Our Stories

NIH supports research in a wide variety of biomedical research areas, advancing our knowledge of health and disease. NIH is an integral part of a biomedical research ecosystem that includes universities, researchers, private companies, and other government agencies. The knowledge produced by NIH-supported research can take many years and pass through many organizations on its pathway toward improving health. Explore this page to look at a few stories of how NIH has contributed to important biomedical advances, and how these advances have made a difference in our knowledge, our health, and our society.

Understanding Immune Cells and Inflammation: Opening New Treatment Avenues for Rheumatoid Arthritis and Other Conditions

Discovery of the JAK-STAT molecular pathway in the early 1990s was a landmark advance explaining how cells sense and respond to their immediate environment. Read the story of how NIH research set a foundation for the development of a new family of drugs, one of which provides a new option for people with rheumatoid arthritis who aren’t helped by older drugs.

Additional materials

References

1Two novel protein-tyrosine kinases, each with a second phosphotransferase-related catalytic domain, define a new class of protein kinase. Wilks AF, Harpur AG, Kurban RR, Ralph SJ, Zürcher G, Ziemiecki A. Mol Cell Biol. 1991 Apr;11(4):2057-65. PMID: 1848670

2Examples include:

A protein tyrosine kinase in the interferon alpha/beta signaling pathway. Velazquez L, Fellous M, Stark GR, Pellegrini S. Cell. 1992 Jul 24;70(2):313-22. PMID: 1386289

Association and activation of Jak-Tyk kinases by CNTF-LIF-OSM-IL-6 beta receptor components. Stahl N, Boulton TG, Farruggella T, Ip NY, Davis S, Witthuhn BA, Quelle FW, Silvennoinen O, Barbieri G, Pellegrini S, et al. Science. 1994 Jan 7;263(5143):92-5. PMID: 8272873

Polypeptide signalling to the nucleus through tyrosine phosphorylation of Jak and Stat proteins. Shuai K, Ziemiecki A, Wilks AF, Harpur AG, Sadowski HB, Gilman MZ, Darnell JE. Nature. 1993 Dec 9;366(6455):580-3. PMID: 7504784

3Molecular cloning of rat JAK3, a novel member of the JAK family of protein tyrosine kinases. Takahashi T, Shirasawa T. FEBS Lett. 1994 Apr 4;342(2):124-8. PMID: 8143863

Molecular cloning of L-JAK, a Janus family protein-tyrosine kinase expressed in natural killer cells and activated leukocytes. Kawamura M, McVicar DW, Johnston JA, Blake TB, Chen YQ, Lal BK, Lloyd AR, Kelvin DJ, Staples JE, Ortaldo JR, et al. Proc Natl Acad Sci U S A. 1994 Jul 5;91(14):6374-8. PMID: 8022790

JAK3: a novel JAK kinase associated with terminal differentiation of hematopoietic cells. Rane SG, Reddy EP. Oncogene. 1994 Aug;9(8):2415-23. PMID: 7518579

Phosphorylation and activation of the Jak-3 Janus kinase in response to interleukin-2. Johnston JA, Kawamura M, Kirken RA, Chen YQ, Blake TB, Shibuya K, Ortaldo JR, McVicar DW, O'Shea JJ. Nature. 1994 Jul 14;370(6485):151-3. PMID: 8022485

4Mutation of Jak3 in a patient with SCID: essential role of Jak3 in lymphoid development. Russell SM, Tayebi N, Nakajima H, Riedy MC, Roberts JL, Aman MJ, Migone TS, Noguchi M, Markert ML, Buckley RH, O'Shea JJ, Leonard WJ. Science. 1995 Nov 3;270(5237):797-800. PMID: 7481768

Mutations of Jak-3 gene in patients with autosomal severe combined immune deficiency (SCID). Macchi P, Villa A, Giliani S, Sacco MG, Frattini A, Porta F, Ugazio AG, Johnston JA, Candotti F, O'Shea JJ, et al. Nature. 1995 Sep 7;377(6544):65-8. PMID: 7659163

5Regulation of JAK3 expression and activation in human B cells and B cell malignancies. Tortolani PJ, Lal BK, Riva A, Johnston JA, Chen YQ, Reaman GH, Beckwith M, Longo D, Ortaldo JR, Bhatia K, McGrath I, Kehrl J, Tuscano J, McVicar DW, O'Shea JJ. J Immunol. 1995 Dec 1;155(11):5220-6. PMID: 7594533

6The amino terminus of JAK3 is necessary and sufficient for binding to the common gamma chain and confers the ability to transmit interleukin 2-mediated signals. Chen M, Cheng A, Chen YQ, Hymel A, Hanson EP, Kimmel L, Minami Y, Taniguchi T, Changelian PS, O'Shea JJ. Proc Natl Acad Sci U S A. 1997 Jun 24;94(13):6910-5. PMID: 9192665

Distinct tyrosine phosphorylation sites in JAK3 kinase domain positively and negatively regulate its enzymatic activity. Zhou YJ, Hanson EP, Chen YQ, Magnuson K, Chen M, Swann PG, Wange RL, Changelian PS, O'Shea JJ. Proc Natl Acad Sci U S A. 1997 Dec 9;94(25):13850-5. PMID: 9391116

Unexpected effects of FERM domain mutations on catalytic activity of Jak3: structural implication for Janus kinases. Zhou YJ, Chen M, Cusack NA, Kimmel LH, Magnuson KS, Boyd JG, Lin W, Roberts JL, Lengi A, Buckley RH, Geahlen RL, Candotti F, Gadina M, Changelian PS, O'Shea JJ. Mol Cell. 2001 Nov;8(5):959-69. PMID: 11741532

Modulation of innate and adaptive immune responses by tofacitinib (CP-690,550). Ghoreschi K, Jesson MI, Li X, Lee JL, Ghosh S, Alsup JW, Warner JD, Tanaka M, Steward-Tharp SM, Gadina M, Thomas CJ, Minnerly JC, Storer CE, LaBranche TP, Radi ZA, Dowty ME, Head RD, Meyer DM, Kishore N, O'Shea JJ. J Immunol. 2011 Apr 1;186(7):4234-43. doi: 10.4049/jimmunol.1003668. Epub 2011 Mar 7. PMID: 21383241

7Prevention of organ allograft rejection by a specific Janus kinase 3 inhibitor. Changelian PS, Flanagan ME, Ball DJ, Kent CR, Magnuson KS, Martin WH, Rizzuti BJ, Sawyer PS, Perry BD, Brissette WH, McCurdy SP, Kudlacz EM, Conklyn MJ, Elliott EA, Koslov ER, Fisher MB, Strelevitz TJ, Yoon K, Whipple DA, Sun J, Munchhof MJ, Doty JL, Casavant JM, Blumenkopf TA, Hines M, Brown MF, Lillie BM, Subramanyam C, Shang-Poa C, Milici AJ, Beckius GE, Moyer JD, Su C, Woodworth TG, Gaweco AS, Beals CR, Littman BH, Fisher DA, Smith JF, Zagouras P, Magna HA, Saltarelli MJ, Johnson KS, Nelms LF, Des Etages SG, Hayes LS, Kawabata TT, Finco-Kent D, Baker DL, Larson M, Si MS, Paniagua R, Higgins J, Holm B, Reitz B, Zhou YJ, Morris RE, O'Shea JJ, Borie DC. Science. 2003 Oct 31;302(5646):875-8. PMID: 14593182

8Super-enhancers delineate disease-associated regulatory nodes in T cells. Vahedi G, Kanno Y, Furumoto Y, Jiang K, Parker SC, Erdos MR, Davis SR, Roychoudhuri R, Restifo NP, Gadina M, Tang Z, Ruan Y, Collins FS, Sartorelli V, O'Shea JJ. Nature. 2015 Apr 23;520(7548):558-62. doi: 10.1038/nature14154. Epub 2015 Feb 16. PMID: 25686607

9ClinicalTrials.gov Identifier: NCT02535689

10Reviewed in The JAK-STAT pathway: impact on human disease and therapeutic intervention. O'Shea JJ, Schwartz DM, Villarino AV, Gadina M, McInnes IB, Laurence A. Annu Rev Med. 2015;66:311-28. doi: 10.1146/annurev-med-051113-024537. Review. PMID: 25587654

11Type I/II cytokines, JAKs, and new strategies for treating autoimmune diseases. Schwartz DM, Bonelli M, Gadina M, O'Shea JJ. Nat Rev Rheumatol. 2016 Jan;12(1):25-36. doi: 10.1038/nrrheum.2015.167. Epub 2015 Dec 3. Review. PMID: 26633291

Related Resources on Rheumatoid Arthritis and Tofacitinib

Rare Autoinflammatory Diseases Research: Saving Lives, Giving Hope to Families

Autoinflammatory diseases are a relatively new category of conditions that differ from autoimmune diseases. Although both kinds of illnesses happen when the immune system attacks the body’s own tissues, they occur by different processes. Read the story of how NIH researchers played a vital role in differentiating between the two groups of diseases, discovering the molecular causes for different autoinflammatory diseases, and identifying life-saving treatments

Additional materials

References

1Examples include: Siegal S. Benign paroxysmal peritonitis. Ann Intern Med. 1945;23(1):1-21, as cited in Centola M, Aksentijevich I, Kastner DL. The hereditary periodic fever syndromes: molecular analysis of a new family of inflammatory diseases. Hum Mol Genet. 1998;7(10):1581-1588. PMID: 9735379 Reimann HA. Periodic disease; a probable syndrome including periodic fever, benign paroxysmal peritonitis, cyclic neutropenia and intermittent arthralgia. J Am Med Assoc. 1948;136(4):239-244. PMID: 18920089/p>

2One of many examples: Wright DG, Wolff SM, Fauci AS, Alling DW. Efficacy of intermittent colchicine therapy in familial Mediterranean fever. Ann Intern Med. 1977;86(2):162-165.

