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Winter 2004 Volume XI Number 1

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Office of International Health Research:
Taking Rigorous Research on CAM Worldwide

Research is NCCAM's central mission--finding out, through carefully designed and executed scientific studies, which complementary and alternative medicine (CAM) practices are effective, and the underlying reasons why. However, many CAM practices have rich histories and traditions of use in other cultures, and there are important insights to be gained from studying them in their original settings--where the effects of possibly related contextual factors such as diet, lifestyle, and beliefs can be more easily studied.

In turn, many international researchers and practitioners are interested in learning more about the American biomedical enterprise and funding for research through the National Institutes of Health (NIH). Through its Office of International Health Research (OIHR), NCCAM is identifying and supporting promising opportunities for international collaboration on CAM research and encouraging the conduct of rigorous CAM research worldwide. The Office, which marks its third anniversary in February 2004, had significant news during calendar year 2003.

New Director Appointed

In September 2003, Jack Killen, M.D., was appointed Director of OIHR, following a nationwide search. Dr. Killen came to NCCAM from the National Institute of Allergy and Infectious Diseases, where he served in a number of senior positions, including Head of the Office of Biodefense Research, Associate Director for Research Ethics, and Director of the Division of AIDS. In the latter position, he worked extensively with international research programs on the prevention and treatment of HIV/AIDS and on addressing a broad array of scientific, ethical, regulatory, and policy issues. Dr. Killen was also Head of the International Research Section of the Department of Clinical Bioethics at the NIH Clinical Center and has worked with multicenter clinical trials and drug development at the National Cancer Institute.

New Planning Grants and Fellowship

Also in September 2003, NCCAM awarded its first Planning Grants for International Centers for Research on CAM (PICRCs; see list). These grants will establish global collaborations and cross-cultural exchange among international and U.S. institutions, to design and implement research on CAM approaches that come from traditional medical systems. ("Traditional" refers here to systems of medicine developed and handed down by tradition within a specific country, region, or culture.) Investigators will conduct research in the countries or cultures from which practices originated, ranging from Japan and China to South Africa, and for such medical problems as bowel disease, women's reproductive health issues, and HIV/AIDS.

Dr. Killen said, "We hope that this initiative will encourage research and bring results that will benefit the health of citizens in many countries. We know that 80 percent of the world's population uses traditional or indigenous practices to meet their primary health care needs, so research on these approaches will have important consequences for global health."

In January 2003, the NCCAM International Postdoctoral Fellowship was established. In this initiative, scientists from other countries are paired with investigators at established research facilities in the United States in order to be trained to conduct research and to continue to do so once they return to their home countries. Projects focus on traditional medical systems (or components of those systems) originating from and/or practiced in cultures throughout the world. More information is on the Internet at grants2.nih.gov/grants/guide/pa-files/PA-03-050.html.

Outreach Workshops

Dr. Jack Killen, OIHR Director, with Mrs. Malti Sinha, Secretary, Department of Indian Systems of Medicine and Homeopathy, Ministry of Health and Family Welfare, Government of India, during the "Indo-US Workshop on Traditional Indian Systems of Medicine Research" held in October 2003.

Over the past 3 years, NCCAM has supported four international outreach workshops. The most recent one took place in October 2003 in Delhi, India, cosponsored with the Indo-US Science and Technology Forum and the Department of Indian Systems of Medicine and Homeopathy, Ministry of Health and Family Welfare, Government of India. It provided an opportunity for U.S. and Indian researchers to discuss their research interests, exchange knowledge about traditional Indian medicine (for example, Ayurveda or Siddha), and develop collaborative studies. In July 2003, a workshop took place in Cuernavaca, Mexico, to help familiarize Latin American and Caribbean scientists with the NIH grant and peer-review processes. It was cosponsored by NCCAM, six other components of NIH, the Mexico Council of Science and Technology, and the Mexico National Institute of Public Health. Earlier cross-cultural workshops took place in Hong Kong (2002) and Singapore (2001).

When asked about the Office's future, Dr. Killen said, "I'm confident that partnerships between NCCAM and international researchers will thrive, as we combine NCCAM's experience and resources in research and training with the practice and expertise of traditional practitioners and researchers in other countries."

