The last century has seen enormous medical progress, but great challenges remain. Chronic diseases such as Parkinson’s and Alzheimer’s are becoming more prevalent as the population ages, and a growing number of patients present multiple diseases at the same time. This so-called multimorbidity is very difficult to address with current treatments, requiring patients to rely on a mix of medications that were never meant to be taken in combination.
In addition, some medical achievements of the past can no longer be taken for granted. The discovery of antibiotics is one of the most significant advancements of healthcare in the past century, but these “miracle drugs” are quickly losing their effectiveness as bacteria become resistant.
According to Professor Friedrich Mühlschlegel, director of the Laboratoire National de Santé, some reports indicate that in 2050 as much as 10 million people might die every year from diseases caused by drug resistant bacteria. Where did it all go wrong? Professor Mühlschlegel indicated a number of reasons, such as the overuse and inappropriate prescribing of antibiotics and the extensive use of antibiotics to treat livestock.
Further research on new classes of antibiotics is of course part of the solution, but it is not sufficient on its own. Professor Mühlschlegel also called for improved diagnostic tools and a “one health” approach that coordinates the use of antibiotics in human medicine as well as in agriculture, a step that is included in Luxembourg’s national antibiotics plan. Work with both patients and doctors is also needed to prevent unnecessary prescriptions of antibiotics.
Innovative Medicines Initiative: A broad European partnership
Such major challenges cannot be addressed by individual players but require wide, interdisciplinary collaborations. This is the mission of the Innovative Medicines Initiative (IMI), the world’s biggest public-private partnership in life sciences. Bringing together the European Union and the European pharmaceutical industry, the initiative facilitates open collaboration in research to advance the development of personalised medicines for the health and wellbeing of all, especially in areas of unmet medical need.
We really need to advance in research to understand the causes of the disease in order to know how to intervene, delay and potentially cure it.
IMI projects involve academia, pharma industry, patient organisations and regulators who work together to develop next generation vaccines, medicines and treatments. Its scope includes cardiovascular diseases, diabetes, neurodegenerative diseases, cancer and rare diseases, to mention but a few examples. The aim is to have a holistic approach, put the patient at the centre and focus on treating not only disease symptoms, but also their cause.
“The discovery of insulin in 1921 radically changed the lives of people suffering from diabetes, but it is still a mortal disease and complications are severe,” said Professor Carine de Beaufort, who represents the Centre Hospitalier de Luxembourg (CHL) in the INNODIA project that receives IMI funding for type 1 diabetes research. “We really need to advance in research to understand the causes of the disease in order to know how to intervene, delay and potentially cure it. This is why INNODIA does not only look at patients, but also studies unaffected family members who run a higher risk to develop diabetes than the average population.”
Sustainable data management
Collecting and managing digital data from this type of large studies makes it possible to undertake analyses on an unprecedented scale. The amounts of available data are massive and increasing exponentially. According to Professor Hernández Rivas from Spanish research institute IBSAL, who participates in an IMI project on the evolution of big data in oncology, the global volume of healthcare data is supposed to double every 73 days in 2020. “The quality of the data collected is essential,” said Dr Charles Betz, National Contact Point for European funding in the health area at Luxinnovation, who supports Luxembourg participants in Horizon 2020 and IMI projects. “Data also has to be hosted and managed in a sustainable way so that it is not lost after a project has ended.”
Data has to be hosted and managed in a sustainable way so that it is not lost after a project has ended.
This is where Luxembourg’s expertise comes in. “It is often difficult for data owners to keep hosting very large datasets and manage the access to this very sensitive type of information,” explained Dr Christophe Trefois from the Luxembourg Centre of Systems Biomedicine (LCSB) of the University of Luxembourg.
The LCSB has a strong reputation in biomedical informatics and hosts the Luxembourg node of ELIXIR, a pan-European infrastructure for life sciences information. ELIXIR-LU specialises in the curating and analysis of medical and translational big data. Various large initiatives, including several IMI projects, have chosen the LCSB’s state-of-the-art infrastructure for hosting their data and making sure it is sustainable for further research. The data can thus be reused for other studies and bring additional, valuable medical insight.
Capitalising on digital expertise
The IBBL (Integrated BioBank of Luxembourg) also plays a key role in several IMI projects for the storage and distribution of biological samples. The biobank has developed an e-catalogue that provides a digital overview of all samples stored to facilitate research access. The IBBL and the LCSB capitalise on Luxembourg’s outstanding digital infrastructure and expertise in handling sensitive data from the financial sector as well as from “e-embassies” installed here by other countries. Luxembourg is also investing in high performance computing infrastructure that will be available for the research and business sectors.
We also want to use artificial intelligence to revolutionise the way pathology analyses are done.
One next step for IMI is to launch a call for proposals in the field of digital pathology. “Many centres already work individually in this field, but we want to create a network of excellence that combines the data from industry and academia,” said Dr Magda Chlebus from EFPIA, the European Federation of Pharmaceutical Industries and Associations that represents the pharmaceutical industry in IMI. “We also want to use artificial intelligence to revolutionise the way pathology analyses are done.”
Luxembourg clearly has the potential to contribute to bringing European medical research to the next digital level.
Photo credit @ Marie de Decker