3Williamson LM, Hull D, Mehta R, Reeves WG, Robinson BH, Toghill PJ. Familial Hibernian fever. Q J Med. 1982;51(204):469-480. PMID: 7156325

4Pras E, Aksentijevich I, Gruberg L, et al. Mapping of a gene causing familial Mediterranean fever to the short arm of chromosome 16. N Engl J Med. 1992 Jun 4;326(23):1509-1513. PMID: 1579134
International FMF Consortium. Ancient missense mutations in a new member of the RoRet gene family are likely to cause familial Mediterranean fever. Cell 1997;90(4):797-807. PMID: 9288758
French FMF Consortium. A candidate gene for familial Mediterranean fever. Nat Genet. 1997;17(1):25-31. PMID: 9288094

5McDermott MF, Aksentijevich I, Galon J, et al. Germline mutations in the extracellular domains of the 55 kDa TNF receptor, TNFR1, define a family of dominantly inherited autoinflammatory syndromes. Cell. 1999;97(1):133-144. PMID: 10199409

6Aksentijevich I, Nowak M, Mallah M, et al. De novo CIAS1 mutations, cytokine activation, and evidence for genetic heterogeneity in patients with neonatal-onset multisystem inflammatory disease (NOMID): a new member of the expanding family of pyrin-associated autoinflammatory diseases. Arthritis Rheum. 2002;46(12):3340-3348. PMID: 12483741
Feldmann J, Prieur A-M, Quartier P, et al. Chronic infantile neurological cutaneous and articular syndrome is caused by mutations in CIAS1, a gene highly expressed in polymorphonuclear cells and chondrocytes. Am J Hum Genet. 2002;71(1):198-203. PMID: 12032915

7Goldbach-Mansky R, Dailey NJ, Canna SW, et al. Neonatal-onset multisystem inflammatory disease responsive to interleukin-1β inhibition. N Engl J Med. 2006;355(6):581-592. PMID: 16899778

8Booty MG, Chae JJ, Masters SL, et al. Familial Mediterranean fever with a single MEFV mutation: where is the second hit? Arthritis Rheum. 2009;60(6):1851-1861. PMID: 19479870

9Aksentijevich I, Masters SL, Ferguson PJ, et al. An autoinflammatory disease with deficiency of the interleukin-1-receptor antagonist. N Engl J Med. 2009;360(23):2426-2437. PMID: 19494218

10Liu Y, Ramot Y, Torrelo A, et al. Mutations in proteasome subunit β type 8 cause chronic atypical neutrophilic dermatosis with lipodystrophy and elevated temperature with evidence of genetic and phenotypic heterogeneity. Arthritis Rheum. 2012;64(3):895-907. PMID: 21953331

11Sibley CH, Plass N, Snow J, et al. Sustained response and prevention of damage progression in patients with neonatal-onset multisystem inflammatory disease treated with anakinra: a cohort study to determine three- and five-year outcomes. Arthritis Rheum. 2012;64(7):2375-86. PMID: 22294344

12Jesus AA, Goldbach-Mansky R. IL-1 blockade in autoinflammatory syndromes. Annu Rev Med. 2014;65:223-244. PMID: 24422572

13Liu Y, Jesus AA, Marrero B, et al. Activated STING in a vascular and pulmonary syndrome. N Engl J Med. 2014;371(6):507-518. PMID: 25029335

14De Jesus AA, Canna SW, Liu Y, Goldbach-Mansky R. Molecular mechanisms in genetically defined autoinflammatory diseases: disorders of amplified danger signaling. Annu Rev Immunol. 2015;33:823-874. PMID: 25706096

15De Jesus AA, Canna SW, Liu Y, Goldbach-Mansky R. Molecular mechanisms in genetically defined autoinflammatory diseases: disorders of amplified danger signaling. Annu Rev Immunol. 2015;33:823-874. PMID: 25706096

16National Institutes of Health. NIH scientists identify gene linked to fatal inflammatory disease in children. NIAMS Press Releases. Published July 17, 2014. Accessed August 1, 2016.

17National Institute of Arthritis and Musculoskeletal and Skin Diseases. NIH study contributes to approval of promising treatment for genetic inflammatory disorder. Spotlight on Research. Published March 2013. Accessed August 1, 2016.

18National Institute of Arthritis and Musculoskeletal and Skin Diseases. Deficiency of the Interleukin-1 Receptor Antagonist (DIRA). Autoinflammatory Diseases. Published March 2016. Accessed August 1, 2016.

19National Institutes of Health. NIH scientists discover link among spectrum of childhood diseases. NIAMS Press Releases. Published October 31, 2011. Accessed August 1, 2016.

20U.S. National Library of Medicine. Familial Mediterranean fever: frequency. Genetics Home Reference. Updated July 26, 2016. Accessed August 1, 2016.

21Jesus AA, Goldbach-Mansky R. IL-1 blockade in autoinflammatory syndromes. Annu Rev Med. 2014;65:223-244. PMID: 24422572

22U.S. National Library of Medicine. Tumor necrosis factor receptor-associated periodic syndrome: Frequency. Genetics Home Reference. Updated July 26, 2016. Accessed August 1, 2016.

23Bulua AC, Simon A, Maddipati R, et al. Mitochondrial reactive oxygen species promote production of proinflammatory cytokines and are elevated in TNFR1-associated periodic syndrome (TRAPS). J Exp Med. 2011;208(3):519-533. PMID: 21282379

24U.S. National Library of Medicine. Neonatal onset multisystem inflammatory disease: Frequency. Genetics Home Reference. Updated July 26, 2016. Accessed August 1, 2016.
Collins F. Meet Alex—Before and after NIH clinical trial. NIH Director’s blog. Published April 9, 2013. Accessed May 23, 2016

Related Resources on Rare Autoinflammatory Diseases Research

Neurostimulation Technologies: Harnessing Electricity To Treat Lost Neural Function

The human nervous system is so complex and fundamental, that until recently, it was believed that any damage to it was irreversible. NIH support and years of scientific effort, however, have begun to make it possible to compensate for lost function using electrical stimulation to enhance nervous system activity. Read the story of how NIH-supported research helped harness the electrical nature of the nervous system to develop cutting-edge therapies

Additional materials

References

1Donald R. McNeal, “2000 years of electrical stimulation” in F. Terry Hambrecht and James B. Reswick, eds., Functional Electrical StimulationApplications in Neural Prosthesis (New York and BaselMacel Dekker, Inc., 1977) pp. 3-35.

2Thompson DM, Koppes AN, Hardy JG, Schmidt CE. Electrical stimuli in the central nervous system microenvironment. Annual review of biomedical engineering. 2014;16:397-430.

3Aquilina O. A brief history of cardiac pacing. Images in paediatric cardiology. 2006;8(2):17-81.

4FDA Premarket Approval P8300693M: Brand Cochlear Implant System/House Design

5FDA Premarket Approval P960009: Medtronic Activa Tremor Control System and Supplement S007: Medtronic Activa Parkinson’s Control System

6http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/DeviceApprovalsandClearances/Recently-ApprovedDevices/ucm343162.htm

7House WF, Urban J. Long term results of electrode implantation and electronic stimulation of the cochlea in man. The Annals of otology, rhinology, and laryngology. 1973;82(4):504-517.

8http://www.nidcd.nih.gov/health/hearing/pages/coch.aspx

9Sekhon LH, Fehlings MG. Epidemiology, demographics, and pathophysiology of acute spinal cord injury. Spine. 2001;26(24 Suppl):S2-12.

10http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/DeviceApprovalsandClearances/Recently-ApprovedDevices/ucm343162.htm

11Gerasimenko YP, Lu DC, Modaber M, et al. Noninvasive Reactivation of Motor Descending Control after Paralysis. Journal of neurotrauma. 2015;32(24):1968-1980.

12Donald R. McNeal, “2000 years of electrical stimulation” in F. Terry Hambrecht and James B. Reswick, eds., Functional Electrical StimulationApplications in Neural Prosthesis (New York and BaselMacel Dekker, Inc., 1977) pp. 3-35.

13Penfield W. Epilepsy and surgical therapy. Archives of Neurology & Psychiatry. 1936;36(3):449-484.

14Aquilina O. A brief history of cardiac pacing. Images in paediatric cardiology. 2006;8(2):17-81.

15Djourno A, Eyries C. Auditory prosthesis by means of a distant electrical stimulation of the sensory nerve with the use of an indwelt coiling. La Presse medicale. 1957;65(63):1417.

