The infinite eyes of the researcher Margarita Salas, the chemist Rosalind Franklin or the pharmacologist Gertrude Belle Elion, promoter of immunotherapy, guard the walls that surround the Vall d’Hebron Research Institute (VHIR) in Barcelona. Their faces, painted in an imposing mural a stone’s throw from the hospital, remember the pioneers of science and set the path for hundreds of heiresses who step onto the scientific campus every day. “I find them all admirable, but probably my favorite is Margarita Salas: her scientific career was marked by talent and personal effort more than by recognition (which came later), and she was a generous scientist, creating a school and offering opportunities to young people.” scientists,” concedes cardiologist Begoña Benito (Barcelona, 48 years old). She is another pioneer: the first director that VHIR has had in its 30 years of life.
With a professional life “straddling hospitals and research institutes”, combining her role as a cardiologist with the study in the laboratory of hereditary disorders that cause arrhythmias and sudden death, the director of the VHIR knows well the ins and outs of scientific activity. , its benefits and its evils. “We have the talent and we must conserve it, but the world of research is very hard. If we focus on clinicians, that is, doctors or health professionals who want to do research, the usual thing is that research is not included in their usual work: they have to do it following hours and on a voluntary basis. And then, in the group of laboratory researchers, the environment is also complicated: there are very few possibilities of getting stable positions, salaries are low and positions are very competitive and difficult to get,” reflects the scientist, who has been working for a year in office.
The cardiologist, who at the end of the year will culminate the celebrations of the VHIR’s thirtieth anniversary by inaugurating the new research building, emphasizes the need to improve funding in science. “The institutes here function by making a living, seeking external funding. But we have the talent and the science we do is good, despite the limitation of funding,” she explains.
Ask. She is the first woman to head the institution. Does the look change?
Answer. A change of perspective that I have contributed, but due to my professional situation as a hospital doctor, is one that places me close to the hospital, that understands the need to promote research in the center and that brings the two institutions closer. Because she is a woman, it is possible that she has implemented changes in the culture of the organization, but I suppose this happens to any person who leads, who transmits her way of doing things to the entire community of workers.
P. Is research carried out with a gender perspective?
R. Yes. It has been progressively introduced and is increasingly implemented. Now research is being done with a gender perspective. There has been a very important change in recent years.
P. You are a cardiologist and, precisely, in the cardiovascular field, a gender bias is still seen: women have a higher risk of dying if they suffer a heart attack, they are detected later, symptoms are undervalued, they also undergo fewer procedures invasive…
R. We are in a process of change. Having introduced the gender perspective does not mean having achieved equity. We are aware that, for example, at a cardiovascular level, women can present a heart attack differently and heart attacks have not been classically recognized in them because they were described in books according to how men feel them. This was previously unknown, but now it has become known. In recent years, the situation of women in cardiovascular disease has become perfectly visible and this makes everyone aware.
“The emergence of big data and AI will allow us to offer health solutions in record time”
P. What is there left to do?
R. In research we are on the right path, which is to include women or the female sex in all scientific research. For any type of research, seeking parity or, at least, a certain proportionality with the prevalence of the disease, is important. Afterwards, carrying out population studies identifying the differential elements between men and women may be of interest; we will not always have to be studied together because the biology may be different. And before I said regarding the female sex because, if we are thinking regarding doing experimental research, in the past only male animals were used and today that is not the case.
P. How have technological advances changed big data and artificial intelligence (AI) the way to investigate?
R. In the field of health, everything that is big data and AI has entered with brutal potential and is advancing at a very rapid speed. So much so that we follow behind, trying to get on the car somehow. But there is a problem that must be overcome, which is data protection, access to data. That has been, perhaps, the immediate limitation, but solutions are being presented at the European level.
P. Do these technologies streamline research?
R. In research it will help us perform analysis and establish relationships and predictions much faster. In medicine, it will help us refine the diagnosis and prognosis of diseases, in addition to providing very valuable support also as a management tool for more administrative tasks, such as reporting.
P. What implications will they have on health?
R. We are in the development and discovery phase of its full potential. Its applications are breaking out little by little and will surely change our way of doing science and medicine in the future. The emergence of big data and AI analyzes will accelerate the achievement of results and that will be positive because it will allow us to offer health solutions in record time. But in the more medical, more clinical part, I like to think that we will maintain the human figure.
P. A strategic line of your project for the VHIR is immunology. What do you expect from advanced therapies?
R. Understanding how immunology works and being able to modify it is essential to treat a large number of diseases. It is essential to study this aspect, either because we want to promote an immune response to fight cancer or because we want to reduce it because we do not want to have a rejection of a transplant. In addition, it is increasingly known that there is an inflammatory component in many diseases. So, being able to regulate this immune response can help treat many diseases transversally.
P. Will the impact of immunotherapy in cancer be transferred to other pathologies?
R. I hope so. We have already participated in a trial that uses CAR-T [una terapia celular que consiste en extraer linfocitos T del paciente, modificarlos en el laboratorio con ingeniería genética y devolverlos al enfermo para que puedan combatir mejor el tumor] in lupus. We are already broadening our sights and immunology is not restricted to cancer. And advanced therapies also include gene therapy, which is another great priority for us because we are a campus that brings together patients with rare diseases. And for many of these diseases the solutions are gene therapy because many of them are genetic. Gene therapy has a way to go and it is going to be important.
