version of a bill that will likely also include medical research funding.
The current fiscal climate requires that the medical community advocate to ensure that medical research becomes a funding priority. As such, throughout the year, the AADA works with several coalitions, including One Voice Against Cancer (OVAC) and the NIAMS Coalition, to call for increased medical research funding. Whether we are specialists, researchers, patients, or lawmakers, we all must work together to make sure the research of today leads to treatments for tomorrow.