16Chatrian GE, Petersen MC, Uihlein A. Electrical stimulation of the human brain through implanted electrodespreliminary observations. Diseases of the nervous system. 1960;21:321-326.

17House WF, Urban J. Long term results of electrode implantation and electronic stimulation of the cochlea in man. The Annals of otology, rhinology, and laryngology. 1973;82(4):504-517.

18Simmons FB, Mongeon CJ, Lewis WR, Huntington DA. Electrical Stimulation of Acoustical Nerve and Inferior Colliculus. Archives of otolaryngology. 1964;79:559-568.

19Kumar K, Rizvi S. Historical and present state of neuromodulation in chronic pain. Current pain and headache reports. 2014;18(1):387.

20DeLong MR. Activity of pallidal neurons during movement. Journal of neurophysiology. 1971;34(3):414-427.

21DeLong MR. Activity of basal ganglia neurons during movement. Brain research. 1972;40(1):127-135.

22DeLong MR. Putamen: activity of single units during slow and rapid arm movements. Science. 1973;179(4079):1240-1242.

23House WF, Urban J. Long term results of electrode implantation and electronic stimulation of the cochlea in man. The Annals of otology, rhinology, and laryngology. 1973;82(4):504-517.

24Hosobuchi Y, Adams JE, Rutkin B. Chronic thalamic stimulation for the control of facial anesthesia dolorosa. Archives of neurology. 1973;29(3):158-161., NIH training grant NS5593

25Mudry A, Mills M. The early history of the cochlear implant: a retrospective. JAMA otolaryngology-- head & neck surgery. 2013;139(5):446-453.

26Clark G. Cochlear Implants: Fundamentals and Applications. Springer; 2003.

27Clark G, Cowan RSC, Dowell RC. Cochlear Implantation for Infants and Children: Advances. Singular Publishing Group; 1997.

28Davis GC, Williams AC, Markey SP, et al. Chronic Parkinsonism secondary to intravenous injection of meperidine analogues. Psychiatry research. 1979;1(3):249-254.

29Langston JW, Ballard P, Tetrud JW, Irwin I. Chronic Parkinsonism in humans due to a product of meperidine-analog synthesis. Science. 1983;219(4587):979-980.

30Burns RS, Chiueh CC, Markey SP, Ebert MH, Jacobowitz DM, Kopin IJ. A primate model of parkinsonism: selective destruction of dopaminergic neurons in the pars compacta of the substantia nigra by N-methyl-4-phenyl-1,2,3,6-tetrahydropyridine. Proceedings of the National Academy of Sciences of the United States of America. 1983;80(14):4546-4550.

31FDA Premarket Approvals P830069: 3M Brand Cochlear Implant System/House Design and P840024: Nucleus Multichannel Implantable Hearing Prosthesis

32FDA Premarket Approval P890027: Nucleus 22 Channel Cochlear Implant Sys /Children

33Benabid AL, Pollak P, Louveau A, Henry S, de Rougemont J. Combined (thalamotomy and stimulation) stereotactic surgery of the VIM thalamic nucleus for bilateral Parkinson disease. Applied neurophysiology. 1987;50(1-6):344-346.

34Benabid AL, Pollak P, Gervason C, et al. Long-term suppression of tremor by chronic stimulation of the ventral intermediate thalamic nucleus. Lancet. 1991;337(8738):403-406.

35Limousin P, Pollak P, Benazzouz A, et al. Effect of parkinsonian signs and symptoms of bilateral subthalamic nucleus stimulation. Lancet. 1995;345(8942):91-95.

36Limousin P, Krack P, Pollak P, et al. Electrical stimulation of the subthalamic nucleus in advanced Parkinson's disease. The New England journal of medicine. 1998;339(16):1105-1111.

37Medtronic DBS Therapy for Parkinson's Disease and Essential Tremor Clinical Summary, 2013

38Rise MT, W. KG, Inventors; Medtronic, Inc., assignee. Method of treating movement disorders by brain stimulation. US patent 5716377. February 10, 1998.

39FDA Premarket Approval P960009, Supplement S007: Medtronic Activa Parkinson’s Control

40http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/DeviceApprovalsandClearances/Recently-ApprovedDevices/ucm125520.htm

41Harkema S, Gerasimenko Y, Hodes J, et al. Effect of epidural stimulation of the lumbosacral spinal cord on voluntary movement, standing, and assisted stepping after motor complete paraplegia: a case study. Lancet. 2011;377(9781):1938-1947.

42Angeli CA, Edgerton VR, Gerasimenko YP, Harkema SJ. Altering spinal cord excitability enables voluntary movements after chronic complete paralysis in humans. Brain: a journal of neurology. 2014;137(Pt 5):1394-1409.

43Gerasimenko YP, Lu DC, Modaber M, et al. Noninvasive Reactivation of Motor Descending Control after Paralysis. Journal of neurotrauma. 2015;32(24):1968-1980.

44http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/DeviceApprovalsandClearances/Recently-ApprovedDevices/ucm343162.htm

45https://consensus.nih.gov/1995/1995CochlearImplants100html.htm

46http://www.nidcd.nih.gov/health/hearing/pages/coch.aspx

47Semenov YR, Yeh ST, Seshamani M, et al. Age-dependent cost-utility of pediatric cochlear implantation. Ear and hearing. 2013;34(4):402-412.

48Contrera KJ, Choi JS, Blake CR, Betz JF, Niparko JK, Lin FR. Rates of long-term cochlear implant use in children. Otology & neurotology: official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. 2014;35(3):426-430.

49Cheng AK, Rubin HR, Powe NR, Mellon NK, Francis HW, Niparko JK. Cost-utility analysis of the cochlear implant in children. Jama. 2000;284(7):850-856.

50Semenov YR, Yeh ST, Seshamani M, et al. Age-dependent cost-utility of pediatric cochlear implantation. Ear and hearing. 2013;34(4):402-412.

51http://www.laskerfoundation.org/awards/2014_c_description.htm

52Weaver FM, Follett K, Stern M, et al. Bilateral deep brain stimulation vs best medical therapy for patients with advanced Parkinson disease: a randomized controlled trial. Jama. 2009;301(1):63-73.

53ibid.

54Rizzone MG, Fasano A, Daniele A, et al. Long-term outcome of subthalamic nucleus DBS in Parkinson's disease: from the advanced phase towards the late stage of the disease? Parkinsonism & related disorders. 2014;20(4):376-381.

55:http://professional.medtronic.com/pt/neuro/dbs-md/eff/data-and-clinical-outcomes

56http://www.laskerfoundation.org/awards/2014_c_description.htm

57Hariz M, Blomstedt P, Zrinzo L. Future of brain stimulation: new targets, new indications, new technology. Movement disorders: official journal of the Movement Disorder Society. 2013;28(13):1784-1792.

58http://braininitiative.nih.gov/about.htm

59https://commonfund.nih.gov/sparc/index

60NIH Grant UH2NS095495, BRAIN initiative

61NIH Grant U18EB021793, SPARC program

62http://news.berkeley.edu/2014/05/27/cnep-targets-brain-circuitry-to-treat-mental-disorders/

63NIH Grant UH3NS095554, BRAIN initiative

Appendix

The table below provides a more detailed list of selected milestones underlying this story’s “Research-to-Practice Milestones” (page 2 of the pdf), including the lead scientists, research institutions, funding sources, and scientific publications involved in each one.

1950s–60s: Stimulating Nerves with Electricity

Year Description of Milestone Primary Investigator(s) Research Institution Funding source (including NIH grant numbers where available) Citation 1 Citation 2 Citation 3 Citation 4
1957 >Attempting to repair a facial nerve injury, scientists electrically stimulated the auditory nerve, causing the patient to perceive sounds and providing evidence that electrical stimulation might restore lost hearing. Andre Djourno, Charles Eyries Faculté de Médecine, Paris, France Unknown, Not likely to be NIH Djourno A, Eyries C. [Auditory prosthesis by means of a distant electrical stimulation of the sensory nerve with the use of an indwelt coiling]. La Presse medicale. 1957;65(63):1417.      
1960 Researchers first tested the long-term safety and effectiveness of implanting electrodes in the human brain. Alfred Uihlein Mayo Clinic Unknown, Not likely to be NIH Chatrian GE, Petersen MC, Uihlein A. Electrical stimulation of the human brain through implanted electrodes: preliminary observations. Diseases of the nervous system. 1960;21:321-326.      
1961 The first prototype single-channel cochlear implant is developed, and inserted into two subjects William F. House and James Doyle Private Practice, Los Angeles Private House WF, Urban J. Long term results of electrode implantation and electronic stimulation of the cochlea in man. The Annals of otology, rhinology, and laryngology. 1973;82(4):504-517. U.S. Patent 3449786 to James Doyle    
1964 First NIH grant for cochlear implants funds a report on the effects of auditory nerve stimulation in a patient with normal hearing. F. Blair Simmons Stanford University Funded by NIH grant NB 02167 from the National Institute of Neurological Diseases and Blindness (NINDB). Simmons FB, Mongeon CJ, Lewis WR, Huntington DA. Electrical Stimulation of Acoustical Nerve and Inferior Colliculus. Archives of otolaryngology. 1964;79:559-568.      
1968 Medtronic became the first company to introduce a spinal cord stimulation system as a treatment for chronic pain. Unknown Medtronic Corp Private Kumar K, Rizvi S. Historical and present state of neuromodulation in chronic pain. Current pain and headache reports. 2014;18(1):387.      

