Why Basic Science Is Nursing Science

May 2013Tara Walhart

Because I’ve chosen to pursue basic science, I’ve been told that I am a very unusual nurse. Most nursing research stays away from connecting basic science to caring for our patients, but I embrace the connection, because advances in areas that include molecular biology, genetics and infectious disease should and do strongly influence nursing scholarship – to say nothing of making our clinical work more effective.

A perfect example is my current interest in prevention of human papillomavirus (HPV) infections, particularly HPV-related anal neoplasia (excessive and abnormal cell growth) in HIV-positive individuals. My goal is to identify compound(s) that can prevent the HPV virus from entering the body through epithelial cells.

According to the Centers for Disease Control and Prevention (CDC), HPV is the most common sexually transmitted infection, and about 95 percent of anal cancers are linked to it. In 2012, there were 6,230 new cases of anal cancer and 780 deaths from anal cancer in both men and women in the United States. HPV-associated anal intraepithelial neoplasia (AIN) disproportionately affects those infected with HIV, with a subset of high-risk strains of HPV associated with AIN evolving to anal cancer. These high-risk strains are particularly prevalent in the HIV-positive population, with a near-universal presence in HIV-positive men who have sex with men.

The recent emergence of what appears to be a remarkably effective vaccine against some HPV strains could help dramatically reduce the incidence of AIN, but lack of access to these expensive vaccines in developing countries, the need to get the vaccine before first sexual contact and the vaccine’s ineffectiveness against other cancer-causing HPV types will limit its impact.

Clearly, there remains a need to identify other treatment options for preventing HPV-related infection. One is a personal lubricant combined with a compound that would block HPV from infecting cells. In my current research, I am seeking to identify such a compound from a library of approximately 150,000 compounds, with the help of a technique known as high-throughput screening. If I can successfully identify the relevant molecular mechanisms, it will help us develop treatments that could prevent HPV-related infection and AIN among sexually active individuals.

What does this have to do with nursing or traditional nursing research? Prevention is at the core of so much of what we strive to do as nurses. By combining my interests in patient care, research and HPV, I could improve prevention in a traditionally high-risk population and, in turn, make a genuine contribution to public health. It would be a wonderful first step in my career in academic nursing. More importantly, it would be another reminder that when we embrace basic science, it can expand what’s possible for present and future research, education and practice in nursing.

Tara Walhart is a third-year doctoral student at UCSF School of Nursing and a member of the Palefsky Laboratory at UCSF. She earned her Master of Science in Nursing and Master of Public Health at the University of Pennsylvania.