Q&A: George King, M.D., Joslin Chief Scientific Officer
Friday, April 15, 2011
Dr. King, who arrived at Joslin in 1981, is also head of the Vascular Cell Biology research section and Professor of Medicine at Harvard Medical School. Here he talks about current and future contributions in understanding and treating diabetes.
How much progress are we making globally in diabetes research?
Worldwide, we’re turning out a lot more new treatments than we did ten years ago. The new treatment for diabetic macular edema, which builds on research at Joslin, can halt it twice as often as the previous treatment, for instance. In type 2 diabetes, there are at least two new types of glucose-lowering agents coming into the market in the next year or two. And for people who are on insulin, continuous glucose monitoring can make control a lot easier—still difficult, but a lot easier.
Obviously we have not won the war; we don’t have a cure. But in research, the tide’s definitely turning.
What are some recent Joslin contributions?
Joslin laid the foundation for the treatment for diabetic macular edema. We made a finding in 1994 that the protein VEGF may increase in the back of the eye in humans, and tested it in our lab at the cellular level to confirm its biological importance. Dr. Lloyd Paul Aiello went on to confirm it in animal studies, and he pioneered one of the clinical trials that showed that inhibitors of VEGF could prevent the late stages of diabetic eye disease. So the Joslin research went from the clinic to the lab and back to the clinic and then into treatment.
That’s just one of our many studies whose results have been applied to clinical care.
One major project is the Joslin 50-Year Medalist Study, looking at patients who have had type 1 diabetes for many years with surprisingly few complications. We’re identifying factors that might protect other patients with diabetes from getting eye or kidney disease. We’re also studying methods that could potentially regenerate the insulin-producing beta cells.
In type 2 diabetes, Dr. Steven Shoelson’s basic work on inflammation identified a small molecule that worked well in animal models. That has translated now to collaborating with Dr. Allison Goldfine on national trials of salsalate, an existing generic anti-inflammatory drug, to decrease inflammation and prevent or treat diabetes, and perhaps also to lower cardiovascular risks.
There’s also the recent finding that brown fat, which can burn calories, can be active in adults.
How important is brown fat?
It’s one of the most exciting discoveries in the past 10 years in type 2 diabetes and obesity, because of its promise to help in controlling weight. But if you double the amount of brown fat in adults, will that have any impact on weight gain? We need intervention treatments and trials to see.
What are the trends in getting federal research funding?
It’s always easier when you have great ideas.
In general, obtaining federal funding is becoming more difficult. Joslin will be impacted by the decrease in National Institutes of Health funding. Thus it is even more important now for our faculty to keep having great ideas, writing papers and getting published.
How critical is funding from foundation grants and personal philanthropy?
It’s absolutely necessary. It supports much of our most important and innovative work. We’re incredibly grateful for what it allows us to do.
In what ways do Joslin scientists work with industry?
We collaborate with pharmaceutical, biotech and device companies to translate our ideas into clinical practice, and we want to do more of that. We have streamlined our process to push our ideas into commercialization quicker, which can improve patient treatments and help with Joslin’s overall financial picture.
Overall, what distinctive role does Joslin play in diabetes research?
Joslin has an outstanding reputation with scientists in the study of diabetes nationally and internationally, due to our productivity and longevity. Joslin has the biggest group of diabetes researchers under one roof in the world, and we have wonderful critical mass. We can carry out many studies, both at the basic science and the clinical levels, with in-house collaborators.
But in addition, we’re situated in a hub of scientific activity of many, many types that multiply what we can offer here. For example, if we need a cardiovascular collaborator, all we have to do is go across the street to Brigham & Women’s Hospital or Beth Israel Deaconess Medical Center. If we want to do stem cell studies, we can collaborate with the Harvard Stem Cell Institute, where many of our faculty are members.
In addition to basic research, we do clinical studies on a large scale, we do outcomes research for adult and pediatric patients, we identify better ways for teaching patient compliance and increasing the knowledge base of care providers. The list of projects is very long. All of them are incredibly important and can lead to new therapies and potential cures for diabetes, which is our mission.