1970s–80s: Unlocking the Potential of Neurotechnology

Year Description of Milestone Primary Investigator(s) Research Institution Funding source (including NIH grant numbers where available) Citation 1 Citation 2 Citation 3 Citation 4
1971-3 NIH researchers characterized the normal electrical function of deep brain areas involved in movement, which are affected in Parkinson’s Mahlon DeLong NIMH Laboratory of Neurophysiology NIMH Intramural DeLong MR. Activity of pallidal neurons during movement. Journal of neurophysiology. 1971;34(3):414-427. DeLong MR. Activity of basal ganglia neurons during movement. Brain research. 1972;40(1):127-135. DeLong MR. Putamen: activity of single units during slow and rapid arm movements. Science. 1973;179(4079):1240-1242.  
1972 Early cochlear implants developed with a single electrode, and the first functional prototype implanted in a patient William F. House Private practice, Los Angeles Private, included support from 3M House WF, Urban J. Long term results of electrode implantation and electronic stimulation of the cochlea in man. The Annals of otology, rhinology, and laryngology. 1973;82(4):504-517.      
1973 Improving upon the pain relief provided by spinal cord stimulation, NIH-supported investigators developed the first long-term, implanted device to stimulate the brain Yoshio Hosobuchi UCSF NIH training grant NS5593 Hosobuchi Y, Adams JE, Rutkin B. Chronic thalamic stimulation for the control of facial anesthesia dolorosa. Archives of neurology. 1973;29(3):158-161.      
1976 The 1976 Bilger report suggests that cochlear implants could be a substantially more useful device for patients with hearing loss than traditional devices and methods. Robert C. Bilger Univ. of Pittsburgh NIH Contract N01 NS-5-2331. Bilger RC, Black FO, Hopkinson NT. Research plan for evaluating subjects presently fitted with implanted auditory prostheses. The Annals of otology, rhinology & laryngology. Supplement. 1977;86(3 Pt 2 Suppl 38):21-24. Bilger RC, Black FO, Hopkinson NT, Myers EN. Implanted auditory prosthesis: an evaluation of subjects presently fitted with cochlear implants. Transactions. Section on Otolaryngology. American Academy of Ophthalmology and Otolaryngology. 1977;84(4 Pt 1):ORL-677-682.    
1970s-80s Several groups of academic researchers begin to partner with technology firms to form corporations in Australia, the U.S., and Europe focused on devices to restore hearing.Both industry and academic researchers focused on upgrading cochlear implants with even better resolution, using multiple electrodes (multi-channel). Graeme Clark; Claude Chouard; F. Blair Simmons and Robert L. White; Michael Merzenich and Robin P. Michelson Academia: Univ. of Melbourne, Australia; INSERM, France; Stanford; UCSF Industry: Nucleus Ltd. , MedEl NIH Grants NS 10532, NS10414, NIH grant NS 11804, NIH Contracts N01-NS-5-2388,-2395,and -2396 Mudry A, Mills M. The early history of the cochlear implant: a retrospective. JAMA otolaryngology-- head & neck surgery. 2013;139(5):446-453. Clark GM. Cochlear implants. New York: Springer Verlag; 2003 Clark GM, Cowan RSC, Dowell DC. Cochlear implantation for infants and children. Advances. San Diego: Singular Publishing Group; 1997.  
1979-83 NIH-supported researchers used a new animal model for Parkinson’s disease, called the MPTP model, to identify the brain regions responsible for motor symptoms. Irwin Kopin NINDS and NIMH Intramural, Stanford NIMH and NINDS Intramural, Santa Clara County Medical Services, NIMH Intramural Davis GC, Williams AC, Markey SP, et al. Chronic Parkinsonism secondary to intravenous injection of meperidine analogues. Psychiatry research. 1979;1(3):249-254. Langston JW, Ballard P, Tetrud JW, Irwin I. Chronic Parkinsonism in humans due to a product of meperidine-analog synthesis. Science. 1983;219(4587):979-980. Burns RS, Chiueh CC, Markey SP, Ebert MH, Jacobowitz DM, Kopin IJ. A primate model of parkinsonism: selective destruction of dopaminergic neurons in the pars compacta of the substantia nigra by N-methyl-4-phenyl-1,2,3,6-tetrahydropyridine. Proceedings of the National Academy of Sciences of the United States of America. 1983;80(14):4546-4550.  
1984, 1985 FDA Approval of first two cochlear implant devices William F. House, Graeme Clark 3M/House Research Institute, Univ. of Melbourne/Cochlear Corp Private--3M and Nucleus Ltd FDA Premarket Approval P830069: 3M Brand Cochlear Implant System/House Design in citation 1 FDA Premarket Approval P840024: Nucleus Multichannel Implantable Hearing Prosthesis    

Late 1980s/1990s: Next Generation Devices and Applications

Year Description of Milestone Primary Investigator(s) Research Institution Funding source (including NIH grant numbers where available) Citation 1 Citation 2 Citation 3 Citation 4
1986 Publication of  first model for parallel organization of circuits involved in both normal movement and Parkinson's Garrett Alexander, Mahlon DeLong, and Peter Strick Johns Hopkins University NIH Grants NS00632 (G.A.), NS17678 (G.A.), NS16375 (Mahlon DeLong), NS02957 (P.S.), VA, private donations Alexander GE, DeLong MR, Strick PL. Parallel organization of functionally segregated circuits linking basal ganglia and cortex. Annual review of neuroscience. 1986;9:357-381.      
1986-1990 Studies in the MPTP primate model implcate dysfunction in two regions for movement symptoms in PD and related  disorders Mahlon DeLong; John Penney, Anne Young; David Sibley Johns Hopkins University;  University of Michigan, Ann Arbor; NINDS/NIMH Intramural NIH Grants NS15655, NS19613,  NS01300,NS015417 private donations Penney JB, Jr., Young AB. Striatal inhomogeneities and basal ganglia function. Movement disorders : official journal of the Movement Disorder Society. 1986;1(1):3-15. Albin RL, Young AB, Penney JB. The functional anatomy of basal ganglia disorders. Trends in neurosciences. 1989;12(10):366-375. DeLong MR. Primate models of movement disorders of basal ganglia origin. Trends in neurosciences. 1990;13(7):281-285. Gerfen CR, Engber TM, Mahan LC, et al. D1 and D2 dopamine receptor-regulated gene expression of striatonigral and striatopallidal neurons. Science. 1990;250(4986):1429-1432.
1990 The FDA approved cochlear implant use in children, providing an opportunity to restore hearing to children during their developmental years Graeme Clark Cochlear Corp Private-Cochlear Corp FDA Premarket Approval P890027: Nucleus 22 Channel Cochlear Implant Sys /Children      
1990-91 Studies demonstrated that inactivation of one deep brain region in a primate model reduces tremor symptoms using the MPTP  model for Parkinson's disease Mahlon DeLong; Alan Crossman Johns Hopkins University; University of Manchester Medical School, U.K. NS15417, private funds from  the E.K. Dunn family, UK Govt. Bergman H, Wichmann T, DeLong MR. Reversal of experimental parkinsonism by lesions of the subthalamic nucleus. Science. 1990;249(4975):1436-1438. Aziz TZ, Peggs D, Sambrook MA, Crossman AR. Lesion of the subthalamic nucleus for the alleviation of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced parkinsonism in the primate. Movement disorders : official journal of the Movement Disorder Society. 1991;6(4):288-292.    
1987-98 Studies in humans revealed that electrical stimulation of deep brain regions could quickly and reversibly reduce the tremors associated with Parkinson’s disease. Alim-Louis Benabid Joseph Fourier University of Grenoble, France INSERM/French Govt Benabid AL, Pollak P, Louveau A, Henry S, de Rougemont J. Combined (thalamotomy and stimulation) stereotactic surgery of the VIM thalamic nucleus for bilateral Parkinson disease. Applied neurophysiology. 1987;50(1-6):344-346. Benabid AL, Pollak P, Gervason C, et al. Long-term suppression of tremor by chronic stimulation of the ventral intermediate thalamic nucleus. Lancet. 1991;337(8738):403-406. Limousin P, Pollak P, Benazzouz A, et al. Effect of parkinsonian signs and symptoms of bilateral subthalamic nucleus stimulation. Lancet. 1995;345(8942):91-95. Limousin P, Krack P, Pollak P, et al. Electrical stimulation of the subthalamic nucleus in advanced Parkinson's disease. The New England journal of medicine. 1998;339(16):1105-1111.
1990s Building on earlier research, Medtronic scientists performed clinical trials of deep brain stimulation for tremor and Parkinson’s disease. N/A Medtronic Private-Medtronic Rise MT, W. KG, Inventors; Medtronic, Inc., assignee. Method of treating movement disorders by brain stimulation. US patent 5716377. February 10, 1998. Medtronic DBS Therapy for Parkinson's Disease and Essential Tremor Data and Clinical Outcomes    
1997 Medtronic received the first FDA approval for deep brain stimulation to treat essential tremor, a common disorder with symptoms similar to Parkinson’s disease. N/A Medtronic Private-Medtronic FDA Premarket Approval P960009: Medtronic Activa Tremor Control System      

