NIDCR 2030, a strategic visioning initiative, began with the launch of an interactive website in March to solicit ideas about future directions for NIDCR-supported research in five key areas:
- Integrating oral health with overall health
- Developing precision prevention, treatment, and public health interventions
- Monitoring health and treating disease in real time using devices in and around the mouth
- Taking advantage of the body’s ability to heal itself through autotherapies
- Building/fostering a multi-disciplinary and diverse dental, oral, and craniofacial research workforce
The website attracted more than 4,000 visitors. Hundreds of ideas, comments, and votes were submitted by the June 2 deadline. This public input is accessible at nidcr2030.ideascale.com. A panel of NIDCR staff is now reviewing the submissions, which will be considered when setting future research priorities and funding opportunities.
Using data from the National Health and Nutrition Examination Survey, staff in NIDCR’s Office of Science Policy and Analysis, in collaboration with a University of Maryland School of Dentistry researcher, found that both untreated caries and severe dental caries in young children decreased significantly between the period 1999-2004 and the period 2011-2014. Caries also declined in preschool-aged children in low-income families, while the prevalence of caries remained mostly stable in older children and adolescents. The findings were published online on June 13 in the Journal of the American Dental Association.
In a National Academy of Medicine paper published on June 23, Dr. Nadya Lumelsky and co-authors outlined the proceedings of an October 2016 workshop on the state of the science in regenerative medicine, convened by the National Academies of Sciences, Engineering, and Medicine’s Forum on Regenerative Medicine. Among other topics, the workshop highlighted the fact that while the number of regenerative medicine products in the clinical pipeline and on the market are increasing, the industry needs to improve procedures for optimizing and standardizing cell sources, cell manufacturing protocols, and safety and efficacy testing for cell-based regenerative medicine products. A June 2017 workshop titled Navigating the Manufacturing Process and Assuring the Quality of Regenerative Medicine Therapies included further discussions to address these issues.
In an NIDCR Clinical Research Fellowship Grand Rounds on March 17, Debra Houry, MD, MPH, director of the National Center for Injury Prevention and Control at the Centers for Disease Control and Prevention, highlighted how dental and medical providers might improve prescribing practices to address the opioid overdose epidemic. Dr. Houry advised practitioners to consider alternatives to opioids, including non-steroidal medications or non-drug therapies. When necessary, providers should prescribe fewer quantities of opioids at lower doses. Dr. Houry’s talk was featured in the NIH Record and can be accessed on the archived webcast. For the May 19 Grand Rounds, Richard Schneider, MSc, PhD, associate professor at the University of California, San Francisco School of Medicine, discussed his research on molecular signaling mechanisms in the developing jaw that link form and function during development, disease, and evolution. NIH staff can access his talk on the archived webcast.
The NIH History Office recently released a transcribed interview in which Dr. Abner Notkins, chief of NIDCR’s Experimental Medicine Section, recounted his early life, education, and 56 years of research at NIH. The interview traces the course of his research from his start at the National Cancer Institute to the present day, where his lab focuses on the role of antibodies and autoantigens in the development of autoimmune diseases.
H.R. 244 “Consolidated Appropriations Act, 2017” was signed into law on May 5 and provides a budget of $34.084 billion for NIH—representing a $2 billion (6.2%) increase over FY 2016–and $425,751,000 for NIDCR, an increase of $12.9 million. The FY 2018 President’s Budget request was released on May 23, and it included a proposed FY 2018 budget for NIH of $26.9 billion and $320,749,000 for NIDCR.
Francis Collins, MD, PhD, Re-Appointed as NIH Director
On June 6, President Trump re-appointed Dr. Francis Collins as NIH director. Dr. Collins was originally sworn in on August 17, 2009, as the 16th director of NIH.
In presentations to Congress, Dr. Francis Collins and directors of several NIH institutes described NIH’s biomedical research investments and highlighted the scientific opportunities on the horizon. They met with the House and Senate Appropriations Subcommittees on Labor, HHS, Education, and Related Agencies on May 17 and June 22, respectively. At the Senate hearing, Dr. Collins discussed the FY 2018 budget request and described some of the medical research taking place to combat diseases. The leaders outlined their respective work in areas such as diabetes, Alzheimer’s disease, cystic fibrosis, cancer research, and opioid addiction.
On June 8, NIH Director Dr. Francis Collins announced the launch of the Next Generation Researchers Initiative, a new approach designed to bolster support for early-stage and mid-career investigators. The initiative was developed to address longstanding challenges faced by researchers trying to launch and sustain independent research careers. The initiative will take a multi-pronged approach to increase the number of NIH-funded early-stage and mid-career investigators, stabilize the career trajectory of scientists, and enhance the potential of the next generation of researchers.
