Background. Chronic diseases (CDs) now account for 84% of all death in Chile, the most prominent being cardiovascular diseases (CVDs, 27%), followed by cancer (26%) (WHO – Noncommunicable Diseases Country Profiles, 2014).
Advanced Center for Chronic Diseases (ACCDiS). This is the first Chilean Center of Excellence to study CVDs & cancer. ACCDiS is a bi-institutional center involving the University of Chile (UCH) & P Catholic University of Chile (PUC) that is financed by the Funds for Research Centers in Priority Areas (FONDAP) program of CONICYT. ACCDiS was officially launched this April 2015 in a ceremony with the participation of government authorities, the Chancellors of the two universities, CONICYT Executive Director and approx. 500 attendees. ACCDiS goals are to observe and dissect the natural history of CVDs and cancer in Chile. Our 6 Research Lines (RLs) and Principal Investigators (PIs) are: a) Metabolism and cardiovascular signaling (S Lavandero, UCH), b) Biomarkers in heart failure and remodeling (P Castro, PUC), c) Mechanisms of tumor cell migration and metastasis (A Quest, UCH), d) Development of biomarkers for early detection of tumors (A Corvalán, PUC), e) Natural history of gallbladder cancer (A Corvalán, PUC), f) Nanomedicine and nanotheranosis (M Kogan, UCH).
Integration strategy. To favor the integration of research efforts in both diseases we adopted the following general strategies: a) Research focused on some common topics of interest: exosomes, angiotensin-(1-9), nanotechnology, epidemiology of CDs and cardio-oncology. b) PhD, MSc students and post-doctoral fellows were recruited to work on (transversal) problems of interest to two or more groups c) A population-based study (MAUCO) is being set up. d) Core facilities providing support in bioinformatics, microRNA and inflammation analysis, and animal models for the study of disease are becoming available.
Organizational strategy. To promote synergy and collaborative activities, the Center organized: a) Weekly Academic Council meetings; b) Weekly scientific seminars with internal ACCDiS speakers or invited national/international speakers; c) an ACCDiS annual retreat; d) An initial ACCDiS integration workshop to generate a global overview of ACCDiS research in CDs that identified well-covered areas of research and others requiring more attention. Further opportunities for collaboration between RLs became apparent; e) Specific weekly meetings to promote interactions in the areas of Cardio & Cancer; f) Mentoring sessions for young investigators; g) MAUCO workshops, on site visits and coordination meetings.
Results. After 2 years in operation, ACCDiS has consolidated itself in the Chilean community as an important center for the study of cancer & CVDs. ACCDiS personnel (226 persons) work in the 6 RLs, MAUCO and/or the two core facilities and includes 6 PIs, as well as 21 Associate Investigators (AIs). ACCDiS organization includes an Administrative Office, an Academic Council, an International Scientific Committee and a National Advisory Committee. Both Committees visited the Center this year and made recommendations to improve ACCDiS functioning.
1) In Advanced Training of Human Resources. The center includes 23 post-docs, 72 PhD students, 22 MSc student and 20 undergraduate students. 35% of the post-docs, 14% of the PhD students, 5% of the MSc students were co-mentored between ACCDiS members from different RLs. ACCDiS also has 6% of international students and post-docs. ACCDiS PIs and AIs coordinated and taught in various PhD, MSc and undergraduate courses of both universities. MAUCO incorporated academics and under-graduate students from local universities in the field activities.
2) In Research. a) The epidemiological Maule Cohort (MAUCO) project. To date 3,400 participants have been enrolled and 1,700 analyzed, 49% of the enrolled population are agricultural workers. We have completed the environmental characterization of the economically most significant activities related to agricultural production and the evaluation of pesticide exposure in the population. The mean age of the population is 54 years; only 8% have been to school for more than 12 years; the average body mass index is 30; diabetes prevails in 10% of women and 9% of men; high blood pressure in 34% and 25%, respectively. No participant fulfilled the 7 characteristics of ideal cardiovascular health. In 2015 we implemented the surveillance system of MAUCO health events. b) Publications & Patents: wepublished 59 ISI and 5 non-ISI papers, whereby 17 (29%) were published in top 10 journals, 38 in Q1 journals (64%), 11 (19%) were in collaboration between the ACCDiS RLs, 38 (66%) and 36 (62%) were the result of collaborations with international and national research centers or groups, respectively. The average ISI impact factor is 5.09. Also, the Center has 5 patent applications (3 in progress and 2 approved), 4 of them in collaborations between the RLs. The cumulative indicators obtained and expected (shown in parenthesis) for the first two years of the Center are: ISI papers: 101 (93); papers published in top ten journals: 24 (9); papers published in Q1 journals: 61 (not declared in the initial proposal) and an average ISI impact factor: 5.07 (4.70). All our expected values have been exceeded.
3) In Outreach to Society. An effective dissemination strategy was developed together with a professional agency. PIs, as well as some AIs, participated in 74 interviews: 42 website news articles, 15 newspaper articles, 10 articles in magazines, 2 television interviews, 5 radio interviews and 1 stand-up comedy. ACCDiS also organized and participated in 48 events with a total of 8.663 participants, including The XXI Science & Technology Week in Santiago (300 high-school students), “Nanoexploradores” (80 students, 5th-6th grade) with practical science activities, an outreach program in two public schools for primary and secondary school teachers, meetings with business men/women and politicians.
4) In International Networking. We have active collaborations with outstanding international research centers in CVDs, cancer, epidemiology & nanobiomedicine. These were strengthened by 41 visits of Chilean and foreign investigators (17 visits of ACCDiS members to foreign institutions and 24 international researchers visited ACCDiS in Santiago). Moreover, 66% of our ISI papers were published in collaboration with our international collaborators.
5) In Contribution to Public Policies: We are collaborating with the Ministry of Health in a “Population Nutrition and Chemical contamination of food and risk of cancer” study. MAUCO now aids the Maule Health Service in the evaluation of food safety and population nutrition and in determining the impact of new public policies.
Perspectives: We will continue to foster integration between basic scientists and clinical and public health disciplines using the current strategies. We initiated several MAUCO sub-studies in 2015 that should yield tangible results in the coming years.