The Remarkable, Humbling and Inspiring Nature of Research
The evolution and importance of research at the UF College of Medicine – Jacksonville.
Recently, “clinical trials” for vaccines and “personal protective equipment” for health care workers have become part of our daily conversations. We previously didn’t give nearly as much thought to these phrases. But because of the novel coronavirus, we have come to understand their importance in the systems that deliver quality care to patients in need.
There is also a need to better address health inequities — gaps that UF Health Jacksonville and the University of Florida College of Medicine – Jacksonville have a tradition of trying to fill for patients in minority and low-income groups. However, what many people still may not realize is that clinical trials and research required for much-needed medical treatments have been taking place at the college for well over 20 years.
Moreover, research on campus can trace its roots back to 1925, when the first residency program in the state launched — a surgical residency at what was then Duval Hospital. Over the intervening years, the campus’ academic endeavors came to affiliate with the University of Florida in Gainesville. In 2002, it became an independent campus in the UF system and the College of Medicine – Jacksonville was created.
“At that time, a benefit was that we could attract more research funding for our independent campus,” said Robert C. Nuss, MD, a retired gynecologic oncologist who served as the first dean of the College of Medicine – Jacksonville.
“We frequently had multi-institutional clinical trials for the effectiveness of estrogen and progesterone replacement therapies, many led by Dr. Andrew Kaunitz,” Nuss said, referring to the longtime professor of obstetrics and gynecology. “And there were studies in cardiology, emergency medicine and pediatrics, many of them funded by the National Institutes of Health, with some of our research receiving grants from other sources.”
Dominick Angiolillo, MD, PhD, a professor of medicine and director of cardiovascular research at the college, says more recent research has been conducted to assess genetic profiles to individualize treatment in cardiology.
“This is an area of great interest, not only to our physicians and patients, but also to professionals at health care systems throughout the world,” said Angiolillo, whose cardiovascular research has impacted the way patients are treated worldwide. “We test the DNA of patients who require cardiac stent procedures and integrate this information with other clinical variables to make better-informed decisions about prescribing blood-thinning medications.”
BUILDING A RESEARCH INFRASTRUCTURE
Mobeen Rathore, MD, is a professor and associate chair of pediatrics and pediatric infectious disease specialist who led the launch of a program in 1991 to provide clinical services to children with HIV/AIDS and their families. It was part of the first NIH grant for the UF Health Jacksonville campus and became the largest clinical research program at the college. Rathore said that development necessitated the creation of a research infrastructure on campus.
“Because of our work in HIV/AIDS research and the existence of a strong clinical infrastructure, combined with sound management, we have been invited to be part of the NIH-funded COVID Vaccine Prevention Network and the COVID-19 Prevention Network,” Rathore said. “We will be conducting coronavirus vaccine, prevention and treatment trials at our COVID research center.”
Phyllis Hendry, MD, a professor and associate chair of research for emergency medicine, said building an infrastructure for emergency medicine research was her initial goal when she formally started the division in 2008.
“I’m an organizer and each research study requires pulling together a multidisciplinary team of doctors, coordinators, pharmacy, nursing, Institutional Review Board and budgetary staff,” Hendry said. “This infrastructure led to the first NIH KL2, K23 and R01 awards for our college and millions of dollars in new funding for private and federal grants and industry clinical trials that have improved sepsis, COVID-19, post-traumatic stress and pediatric care and the development of new nonopioid approaches to pain management at local and national levels.”
The infrastructures Rathore and Hendry speak of are part of an “ecosystem” now considered foundational to the college’s research efforts. That ecosystem, which includes the Center for Data Solutions and Center for Research Training, is the base on which all research programs are now built, according to Tina Bottini, senior assistant dean for research.
However, that infrastructure would be meaningless if not for the “dedication of people,” says Mark Hudak, MD, a professor and chair of pediatrics and chief of neonatology.
“Our studies in neonatology with newborns in the Neonatal Intensive Care Unit depend greatly on nursing, medical staff and pharmacy to work with patients, families and each other,” Hudak said. “That involves getting a family’s approval, explaining aspects of research throughout the process, getting the medication doses right and all the information recorded correctly. The paperwork is extremely important, and our group is equally expert at that and at patient care. It’s a delicate balance in the NICU, and infrastructure wouldn’t matter unless we had fantastic people. And we do have fantastic people.”
Hudak and the pediatrics research team have pioneered the use of surfactant treatment for newborns with life-threatening lung conditions. It is now the standard of care internationally.
In addition to a solid infrastructure and talented, dedicated personnel, stakeholders cite the college’s location as its primary appeal for doing research.
“We’re in an urban setting with a variety of patients across different age, ethnic and socioeconomic groups. And based on this, many people will say UF College of Medicine – Jacksonville is a good place to conduct research,” said Alexander Parker, PhD, an epidemiologist, the college’s senior associate dean for research and director of precision medicine.
“I politely correct them that this is a vital place to do research,” Parker said. “The COVID-19 pandemic has laid bare the longstanding inequities in our nation’s health care system, and this includes our research activities. What worries me is that exciting new technologies like genomics, telehealth and machine learning have the potential to make these inequities worse if we are not careful. That is why our research teams, both past and present, are so extremely important. Our deep commitment to conducting research that will advance care for the most vulnerable members of our community is remarkable, humbling and inspiring.”
Visit History.UFHealthJax.org to learn more about our diverse history.