The Medical Science Liaison Role in Spain: A Survey Capturing the Opinion of Medical Department Professionals

BACKGROUND

Literature that addresses the role of Medical Science Liaison (MSL) is currently limited. To the best of our knowledge, this is the first survey in Spain that gathers opinions from professionals whose work is either in or related to the medical departments from pharmaceutical companies.

METHODS

A survey delivered by the SurveyMonkey online platform was completed by 101 pharmaceutical industry professionals (medical advisor/manager, 31.7%; medical director, 26.7%; medical information, 12.9%; and MSL manager, 11.9%).

RESULTS

The median score for the global impression of the MSL was 8.7. The collaboration goes beyond formation since 85.1% of the respondents believed that MSLs should actively collaborate in both clinical trials and investigator-initiated studies, they should have more involvement with market access (51.5%), and they play an important role in compliance (94.0%). There was a tendency toward granting MSLs more responsibilities in terms of budget (73.3%) and their participation in the elaboration of the Medical Plan (91.1%). This position was considered as a strategic partner both internally and externally (76.2%).

CONCLUSION

MSL is a well-known field-based profile with increasing importance and responsibilities. MSLs represent a strategic position as internal collaborators in the company, whose success relies on cross-functional work. The MSL's profile is in constant development, currently facing challenges such as adapting to remote interactions, or providing a clear definition with the best metrics to measure their performance as a non-promotional position.

The medical science liaison role in Spain: A nationwide survey

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The Medical Science Liaison Role in Spain: A Survey About the Opinion of HealthCare Professionals

Purpose/Aim

There are limited studies addressing the knowledge of healthcare professionals (HCPs) on the Medical Science Liaison (MSL) role. The objective of this study was to determine the percentage of HCPs that know the role, and to describe their opinion about the utility of the MSL activities on their clinical practice.

Methods

An online survey was completed by 107 HCPs between June 2019 and January 2020 through three Scientific Societies. It consisted of 17 or 25 questions, depending on the answers.

Results

Most HCPs (73.8%) knew the MSL role inside the pharmaceutical industry and were able to differentiate the MSL role from others in marketing/sales departments (77.6%). Support for research projects (70.8%) and training courses (68.1%) were the most valuable activities. Participants scored the credibility of data provided by the MSL with a mean of 7.5 (out of 10), and the added value that the MSL provides to their clinical practice with a mean of 6.9. Among HCPs unfamiliar with the role (26.2%), 60% of them are interested in meeting with the local MSL.

Conclusion

Our study demonstrates that the MSL role is well-known by HCPs, mostly Key Opinion Leaders, and they agree on the importance of working together in scientific projects on, e.g., disease awareness, medical training, or clinical trials. Given the advance of targeted therapies and the move toward personalized medicine, the MSL role will be in more demand and necessary for HCPs in the years to come.

A Novel Circulating MicroRNA for the Detection of Acute Myocarditis

BACKGROUND

The diagnosis of acute myocarditis typically requires either endomyocardial biopsy (which is invasive) or cardiovascular magnetic resonance imaging (which is not universally available). Additional approaches to diagnosis are desirable. We sought to identify a novel microRNA for the diagnosis of acute myocarditis.

METHODS

To identify a microRNA specific for myocarditis, we performed microRNA microarray analyses and quantitative polymerase-chain-reaction (qPCR) assays in sorted CD4+ T cells and type 17 helper T (Th17) cells after inducing experimental autoimmune myocarditis or myocardial infarction in mice. We also performed qPCR in samples from coxsackievirus-induced myocarditis in mice. We then identified the human homologue for this microRNA and compared its expression in plasma obtained from patients with acute myocarditis with the expression in various controls.

RESULTS

We confirmed that Th17 cells, which are characterized by the production of interleukin-17, are a characteristic feature of myocardial injury in the acute phase of myocarditis. The microRNA mmu-miR-721 was synthesized by Th17 cells and was present in the plasma of mice with acute autoimmune or viral myocarditis but not in those with acute myocardial infarction. The human homologue, designated hsa-miR-Chr8:96, was identified in four independent cohorts of patients with myocarditis. The area under the receiver-operating-characteristic curve for this novel microRNA for distinguishing patients with acute myocarditis from those with myocardial infarction was 0.927 (95% confidence interval, 0.879 to 0.975). The microRNA retained its diagnostic value in models after adjustment for age, sex, ejection fraction, and serum troponin level.

CONCLUSIONS

After identifying a novel microRNA in mice and humans with myocarditis, we found that the human homologue (hsa-miR-Chr8:96) could be used to distinguish patients with myocarditis from those with myocardial infarction. (Funded by the Spanish Ministry of Science and Innovation and others.).

Immune-Regulatory Molecule CD69 Controls Peritoneal Fibrosis

Patients with ESRD undergoing peritoneal dialysis develop progressive peritoneal fibrosis, which may lead to technique failure. Recent data point to Th17-mediated inflammation as a key contributor in peritoneal damage. The leukocyte antigen CD69 modulates the setting and progression of autoimmune and inflammatory diseases by controlling the balance between Th17 and regulatory T cells (Tregs). However, the relevance of CD69 in tissue fibrosis remains largely unknown. Thus, we explored the role of CD69 in fibroproliferative responses using a mouse model of peritoneal fibrosis induced by dialysis fluid exposure under either normal or uremic status. We found that cd69^-/- mice compared with wild-type (WT) mice showed enhanced fibrosis, mesothelial to mesenchymal transition, IL-17 production, and Th17 cell infiltration in response to dialysis fluid treatment. Uremia contributed partially to peritoneal inflammatory and fibrotic responses. Additionally, antibody-mediated CD69 blockade in WT mice mimicked the fibrotic response of cd69^-/- mice. Finally, IL-17 blockade in cd69^-/- mice decreased peritoneal fibrosis to the WT levels, and mixed bone marrow from cd69^-/- and Rag2^-/-_γc^-/- mice transplanted into WT mice reproduced the severity of the response to dialysis fluid observed in cd69^-/- mice, showing that CD69 exerts its regulatory function within the lymphocyte compartment. Overall, our results indicate that CD69 controls tissue fibrosis by regulating Th17-mediated inflammation.

Maintenance of immune tolerance by Foxp3+ regulatory T cells requires CD69 expression

Although FoxP3(+) regulatory T cells are key players in the maintenance of immune tolerance and autoimmunity, the lack of specific markers constitute an obstacle to their use for immunotherapy protocols. In this study, we have investigated the role of the C-type lectin receptor CD69 in the suppressor function of Tregs and maintenance of immune tolerance towards harmless inhaled antigens. We identified a novel FoxP3(+)CD69(+) Treg subset capable to maintain immune tolerance and protect to developing inflammation. Although CD69(+) and CD69(-)FoxP3(+) Tregs exist in homeostasis, only CD69-expressing Tregs express high levels of CTLA-4, ICOS, CD38 and GITR suppression-associated markers, secrete high amounts of TGFβ and have potent suppressor activity. This activity is regulated by STAT5 and ERK signaling pathways and is impaired by antibody-mediated down-regulation of CD69 expression. Moreover, immunotherapy with FoxP3(+)CD69(+) Tregs restores the homeostasis in Cd69(-/-) mice, that fail to induce tolerance, and is also highly proficient in the prevention of inflammation. The identification of the FoxP3(+)CD69(+) Treg subset paves the way toward the development of new therapeutic strategies to control immune homeostasis and autoimmunity.