2000s-2010s: A Rapidly Growing Field Seeking New Targets

Year Description of Milestone Primary Investigator(s) Research Institution Funding source (including NIH grant numbers where available) Citation 1 Citation 2 Citation 3 Citation 4
2002-03 The Medtronic deep brain stimulation device was approved by the FDA to treat symptoms of Parkinson’s disease N/A Medtronic Private-Medtronic FDA Premarket Approval P960009: Medtronic Activa Tremor Control System, Supplement S007: Medtronic Activa Parkinson’s Control System      
2009 A large clinical trial demonstrated that deep brain stimulation is superior to best medical therapy Frances Weaver Hines VA Hospital (and many others via the CSP 468 Study Group) VA, NIH-NINDS, Medtronic Weaver FM, Follett K, Stern M, et al. Bilateral deep brain stimulation vs best medical therapy for patients with advanced Parkinson disease: a randomized controlled trial. Jama. 2009;301(1):63-73.      
2009 FDA approves a humanitarian exemption for deep brain stimulation as a treatment for Obsessive-Compulsive Disorder N/A Medtronic Private-Medtronic FDA: Reclaim™ DBS™ Therapy for OCD - H050003      
2011-14 NIH-funded researchers used electrical stimulation strategies to restore lost function in patients with spinal cord injury, who regained bladder control, blood pressure control, sexual function, and the ability to make small voluntary lower body movements and stand unaided for up to 20 minutes V. Reggie Edgerton; Susan Harkema University of California, Los Angeles; University of Louisville NIH Grants EB007615 and GM103507, Reeve Foundation, Leona M. and Harry B. Helmsley Charitable Trust, Kessler Foundation, University of Louisville Foundation, and Jewish Hospital and St. Mary’s Foundation, Frazier Rehab Institute and University of Louisville Hospital Harkema S, Gerasimenko Y, Hodes J, et al. Effect of epidural stimulation of the lumbosacral spinal cord on voluntary movement, standing, and assisted stepping after motor complete paraplegia: a case study. Lancet. 2011;377(9781):1938-1947. Angeli CA, Edgerton VR, Gerasimenko YP, Harkema SJ. Altering spinal cord excitability enables voluntary movements after chronic complete paralysis in humans. Brain : a journal of neurology. 2014;137(Pt 5):1394-1409.    
2014 The FDA approved a humanitarian exemption for the use of the first visual prosthesis,the Argus II, which allows patients with certain types of vision loss to perceive a small, low-resolution visual field. Mark Humayan, Robert Jay Greenberg Johns Hopkins University, Second Sight Medical Products, Inc. NIH Grants: EY011888 and EY012893 FDA: Argus II Retinal Prosthesis System - H110002      
2015 NIH-funded researchers stimulate the spinal cord through the skin, generating intentional step-like movements in patients with spinal cord injury V. Reggie Edgerton University of California, Los Angeles NIH Grants EB15521, EB007615, TR000124, Reeve Foundation, Walkabout Foundation, F.M. Kirby Foundation Gerasimenko YP, Lu DC, Modaber M, et al. Noninvasive Reactivation of Motor Descending Control after Paralysis. Journal of neurotrauma. 2015;32(24):1968-1980.      

Related Resources on Neurostimulation Technologies

Fighting Cancer: Ushering in a New Era of Molecular Medicine

Huge advances in our understanding of disease at a molecular level are paving the way for more effective, personalized treatments. Gleevec®, a drug used to treat chronic myelogenous leukemia (CML), was among the first successful molecular medicines developed. Read the story of how NIH-supported research helped create a revolutionary cancer drug that changed the way we think about designing new medicines

Additional materials

References

1A Story of Discovery: Gleevec Transforms Cancer Treatment for Chronic Myelogenous Leukemia. National Cancer Institute. Retrieved October 29, 2015, from http://www.cancer.gov/research/progress/discovery/gleevec

2Druker BJ, Guilhot F, O'Brien SG, et al. Five-year follow-up of patients receiving imatinib for chronic myeloid leukemia. The New England journal of medicine. 2006;355(23):2408-2417.

3http://www.cancer.org/cancer/cancerbasics/thehistoryofcancer/the-history-of-cancer-cancer-treatment-targeted-therapy

4https://www.jstage.jst.go.jp/article/kjm/59/1/59_1_1/_pdf

5Huang X, Cortes J, Kantarjian H. http://www.ncbi.nlm.nih.gov/pubmed/22294282 Estimations of the increasing prevalence and plateau prevalence of chronic myeloid leukemia in the era of tyrosine kinase inhibitor therapy. Cancer. 2012;118(12):3123-3127.

6http://www.cancer.org/acs/groups/content/@editorial/documents/document/acspc-044552.pdf

7A Decade of Innovation in Rare Diseases. PhRMA 2015. http://www.phrma.org/sites/default/files/pdf/PhRMA-Decade-of-Innovation-Rare-Diseases.pdf

8Boveri T. Concerning the origin of malignant tumours by Theodor Boveri. Translated and annotated by Henry Harris. Journal of cell science. 2008;121 Suppl 1:1-84.

9https://www.genome.gov/Pages/Education/GeneticTimeline.pdf

10Nowell PC, Hungerford DA. Chromosome studies on normal and leukemic human leukocytes. Journal of the National Cancer Institute. 1960;25:85-109.

11Rowley JD. Letter: A new consistent chromosomal abnormality in chronic myelogenous leukaemia identified by quinacrine fluorescence and Giemsa staining. Nature. 1973;243(5405):290-293.

12Heisterkamp N, Stephenson JR, Groffen J, et al. Localization of the c-ab1 oncogene adjacent to a translocation break point in chronic myelocytic leukaemia. Nature. 1983;306(5940):239-242.

13Groffen J, Stephenson JR, Heisterkamp N, de Klein A, Bartram CR, Grosveld G. Philadelphia chromosomal breakpoints are clustered within a limited region, bcr, on chromosome 22. Cell. 1984;36(1):93-99.

14Konopka JB, Watanabe SM, Singer JW, Collins SJ, Witte ON. Cell lines and clinical isolates derived from Ph1-positive chronic myelogenous leukemia patients express c-abl proteins with a common structural alteration. Proceedings of the National Academy of Sciences of the United States of America. 1985;82(6):1810-1814.

15Druker BJ. Perspectives on the development of imatinib and the future of cancer research. Nature medicine. 2009;15(10):1149-1152.

16Ibid.

17Hunter T. Treatment for chronic myelogenous leukemia: the long road to imatinib. The Journal of clinical investigation. 2007;117(8):2036-2043.

18Pray L. Gleevec: the breakthrough in cancer treatment. Nat Education. 2008;1(1):37.

19Druker BJ, Tamura S, Buchdunger E, et al. Effects of a selective inhibitor of the Abl tyrosine kinase on the growth of Bcr-Abl positive cells. Nature medicine. 1996;2(5):561-566.

20Food and Drug Administration Modernization Act. S. 830. 105th Congress. (1997).

21Fast Track. Food and Drug Administration. Updated 2014, September 15. Retrieved October 29, 2015, from http://www.fda.gov/ForPatients/Approvals/Fast/ucm405399.htm

22Druker BJ, Talpaz M, Resta DJ, et al. Efficacy and safety of a specific inhibitor of the BCR-ABL tyrosine kinase in chronic myeloid leukemia. The New England journal of medicine. 2001;344(14):1031-1037.

23Waalen J. Gleevec’s Glory Days. Howard Hughes Medical Institute Bulletin. 2001 Dec;14(5):10-15.

24Druker BJ, Guilhot F, O'Brien SG, et al. Five-year follow-up of patients receiving imatinib for chronic myeloid leukemia. The New England journal of medicine. 2006;355(23):2408-2417.

25http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm110505.htm

26Cumulative number of publications containing the search term “imatinib” from 1996-2014 in the PubMed database.

27A Decade of Innovation in Rare Diseases. PhRMA 2015. http://www.phrma.org/sites/default/files/pdf/PhRMA-Decade-of-Innovation-Rare-Diseases.pdf

28Ibid.

29https://www.jstage.jst.go.jp/article/kjm/59/1/59_1_1/_pdf

30Determined by searching clinicaltrials.gov for registered clinical trials using the term “imatinib,” “Gleevec,” or “Glivec.”

31http://www.accessdata.fda.gov/drugsatfda_docs/label/2015/021588s042lbl.pdf

32http://seer.cancer.gov/csr/1975_2012/browse_csr.php?sectionSEL=13&pageSEL=sect_13_table.16.html#table4

33https://www.jstage.jst.go.jp/article/kjm/59/1/59_1_1/_pdf

34Determined using data provided by FDA’s Center for Drug Evaluation and Research on mechanism of action of approved FDA drugs, 1999-2015.

35Determined using data provided by FDA’s Center for Drug Evaluation and Research on the companies associated with approved FDA drugs.

36DiMasi JA, Hansen RW, Grabowski HG. The price of innovation: new estimates of drug development costs. Journal of health economics. 2003;22(2):151-185.

