Recently, 100 basic scientists and neurosurgeons from all across Europe, Australia, Canada, and the United States gathered for a three-day meeting in Kartause Ittingen, Switzerland to discuss the "State of the Art in Spinal Cord Injury Research and Clinical Application." It was the first-ever meeting of its kind bringing together the research networks of the three largest free-standing research funding organizations in the world -- Christopher and Dana Reeve Foundation, International Spinal Research Trust, and International Institute for Research in Paraplegia.
Susan Howley, our Foundation's vice president of research, and one of the motivating forces behind the conference, shares her first-hand account.
Barbara Moore, PhD and Susan Howley Director of Research, Reeve Foundation on Monastery grounds.
Our meeting is in an old monastery just outside of Zurich. It's now a working farm, owned by a private foundation that maintains it as a meeting center. They grow all their own vegetables and fruits. The food is awesome! It's beautiful, and inexpensive -- we always worry about money!
We are secluded, and there is nothing to distract us from the business at hand. It's a wonderful place for off-line conversations and walks. Some of the best science gets discussed in just these kinds of settings.
Getting on the Same Page
The idea for this historic gathering came a year-and-a-half ago when we brought our Research Consortium together with investigators from our North American Clinical Trials Network. We asked them to talk to each other about the realities of spinal cord injury, as they, the basic scientists and the neurosurgeons, perceive it. I admit to a lot of nervousness before that meeting; in fact, I was afraid it might be disastrous. After all, could such brilliant people from two very opposite ends of the spinal cord spectrum find common ground and understanding?
But, it was fabulous! They never stopped talking. That daylong meeting gave rise to this much larger Kartause Ittingen meeting of clinicians and scientists. It's a relatively new thing in spinal cord injury research, bringing the medical and science communities together, but it's a critical step in the right direction.
From Bench to Bedside
Why is it critical? Basic scientists need to have an understanding of the realities of the human condition. Without that intersection between basic science and the clinic, discoveries made at the research bench may have little relevance or application to the real-life human situation and developing effective therapies.
Think about it: There are mice walking in labs all over the world. Sadly, the same can't be said for those who are spinal cord injured. Why? Certainly one of the reasons is that it is very difficult to translate lab successes to humans. Lab animals are not people and their injuries don't faithfully mimic the chaos of a human injury or anticipate the human response to injury and subsequent interventions. These kinds of meetings are in attempt to fill that void.
New Scientists, New Techniques
One of the wonderful things going on here is that there are a lot of young scientists. They are very excited about how rapidly research is approaching a point where we can reasonably expect to begin to deliver some effective treatments soon, particularly in the acute phase of injury. It makes them hungrier to do good cutting-edge work.
An insistent drumbeat at Kartause Ittingen is the need for more sensitive outcome measures for people. Most available measures are so insensitive that the scientists who think about clinical trial design fear they will be unable to detect the small incremental improvements likely to emerge from these early therapies. It is a real possibility that an intervention might foster a small improvement that will be missed because of insensitive outcome tests. The good news is that bright people all over the world have begun to systematically develop new measures to test recovery of function.
I hope the meeting participants go home thinking about the new ideas and concepts they heard and that new collaborations and research paths will emerge from it all. It's hard to imagine that the excitement and energy of these three days won't have a lasting impact.