Skin researcher calls for multidisciplinary collaboration: ‘I want to pool expertise’
In dermatology, there should be a high level of multidisciplinary collaboration among institutes and specialists, Professor of Translational Dermatology, Robert Rissmann, will say in his inaugural lecture on 8 July. He is building an infrastructure that will put pre-clinical and clinical skin research more firmly on the map.
The impact of a skin disorder
The skin is the human body’s largest organ and an important part of our immune system. It is highly likely that you will come into contact with a skin disorder sometime during your life. Eczema, warts, burns and fungal infections: the impact of such conditions differs greatly per patient. Some patients barely dare to go outside because of their skin disease, whereas others are unable to sleep, says Rissmann.
It’s a complex biological puzzle: the skin is not in isolation but is connected to the rest of the body. This means that each individual skin patient has different care needs. This complexity and the many new scientific insights make multidisciplinary collaboration essential.
Garden in East Berlin
As a child in East Berlin, Rissmann was fascinated by his father’s work as a pharmacist. He spent a lot of time in the garden where he showed Rissmann poisonous plants like foxgloves.
‘Words like digoxin made a big impression on me as a boy. Digoxin is one of the active substances in digitalis, the foxglove. My father explained that it was poisonous for children to eat the beautiful foxglove flowers but that in heart patients a low (microgram) dose could strengthen the heart muscle’s contractions,’ he explains. Today, as a pharmacist, clinical pharmacologist and researcher, Rissmann is always looking for the right dose – and the right effect.
More-effective drug development
This is why the main question for skin researchers is: ‘Is there a more effective way to develop skin disease treatments?’ Many dermatological drugs fail during the clinical development process. This is mainly because of the complexity of biology and the disease. Some inflammatory diseases are associated with impaired skin barrier function, altered skin flora and disrupted immune system. This in turn affects the rest of the body and means allergies may be more frequent.
‘The other reason why it’s difficult to develop drugs is of a pharmacological nature. The drug appears to work differently in humans than in the prior animal studies and in the test tube,’ says Rissmann. So there is a big discrepancy between the lab findings and the patient results.
Multidisciplinary bridge building
Rissmann wants to bridge this gap between lab research and clinical practice. He will do so ‘translationally’: as a bridge-builder between different institutes and specialisms. Over the past decade he has developed new methods and strategies for clinical pharmacology research in the area of dermatology at the Centre for Human Drug Research (CHDR). He has been working at the Leiden Academic Centre for Drug Research (LACDR) since last year. LACDR and CHDR will work with Erasmus MC and the LUMC teaching hospitals to make new studies possible.
The highly specialised methods that are used in each domain require the input of different experts: microbiologists, physicians, pharmacologists, pharmacists, biologists, physicists, analytical chemists, analysts and even patients themselves. The advantage is that Rissmann operates from neutral ground, which makes him more able to pool existing expertise. ‘The Netherlands has a great deal of expertise and there are many possibilities. The network isn’t just for academic dermatologists. We also want to work with colleagues in non-teaching hospitals.’
Teamwork in research and teaching
The further professionalisation of and innovation in the field of dermatology should be a major focus, says Rissmann. ‘We are also lucky that we offer so many different programmes in Leiden, Rotterdam and Delft.’ As these programmes are complementary, so too is the students’ knowledge. Within the field of dermatology, there are plenty of opportunities to take a translational approach to fundamental and applied science. Rissmann: ‘Clinical research is always teamwork.’