‘These Breakthroughs Would Not Be Possible without Continuous Curiosity’.
Discovery-based science, precision medicine, and genomics present unprecedented opportunities for the future of health and health care, as clinical and science experts seek innovative ways to prevent, diagnose, and treat chronic diseases.
On Wednesday, February 27, the School of Public Health will host the Public Health Forum “Advancing Discovery Science for Public Health Impact,” featuring Gary Gibbons, director of the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health (NIH). The third-largest institute at the NIH, the NHLBI provides global leadership for research, training, and education programs to promote the prevention and treatment of heart, lung, and blood diseases.
“It is a challenge and a great privilege to guide the NHLBI in responsible stewardship of a research agenda that supports groundbreaking research in heart, lung, blood and sleep science,” says Gibbons, who has led the institute since 2012.
Ahead of the Public Health Forum, Gibbons spoke about his strategic vision for the NHBLI and the institute’s embracement of data science and implementation science to reduce health disparities and predict or prevent health disorders and diseases in the 21st century.
What is one way discovery science will advance the mission and goals of the NHLBI in the next 5 to 10 years?
NHLBI’s legacy of excellence is sustained by valuing fundamental discovery science and maintaining a balanced research portfolio across the translation spectrum—from bench to bedside to neighborhoods. This spectrum begins with basic science, takes us through clinical research, and ultimately informs and is informed by implementation science in the clinical setting and communities. Our Strategic Vision, shaped by extensive and interactive engagement with our research community, guides our institute-initiated scientific activities to align with the needs and new directions in the community. Seminal discoveries in normal biology and pathobiology from basic research and observational studies, novel findings related to the molecular basis of disease, new understandings of genetics and omics profiles, and data science and emerging technologies have the potential for personalized risk assessment, novel drug targets, and much more to advance research that will realize the promise of precision medicine, and, one day possibly predict, prevent, or even preempt heart, lung, blood and sleep diseases and disorders.
What are some of the main challenges that data science and precision medicine face? How can discovery science and precision medicine support the prevention, diagnosis, and treatment of heart, lung, and blood diseases without compromising patients’ privacy and security?
Precision medicine can inform treatment that addresses both individual and population differences; it can offer insights into improving disease detection, classification, and treatment; it can uncover interactions between social determinants of health, clinical, and other factors that affect populations facing health disparities or sex-specific risks. The ability to integrate data across environmental, clinical, imaging, and genomic areas creates a challenge for biomedicine in the digital age—how to move from data to knowledge, and from knowledge to action to enhance patients’ day-to-day lives.
For example, consider hypertension care in health systems: How can we enable learning health systems to identify patients with hypertension who are most likely to benefit from more intensive treatment with the lowest risk of harm and implement innovative strategies to ensure evidence-based treatment to lower blood pressure? The new tools of computation, imaging, and high-throughput molecular analysis provide unprecedented opportunities to answer questions such as these, and revolutionize clinical research and practice as we know it, but they will require constant refinement as we enhance patient needs and care.
Disparities exist not only in chronic diseases, but also in access to health information, services, and technology. What can be done to expand access to health services, such as genetic testing, so that all people have the ability to benefit from advances in science?
Research increasingly tells us that neighborhood, place of residence, and geography matter and that community and neighborhood factors play a role in health disparities. Precision medicine can be both geographically informed and geographically neutral. Supporting research that investigates factors that account for differences in health among populations is a core objective of NHLBI’s Strategic Vision. That support includes implementation science for community health where community stakeholders—health centers, thought leaders, civic organizations and nongovernmental organizations, among others—are actively engaged. Fostering this inextricable link between an engaged community and implementation of effective interventions will help us address these disparities on the path to achieving health equity.
As the director of the third-largest institute of the National Institutes of Health, what are the most challenging and rewarding aspects of your role, and what advice do you have for public health students who would like to pursue careers in discovery science?
The NHLBI is currently advancing research for cures for a number of rare disorders, including sickle cell disease, which is the oldest molecular disease. It is especially rewarding for me to see the promising results from new technologies such as genetic therapies on a path to curing this incredibly painful, and often deadly condition. It is my fervent hope that the groundbreaking work being done on sickle cell disease establishes a living template for future generations of clinician-researchers tackling rare diseases. But these breakthroughs would not be possible without continuous curiosity, which starts in our earliest years. As a student, I was insatiably curious, a trait that led me the lab of one of my most influential mentors at Harvard, and ultimately a research career in vascular biology. For young people entering this exciting era of discovery science, precision medicine, and rapid technological advancement, I would urge them to cultivate their continuous curiosity—to listen to that voice that is propelling them to ask “how” and “why.” It is through their curiosity—and a lot of hard work along the way—that the next major scientific discoveries will emerge and flourish.
February is American Heart Month. Can you explain what the NHLBI’s #OurHearts initiative is?
It’s well known that lifestyle changes such as regular physical activity, smart eating, maintaining a healthy weight, and avoiding cigarette smoke significantly lower the risk of heart disease and stroke. What may surprise people is that these lifestyle changes can be easier to achieve and sustain when we join with friends and family. In fact, research shows that our health improves overall when we feel connected to others.
That’s why this year’s theme—our hearts are healthier together—strikes an especially meaningful chord. We’re asking people to reach out to each other. Invite a friend or colleague to take a walk between classes, swap healthy recipes, or start a step challenge. The important thing is to be creative and make these activities fun. Because it doesn’t matter what you choose, as long as you are moving more and taking steps to reduce your risk for heart disease.
We’d love to see what you are doing around campus. Share your heart-healthy activities using #OurHearts. Post a fun picture or short video that captures how you and your partners are motivating each other. You can also visit www.nhlbi.nih.gov/ourhearts to see how other enthusiasts around the country are engaging their networks to collectively pursue heart-healthy living. Your posts might just be the inspiration someone else needs to get going.