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Unlocking the full potential of pathology data by gaining computational access to histological pixel data and metadata (digital pathology) is one of the key promises of computational pathology. Despite scientific progress and several regulatory approvals for primary diagnosis using whole-slide imaging, true clinical adoption at scale is slower than anticipated. In the U.S., advances in digital pathology are often siloed pursuits by individual stakeholders, and to our knowledge, there has not been a systematic approach to advance the field through a regulatory science initiative. The Alliance for Digital Pathology ( the Alliance) is a recently established, volunteer, collaborative, regulatory science initiative to standardize digital pathology processes to speed up innovation to patients. The purpose is: (1) to account for the patient perspective by including patient advocacy; (2) to investigate and develop methods and tools for the evaluation of effectiveness, safety, and quality to specify risks and benefits in the precompetitive phase; (3) to help strategize the sequence of clinically meaningful deliverables; (4) to encourage and streamline the development of ground-truth data sets for machine learning model development and validation; and (5) to clarify regulatory pathways by investigating relevant regulatory science questions. The Alliance accepts participation from all stakeholders, and we solicit clinically relevant proposals that will benefit the field at large. The initiative will dissolve once a clinical, interoperable, modularized, integrated solution (from tissue acquisition to diagnostic algorithm) has been implemented. In times of rapidly evolving discoveries, scientific input from subject-matter experts is one essential element to inform regulatory guidance and decision-making. The Alliance aims to establish and promote synergistic regulatory science efforts that will leverage diverse inputs to move digital pathology forward and ultimately improve patient care.

The rise in antibiotic-resistant bacteria has led to an active search for new and more effective antimicrobial drugs. A hexapeptide (LfB6: RRWQWR-NH2) derived from the iron-binding protein lactoferrin exhibits antimicrobial activity (Tomita, Acta Paediatr Jpn, 1994, 36:585). A related heptapeptide produced in our lab, with 4 positively charged arginines and 2 methylated tryptophans (RRMeWQMeWRR-NH2; MeTrp-LfB7), exhibits enhanced activity against gram negative and gram positive bacteria. Substitutions of the central glutamine (Gln4;Q) residue that may alter peptide conformational flexibility are now being investigated. When Gln4 was changed to glycine (Gly;G) or proline (Pro;P), significant changes in peptide-membrane interactions were observed, although the antimicrobial activity was not increased. We now examine the effects of replacing Gln4 with gamma amino butyric acid (GABA), to introduce more flexibility; or D-Pro-Gly, to constrain the backbone into a β-hairpin turn (Stanger and Gellman, J. Am. Chem. Soc. 1998, 120:4236). The increased positive ellipticity at ∼230 nm observed in the CD spectrum of the D-Pro-Gly peptide in anionic membranes suggests significant Trp-Trp interactions. Tryptophan fluorescence emission spectra indicate that peptides with either GABA or D-Pro-Gly substitutions are more deeply buried in anionic membranes. Although the GABA and D-Pro-Gly peptides were both more active against gram negative (E. coli), compared to gram positive (S. aureus) bacteria, they were not as active as the Gln4 peptide. Investigations of the peptide-lipid interactions are being continued by means of solid-state 2H and 31P NMR spectra.