The overall goal of the Research Program at the UCSF Osher Center for Integrative Medicine is to strengthen the scientific evidence-base about integrative medicine through addressing the following core aims:
- To rigorously test the effectiveness and safety of integrative medicine approaches for treatment of specific conditions. We focus on issues for which conventional pharmaceutical or surgical treatments have important limitations, such as pain, mood regulation, stress management, and obesity.
- To determine the mechanisms of action of integrative medicine treatments. An important focus is on understanding mechanisms of action that involve the interaction between mind and body.
- To assess how to best use technological, behavioral, and integrative medicine tools to achieve healthy lifestyles, including healthy diets and levels of physical activity.
Overview: Present Focus and Emerging Directions
The UCSF Osher Center for Integrative Medicine conducts rigorous scientific research on treatments that address multiple aspects of patients’ health and wellness—biological, psychological, social and spiritual. Our research seeks to improve our understanding of how treatments work, and how well they work. Through this research, the Osher Center works to advance the evaluation of integrative medicine approaches and the inclusion of effective approaches in medical care.
The UCSF Osher Center has rapidly established itself as one of the leading centers in the world for research on integrative medicine. As one measure of the Center’s research program, we are the recipients of two Center of Excellence Program Project grants from the National Center for Complementary and Alternative Medicine (NCCAM, now NCCIH) of the National Institutes of Health (NIH), the only institution so far to achieve this benchmark. The first Center of Excellence grant (2004-2010) has investigated the effects of a meditation-based stress reduction intervention in HIV infection, including the impact on disease course, neuroendocrine function, and the immune system. The second Center of Excellence grant (2008 – 2013) involves a clinical trial investigating long-term weight loss and maintenance in obesity.
An important focus of our current research is mind-body health approaches, with a particular focus on the effects of meditation and yoga. In addition to the two Center of Excellence Program Project grants, mind-body research areas include: mind-body approaches to understanding and treating low back pain (Dr. Wolf Mehling); the psychological, physical, and behavioral effects of interventions aimed at improving mood in persons with HIV (Dr. Rick Hecht); pranayama (yogic breathing exercises) for cancer treatment related fatigue (Dr. Anand Dhruva); the effects of mindfulness-based childbirth and parenting interventions (Dr. Larissa Duncan); and research examining the extent to which deep breathing is a key mechanism by which mindfulness research may have effects on health (Dr. Margaret Chesney).
An important overall element of the Osher Center’s Research Program is a focus on elucidating the mechanisms of action of the therapies we study. The goal of this effort is to turn therapies such as meditation from a “black box” effect on a condition to a process in which we better understand the mechanisms by which such a therapy might influence health via effects on the neuroendocrine, immune, respiratory and metabolic systems. We view this process as important in establishing the biological plausibility of health effects of integrative medicine therapies, and in guiding future clinical research, by basing it on better understood physiological effects. Our Complementary/Alternative Medicine (CERC) Program Project grants, described below, exemplify this approach. Overall, this work builds on the strengths of UCSF in biological sciences.
Integrative oncology is an important emerging focus for our center. This is a key area in which there is strong interest by patients, and in which there is a significant need for non-pharmacologic approaches to management of treatment-related side effects. Dr. Mehling has conducted a trial on massage and acupuncture for cancer patients after surgery and recently completed a study of massage and acupressure for treating symptoms during pediatric hematopoietic stem cell transplant. Dr. Dhruva, an oncologist, has received a K-award from the NIH for research career development, and is focusing on approaches to symptom relief in breast cancer, drawing on yoga and Ayurvedic (traditional Indian) medicine.
An important goal of the research program is to test the ability of integrative medicine approaches to improve health for medically underserved populations. Integrative medicine potentially offers cost-effective ways to enhance medical care in underserved settings. Several of our researchers, including Dr. Larissa Duncan and Dr. Maria Chao, are focusing their work at San Francisco General Hospital and in the San Francisco public schools in innovative ways.
Another key focus of the research program is developing the next generation of researchers. We have a highly successful postdoctoral fellowship program that prepares physicians and PhDs for research careers. This year, there were 21 applicants for three positions. We have been quite successful in building junior faculty who can compete for NIH career development awards (K-01 and K-08). UCSF now has five NIH junior career award faculty members (K-01 and K-08) from NCCAM, more than any other institution in the country.
In the past year, Dr. Maria Chao, a recent post-doctoral fellow, received a K award. We are particularly pleased that Dr. Jeff Milush, an immunologist and recent postdoctoral fellow in the Division of Experimental Medicine at UCSF, has received a K award from NCCAM. He will work closely with the Osher Center, but will be based in the Division of Experimental Medicine. His research project grows out of our CERC grant, and focuses on applying novel flow cytometry approaches to understand the effects of meditation and stress reduction approaches on glucocorticoid receptor density on leukocytes (white blood cells), and the sensitivity of leukocytes to the anti-inflammatory actions of glucocorticoids. Dr. Milush’s K award exemplifies both our commitment to building research collaborations with other programs at UCSF, and the type of interdisciplinary approaches we aim to bring to bear on understanding the pathways through which approaches like meditation may work.