FFB Support Helped Dr. Paul Sieving Become a Leader in the Vision Science Community

Dr. Paul Sieving Photo
Dr. Paul Sieving
Dr. Paul Sieving is a long-time vision researcher and director of the National Eye Institute, a part of the National Institutes of Health. FFB recently spoke with Dr. Sieving about his work.

Q: Our understanding of retinal disease and the science of restoring vision is at a very promising juncture—would you agree? What are the next most important steps to fulfill this promise?

A: I agree. The work in stem cells, in gene discovery and in fundamental vector biology is coming together right now in a way that is quite astonishing. How do we put it all together? We’re going to put it together by having smart, creative and curious basic scientists work together with clinical researchers.

There are three to four key players going forward. First are the researchers doing basic science, as there is a lot of basic biology that must still be discovered. Second isa a critical role filled by clinical researchers who work to identify the natural history of progression of a patient’s disease and then to run the trials. Third are the patients themselves. Patients need to be partners in these studies. As partners, the patients need to recognize that not all treatment trials will be immediately successful but to go ahead anyway. The fourth key element is funding through the public and private institutions that support the research. FFB is a key player in this, and the National Eye Institute is a key player. Both of us working together and independently need to identify the best opportunities in science and to catalyze those opportunities.

Q: In moving the field forward, where is NEI investing?

A: The National Eye Institute strives to support science that builds on decades of research and move it forward into the future. A key component is to take work that has been done over the past several decades and put it together into high risk but high reward venture. Namely, NEI is investing in restoring vision by regenerating the retina. We call this the “NEI Audacious Goal Initiative.” You can find out more about this at the NEI web site https://nei.nih.gov/audacious.

A key element in success is to get creative scientists together—to have them think together and talk together and dream together and speculate together. NEI is investing in putting together the creative thoughts that will culminate in replacing dead and dying photoreceptor cells.

Another critical element in our long-term strategy is to train the young, creative scientists who will be the leaders of the future. 

Q: How do the missions of the NEI and FFB complement each other?

A: We complement each other in really critical ways. FFB has the mission to find cures for degenerative retinal diseases. The NEI has the same mission and additionally, in broader terms, to find treatments and cures for all eye diseases. We are mutually dependent. There is a term for this relationship—public-private partnerships. I see the NEI and FFB working together in that sense. Public, taxpayer money from NEI funds major university laboratories. FFB monies are smaller, but these are very flexible money. This support complements the larger federal dollars. FFB funding gives the investigator the opportunity to propose the highly novel ideas that make all the difference in where the field can go. FFB has been very strategic in funding strong, creative vision scientists that complement what NEI can do.

Q: I’m struck by your use of the term “creative science.” Can you say more about that?

A: A good example is Sir Isaac Newton. The anecdotal story is that he was sitting under an apple tree when an apple fell on his head. Most of us would complain, “Geez, an apple hit me on the head.” But Newton took that opportunity to think about the nature of gravity. That kind of creativity is what scientists bring to the table. They find insights in spontaneous occurrences. You can’t actually program the best of creative science.  I wish you could, but in science, you have to identify the good people who are working hard and support them with the opportunity to be curious and spontaneous.

Q: What role did the Foundation Fighting Blindness play in your research and career?

A: I have great respect for the FFB. In the early 1980s, trustees of what was then the RP Foundation (now FFB) came up with the idea of having a career development award. The idea was to develop and support the careers of young vision scientists. I was fortunate to receive one of these FFB awards. That three years of support made all the difference for me to develop a research career.

Q: How will the aging of the population affect eye health in general? How will it affect the work of the NEI?

A: As we age, we increase our risk for disease, including diseases that cause vision loss. That burden is growing year by year as the population ages. What is NEI going to do about it? I am pleased to say that some key advances have already been made for AMD, or age-related macular degeneration, in the form of actual treatments. Starting about 2005, new drugs came on the market which treat AMD by suppressing the VEGF (vascular endothelial growth factor) molecule. This has had a real benefit in preserving vision for older people who have AMD.

Where did the drug come from? It came from 30 years of creative thinking by scientists, including scientists supported by the NEI and other institutes of the NIH, and from creative scientists working for drug companies, and from scientists supported by private funding sources. I hope that society can appreciate that investing in creative science may be a slow process, but ultimately it pays off in helping people with disease.

Q: As you know, FFB’s work is focused on inherited retinal disease. How do you see our growing understanding of the human genome impacting this work? How important is genetic testing?

A: When you understand what a gene does, you can understand where in the cell there is a vulnerability. Once you understand the vulnerability, and where the defect in the cell is, you can begin to think about how to fix it; that’s called treatment. Doing gene discovery is a good way to begin to understand disease and to ultimately treat it. But it’s a long road; it takes years, and it takes a lot of money. We are in the era of collaborative research—collaboration between investigators, between investigators and patients and between institutions.  It takes a whole village to do this work.