As announced on May 2, NIH and the US Food and Drug Administration have created a template to help facilitate the FDA review process for NIH-funded clinical trial protocols. The template, which is initially aimed at Phase 2 and 3 Investigational New Drug (IND)/Investigational Device Exemption (IDE) protocols, meets International Council for Harmonisation E6 (R2) Good Clinical Practice Guidance. The template will help investigators prepare protocols that contain all information needed for efficient and timely review by institutional review boards as well as compliance with FDA regulations. The template is the latest in a series of achievements announced to reform clinical research by improving the quality, relevance, feasibility, efficiency, accountability, and transparency of NIH-funded clinical trials.
On July 7, Dr. Brenda Fitzgerald was appointed as the 17th director of the CDC and as the administrator of the Agency for Toxic Substances and Disease Registry. Dr. Fitzgerald previously served as the commissioner of the Georgia Department of Public Health and state health officer from 2011 to 2017. Dr. Fitzgerald is a board-certified obstetrician-gynecologist and has practiced medicine for three decades. She holds a bachelor of science degree in microbiology from Georgia State University and a doctor of medicine degree from Emory University School of Medicine. She completed post-graduate training at the Emory-Grady Hospitals in Atlanta and held an assistant clinical professorship at Emory Medical Center. As a major in the US Air Force, Dr. Fitzgerald served at the Wurtsmith Air Force Strategic Air Command Base in Michigan and at the Andrews Air Force Base in Washington, DC.
Dr. Scott Gottlieb was sworn in as the 23rd commissioner of the FDA on May 11. Dr. Gottlieb is a physician, medical policy expert, and public health advocate who previously served as the FDA's deputy commissioner for Medical and Scientific Affairs and before that, as a senior advisor to the FDA commissioner. He completed a residency in internal medicine at the Mount Sinai Medical Center in New York and is a graduate of the Mount Sinai School of Medicine and of Wesleyan University in Middletown, CT, where he studied economics.
Dr. George Sigounas became administrator for HRSA on May 1. HRSA is the primary Federal agency for improving health care to people who are geographically isolated, or economically or medically vulnerable. Before coming to HRSA, Dr. Sigounas spent 23 years as professor of medicine at the East Carolina University’s Brody School of Medicine in Greenville, NC, where he helped establish the Bone Marrow Transplantation Program. Prior to that, Dr. Sigounas was a scientist and researcher at NIDCR and the Naval Medical Center. Dr. Sigounas earned his bachelor of science degree in biology and chemistry from the University of Patras in Greece, a master of science in physiology and biology from Northeastern University, and a PhD in cell biology and physiology from Boston University.
Dr. Alfred C. Johnson was appointed as NIH deputy director for Management on May 28. Dr. Johnson had been serving as the NIH acting deputy director for management since May 2016. Before joining the NIH Office of the Director leadership team, Dr. Johnson was the director of the NIH Office of Research Services (ORS), a position he held since 2006. Before joining ORS, Dr. Johnson held several leadership positions at NIH including assistant director in the Office of Intramural Research, acting director of the Office of Loan Repayment and Scholarship, and principal investigator in the Laboratory of Molecular Biology, Center for Cancer Research at the National Cancer Institute. He joined NIH in 1985 as an American Cancer Society postdoctoral fellow. Dr. Johnson received a bachelor of arts in chemistry at Albany State University in 1979. He completed his PhD in biomedical sciences at the University of Tennessee in 1985 and conducted his doctoral research at the biology division of Oak Ridge National Laboratory.
HHS and NIH Announce Strategies for Fighting Opioid Crisis
In April at the National Rx Drug Abuse and Heroin Summit in Atlanta, HHS Secretary Thomas E. Price, MD, announced the HHS strategy for fighting the opioid crisis.
The strategy will focus on:
- Improving access to treatment and recovery services
- Promoting use of overdose-reversing drugs
- Strengthening our understanding of the epidemic through better public health surveillance
- Providing support for cutting-edge research on pain and addiction
- Advancing better practices for pain management
As part of the strategy, HHS announced $485 million in grants to every state for evidence-based prevention and treatment activities. The grants are funded by the 21st Century Cures Act and distributed through the Substance Abuse and Mental Health Services Administration.
