Background. Chronic diseases (CDs) now account for 84% of all death in Chile, the most prominent being cardiovascular diseases (CVD, 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 CVD & cancer. ACCDiS is a bi-institutional center involving the University of Chile (UCH) & Pontifical Catholic University of Chile (PUC) that is financed by the Funds for Research Centers in Priority Areas (FONDAP) program of CONICYT. ACCDiS goals are to observe and dissect the natural history of CVD 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 (K Ferreccio, PUC), f) Nanomedicine and nanotheranosis (M Kogan, UCH).
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) The second 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.
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.
Results. After 3 years in operation, ACCDiS has consolidated itself in the Chilean community as an important center for the study of cancer & CVD. ACCDiS personnel (246 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 in 2016 and made recommendations to improve ACCDiS functioning.
1) In Advanced Training of Human Resources. The center includes 25 post-docs, 74 PhD students, 26 MSc student and 15 undergraduate students. 40% of the post-docs, 14% of the PhD students, 4% of the MSc students were co-mentored between ACCDiS members from different RLs. Of the students and post-doctoral fellows in training at ACCDiS, 5% are foreigners. 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. By December 2016, we have enrolled 6,700 participants. Baseline results were presented in scientific meetings (abstracts in annexes). We are preparing manuscripts describing the baseline analysis of the health status in the areas cardiovascular, digestive, neurocognitive, respiratory, psychosocial, occupational and environmental exposures. Various MAUCO-based master’s thesis projects have been completed or are underway. We completed the design of the details of the 2-year follow-up of the cohort, due to start in January 2017. b) Publications & Patents: we published 70 ISI and 6 non-ISI papers, whereby 7 (10%) were published in top 10 journals, 41 in Q1 journals (59%), 17 (24%) were in collaboration between the ACCDiS RLs, 39 (56%) and 35 (50%) were the result of collaborations with international and national research centers or groups, respectively. The average ISI impact factor of publications this year is 3.9. Also, the Center has 5 patents (1 patent application was presented, another 2 applications are in progress and 2 were granted), all of them in collaborations between the RLs. The cumulative indicators obtained and expected (shown in parenthesis) for the first three years of the Center are: ISI papers: 171 (143); papers published in top ten journals: 31 (14); papers published in Q1 journals: 102 (not declared in the initial proposal) and an average ISI impact factor: 4.9 (4.8). 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 71 interviews: 29 website news articles, 23 newspaper articles, 8 articles in magazines, 5 television interviews, 6 radio interviews and 1 stand-up comedy. ACCDiS also organized and participated in 95 events with a total of 11.669 participants, including The XXII Science & Technology Week in Santiago (110 high-school students), “Meeting for promotion of science for public high-school students, including talk and laboratory work on chronic diseases” (16 students), outreach program for 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 36 visits of Chilean and foreign investigators (24 visits of ACCDiS members to foreign institutions and 12 international researchers visited ACCDiS in Santiago). Moreover, 56% of our ISI papers were published in collaboration with our international collaborators. Finally, we organized the first ACCDiS Cancer Spring Symposium (ACSS) 07-09 September, at the Rosa Agustina Conference Resort Olmue, Chile which included the participation of 11 international and 6 national invited speakers together with 10 ACCDiS researchers as well as some 80 PhD and Masters students.
5) In Contribution to Public Policies. We maintained our collaboration with the Ministry of Health. During 2016, we co-organized a seminar in which we presented the policy challenges derived from our studies in arsenic-associated cancers, gallbladder cancer, stomach cancer and cervical cancer. Most of the information and the results of the discussion in the Seminar were included in the Ministry of Health “Cancer Strategic Planning 2016”.
Perspectives: We initiated a fruitful collaboration with the clinicians at the Hospital of Curicó, the reference Hospital for the Molina population, this facilitates our access to events in our participants.