At the Windber Research Institute, not all studies follow the traditional medicine path — that a bench scientist comes up with a clinical test and then moves it to the bedside. Instead, these researchers start in the clinic, find a niche that needs to be filled or re-examined, and then head back to the bench to develop a solution that is subsequently pushed forward into the clinic. It’s a more circular path, and one that represents the field’s hope for the promise of translational medicine.
Their modus operandi might have something to do with how this nonprofit institute was set up when it started in 2001, about 80 miles east of Pittsburg, near Johnstown, Pa. The institute opened with support from Congressman John Murtha as a means to promote technological and economic development in his Pennsylvania district. Thanks to the Congressman’s ties to the Department of Defense, Windber has since its inception worked with Walter Reed Army Medical Center. Windber also has ties to other medical centers, so its researchers are often in the clinic.
“All the programs that we have have pretty strong clinical partners, and particularly the breast cancer program which is a collaboration that we’re involved in with Walter Reed Army Medical Center,” says Richard Mural, the chief scientific officer. “We’re continually trying to take cues from real problems in the clinic and let those drive where we’re going with the research and then hopefully those findings are easier to translate back into the clinic.”
Windber has prospered from its connections to the military, both to the Department of Defense and to Walter Reed Army Medical Center. The defense department provides the institute’s main source of funding, while Walter Reed is a major collaborator. Those collaborative projects helped build the strength of Windber’s core facilities. Windber has a large, highly annotated tissue repository and a strong biomedical informatics group, as well as genomics and proteomics core areas that focus on women’s health, cardiovascular disease, and aging. (Soon, the institute may be adding post-traumatic stress disorder studies to that mix.) Currently, Windber is expanding its reach to diversify not only its research areas, but also its funding sources.
Breast Cancer First
When it opened, the major focus of research at Windber was in women’s health, primarily breast cancer. With Walter Reed, the Joyce Murtha Breast Care Center, and the Windber Medical Center (located across the street), Windber Research Institute scientists began a clinical project to develop preventive treatments and refine the best approaches for breast care. This Clinical Breast Care Project takes advantage of, and highlights, the variety of Windber’s core areas, especially its tissue bank — which boasts more than 25,000 samples of serum and tissue samples, taken at different disease stages from about 3,000 breast cancer patients. Windber scientists are responsible for the more basic side of the research in the project, while the clinical collaborators continue data and sample collection.
That repository has a central role in this, and other projects, at Windber. “The goal is to collect tissue samples from the clinical arm of the program, make sure they are of good quality, and process them in ways that allow the downstream experimental processes — genomics and proteomics high-throughput research,” says Stella Somiari, who heads up the tissue bank. “Getting appropriate and adequately annotated tissue samples, and of good quality, is a number one problem for any scientist.”
In this project, the various programs at Windber work together. Mural says that even though the institute is set up like a core lab facility, scientists there try not to have strict walls between the different units. Indeed, they are still looking for the right model for the institute to follow, he says, and they are contemplating a change to a more platform-based concept.
The biomedical informatics section of the institute also backs the breast care project through its data warehouse system. Developed in conjunction with Walter Reed, the data warehouse system creates a personalized health record for each patient who contributes to the tissue bank. This data repository supports the translational medicine approach between the clinic and the lab, says Michael Liebman, executive director of the institute.
For the repository, the biomedical informatics researchers collect more than 600 data points, some from a questionnaire. But the tool they are developing hides that questionnaire in the background and instead presents the data more as a medical history. The researcher or clinician sees data broken down into modules and sub-modules, such as diagnostic testing which might contain X-rays and blood tests results, explains Hai Hu, Windber’s director of biomedical informatics. “This way, this system will not only be able to support one specific research project — let’s say the CBCP, the breast care project — it will also be to support … diabetes, cardiovascular disease, or any other disease.”
These varied approaches to studying breast disease appear to be paying off. Researchers from Windber recently submitted two abstracts to the San Antonio Breast Cancer Symposium, one looking at differential gene expression in healthy tissue and the other at a biomarker for response to herceptin, a breast cancer drug that targets only certain types of tumors. Using the bioinformatics library and proteomics capabilities, a team led by Hu identified seven genes that may explain why healthy breast tissue from African American women and Caucasian American women show the differential gene expression. They hope that this finding will lead to further understanding of why breast cancer growth in African American women is more aggressive, and why African American women have poorer prognoses. The other study, led by Liebman, assayed gene expression levels of Her2/neu, the target of herceptin, to look for a herceptin susceptibility biomarker to better predict patient response with the goal of eventually improving the drug’s treatment success rate.
Research at Windber is not limited to breast cancer, nor is the tissue bank relegated to cataloguing only breast tissue samples — the repository holds samples from healthy people as well as patients with a variety of diseases. The biomedical informatics group is fleshing out its tools to be applicable to diseases beyond the institute’s main focus.
The institute as a whole is expanding too. Windber is beginning to venture into the commercial world: earlier this year, the institute began a for-profit partnership with Strategic Medicine, which has been tasked with developing and bringing to market Windber’s intellectual property. Together, the company and Windber have partnered with Biobase to create a patient-based data model. Liebman, both executive director of Windber and president and managing director of Strategic Medicine, says this will also bring a little revenue to help sustain the research projects at the institute.
With both its established and nascent collaborations, Windber is getting bigger and expanding quickly into more fields. “It’s rapid growth, even for a startup. I think we have a lot of the growing pains of a startup,” says Mural.
Name: Windber Research Institute
Leadership: F. Nicholas Jacobs, president and CEO; Michael Liebman, executive director
Established: The institute opened in 2001, and moved to a larger 36,000-square-foot facility in 2005
Staff: 55 people, including scientists, fellows, and associates
Funding: The institute’s main source of funding is the Department of Defense, though it has smaller grants from other federal agencies and the Susan G. Komen Breast Cancer Foundation
Key research areas: Windber focuses on translational research into women’s health, especially breast cancer, as well as cardiovascular disease and aging
Core facilities: The institute’s major facilities include tissue banking, biomedical informatics, genomics, and proteomics
Notable collaborations: Windber works closely with Walter Reed Army Medical Center, Windber Medical Center, and the Joyce Murtha Breast Care Center