Grand Rounds Report: Synergies with Pharma?

by Academy of Clinical Excellence on October 6, 2009

The Medical Grand Rounds on September 22 was different than many of the others I have attended. Not only was there not a patient present, but there was not even really a specific disease discussed. The presentation, by Dr. Bruce Bochner, Professor of Medicine and Chief of the Division of Allergy and Immunology, focused on the way in which his own relationship with the pharmaceutical industry has been a synergistic one, advantageous to his own professional growth and how it has resulted in research that might not have otherwise been possible. As disclosure, he acknowledged that he is a consultant to ‘Pharma’ and that he has several grants supporting his work from the pharmaceutical industry.
The domain of clinical excellence that was touched on in this Grand Rounds was the scholarly approach to clinical practice. Dr. Bochner presented the case of a 52-year old man who was incidentally was found to have a white blood cell count of 42,000 - with 95% of them being eosinophils. Eosinophils are blood cells that are part of our immune system that combat infection (particularly parasitic infection) and control mechanisms associated with allergy and asthma. While caring for this patient, and with the patient’s consent, he set out to try to learn something new about eosinophil pathophysiology. In particular, he hoped to use this patient's blood (which was chock-full of eosinophils) to identify a new ‘eosinophil-specific’ molecule. The pharmaceutical company had the equipment, personnel, and finances to support this venture. Traditional research funding mechanism would not have been as supportive given the lack of specificity of the research question and hypothesis. The happy end to the story was the identification of ‘Siglec-8’ which is found on the surface of eosinophils. Further work has led to the development of antibodies against Siglec-8 which have the potential to be useful in diseases that are characterized by a surplus of eosinophils.
Dr. Bochner’s presentation reminded me that clinically excellent physicians in academia understand that scientific discovery can start with a single patient. In caring for patients and through collaborations with our researcher colleagues, we have the opportunity to improve our understanding of human disease for the benefit of the patients that we serve today and those that will see us tomorrow.
There were some comments at the end of the presentation related to concerns and unfavorable consequences that might arise from interactions with ‘Pharma’. This controversial discussion was intentionally left out of this post in an effort to appreciate Grand Rounds through the lens of clinical excellence.
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