Mentoring and Research in Placebo Studies, Asian Medicine, and CAM

描述(申请人提供)：四年前，OMD的Kaptchuk教授获得了职业生涯中期的K24奖。这是续签申请。首席研究人员的短期目标是获得受保护的时间，以1)稳定和扩大他对下一代CAM科学家的培训，以及2)发展安慰剂、东亚医学以及补充和替代医学(CAM)的多学科研究计划。他的长期目标，对于他和他的实习生的工作，是为临床护理做出临床相关的贡献。泰德·卡普切克是哈佛医学院的医学副教授。他的研究和学术融合了基础、临床和社会科学以及人文科学的概念、研究设计和分析方法。K24头四年的成就：首席研究员完成了三项研究安慰剂效应的主要RCT和两项测试针灸疗效的RCT。他还进行了开创性的研究，确定了对安慰剂和针灸反应的大脑回路。在此期间，首席研究员发表了70篇文章，其中8篇为第一作者，28篇为资深作者。首席研究员还收到了两个新的R01，涉及安慰剂/预期效应和针灸，作为高级合作研究员，收到了P01，U19和各种R21。在最初的K24期间，他一直是25名拥有博士学位的实习生的主要或联合主要CAM导师。11名学员获得了K培训奖。他的受训人员撰写了53本第一作者同行评议的出版物，并与他人合著了82本。他希望在更新期内扩大这些成功的努力。哈佛大学及其17家教学医院由NIH下属的CTSA机构联盟组成。Kaptchuk教授完全融入了CTSA，最近被任命为哈佛大学安慰剂研究和治疗相遇项目的主任。他积极参与了许多哈佛奖学金项目，包括担任哈佛全美NCCAM资助的T32 CAM奖学金项目的副主任。首席研究员将参加生物伦理学、科学哲学、免疫学和统计学的相关课程，并参与分子和神经成像研究的实践培训。在他的K24的头四年里，首席研究员开发了一个研究组合，其中包括肠易激综合征、哮喘、抑郁症、骨关节炎和偏头痛的翻译研究。这些研究领域将会扩大。他目前正在使用功能磁共振成像将他之前在安慰剂和针灸在健康志愿者中的神经回路方面的工作扩展到慢性疼痛障碍患者。一项PET-fMRI研究将比较依赖于吗啡调节和酮咯酸调节的安慰剂反应。他将启动功能磁共振实验，以阐明医患关系中医生部分的神经生物学。首席研究人员还通过同时检测循环血清细胞因子、自身抗体、microRNAs和感兴趣基因的多态性(SNPs)，研究与安慰剂和针灸反应有关的特定生物途径及其调节机制。 与公共健康相关：在最广泛的意义上，安慰剂效应可以被理解为由治疗的仪式、患者与医生的关系以及想象力、希望和信念的力量产生的自我康复。亚洲医学是一种日益增长的医疗保健职业。这个K24应用程序寻求指导下一代科学家，并在这两个领域制定翻译和机械化的研究议程。

DESCRIPTION (provided by applicant): Four years ago, Professor Kaptchuk, OMD, received a Midcareer K24 award. This is a renewal application. The principal investigator's short-term goal is to obtain protected time to 1) stabilize and expand his training of the next generation of CAM scientists and 2) develop a multi-disciplinary research program in placebo, East Asian medicine and complementary and alternative medicine (CAM). His long-term goal, for his work and that of his trainees, is to make clinically relevant contributions to clinical care. Ted Kaptchk is Associate Professor of Medicine at Harvard Medical School. His research and scholarship integrates concepts, research designs and analytic methods drawn from the basic, clinical, and social sciences, as well as the humanities. Achievements in first four years of K24: The principal investigator has completed three major RCTs investigating placebo effects and two RCTs testing acupuncture's efficacy. He also performed groundbreaking studies identifying the brain circuitry of responses to placebo and acupuncture. In this period, the principal investigator published 70 articles, eight as first author and 28 as senior author. The principal investigator also received two new R01s concerned with both placebo/expectation effects and acupuncture and, as senior co-investigator, a P01, U19 and various R21s. During the initial K24 period, he has been primary or co-primary CAM mentor for 25 trainees with doctoral degrees. Eleven trainees held K training awards. His trainees authored 53 first-authored peer-reviewed publications and had 82 co-authorships. He expects to expand these successful efforts in a renewal period. Harvard University and its 17 teaching hospitals comprise an NIH affiliated CTSA institutional consortium. Professor Kaptchuk is fully integrated into the CTSA and has recently been appointed director of Harvard-wide Program in Placebo Studies and Therapeutic Encounter. He is active in many Harvard fellowship programs including serving as associate director of the Harvard-wide NCCAM-funded T32 CAM fellowship program. The principal investigator will take relevant courses in bioethics, philosophy of science, immunology, and statistics and engage in hands-on training in molecular and neuroimaging research. In the first four years of his K24, the principal investigator developed a research portfolio that includes translational research in irritable bowel syndrome, asthma, depression, osteoarthritis, and migraine. These research areas will be expanded. He is currently using fMRI to extend his previous work on the neural circuitry of placebo and acupuncture in healthy volunteers to patients with chronic pain disorders. A PET-fMRI study will investigate placebo responses dependent on morphine conditioning verses ketorolac conditioning. He will initiate fMRI experiments to elucidate the neurobiology of the physician component of the patient-physician relationship. The principal investigator is also investigating specific biological pathways implicated in placebo and acupuncture responses and their mechanisms of regulation by concurrently examining circulating serum cytokines, auto antibodies, microRNAs and polymorphisms (SNPs) in genes of interest. PUBLIC HEALTH RELEVANCE: In their broadest sense, placebo effects can be understood as self-healing engendered by the ritual of treatment, the patient-practitioner relationship, and the power of the imagination, hope and belief. Asian medicine is a growing health care profession. This K24 application seeks to mentor the next generation of scientists and develop a translational and mechanistic research agenda in these two fields.