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Analysis

Cleveland Clinic Facility Could Play Key Role in Fighting Viruses Like COVID-19

By Mandy Roth  
   July 27, 2020

With a focus on infectious diseases and immuno-oncology, the new Florida Research and Innovation Center is studying therapies to address "some of the most challenging conditions we face," says the organization's interim CEO.

How does a research facility capable of studying dangerous viruses, such as COVID-19, spring up when a global pandemic occurs? An interesting series of events led to this month's opening of the Florida Research and Innovation Center, which is part of Cleveland Clinic Florida. 

Joseph P. Iannotti, MD, PhD, interim CEO & president, and chief of staff of Cleveland Clinic Florida, as well as its chief academic and innovation officer, says it was coincidence. A closer examination shows that some key strategies aligned. The Center's mission is to develop, "therapies that address some of the most challenging medical conditions we face,” said Iannotti when the facility opened. The pandemic, he says, has showcased the value in engaging in this type of scientific exploration.

More than a decade ago, Former Florida governor Jeb Bush launched a strategic economic initiative to attract biomedical research, medical technologies, and drug discovery to the state. Oregon Health & Science University's Vaccine and Gene Therapy Institute built a special lab research facility in Port St. Lucie, Florida, as part of that endeavor. The building was vacated in 2015. Meanwhile, Cleveland Clinic Florida launched its initiative to study the role of viruses and the immune system in cancer, as well as infectious diseases. The building, located across a pond from one of the health system's hospitals, turned out to be an ideal location to conduct this type of research, and was already outfitted accordingly.

Iannotti talked to HealthLeaders about the role of this type of research and why therapeutic innovations are essential to improve the future of healthcare. His comments have been lightly edited for clarity and space.

HealthLeaders: You wear a number of different hats at Cleveland Clinic Florida. Describe your role as chief academic and innovation officer.

Iannotti: The role involves all of the activities that relate to research and education. Within the scope of research, there is intellectual property and within that scope is the concept of intellectual property protection and innovations. The administrative role involves research, education, and innovations. My primary responsibilities have been to build out the research program that is the building in Port St. Lucie. I was responsible for acquiring, funding, and staffing it. And we're in the process of doing the same thing for clinical research throughout the Cleveland Clinic Florida region and all the partnerships that are associated with that between Cleveland Clinic Florida and Cleveland Clinic Cleveland.

HL: Can you share a bit about the timeline involved in opening the Florida Research and Innovation Center?

Iannotti: We acquired the research building in November of 2019 after several months of discussion with the city of Port St. Lucie. Throughout that time, we've been recruiting researchers from all over the country, both for Cleveland and Florida. Those individuals started their work in the building as of July 1.  

HL: How is the work at the Florida Research and Innovation Center connected to other work Cleveland Clinic is doing?

Iannotti: Cleveland Clinic is a global healthcare delivery system with hospitals in other countries. [The Innovation Center] is a Florida entity, but it's part of Cleveland Clinic's global enterprise strategy. The work that's being done in Florida is closely linked with researchers and infrastructure in northeast Ohio. The Lerner Research Institute [which is home to 190 laboratories on Cleveland Clinic’s main campus in Cleveland, Ohio], which is many-fold larger than this one building here in Florida, is part of the effort and the researchers in Florida are also working in Cleveland. It's a collaborative effort between the two states. [The Florida facility is also closely integrated with Cleveland Clinic's Center for Global and Emerging Pathogens Research, established in April].

HL: How many people do you expect to recruit and how is the Innovation Center funded?

Iannotti: Right now, there are nine researchers in the building; we expect somewhere between 20 to 25 by the end of the year, including both the senior investigators, as well as their junior research investigators. We anticipate having about two-thirds of the building filled within a five-year period.

That's a very small enterprise in comparison to most other large research institutes, but when you combine it with Lerner and all of the efforts that are ongoing there, then it becomes substantial and meaningful and likely to be successful.

The funding is from multiple sources. Cleveland Clinic has put a large amount of capital investment in the program, the researchers who we have recruited all have NIH [National Institutes of Health] funding, and the third component is philanthropy.

HL: How is your innovation center different from other health system innovation centers?

Iannotti: The focus is research. We called it a research and innovation center with the expectation that the research that comes out of it will be innovative and will affect the care of patients, particularly in the areas of cancer and infectious diseases. Our goals are to create new treatments and to affect the health of patients that have cancer and infectious diseases. Also, the building has very specialized facilities for highly contagious viruses. That type of research cannot be done in a general research lab. We acquired the building to increase our capabilities as an academic medical center to do this type of research.  

