91¿´Æ¬Íø

Translational Research Unit (IM-TRU)

The 91¿´Æ¬Íø Internal Medicine Translational Research Unit (IM-TRU) was established to leverage the genomics and precision medicine era.

The unit is the nexus of clinical care and fundamental science. The 11 clinical divisions of the Department of Internal Medicine deliver clinical care to patients across the 3 academic teaching hospitals in Johannesburg. The unit is embedded in this strong clinical context of patient-focused care.

The mapping of the human genome has dramatically changed medicine, and the emergence of the–omics (genomics, transcriptomics, proteomics, and metabolomics) has changed how we understand and treat disease. New technologies have advanced biomedicine and changed how we diagnose and treat disease.

There has been a shift from a “one-size-fits-all” approach to one that is more personalised to the individual patient. This is evident in cancer care, where treatment strategies are being developed based on the patient's genetic makeup.

Advances in biomedicine have ushered in the era of precision medicine. We can predict disease susceptibility, detect disease earlier and more accurately, and predict and assess drug response. This enables patient-specific, pharmacogenomically informed therapy alongside real-time monitoring of disease evolution in response to therapy, facilitating early detection of druggable resistance mechanisms and highlighting opportunities for synthetic lethal approaches based on the vulnerabilities in individual patients’ mutation profiles.

The main aim 91¿´Æ¬Íø IM-TRU is to provide an enabling research environment for students and researchers and to train South Africa’s future scientists and clinicians. We will do this by leveraging our key strengths: a highly skilled faculty with expertise across all areas and direct access to specialised equipment.

Strategic goals and objectives

To advance precision medicine-directed research activities

Internal Medicine Translational Research has differentiated itself at the intersection of competitive clinical research and advanced technologies. Research initiatives will leverage the precision medicine revolution to improve diagnostics, therapeutics, and prognostication for the African continent.

Research will expand in pharmacogenomics and the development of disease molecular signatures.

Development of disease molecular signatures:

A molecular signature is a set of measurable biological features (DNA mutations, RNA expression profiles, protein levels, metabolites) that define a specific condition. Derived from high-throughput profiling technologies, they act as biological fingerprints.

Strengthen interdisciplinary collaboration:

Strengthening partnerships across medicine, bioinformatics, public health, and ethics to create a holistic framework for precision medicine.

We have adopted the National Centre for Advancing Translational Sciences framework for Translational Research. In this framework, the various phases of Translational Research do not occur in the conventional linear fashion or in one direction. Instead, each stage is a node and informs all other research nodes.

This patient-centric approach puts patient benefit at the heart of all activities. This framework also ensures researchers work together to accelerate findings and implement them for patient benefit.

Increase our footprint on the continent by positioning the institution as a hub for precision medicine research, contributing to international collaborations.

Our research network extends beyond 91¿´Æ¬Íø in that programmes are being developed with researchers across the continent.

Promote equity in cancer research: Expanding research and clinical programs that address ancestry, other determinants of health and ensuring inclusivity in genomic applications.

We will achieve this goal by participating in the SAMBAI (Societal, Ancestry, Molecular and Biological Analyses of Inequalities) study. This is a 5-year, $25M Cancer Grand Challenges-funded project. The African team is led by Prof. Zodwa Dlamini of the Pan African Cancer Research Institute, and 91¿´Æ¬Íø will be a study site (R Duarte, 91¿´Æ¬Íø PI)

This project is designed to address cancer disparities, particularly in populations of African descent. An international team of scientists aim to understand how social, environmental, and genetic factors contribute to higher rates of aggressive prostate, breast, and pancreatic cancers.

The key objectives are:

• To develop comprehensive health determinant measures for global correlations. We will develop structural and social determinants of health to assess how these measures correlate across the African diaspora and affect tumour characteristics and cancer risk. We will retrieve demographic and clinical data from patient records.

At the time of recruitment, participants will be invited to participate in a survey,

• To establish a genome database to represent the African diaspora. Whole-genome sequencing will define the genomic architecture and identify variations that affect different cancer phenotypes.
• Establish a reference exposome. We will examine environmental factors influencing disease aetiology, progression, and treatment response, contributing to a more diverse reference exposome.
• To establish population-specific social determinants associated with tumour phenotypes. We will investigate the influence of structural and social determinants on tumour biology, immunological signatures, and treatment responses.
• Development of a sustainable Global Research Network. To integrate large-scale social, environmental, genomic, epigenomic, immunological and tumour biological data. Data science tools and AI will be leveraged to integrate the large- scale data generated by the SAMBAI consortium.
• To develop a platform for patient-centred policy advocacy. Patient advocacy will influence political, legislative, and social decision-makers to improve cancer patient care. Develop business units to generate income by leveraging specialised competencies.