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Clinical Chemosensory Research: Needs, Future Directions, and Priorities
April 9, 2014
Hyatt Coconut Point
Bonita Springs, FL
Chemosensory (taste and smell) deficits affect the lives of millions of Americans. In one study, nearly a quarter of men ages 60–69 had a smell disorder, while about 11 percent of women in that age range reported a smell disorder. More than 200,000 people visit a doctor each year for problems with their chemical senses. These problems can have profound effects on an affected individual's quality of life and nutritional intake. Current treatment options for taste and smell disorders are very limited and unable to help most people. As noted in the NIDCD Strategic Plan, the lack of treatment strategies is a critical gap in the chemical senses research field, especially given that taste and smell deficits have become increasingly common.
To address this gap, the NIDCD held a workshop in April 2014 to discuss ways to facilitate clinical chemosensory research and enhance health care outcomes of such research. Additional impetus for this workshop included the minimal presence of clinical research within the NIDCD Taste and Smell Program's grant portfolio and the concern among leaders in the field that the number of new chemosensory clinician-scientists entering the pipeline needs to be substantially augmented.
Thirteen scientists and clinicians who are leaders in the fields of clinical and translational chemosensory research were invited to participate in the workshop. The workshop was chaired by Dr. Gary Beauchamp, Director and President of Monell Chemical Senses Center, and organized by Dr. Susan Sullivan, Director of the NIDCD Taste and Smell Program.
The workshop was divided into two broad sessions: training opportunities and clinical research opportunities. In a discussion facilitated by the NIDCD's training officer, Daniel A. Sklare, Ph.D., the participants were asked to consider if there were unmet needs with respect to training opportunities throughout different career stages and whether there were specific approaches needed to stimulate the research pipeline. Following individual presentations and group discussions, the panelists were also asked to make recommendations regarding research needs and priorities. Questions for discussion included:
- What research areas are likely to have the biggest impact with respect to health care outcomes?
- What areas are ripe for clinical research or trials?
- What needs to be done to set the groundwork for future clinical research/trials?
- What are the obstacles and perceived needs with respect to resources, clinical assessments of chemosensory function, and technology development?
The panel made several recommendations with respect to research and training opportunities.
- Development of validated hedonic and other measures and methods for assessing and diagnosing chemosensory deficits; for evaluating chemosensory function in adult, pediatric, and disordered populations; for determining outcomes of interventions; and for research purposes as well as for in-the-field clinical assessments.
- Development of improved tools and technologies (e.g., neuroimaging, non-invasive recordings, optogenetics, and histological markers) for evaluating central and peripheral chemosensory function.
- More studies to link chemosensory deficits to other clinical disorders such as diabetes, obesity, and malnutrition as well as to identify early biomarkers for neurodegenerative diseases and developmental disorders.
- Further development and characterization of animal models for chemosensory dysfunction to identify the nature of deficit, understand the pathophysiology, and test potential treatments at the molecular or cellular level. Mouse models of the human disease process are needed to address underlying diverse causes of chemosensory deficits including viral infection, head trauma, developmental disorders, aging, and neurodegeneration. To aid in clinical translation, the formation of multidisciplinary teams consisting of basic scientists and clinicians would be beneficial.
- Studies to better understand flavor and multisensory integration and how flavor and its distortion affect food choices and eating behavior.
- Studies to determine the effects of diet, early dietary experiences, and individual genetic variation on taste preferences.
Among the training issues discussed was the compelling need to recruit physicians into the chemical senses field to facilitate "bench to bedside" translation of many of the fundamental scientific discoveries that have been made over the past two decades.
As an initial response to the need to recruit physician-scientists, the NIDCD initiated a new administrative supplement program, NIDCD Administrative Research Supplements to Promote Emergence of Clinician-Scientists in Chemosensory Research, to support one-year intensive research experiences for medical students, introducing them to biomedical and behavioral chemosensory research early in their careers. In addition to addressing a major concern of the workshop participants, this program directly addresses one of the priority areas in the NIDCD Strategic Plan: to "promote clinical training in the chemical senses, and create targeted funding opportunities, to encourage more clinical research and interdisciplinary teams of clinicians and basic scientists."