HL: What is the strategic reason Cleveland Clinic is focusing on these areas?

Iannotti: This is a critically important area of healthcare. Obviously, we didn't anticipate COVID-19 consuming the attention of every human being on the planet when we took the building over in November, but the fact that we're having a global pandemic has certainly highlighted the importance of population health, public health, and virus diseases that can cause not only disease, but cripple the world economy. So it's an important problem.

It happens to be coincidental that we're in this global pandemic. People have died of influenza every year for the last decades, but I don't think people paid much mind to it. I mean, more than half the people in the country don't even get a flu shot. Now, it's got everybody's attention. COVID has accelerated everybody's understanding of the problems associated with viral illness. So what we thought was extremely important for the public and Cleveland Clinic has been highlighted, bolded, and underlined since November 2019 when everybody learned a new word: coronavirus.

HL: In  November, you had one vision for moving ahead, then COVID hit. What's changed?

Iannotti: Nothing's changed. The world has changed. We didn't change. Let's put it this way: COVID wasn't an NIH-funded program until February of this year. There are now several research grants on COVID-19 at Cleveland Clinic Florida, so that's the only thing that's changed. The work that's ongoing in there in terms of viral diseases with cancer, influenza, dengue and Zika research, we recruited those people well before COVID was even a thought. It wasn't a word. 

Among the studies underway [Editor's note: Cleveland Clinic supplied this information following the interview with Iannotti]:

  • COVID-19 research currently taking place at the Florida Research and Innovation Center involves investigating how one of the viral proteins of the COVID-19 virus suppresses the so-called "innate immune response," which is the immediate response of the human immune system to viral infection

In addition, Cleveland Clinic is involved in multiple coronavirus research initiatives. Those taking place at Cleveland Clinic Florida include:

  • Convalescent plasma therapy, which collects antibody-rich plasma from donors who have recovered from COVID-19.
     
  • A randomized outpatient clinical trial testing the use of vitamin C and zinc to determine whether they shorten the duration and type of symptoms, and prevent hospitalizations in patients with a new diagnosis of COVID-19.
     
  • An inpatient study regarding the use of canakinumab, specifically for admitted COVID-19 patients who have had a heart attack.
     
  • An inpatient study regarding the use of mavrilimumab for COVID-19-positive patients to determine whether it can reduce the progression of acute respiratory failure and need for ventilation in patients. 

HL: What concerns do you have about COVID-19 research?

Iannotti: My biggest concern with COVID-19 is obviously the ability for us to get a vaccine that's effective and safe. I think that's everybody's concern. [While] we're not directly involved in developing a vaccine, we're potentially involved in being a site for the clinical trial, which has not yet been determined.

If there's not a vaccine, everybody's concerned about having effective antiviral treatment. Right now, we're using existing drugs and existing therapies and hopefully seeing some positive effect with use, but none of them have been designed specifically to be COVID-19 effective. That's primarily the research that's being done at the Florida Research and Innovation Center. It's not vaccine development; it's looking at how the virus infects cells and tissues and what are some of the targets for antiviral therapies.

HL: The pandemic has accelerated all kinds of scientific processes and even the process of innovation itself. What's good about that and what concerns do you have?

Iannotti: What's good about it is that if you have reasonable judgment—maybe not the same level of scrutiny that is typically part of the regulatory process—then you might be able to advance therapies that are effective that help in a crisis. The negative is that those processes were put in place to protect the public from either ineffective treatment or treatments that have too many side effects or risks. That's the downside of short-circuiting the system.

HL: Let's jump into the future. If you look back three years from now, what do you hope to say that you've accomplished at the Innovation Center?

Iannotti: I would love to be able to look back and say, we have taken benchtop research and brought it to effective clinical treatment. That's our primary mission. It's not to do research for the sake of research; it's to bring effective therapies to the clinical care of our patients. I think that's very doable in that three-year time frame, given the accelerated rate by which we're putting time, effort, talent, and money to treat this problem.

“The fact that we're having a global pandemic has certainly highlighted the importance of population health, public health, and virus diseases that can cause not only disease, but cripple the world economy.”

Mandy Roth is the innovations editor at HealthLeaders.

Photo credit: Photo courtesy of Cleveland Clinic


KEY TAKEAWAYS

The coronavirus pandemic has highlighted the value of virus research and therapeutic innovation.

The Florida Research and Innovation Center is studying how COVID-19 infects cells and tissues and targets for antiviral therapies.


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