Applied medical research for health care

In the early 1970s, in a small laboratory in southern Maine, Dr. Robert Ritchie discovered a new way of diagnosing arthritis that revolutionized laboratory testing around the world. The new method was more reliable and more complete. It greatly expanded the number of substances that could be rapidly tested in blood samples to give a more complete picture of how severe the arthritis was.

As more experience was gained with the new test, it became apparent that it provided useful information for a variety of other medical conditions as well. This led to a shift in research toward determining how computers could be programmed for interpreting the multiple laboratory measurements performed on each individual. The resulting “expert system” design became a prototype in the field of clinical medicine. This testing approach, linked to the interpretive program, is still in use today.

This research and testing program is available to every physician in Maine today through the efforts of the Foundation for Blood Research (FBR). The foundation, located in Scarborough, was founded by Dr. Ritchie and his colleagues in 1977. Its emphasis is on applied research, aimed at supporting health care providers in their daily activities – a natural outgrowth of the fact that its two founders’ had extensive experience in the practice of medicine as well as in the laboratory.

The foundation is a member of the statewide Maine Biomedical Research Coalition. Other Coalition members include The Jackson Laboratory, the Maine Medical Center Research Institute, the Mount Desert Island Biological Laboratory and the University of New England’s College of Osteopathic Medicine. These five institutions are on the cusp of the genetics revolution, and are growing in research projects, in employment, and in economic impact. In the last year alone they have attracted over $50 million in federal and private research grants to Maine.

Here are some examples of the research taking place at the Foundation for Blood Research in Scarborough. In the early 1980s, the Foundation’s scientific staff was asked to develop a test in blood or saliva for measuring how much nicotine was being taken into the lungs of smokers as well as into the lungs of non-smokers who were exposed to second-hand smoke.

The request was made by a collaborating scientist at London University who wanted to use the test as a more accurate way to measure cigarette smoke-related risk of disease. The test, called the cotinine test, was successfully developed and shared. FBR’s research staff then used the test over the next 10 years in several studies involving pregnant women, infants, and children with asthma. One of the studies for smoking cessation during pregnancy – in which women throughout Maine participated – was the largest in the world,.

FBR recently reported a study on mothers’ thyroid function during pregnancy. The research analyzed how frequently thyroid deficiency might occur in pregnant women and what the consequences might be. It was found that two out of every 100 pregnant women demonstrate some degree of thyroid deficiency, as measured by laboratory testing. Only occasionally, however, do the pregnant women with this problem have obvious symptoms. Only later does the thyroid deficiency worsen sufficiently to make the woman unwell.

The study found that two out of three women with thyroid deficiency during pregnancy become permanently thyroid deficient, and that it takes an average of five years to make the diagnosis clinically. The results of this study indicate that thyroid testing ought to become a routine part of prenatal care.

Last year, the Centers for Disease Control (CDC) in Atlanta asked FBR’s scientific staff to help develop a model system for evaluating genetic tests. The goal of this three-year project is to develop and implement an in-depth method for collecting and assembling relevant genetic information in a way that allows policy-makers at the national and regional levels to base their analyses and understanding on the best available scientific evidence. This project makes use of the range of skills developed by our research group over the past 20 years – knowledge of laboratory techniques, quality assessment, data analysis, and screening concepts.

Research is only good if it is used. For that reason outreach education has always been a part of the foundation’s activities. We use our scientific staff’s knowledge of immunology, genetics, and data analysis to provide support to biology teachers at the secondary school level in schools throughout Maine. The program is called ScienceWorks, and it provides summer institutes, curriculum units, a learning laboratory for teachers and students, and an equipment donation program to which hospitals, biotechnology businesses, colleges, and our colleagues in the Biomedical Research Coalition, all contribute.

Success leads to more grants, more hiring, and more space needs. It is the same phenomenon that is being experienced by our other four partners in the Maine Biomedical Research Coalition. Last year the Governor and Legislature appropriated $10 million to support biomedical research activities. This state investment has already been rewarded with over $50 million in outside grants to the members of the Biomedical Research Coalition. This will lead to 200 new, well-paying, year-round jobs in Maine over the next five years. So biomedical research is not just an investment in our health, it is also an investment in our economy.

For further information about the Foundation for Blood Research, please visit our Web site at www.fbr.org.

James E. Haddow, M.D. is vice president and medical director of the Foundation for Blood Research.