NCCAM's First PICRC Awards

Institution: Bastyr University, Kenmore, Washington
Principal Investigator: Leanna J. Standish, N.D., Ph.D., L.Ac.
Collaboration with scientists and practitioners in India to develop an International Center for CAM Research on Ayurvedic Medicine

Columbia University College of Physicians and Surgeons, New York
Principal Investigator: Fredi Kronenberg, Ph.D.
Collaboration to establish a Center for Traditional Chinese Medicine and Women's Health at Fudan University in China

Harvard Medical School, Boston
Principal Investigator: David M. Eisenberg, M.D.
Collaboration with the China Academy of Traditional Chinese Medicine, The Chinese University of Hong Kong, and Keio University (Japan) to establish the U.S.-China-Japan Research Consortium on Herbal Medicine

Johns Hopkins School of Medicine, Baltimore
Principal Investigator: Paul S. Lietman, M.D.
Collaboration between The Johns Hopkins University (JHU) and the National University of Singapore (NUS) and other units in China to create the JHU-NUS Center for Research on CAM in Singapore

Mount Sinai School of Medicine, New York
Principal Investigator: Henry S. Sacks, M.D., Ph.D.
Collaboration with The Foundation for Integrative AIDS Research in New York City and Gandeepam, an organization in India, to establish the HIV/AIDS Development Project in India

University of California, San Francisco (UCSF)
Principal Investigator: Frederick M. Hecht, M.D.
Collaboration with the Osher Center for Integrative Medicine at UCSF and the Swami Vivekananda Yoga Anusandhana Samsthana in India to establish the Center on Yoga, Health, and Meditation

University of Maryland, Baltimore
Principal Investigator: Brian M. Berman, M.D.
Collaboration with The Chinese University of Hong Kong and the University of Illinois at Chicago Program for Collaborative Research in the Pharmaceutical Sciences to create the Center for Functional Bowel Disorders and Traditional Chinese Medicine

University of Missouri, Columbia
Principal Investigator: William R. Folk, Ph.D.
Collaboration with the University of Western Cape, South Africa, and the Missouri Botanical Garden in St. Louis to establish the International Center for Indigenous Phytotherapy Studies

University of North Carolina, Chapel Hill
Principal Investigator: John D. Mann, M.D.
Collaboration with the Kyung Hee University in Korea to establish the Korean Acupuncture in Central Nervous System Disorders Center to study the use of Korean acupuncture in central nervous system disorders

University of Washington, Seattle
Principal Investigator: Margaret M. Heitkemper, Ph.D., R.N.
Collaboration with Ewha Woman's University, Won Kwang University, and Koryo Hand Therapy Clinic in Seoul, Korea, to establish the Center for Women's Health Complementary and Alternative Therapies Research

For more information, see nccam.nih.gov/news/2003.

Other New Research Centers

In addition to the international PICRC awards, NCCAM made four additional awards in September 2003 to establish research centers on CAM. These centers are intended to advance scientific research, forge new partnerships, and build the next generation of centers and experts in rigorous CAM research.

Two awards established NCCAM's first Centers of Excellence for Research on Complementary and Alternative Medicine. In this initiative, scientists at established research organizations will apply cutting-edge technologies to study the fundamental questions related to CAM practices. The recipients were:

• Massachusetts General Hospital, Harvard Medical School, Boston. Bruce R. Rosen, M.D., Ph.D., principal investigator. Dr. Rosen's team will use a variety of neuroimaging techniques and physiological and gene microarray studies to understand how acupuncture affects human brain activity.
• Oregon State University, Corvallis. Balz Frei, Ph.D., principal investigator. Dr. Frei's group will study the mechanisms of antioxidants and explore their potential roles and implications for the prevention and treatment of amyotrophic lateral sclerosis, cardiovascular disease, and aging in general.

A second group of awards established the first two Developmental Centers for Research on Complementary and Alternative Medicine (DCRCs). This initiative partners CAM institutions and major research universities to conduct rigorous exploratory and developmental research on CAM. The recipients were:

• Palmer Center for Chiropractic Research, Davenport, Iowa. William Meeker, D.C., M.P.H., principal investigator. This DCRC will focus on the mechanisms of action and effects of chiropractic manipulation, especially for low-back pain. Collaborators are the University of Iowa, Kansas State University, the State University of New York at Stony Brook, and the National University of Health Sciences in Illinois.
• New England School of Acupuncture, Watertown, Massachusetts. Peter M. Wayne, Ph.D., principal investigator. This DCRC will evaluate the efficacy and safety of acupuncture, develop methodologies and study designs required for acupuncture research, and address the benefits of acupuncture in the treatment of women's health problems. Collaborators are the Osher Institute at Harvard Medical School, the Dana-Farber Cancer Institute, and Children's Hospital Boston.