37http://csdd.tufts.edu/files/uploads/Tufts_CSDD_briefing_on_RD_cost_study_-_Nov_18,_2014..pdf

Appendix

The table below provides a more detailed list of selected milestones underlying this story’s “Research-to-Practice Milestones” (page 2 of the pdf), including the lead scientists, research institutions, funding sources, and scientific publications involved in each one.

Identifying the Molecular Trigger of CML (1914–1990)

Year Description of Milestone Primary Investigator(s) Research Institution Funding source (including NIH grant numbers where available) Citation 1 Citation 2
1914 Biologist Theodor Boveri first hypothesized that chromosomal abnormalities may play a role in tumor development, but no tools existed at that time to test his theory. Boveri N/A Unknown (Germany) Boveri T. Concerning the origin of malignant tumours by Theodor Boveri. Translated and annotated by Henry Harris. Journal of cell science. 2008;121 Suppl 1:1-84.  
1950s Using newly developed techniques to study cells and chromosomes, researchers began to link chromosomal abnormalities to specific human diseases. None specific N/A N/A Genome.gov Timeline: From Darwin and Mendel to the Human Genome Project  
1960 Drs. Nowell and Hungerford studied cells from CML patients and discovered an atypical small chromosome in the cancer cells, called the Philadelphia chromosome. Nowell and Hungerford University of Pennsylvania NIH (C-3562), American Cancer Society, US Public Health Service Nowell PC, Hungerford DA. Chromosome studies on normal and leukemic human leukocytes. Journal of the National Cancer Institute. 1960;25:85-109.  
1973 Dr. Rowley discovered that the Philadelphia chromosome results from a chromosomal translocation between chromosomes 9 and 22. Rowley University of Chicago Unknown Rowley JD. Letter: A new consistent chromosomal abnormality in chronic myelogenous leukaemia identified by quinacrine fluorescence and Giemsa staining. Nature. 1973;243(5405):290-293.  
1983 Researchers identified the genes involved in the Philadelphia chromosome, showing that the human oncogene c-abl is part of the translocation. Heisterkamp NIH (NCI intramural); Erasmus University NIH (contract COI-CP-75380), Netherlands Cancer Society Heisterkamp N, Stephenson JR, Groffen J, et al. Localization of the c-ab1 oncogene adjacent to a translocation break point in chronic myelocytic leukaemia. Nature. 1983;306(5940):239-242.  
1984 Scientists identified the breakpoint cluster region (bcr) on chromosome 22. Groffen NIH (NCI intramural); Erasmus University NIH (contract COI-CP-75380), Netherlands Cancer Society Groffen J, Stephenson JR, Heisterkamp N, de Klein A, Bartram CR, Grosveld G. Philadelphia chromosomal breakpoints are clustered within a limited region, bcr, on chromosome 22. Cell. 1984;36(1):93-99.  
1990 Researchers identified the function of the bcr-abl fusion gene, which prompts production of an improperly regulated abnormal tyrosine kinase protein. Lugo University of California, Los Angeles NIH/NCI (T32GM08243 and T32GM07185), Howard Hughes Medical Institute, Leukemia Society of America Lugo TG, Pendergast AM, Muller AJ, Witte ON. Tyrosine kinase activity and transformation potency of bcr-abl oncogene products. Science. 1990;247(4946):1079-1082.  

Developing a targeted Bcr-abl kinase inhibitor (1990–1996)

Year Description of Milestone Primary Investigator(s) Research Institution Funding source (including NIH grant numbers where available) Citation 1 Citation 2
1990 Scientists at pharmaceutical company Ciba-Geigy (later became Novartis) began to refine a compound that blocks the enzyme that triggers CML without harming other kinases. Nick Lydon Ciba-Geigy (now Novartis) Ciba-Geigy Druker BJ. Perspectives on the development of imatinib and the future of cancer research. Nature medicine. 2009;15(10):1149-1152.  
1990 Dr. Druker began developing model systems to study BCR-ABL signaling and outlined how to characterize BCR-ABL kinase inhibitors. Brian Druker Dana-Farber Cancer Institute NIH/NCI (K08CA001422) Druker BJ. Perspectives on the development of imatinib and the future of cancer research. Nature medicine. 2009;15(10):1149-1152.  
1992 The compound that would become Gleevec was first synthesized, although many years of testing would be needed before its effectiveness was known. N/A Ciba-Geigy Ciba-Geigy Hunter T. Treatment for chronic myelogenous leukemia: the long road to imatinib. The Journal of clinical investigation. 2007;117(8):2036-2043.  
1993 Dr. Druker started his own lab with the goal of finding a drug company that had a BCR-ABL kinase inhibitor that he could help move to the clinic. He partnered with Ciba-Geigy to screen their collection of synthesized compounds for signs of anticancer activity. Brian Druker Oregon Health & Sciences University; Ciba-Geigy NIH/NCI (K08CA001422); Ciba-Geigy Druker BJ. Perspectives on the development of imatinib and the future of cancer research. Nature medicine. 2009;15(10):1149-1152. Pray L. Gleevec: the breakthrough in cancer treatment. Nat Education. 2008;1(1):37.
1996 One of the compounds showed promising results in cultured cells. The compound (ST1571) caused a 92-98% decrease in the number of bcr-abl colonies formed and did not appear to harm healthy cells. Brian Druker Oregon Health & Sciences University; Ciba-Geigy NIH/NCI (K08CA001422); Ciba-Geigy Druker BJ, Tamura S, Buchdunger E, et al. Effects of a selective inhibitor of the Abl tyrosine kinase on the growth of Bcr-Abl positive cells. Nature medicine. 1996;2(5):561-566.  

Testing and Approving a Life-changing Drug (1997–2015)

Year Description of Milestone Primary Investigator(s) Research Institution Funding source (including NIH grant numbers where available) Citation 1 Citation 2
1998 Ciba-Geigy helped develop the drug for patient use, and the first Phase I clinical trial of ST1571 (later renamed Gleevec) began. All 31 patients in the initial trial experienced complete remission with limited side effects. Brian Druker Ciba-Geigy; Oregon Health & Sciences University NIH (R01CA65823 and P01CA032737); Novartis Druker BJ, Talpaz M, Resta DJ, et al. Efficacy and safety of a specific inhibitor of the BCR-ABL tyrosine kinase in chronic myeloid leukemia. The New England journal of medicine. 2001;344(14):1031-1037.  
2001 Successful clinical trial results led the FDA to grant “fast track” designation for Gleevec, and it was approved only ten weeks after the New Drug Application was submitted. N/A Novartis NIH, Novartis Waalen J. Gleevec’s Glory Days. Howard Hughes Medical Institute Bulletin. 2001 Dec;14(5):10-15.  
2006 After five years of continuous follow-up treatment, patients receiving Gleevec continued to have a high response rate to the drug, and most remained cancer-free. Druker Novartis; Oregon Health & Sciences University Novartis Druker BJ, Guilhot F, O'Brien SG, et al. Five-year follow-up of patients receiving imatinib for chronic myeloid leukemia. The New England journal of medicine. 2006;355(23):2408-2417.  

Related Resources on Gleevec

Childhood Hib Vaccines: Nearly Eliminating the Threat of Bacterial Meningitis

NIH has contributed to the development of many important vaccines, including the vaccine against Haemophilus influenzae type b (Hib) infection. Once the leading cause of bacterial meningitis in children, Hib infection can result in serious, long-term disability and death. Today, Hib has been nearly eliminated. Read the story of how NIH-supported research helped create a vaccine that has nearly eliminated childhood meningitis

Additional materials

References

1NIAID Health and Research Topics: Vaccines , CDC Vaccines and Immunizations: List of Vaccines Used in United States

2NIAID Health and Research Topics: Vaccine Benefits , NICHD Mission and Scientific Accomplishments: Hib Vaccine, and WHO Position Paper on Haemophilus infl uenzae type b conjugate vaccines Weekly Epidemiological Record. 2006;81(47):445.

3Whitney CG, Zhou F, Singleton J, Schuchat A, Centers for Disease C, Prevention. Benefits from immunization during the vaccines for children program era - United States, 1994-2013. MMWR. Morbidity and mortality weekly report. 2014;63(16):352-355.

4Robbins JB, Schneerson R, Anderson P, Smith DH. The 1996 Albert Lasker Medical Research Awards. Prevention of systemic infections, especially meningitis, caused by Haemophilus influenzae type b. Impact on public health and implications for other polysaccharide-based vaccines. Jama. 1996;276(14):1181-1185.

5Decker MD, Edwards KM. Haemophilus influenzae type b vaccines: history, choice and comparisons. The Pediatric infectious disease journal. 1998;17(9 Suppl):S113-116.

6CDC Diseases and the Vaccines that Prevent Them: Hib and NICHD Press Release: NICHD Researchers Honored by WHO for Developing Vaccines Against Haemophilus Influenzae, December 10, 1996.

7Coverage with Individual Vaccines and Vaccination Series, by State and Local area. In: CDC, ed. National Immunization Survey 2013.

8CDC Vaccine Information Statements: Hib

9NIAID Health and Research Topics: Vaccine Benefits

10NICHD Press Release: NICHD Researchers Honored by WHO for Developing Vaccines Against Haemophilus Influenzae, December 10, 1996.