NIH is supplementing these efforts with a public-private collaborative research initiative on pain and opioid abuse. In April, NIH Director Dr. Francis Collins met with research and development leaders from biopharmaceutical companies to discuss new ways for government and industry to work together to address the opioid crisis. The initial plan for this initiative was recently laid out by Dr. Collins and National Institute on Drug Abuse Director Nora D. Volkow, MD, in the New England Journal of Medicine. In June and July, NIH convened experts from government, industry, and academia for a series of meetings to identify scientific strategies with the greatest potential for solutions to the opioid problem.
On May 31 and June 1, the NIH Pain Consortium (of which NIDCR is a participant) convened the 12th Annual NIH Pain Consortium Symposium: Multidisciplinary Strategies for Pain. The meeting highlighted advances in research on prevention of chronic pain and multidisciplinary pain care. This annual symposium features NIH-supported pain research from the more than 20 NIH institutes, centers, and offices that participate in the NIH Pain Consortium. To learn more, access the agenda and webcast.
HHS is soliciting written comments on the proposed framework for Healthy People 2030. The Healthy People initiative provides science-based, 10-year national objectives for improving the health of all Americans. Members of the public—including individuals, stakeholders, and organizations—are invited to provide comments on the Healthy People 2030 framework, including its vision, mission, foundational principles, plan of action, and overarching goals. This round of public comment will be open through September 29, 2017.
The All of Us Research Program announced June 5 that researchers had begun enrolling the first participants as beta testers of the program. The program consists of a nationwide team of universities, medical centers, and technology companies that will collect data, blood, and urine samples, as well as information about participants’ health, lifestyles, and environments over the course of many decades to create a research resource to drive future discoveries. The beta phase will start at one site and will gradually expand to more than 100 sites, with an aim to enroll at least 10,000 people across the country. The beta phase is intended to test the systems and processes and fix any problems that arise. A national launch is anticipated for late fall or early next year, with the goal of building a national research cohort of 1 million or more US participants.
Despite medical advances, cancer often remains an elusive foe. A major reason is treatment resistance coupled with metastasis. New NIDCR-funded research adds to growing evidence that the underlying culprits may be cancer stem cells, a type of tumor cell. UCLA School of Dentistry scientists led by Cun-Yu Wang, DDS, PhD, found that targeting cancer stem cells holds promise for overcoming treatment resistance and metastasis of squamous cell carcinoma, at least in mice. The results suggest that combination therapies that target both cancer stem cells and the tumor bulk may be more effective than chemotherapy alone in preventing drug resistance and metastasis in this cancer.
In a proof-of-concept case study published in the New England Journal of Medicine, first author and NIDCR intramural researcher Niki Moutsopoulos, DDS, PhD—along with colleagues from NIDCR, the National Institute of Allergy and Infectious Diseases, and outside institutions—reported the successful treatment of a patient with leukocyte adhesion deficiency (LAD). LAD is a rare, inherited disorder that causes recurrent bacterial infections and severe gum disease. Patients often lose their teeth early in life, and better treatments are needed. Earlier mouse studies suggested that interleukin (IL)-17, which is found at abnormally high levels in LAD, may play a key role in the disease and that blocking activity of IL-17 or a molecule in the same pathway called IL-23 may be an effective treatment. Dr. Moutsopoulos and colleagues used an FDA-approved drug for psoriasis that blocks IL-23 to treat a 19-year-old LAD patient. A year of treatment resolved the patient’s non-healing skin wound and significantly improved oral inflammation. The case study was also highlighted in an accompanying editorial titled “Breaking a Vicious Cycle,” as well as a video about LAD.
As part of their research on osteoporosis, scientists from the UCLA School of Dentistry and UCLA Broad Stem Cell Research Center sent 40 rodents to the International Space Station (ISS) on June 3, where the animals are receiving injections of an experimental drug that is engineered to diminish bone loss. The project is being done in collaboration with NASA and the Center for the Advancement of Science in Space, which manages the US National Laboratory on the space station. In 1996, supported by an NIDCR grant, Kang Ting, DMD, DMSc, discovered NELL-1, a protein that helps build bone and prevents it from breaking down. Along with Chia Soo, MD, and Ben Wu, DDS, PhD, Dr. Ting has spent the past 18 years studying the protein and enhancing its potential to treat bone loss and regenerate new bone. Since bone loss accelerates in space, the ISS is an ideal environment to test NELL-1’s effect on bone remodeling. NIDCR continues to support this work through a recently awarded K08 Mentored Clinical Scientist Development Award to Jin Hee Kwak, DDS, MS, in which Drs. Soo, Ting, and Wu are co-mentors.