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Breakthroughs in the ability to probe and better understand biologic systems during the past 30 years1-3 have enabled the medical community to produce new healing agents and alter the course of many life-shortening diseases. 4, 5 Naturally success, bridging the gap between promising laboratory observations and the development of effective therapies remains risky and expensive, with fewer than 1 in 10, 500 early translational programs successfully reaching Fda (FDA) authorization, at a cost of practically $1 billion. 6 Many therapeutic development fails in the preclinical phase, which is sometimes described as the "valley of dying. "7
For this reason and because therapies for some conditions will have a limited eventual market value, the pharmaceutical industry has been hesitant to initiate early-stage programs to deal with so-called orphan diseases. In recognition of a critical need, federal agencies have developed programs to catalyze innovation and reduce limitations to early development of new therapies. 8 During the past two decades, disease-focused foundations also have developed a new strategy to bridging this preclinical gap. Within a process known as venture philanthropy, such foundations have formed partnerships with industry and federal agencies to share the financial risk of therapeutic development, shorten the early translational pipeline, and advance research with "a give attention to human, not financial, return. "9 In addition, foundations and their academic partners have accelerated early development by providing access to patient populations for clinical trials and assistance from disease-specific experts in study design, which has helped in bridging the gap in therapeutic development.
With this review, we will give attention to three diseases -- cystic fibrosis, multiple myeloma, and type 1 diabetes mellitus -- to illustrate how collaborations among academic institutions, fundamentals, and industry partners have evolved to address the therapeutic challenges of these conditions.
CYSTIC FIBROSIS
In 1989, the discovery of the gene that leads to cystic fibrosis and the cystic fibrosis transmembrane conductance regulator (CFTR) protein10, 10 greatly increased interest within the scientific community in this life-shortening genetic disease, which influences approximately seventy, 000 patients worldwide. With support from the Cystic Fibrosis Foundation (CFF) and the National Institutes of Health (NIH), researchers swiftly expanded knowledge about the biogenesis, maturation, and function of CFTR, a controlled epithelial anion channel12; such knowledge provided the necessary scientific framework for the development of therapeutic goals. In addition, an international consortium13 determined more than 1700 mutations and described genotype-phenotype correlations with standard case definitions, 14 which enabled a precision-medicine strategy to therapeutic development. Inside the 1990s, attempts were made to treat cystic fibrosis by gene-replacement remedy shipped to airway epithelia. Despite the fact that early in vitro15 and in vivo studies16 provided proof of concept, many barriers, including a robust host immune response, were encountered. 17 These obstacles ended such initial clinical development programs.
In the decade following the discovery of the cystic fibrosis gene, scientific knowledge expanded but did not cause a remedy that corrected CFTR function. In 1999, the CFF launched the Healing Development Program (TDP) to draw both academic and industry partners and start high-throughput screening for CFTR modulators. 18, 19 The CFF embraced the concept of venture philanthropy9, 20 to improve the interest of industry in an orphan disease. However, the success of the TDP was centered on a lot more than financial support. 21 The program created a cultural shift that allowed the CFF, academic clinicians and experts, federal agencies (the NIH and FDA), and industry to create a strong partnership with common goals and timelines.

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