Nearly five years ago, Cleveland Clinic began building a structure within its Lerner Research Institute to focus on microbes (viruses, bacteria, fungi, any simple unicellular organism), which control human health in many different ways.
“Whether or not that microbe was beneficial to your health or a pathogen — meaning the microbe was detrimental to your health — it depended upon both the microbe and equally, your immune response,” said Dr. Serpil Erzurum, chair of the Clinic’s Lerner Research Institute. “So that meant that we started to investigate not just the person, the human being, but what was coming into their living system, their body.”
As part of this effort, the Clinic in April established two new centers after more than a year of planning: the Center for Immunotherapy and Precision Immuno-Oncology and the Center for Global and Emerging Pathogens Research.
“We took the leap here, but it’s turned out that … the timing, unfortunately or fortunately, was good,” Erzurum said.
COVID-19 is just the first of what’s expected to be many opportunities for cross-functional collaboration between the two centers.
This summer, the Clinic opened its 107,000-square-foot Florida Research and Innovation Center in Port St. Lucie, Fla., which will collaborate closely with the centers in Cleveland.
Jae Jung was recently named director of the Center for Global and Emerging Pathogens Research as well as chair of Lerner Research Institute’s Department of Cancer Biology. He joins the system from the University of Southern California.
Cancers and viruses behave quite similarly, attacking and using a host system to grow, he said. Because of these similar properties, he will be working closely with Dr. Timothy Chan, an immuno-oncology and cancer genomics expert, who was recruited from Memorial Sloan Kettering Cancer Center and Weill Cornell School of Medicine to serve as the director of the Clinic’s Center for Immunotherapy and Precision Immuno-Oncology.
2020 has highlighted the importance of biology, said Chan, noting that the National Institutes of Health’s budget is a fraction of what is allocated to the U.S. Department of Defense.
“And yet what is bringing the world to a standstill now? It’s a biological question,” Chan said.
Whether it’s cancer, infectious disease or other biological challenges, “it’s really clear that human health and disease and specifically translational immunology is very, very important,” Chan said.
Essentially, Jung’s work and Chan’s work are two sides of the same coin. While Jung studies how a virus gets into a cell and takes over function, Chan is focused on the host and immune response, Erzurum said.
The Clinic began its focus on microbes’ impact on health by establishing the Center for Microbiome and Human Health a couple of years ago, where researchers have examined how what people eat changes their gut microbiome, impacting susceptibility to vascular diseases, stroke, heart attack and more.
Other moves in recent years to grow the Clinic’s research efforts include the Center for Therapeutics Discovery — created in 2018 to bridge the gap between translational research and clinical drug trials — and the biorepository building currently under construction at the corner of East 100th Street and Cedar Avenue. The Clinic is talking to local health systems about how to partner to allow them access to the new facility, which will at least double the Clinic’s capacity to hold and study tissue and materials from patients for researchers to study.
Microbes cause a lot of illnesses, and while there are antibiotics to treat some, “one of the things we were lacking was a really strong defense for viruses,” Erzurum said.
When the body recognizes something foreign, whether it’s a pathogenic microbe or cancer, it launches an immune response, she said. Researchers began to study this and recognized an intersection in how they might think differently in treating cancers using a patient’s own immune system and how to be more effective in fighting against emerging pathogens that were coming to the United States — Severe Acute Respiratory Syndrome (SARS), Middle East Respiratory Syndrome (MERS), Zika virus, Ebola virus disease and now, COVID-19.
These are all threats “we have no defenses against,” Erzurum said. “All these things tie together when you understand the biology of our immunity and the biology of a microbe.”
As “very clever” viruses evade and change themselves, Erzurum said she was fortunate to be able to focus these research efforts and recruit leaders who saw the same issue and wanted to join the Clinic.
Both Chan and Jung will work closely with researchers in Florida, where the new research and innovation center represents the Clinic’s first trans-United States research endeavor. Though the system has long been part of national and international research networks and has rented laboratory space elsewhere, this is the first time it has its own dedicated space for basic science research in the United States outside of Cleveland.
The Clinic’s yearly research spend in 2019 was $307 million, including federal and nonfederal grants as well as internal and treasury funding. Erzurum said she expects this year’s research spend to be just over $300 million. As the Florida Research and Innovation Center grows, she expects it to be $40 million to $50 million annually.
Chan said getting to help build the Center for Immunotherapy and Precision Immuno-Oncology is both a challenge and a unique opportunity. He wants to put together an integrated early phase immunotherapy development program and is setting up a precision oncology initiative to help translate discoveries into clinical care quickly.
“That will be a launching pad to basically prioritize and launch a new generation of early phase clinical trials at the Cleveland Clinic involving immunotherapy,” he said.
Jung is looking to building on the Clinic’s global network (in Cleveland, Florida, Nevada, Toronto, Abu Dhabi, London, Shanghai and beyond) to create a sort of “one-stop-shop” with data from all the system’s infectious disease studies from basic research to drugs/vaccines development to clinical trials.
Although both Chan and Jung were recruited long before the pandemic, they’re among the many researchers at the Clinic and around the country studying COVID-19.
“I am looking at the COVID-19 area from the virus side and then Tim is looking from the host side and patient side,” Jung said.
COVID-19 will one day pass, Chan said, and the collaborations they’re forming and things they’re learning now will help advance research far into the future.
“Perhaps the silver lining is that we all really understand how important it is to be ready for biologic challenges, right?” Chan said. “And not just cancer, but the things that are sometimes unexpected. We both study human disease using complementary methods and approaches. It’s exciting to be able to begin to set up collaborations.”
