Wouter Dhert: ‘The idea is to translate findings to patient care as effectively as possible’

Dhert says the concept of TPI piques his interest on multiple fronts. He spent years conducting what is known as translational research, aimed at the practical translation of scientific research to patient care. 'In our Orthopaedics research group, we developed new surgical treatment methods for people with musculoskeletal disorders. In doing so, I found that we were increasingly able to achieve our objectives with less animal testing, or none at all. A good example is the study we did involving stem cells in the knee. Initially, we thought animal studies would be necessary before we could start the clinical stage. But then we took a good long look at international literature, and lo and behold: we were able to build a case for making the transition to humans with hardly any animal testing. That taught me first-hand that if you try your hardest, your results will exceed your expectations. But you have to be really open to asking yourself whether animal testing is truly necessary.’

Patient

As a parallel to this work, he is a professor at the Horse and Companion Animal department of the Faculty of Veterinary Medicine. ‘In 2008, I was tasked with further integrating the research aimed at animals and people. The key question was to learn what benefit animals might offer people, but vice versa as well. There are many disorders that affect animals as well. Research into those conditions takes on an entirely different aspect when the animal involved isn't so much your test subject, but a patient. As a result, I know that people and animals can be quite effective models for one another, and that you don't necessarily need lab animals to achieve this.’

Hockey injury

‘At the same time, it's becoming increasingly clear to us that many animal studies have only limited predictive value, such as in research aimed at treating cartilage injuries. When animals are used in these trials, they tend to be healthy. But imagine that you've hurt your knee while playing field hockey. Before you go see your GP, let alone an orthopaedic specialist, it's likely that days, week or even months will have passed with pain, limited range of movement, swelling and all kinds of inflammation going on in the knee. Maybe you have other conditions as well, such as diabetes or obesity, that affect the healing process, or maybe you're a heavy smoker. As a result, the initial situation your treating physician encounters is many times more complex than in a standard animal model.’

As far as Dhert is concerned, that is another important argument in favour of TPI. ‘We have to translate findings to patient care as effectively as possible – better than we are now, in any case. And that means we must look for new methods and better predictive models. It's entirely possible that these will not involve animal testing; in fact, it's preferable that they don't. How fantastic would it be if we could make that happen? Every scientist should focus on this challenge. And we should also be looking into using human models more often. It's a risky proposition, but also an incredibly interesting one to consider.’

3-D bioprinting

Dhert sees promise and reason for optimism in ICT simulation, in the growing knowledge of stem cells, in organoid technology (mini-organs), biomaterials and 3-D modelling of organs and processes, including 3-D bioprinting. ‘This offers us a way to explore more effective means of simulating an in vivo situation. That situation is exceedingly complex, and we're still a long way off, but we're definitely on the right track. As Dean of the Faculty of Veterinary Medicine and chair of Utrecht Life Sciences, this is a true mission of mine. Our campus offers me a great environment in which to combine all available knowledge and contribute to the transition.’

Another argument in favour of TPI is moral in nature. ‘Societal pressure is growing. I wouldn't go so far as to say: animal testing is never acceptable. But I do think that we should try our very hardest to manage with less of it, and preferably none at all. Regulatory factors mustn't needlessly impede that process. We are also dealing with a much broader system, one we should continually challenge and in which we should attempt to affect permanent change. We'll gain the momentum needed to do so when the people that support this direction join together, as they are in TPI.’

Investments

Dhert emphasises that while animal trials are expensive, eliminating them won't automatically reduce costs, because the alternatives are expensive as well. ‘The question is: what do we need to invest in order to do our work without the use of animal testing? If we're serious about achieving this goal, one part-time endowed chair in Alternatives to Animal Testing isn't going to be enough to get us there. We'll need to set up a programme in multiple, generally interdisciplinary scientific fields, with each field having its own research group tasked primarily with pursuing alternatives. And then you're talking about millions. This presents a joint responsibility and challenge to governments and universities, to the National Science Agenda and to a programme like TPI.’

A development such as open science is a crucial prerequisite. ‘When scientific knowledge becomes more accessible and easier to share, there will be no need to repeat animal studies that have already been conducted.’ But there's more at play, Dhert says. ‘I'm seeing shifts in how we assign value to research results and scientific careers. Having your publications in the right journals is becoming less and less important as people are increasingly focused on how important your work is to society. This is a positive development for TPI, because the search for alternatives carries an inherent risk of failure.’

Help-a-thons

Another positive sign is that scientists in general are working on new ways to acknowledge and reflect the complexity of the systems they are studying. This requires different and more complex approaches. ‘And that's why methods like the help-a-thons organised by TPI are exactly what you need. You need to get together and brainstorm, to see whether a different approach is better than what you've been doing.’ Another thing that helps: greater attention to alternatives for animal testing in study programmes, and training on how to use these alternatives. ‘That's how you change thought patterns.’

According to Dhert, the transition will succeed or fail depending on whether all parties share the same ambition. ‘But it's important that we preserve the nuance as well. It's not about whether you're for or against, it's about finding that common ground. I completely understand the need for regulations, and where the current thinking and objections come from – particularly because I'm looking to break free of existing routines, to coax researchers into stepping out of their comfort zones and trying a different approach than they're used to.’

‘The most important question is: how can we work together in this area to achieve shared benefit? To me, the greater goal in connection with our scientific research is to translate the findings to patient care – for both people and animals – as effectively as possible.’