Research News

In its most general sense, the practice of medicine is taking something atypical and trying to restore it to its typical function. Because living organisms are incredibly complex, research is critical to deepen our understanding of what is considered typical—as well as what changes result in disease. The study of these deviations is called pathophysiology, and it helps Cleveland Clinic researchers who investigate and characterize pathophysiology work toward better, more precise treatments.

Sometimes, the pathophysiology of something atypical is obvious: an orthopaedic surgeon resets a broken femur, or a cardiologist prescribes a specific intervention or medication to open a blood vessel that supplies oxygen to the heart muscle. However, other disease states, like cancer, are more challenging; the changes hidden deep within individual cells are invisible to even the most powerful microscope. In these situations, returning to what is typically observed provides an important reference point.

What is pathophysiology?

Pathophysiology is the study of what changes in the typical functions of the body to cause unhealthy states, disease or injury. It is related to the fields of physiology and etiology. While physiology focuses on the typically observed functions of the body, etiology refers to the study of what initiates a shift in the body toward disease.

Is pathophysiology a foundational element of every researcher’s work?

No; the relevance of pathophysiology depends on the focus of a researcher’s work. Many researchers work to advance our understanding of typical, complex life functions and processes. Other scientists build on this understanding of physiology to investigate disease and devise methods for healing or repair.

“The first step is always to understand what is expected before you can characterize what has gone wrong,” says Yogen Saunthararajah, MD. He explains that physiological study is the foundation for the study of pathophysiology.

How does understanding pathophysiology enhance research and patient care?

To understand pathophysiology is to understand cause–effect relationships in disease, and guide methods and strategies that stop or reverse the disease process, therefore healing a patient. Pathophysiology is essential in translational science to move research from bench to bedside, especially if drug development is involved.

“Doing translational science well means caring about what is actually happening in patients,” says Sarah Schumacher Bass, PhD. “It’s more than just understanding a disease in general—essentially, translational science is pathophysiology applied at a level that enables the safe and specific targeting of a disease.” Beyond understanding what is happening, pathophysiology also encompasses knowing what could happen—including the potential effects and complications of a newly developed treatment.

An understanding of pathophysiology also helps scientists improve current methods of treatment for diseases like cancer. Chemotherapy and radiation stress both cancer cells and healthy cells to the point where they shut down, resulting in serious side effects for patients.

New advances in research and technology, including genomics and genome sequencing, have helped scientists like Dr. Saunthararajah look deeper into molecular function. This enhanced ability, he says, helps researchers better understand how normal cells divide and grow, and how mutations (random changes to the DNA instruction sheet in cells) lead to relentless growth and cause cancer. Identifying what has gone wrong then makes it easier for clinicians to prescribe treatments that heal—and for scientists to develop better ones, including more precise, less toxic cancer treatments.

For some researchers, like Dr. Schumacher Bass, a pathophysiological approach expands connections between organs and systems and identifies how abnormalities in one area lead to diseases that affect other areas. For example, her lab studies the structure and function of the heart and the basis for links between the heart and conditions like obesity and metabolic dysfunction in relation to heart failure.

Why is pathophysiology important for research at Cleveland Clinic?

As a research hospital, researchers and clinicians frequently collaborate, often across departments, to ask questions based on observations in the lab or with patients. An approach grounded in physiology and pathophysiology helps them advance knowledge about common and rare diseases and work to develop treatments that will heal the patients in their care. By working together to explore the why and how from both the clinical and lab-based perspectives, this pursuit of pathophysiology contributes to patient care and the field of biomedical research at large.