11Zhou F, Shefer A, Wenger J, et al. Economic evaluation of the routine childhood immunization program in the United States, 2009. Pediatrics. 2014;133(4):577-585.

12Albert Lasker Clinical Medical Research Award, 1996 Winners

13Zhou F, Shefer A, Wenger J, et al. Economic evaluation of the routine childhood immunization program in the United States, 2009. Pediatrics. 2014;133(4):577-585.

14 Baker JP, Katz SL. Childhood vaccine development: an overview. Pediatric research. 2004;55(2):347-356. and CDC: The Pink Book: Tetanus Vaccine

15Pittman M. Variation and Type Specificity in the Bacterial Species Hemophilus Influenzae. The Journal of experimental medicine. 1931;53(4):471-492. and Pittman M. The Action of Type-Specific Hemophilus Influenzae Antiserum. The Journal of experimental medicine. 1933;58(6):683-706.

16Robbins JB, Schneerson R, Anderson P, Smith DH. The 1996 Albert Lasker Medical Research Awards. Prevention of systemic infections, especially meningitis, caused by Haemophilus influenzae type b. Impact on public health and implications for other polysaccharide-based vaccines. Jama. 1996;276(14):1181-1185. and Jin Z, Romero-Steiner S, Carlone GM, Robbins JB, Schneerson R. Haemophilus influenzae type a infection and its prevention. Infection and immunity. 2007;75(6):2650-2654.

17Landsteiner K, van der Scheer J. On Cross Reactions of Immune Sera to Azoproteins. The Journal of experimental medicine. 1936;63(3):325-339. and Avery OT, Goebel WF. Chemo-Immunological Studies on Conjugated Carbohydrate-Proteins : Ii. Immunological Specificity of Synthetic Sugar-Protein Antigens. The Journal of experimental medicine. 1929;50(4):533-550.

18Alexander DF. Why should there be an NICHD? Pediatrics. 2011;127(2):325-333, also Albert Lasker Clinical Medical Research Award, 1996 Winners, and Rodrigues LP, Schneerson R, Robbins JB. Immunity to Hemophilus influenzae type b. I. The isolation, and some physicochemical, serologic and biologic properties of the capsular polysaccharide of Hemophilus influenzae type b. Journal of immunology. 1971;107(4):1071-1080.

19Smith DH, Peter G, Ingram DL, Harding AL, Anderson P. Responses of children immunized with the capsular polysaccharide of Hemophilus influenzae, type b. Pediatrics. 1973;52(5):637-644. and Peltola H, Kayhty H, Sivonen A, Makela H. Haemophilus influenzae type b capsular polysaccharide vaccine in children: a double-blind field study of 100,000 vaccinees 3 months to 5 years of age in Finland. Pediatrics. 1977;60(5):730-737.

20Albert Lasker Clinical Medical Research Award, 1996 Winners and University of Rochester: Childhood Vaccine with Rochester Roots Recognized

21Robbins JB, Schneerson R, Anderson P, Smith DH. The 1996 Albert Lasker Medical Research Awards. Prevention of systemic infections, especially meningitis, caused by Haemophilus influenzae type b. Impact on public health and implications for other polysaccharide-based vaccines. Jama. 1996;276(14):1181-1185.

22ibid. and Albert Lasker Clinical Medical Research Award, 1996 Winners

23Schneerson R, Barrera O, Sutton A, Robbins JB. Preparation, characterization, and immunogenicity of Haemophilus influenzae type b polysaccharide-protein conjugates. The Journal of experimental medicine. 1980;152(2):361-376. and Robbins JB, Schneerson R, Anderson P, Smith DH. The 1996 Albert Lasker Medical Research Awards. Prevention of systemic infections, especially meningitis, caused by Haemophilus influenzae type b. Impact on public health and implications for other polysaccharide-based vaccines. Jama. 1996;276(14):1181-1185.

24Schneerson R, Robbins JB, Chu C, et al. Serum antibody responses of juvenile and infant rhesus monkeys injected with Haemophilus influenzae type b and pneumococcus type 6A capsular polysaccharide-protein conjugates. Infection and immunity. 1984;45(3):582-591.

25Claesson BA, Schneerson R, Robbins JB, et al. Protective levels of serum antibodies stimulated in infants by two injections of Haemophilus influenzae type b capsular polysaccharide-tetanus toxoid conjugate. The Journal of pediatrics. 1989;114(1):97-100. also Anderson P, Pichichero M, Edwards K, Porch CR, Insel R. Priming and induction of Haemophilus influenzae type b capsular antibodies in early infancy by Dpo20, an oligosaccharide-protein conjugate vaccine. The Journal of pediatrics. 1987;111(5):644-650. and Anderson P, Pichichero ME, Insel RA. Immunization of 2-month-old infants with protein-coupled oligosaccharides derived from the capsule of Haemophilus influenzae type b. The Journal of pediatrics. 1985;107(3):346-351

26Decker MD, Edwards KM. Haemophilus influenzae type b vaccines: history, choice and comparisons. The Pediatric infectious disease journal. 1998;17(9 Suppl):S113-116.

27ibid.

28CDC Notice to Readers Recommended Childhood Immunization Schedule — United States, January 1995

29Albert Lasker Clinical Medical Research Award, 1996 Winners

30Kelly DF, Moxon ER, Pollard AJ. Haemophilus influenzae type b conjugate vaccines. Immunology. 2004;113(2):163-174.

31Coverage with Individual Vaccines and Vaccination Series, by State and Local area. In: CDC, ed. National Immunization Survey 2013.

32NIAID Health and Research Topics: Vaccine Benefits and CDC: The Pink Book: Course Textbook — 13th Edition (2015) — Hib (graph adapted from “Secular Trends in the United States” section)

33Briere EC, Rubin L, Moro PL, et al. Prevention and control of haemophilus influenzae type b disease: recommendations of the advisory committee on immunization practices (ACIP). MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control. 2014;63(RR-01):1-14.

34Whitney CG, Zhou F, Singleton J, Schuchat A, Centers for Disease C, Prevention. Benefits from immunization during the vaccines for children program era — United States, 1994–2013. MMWR. Morbidity and mortality weekly report. 2014;63(16):352-355.

35Zhou F, Shefer A, Wenger J, et al. Economic evaluation of the routine childhood immunization program in the United States, 2009. Pediatrics. 2014;133(4):577-585.

36Whitney CG, Zhou F, Singleton J, Schuchat A, Centers for Disease C, Prevention. Benefits from immunization during the vaccines for children program era — United States, 1994–2013. MMWR. Morbidity and mortality weekly report. 2014;63(16):352-355. (see Appendix Table 2)

37Albert Lasker Clinical Medical Research Award, 1996 Winners

38Robbins JB, Schneerson R, Anderson P, Smith DH. The 1996 Albert Lasker Medical Research Awards. Prevention of systemic infections, especially meningitis, caused by Haemophilus influenzae type b. Impact on public health and implications for other polysaccharide-based vaccines. Jama. 1996;276(14):1181-1185, also Albert Lasker Clinical Medical Research Award, 1996 Winners and NICHD Press Release: NICHD Researchers Honored by WHO for Developing Vaccines Against Haemophilus Influenzae, December 10, 1996.

39Zhou F, Shefer A, Wenger J, et al. Economic evaluation of the routine childhood immunization program in the United States, 2009. Pediatrics. 2014;133(4):577-585.

Appendix

The table below provides a more detailed list of selected milestones underlying this story’s “Research-to-Practice Milestones” (page 2 of the pdf), including the lead scientists, research institutions, funding sources, and scientific publications involved in each one.

Foundational Research

Year Description of Milestone Primary Investigator(s) Research Institution Funding source (including NIH grant numbers where available) Citation 1 Citation 2
1892 Bacteria isolated in sputum of patients during an influenza outbreak – later named Haemophilus Pfeiffer N/A N/A Jin Z, Romero-Steiner S, Carlone GM, Robbins JB, Schneerson R. Haemophilus influenzae type a infection and its prevention. Infection and immunity. 2007;75(6):2650-2654  
1923 First diphtheria vaccine developed  Ramon Pasteur Institute (France) N/A Baker JP, Katz SL. Childhood vaccine development: an overview. Pediatric research. 2004;55(2):347-356  
1924 First tetanus vaccine developed Descombey N/A N/A CDC: The Pink Book: Tetanus Vaccine  
1929 The ability of the sugar coat surrounding some bacteria, called the capsular polysaccharide, to generate an immune response was enhanced. Avery and Goebel Rockefeller Institute N/A Avery OT, Goebel WF. Chemo-Immunological Studies on Conjugated Carbohydrate-Proteins : Ii. Immunological Specificity of Synthetic Sugar-Protein Antigens. The Journal of experimental medicine. 1929;50(4):533-550.  
1930s Hib was discovered and found to be the primary cause of bacterial meningitis.  A unique feature of the type b strain is the structure of the sugar molecules on the bacterial coat, later known as the capsular polysaccharide. Pittman Rockefeller Institute N/A Pittman M. Variation and Type Specificity in the Bacterial Species Hemophilus Influenzae. The Journal of experimental medicine. 1931;53(4):471-492. Pittman M. The Action of Type-Specific Hemophilus Influenzae Antiserum. The Journal of experimental medicine. 1933;58(6):683-706.
1933 Determined that children develop systemic Hib infections when placental antibodies waned  Fothergill and Wright Harvard University Philip Ellis Stevens, Jr., Memorial Fund Fothergill L, Wright J. The Relation of Age Incidence to the Bactericidal Power of Blood Against the Causal Organism. J Immunol. 1933; 24(4): 273-284  
1936 A molecule’s ability to generate antibodies in animals is enhanced when bound to a more immune stimulating molecule Landsteiner Rockefeller Institute N/A Landsteiner K, van der Scheer J. On Cross Reactions of Immune Sera to Azoproteins. The Journal of experimental medicine. 1936;63(3):325-339.  