To read the full news releases about these initiatives, go to nccam.nih.gov/news/2003. They were developed after an expert panel's review in 2002 of the NCCAM research centers established shortly after NCCAM's creation in 1999.

Calendar of Events

This calendar lists events on complementary and alternative medicine (CAM) that are sponsored or organized by NCCAM or other components of NIH, and includes information available at press time. For more information, go to nccam.nih.gov or call the NCCAM meeting line at 301-594-9632.

On October 22, 2003, Norman R. Farnsworth, Ph.D., Director of the Program for Collaborative Research in the Pharmaceutical Sciences at the University of Illinois at Chicago, spoke at NIH on "Herbal Medicine: Ancient Practice Meets Modern Science," part of NCCAM's "Distinguished Lectures in the Science of Complementary and Alternative Medicine." A videocast is available at nccam.nih.gov/news/lectures/.

January 2004
Meeting of the National Advisory Council for Complementary and Alternative Medicine: January 30. Location: NIH Neuroscience Building, 6001 Executive Boulevard, Rockville, Maryland. For more information, go to nccam.nih.gov/about/advisory/naccam.

March 2004
Frontiers of Knowledge in Sleep and Sleep Disorders: Opportunities for Improving Health and Quality of Life: March 29-30. Location: Natcher Auditorium, NIH, Bethesda, Maryland. Cosponsors include NIH and the Trans-NIH Sleep Research Coordinating Committee, of which NCCAM is a member. .

Distinguished Lectures in the Science of Complementary and Alternative Medicine: March 31, 12 noon. Speaker: Bruce S. McEwen, Ph.D., Alfred E. Mirsky Professor, Laboratory of Neuroendocrinology, The Rockefeller University. Location: Masur Auditorium, NIH, Bethesda, Maryland.
More information will be posted at nccam.nih.gov/news/lectures/.

Other Information

Videocasts and/or transcripts of recent events are posted on the Internet and can be viewed via nccam.nih.gov/news/pastmeetings.

• Videocast: NIH "Medicine for the Public" Lecture, "Complementary and Alternative Medicine: From Promises to Proof," Stephen E. Straus, M.D., NCCAM Director. October 28, 2003, at NIH.
  
  
• Transcript: "Web Chat on CAM and Cancer," with Dr. Straus. Sponsors: NCCAM, the American Society of Clinical Oncology, and CancerCare, Inc. October 7, 2003.
  
  
• Videocast: Lecture by Norman R. Farnsworth, Ph.D.  (see photo)

NCCAM is continually developing new fact sheets and posting them on the Web. To obtain copies, go to nccam.nih.gov/health or contact the NCCAM Clearinghouse at info@nccam.nih.gov. New titles posted recently include:

• "About Chiropractic and Its Use in Treating Low-Back Pain"
  
  
• "Herbal Supplements: Consider Safety, Too"
  
  
• "Questions and Answers About Valerian for Insomnia and Other Sleep Disorders"^a
  
  
• "Dietary Supplements: Background Information"^a
  
  
• "Botanical Dietary Supplements: Background Information"^a

^aDeveloped in partnership with the NIH Office of Dietary Supplements

News For Researchers

Visit nccam.nih.gov/research/announcements for more information on these and other NCCAM funding opportunities.

• Program Announcement (PA-04-008): NIH Clinical Trial Planning Grant (R34) Program. Sponsors: NCCAM and 11 other components of NIH. This planning grant will support the development of Phase III clinical trials.
  
  
• Request for Applications (DK-03-022): Ancillary Studies to Obesity-Related Clinical Trials. Sponsors: NCCAM, National Institute of Diabetes and Digestive and Kidney Diseases, and National Institute on Aging. These grants will support ancillary studies investigating obesity-related research questions in conjunction with seven cooperative agreement clinical trials and consortia.
  
  
• NIH Notices (NOT-AT-04-002 and NOT-AT-04-003). These notices clarify the requirements of two program announcements: Centers of Excellence for Research on CAM (PAS-03-038) and Developmental Centers for Research on CAM (PAR-03-046).