The Orlando Medical News caught up with Steven Smith, MD, soon after he started his new post as executive director of the Florida Hospital-Burnham Clinical Research Institute (CRI) and asked him about his decision to move to Orlando, what initially piqued his interest about studying the correlation of obesity and diabetes, and his game plan for the new institute. The CRI will be located on Princeton Street and will serve as the gateway to Florida Hospital's Health Village, an area being developed around Florida Hospital Orlando for medical space, residential areas, and retail. The two-year project should begin with a groundbreaking event during the first quarter of 2010.

 

 

There's a huge gap between the discoveries in the basic sciences and the application of this knowledge in clinical care. The partnership between Florida Hospital and the Burnham Institute for Medical Research will fill that gap through what we call translational research. The idea is to use these discoveries and new technologies to better understand how and why some people become obese and develop diabetes. So many people with diabetes go on to develop cardiovascular diseases like heart attacks, stroke and heart failure. We're spending a huge fraction of our healthcare dollars to treat these diseases. To build a new institute that focuses on translational research is an exciting opportunity. Our discoveries will ultimately change how we practice medicine in Orlando and across the United States.

 

In the short run, I'll move my basic science lab over to the Burnham and start the process of building the CRI. Initially, we're focused on two key areas: infrastructure and people. The kind of high-tech research that we'll conduct at the CRI takes special equipment. For example, special rooms will have to be designed and constructed for people to come and stay so we can measure metabolism. We'll also use advanced magnetic resonance spectroscopy to probe metabolism. But it takes more than gizmos in a building to make progress in research. We'll recruit first-class physicians and clinical scientists from across the United States and even abroad who are experts in metabolism and diabetes. Creative, talented, and innovative scientists make a successful clinical research institute. I've been very impressed with the talent at Florida Hospital and a vision for what is possible. We've assembled a super multi-disciplinary team and are off to a great start. 

 

I started doing research in obesity and diabetes about 15 years ago, when the epidemic was just taking off. At the time, many believed it wasn't a legitimate field of study and that all we needed to do was to get people to put down the fork and push away from the table. About that same time, we discovered that fat cells make a hormone that regulates body weight and began to learn more about how the body controls metabolism, just like it controls blood pressure. These discoveries 'legitimized' the research and as the epidemic expanded – 60 million American adults are now considered to be overweight or obese – people became more interested in understanding why some people are susceptible to our rich environment. Obesity accounts for 9.1 percent of annual healthcare spending in the United States, nearly $150 billion a year!

 

We published a paper a few years ago that showed that our ability to burn fat (or not) is programmed into our cells. This surprised quite a few people, but researchers are beginning to understand how this programming works. We continue to work in my lab to tease out the molecular differences that turn off fat burning. I've already established collaborations at Burnham that we believe will lead to new treatments to turn on the ability to burn fat. This has been to many the Holy Grail and the technological resources at the Burnham will help us get there faster.

 

Just like the fingerprints on our fingers, we each have a unique pattern of genes that are turned on and off, and different patterns of metabolites in our blood. Our initial approaches were pretty sophisticated at the time, but the new cutting-edge analytic technologies of the Burnham will really accelerate our progress in this area. Kind of like the difference between a Corolla and a Lamborghini! When we combine that horsepower with the ability to understand metabolism in greater detail, this combination will synergize and move us ahead faster towards a more 'personalized' approach to treating obesity and diabetes.

 

The key word in biomedical research these days is "multi-disciplinary." Gone are the days when a single scientist in a lab working alone can make the big breakthrough. It takes teams of scientists working on a problem from several different angles to make the big discovery; from genes to cells to mice and importantly on into man. Genomics, proteomics, transcriptomics, and epigenomics–these are all new tools developed in the last decade. No one person can keep up with all that technology. Matrixed, interdisciplinary teams are "in" and especially powerful when we can use multiple approaches to study real people in a clinical research institute like the CRI.