Early Hib Vaccine Development

Year Description of Milestone Primary Investigator(s) Research Institution Funding source (including NIH grant numbers where available) Citation 1 Citation 2
1968 Hib polysaccharides were isolated, purified, and considered for clinical use Smith and Anderson Harvard Medical School N/A Albert Lasker Clinical Medical Research Award, 1996 Winners  
1970s Hib polysaccharides were recognized as the predominate bacterial substances that elicited immune responses, as opposed to proteins as widely believed. Robbins and Schneerson NIH NICHD Intramural Research Program Alexander DF. Why should there be an NICHD? Pediatrics. 2011;127(2):325-333  
1971 Hib polysaccharides were  isolated and purified Robbins and Schneerson Albert Einstein College of Medicine NIAID grant (R01AI8110), NICHD contract (69-2246), and NICHD grant (K03HD22856) Rodrigues LP, Schneerson R, Robbins JB. Immunity to Hemophilus influenzae type b. I. The isolation, and some physicochemical, serologic and biologic properties of the capsular polysaccharide of Hemophilus influenzae type b. Journal of immunology. 1971;107(4):1071-1080.  
1973 First purified Hib polysaccharide vaccine induced antibody responses in 87% of children over the age of two years, but only in a quarter of infants tested. Smith and Anderson Harvard Medical School NIAID contract (71-2196), NIAID grants (AI20376, AI46905) Smith DH, Peter G, Ingram DL, Harding AL, Anderson P. Responses of children immunized with the capsular polysaccharide of Hemophilus influenzae, type b. Pediatrics. 1973;52(5):637-644.  
1977 A clinical trial assessed the effectiveness of the Hib polysaccharide vaccine in 100,000 children between three months to two years of age. The vaccine proved highly efficacious in those children over 18 months of age, as opposed to younger children. Peltola University of Helsinki & National Public Health Institute (Finland) NIAID contract (AI52502) Peltola H, Kayhty H, Sivonen A, Makela H. Haemophilus influenzae type b capsular polysaccharide vaccine in children: a double-blind field study of 100,000 vaccinees 3 months to 5 years of age in Finland. Pediatrics. 1977;60(5):730-737.  
1983 Praxis Biologics was founded to further develop childhood vaccines, including Hib. Smith and Anderson Praxis Biologics N/A Albert Lasker Clinical Medical Research Award, 1996 Winners  
1984 When half of the children from the 1977 study were re-evaluated, the children who received the vaccine after 18 months of age continued to show good immune responses, while those vaccinated as infants only showed short-lived antibody responses. Peltola University of Helsinki & National Public Health Institute of Finland NIAID contract (AI52502) Peltola H, Kayhty H, Virtanen M, Makela PH. Prevention of Hemophilus influenzae type b bacteremic infections with the capsular polysaccharide vaccine. The New England journal of medicine. 1984;310(24):1561-1566. Kayhty H, Karanko V, Peltola H, Makela PH. Serum antibodies after vaccination with Haemophilus influenzae type b capsular polysaccharide and responses to reimmunization: no evidence of immunologic tolerance or memory. Pediatrics. 1984;74(5):857-865.
1985 The FDA approved Hib polysaccharide vaccines from three companies (including Praxis Biologics) for use in children older than two years of age. N/A N/A N/A Robbins JB, Schneerson R, Anderson P, Smith DH. The 1996 Albert Lasker Medical Research Awards. Prevention of systemic infections, especially meningitis, caused by Haemophilus influenzae type b. Impact on public health and implications for other polysaccharide-based vaccines. Jama. 1996;276(14):1181-1185. Albert Lasker Clinical Medical Research Award, 1996 Winners

Protecting Infants with a Next-Generation Conjugate Vaccine

Year Description of Milestone Primary Investigator(s) Research Institution Funding source (including NIH grant numbers where available) Citation 1 Citation 2
1980 By applying the foundational early 20th century research highlighted above, Hib polysaccharides were linked to proteins shown to be effective vaccines against other bacteria (e.g., diphtheria), producing what is now known as a “conjugate vaccine." Robbins and Schneerson FDA FDA Schneerson R, Barrera O, Sutton A, Robbins JB. Preparation, characterization, and immunogenicity of Haemophilus influenzae type b polysaccharide-protein conjugates. The Journal of experimental medicine. 1980;152(2):361-376.  
1984 NIH and FDA scientists found that this conjugate vaccine triggered immune responses in appropriate animal models. Robbins and Schneerson NIH and FDA NIH Intramural research programs at NICHD, National Institiute of Neurological and Commlunicative Disorders and Stroke, and National Instituite of Arthritis, Metabolism, and Digestive Diseases; FDA's Center for Drugs and Biologics Schneerson R, Robbins JB, Chu C, et al. Serum antibody responses of juvenile and infant rhesus monkeys injected with Haemophilus influenzae type b and pneumococcus type 6A capsular polysaccharide-protein conjugates. Infection and immunity. 1984;45(3):582-591.  
1986 Immune responses in infants could be enhanced if fewer sugar molecules were used with the Hib conjugate vaccine. Smith and Anderson University of Rochester, Praxis Biologics NIAID grants (AI17938, AI12673, AI17217, AI02653) Anderson PW, Pichichero ME, Insel RA, Betts R, Eby R, Smith DH. Vaccines consisting of periodate-cleaved oligosaccharides from the capsule of Haemophilus influenzae type b coupled to a protein carrier: structural and temporal requirements for priming in the human infant. Journal of immunology. 1986;137(4):1181-1186.  
1986 The Hib polysaccharide vaccine linked to tetanus proteins elicited strong, protective immune responses in young adults. Robbins and Schneerson NIH, FDA, Uniformed Services University of the Health Sciences, Charlotte Memorial Hospital and Medical Center, State University of New York NIH Intramural research programs at NICHD and National Institute of Arthritis, Diabetes, Digestive and Kidney Diseases Schneerson R, Robbins JB, Parke JC, Jr., et al. Quantitative and qualitative analyses of serum antibodies elicited in adults by Haemophilus influenzae type b and pneumococcus type 6A capsular polysaccharide-tetanus toxoid conjugates. Infection and immunit  
1987 Infants produced protective antibodies against Hib following vaccination with short segments of Hib sugars linked to diphtheria proteins. Anderson University of Rochester  NIAID grants (AI17938, AI02645, AI17217) Anderson P, Pichichero M, Edwards K, Porch CR, Insel R. Priming and induction of Haemophilus influenzae type b capsular antibodies in early infancy by Dpo20, an oligosaccharide-protein conjugate vaccine. The Journal of pediatrics. 1987;111(5):644-650. Anderson P, Pichichero ME, Insel RA. Immunization of 2-month-old infants with protein-coupled oligosaccharides derived from the capsule of Haemophilus influenzae type b. The Journal of pediatrics. 1985;107(3):346-351
1988 Hib polysaccharides linked to tetanus proteins was safe and effective in 18- to 23-month old healthy children Robbins and Schneerson NIH, CDC, University of
Gothenburg (Sweden)
NICHD Intramural Research Program Claesson BA, Trollfors B, Lagergard T, et al. Clinical and immunologic responses to the capsular polysaccharide of Haemophilus influenzae type b alone or conjugated to tetanus toxoid in 18- to 23-month-old children. The Journal of pediatrics. 1988;112(5):695-702.  
1989 A clinical study demonstrated infants produced protective antibodies following Hib polysaccharide-tetanus protein conjugate vaccination Robbins and Schneerson NIH, University of
Gotheburg (Sweden)
NICHD Intramural Research Program Claesson BA, Schneerson R, Robbins JB, et al. Protective levels of serum antibodies stimulated in infants by two injections of Haemophilus influenzae type b capsular polysaccharide-tetanus toxoid conjugate. The Journal of pediatrics. 1989;114(1):97-100  
1987-1993 The FDA approved the first 4 Hib conjugate vaccines for use in infants. N/A N/A N/A Decker MD, Edwards KM. Haemophilus influenzae type b vaccines: history, choice and comparisons. The Pediatric infectious disease journal. 1998;17(9 Suppl):S113-116.  
1995 The CDC includes Hib conjugate vaccines in the first childhood vaccine schedule. N/A N/A N/A CDC Notice to Readers Recommended Childhood Immunization Schedule -- United States, January 1995  

Related Resources on Hib and Other Vaccines

This page last reviewed on March 16, 2017