“It’s truly amazing the progress we have made in our understanding of the disease process and how to treat it—all through basic cellular research. I have witnessed it all over the course of my career.”
I sat next to the Chinese woman and stared out of the salt-streaked window at the white-capped waves, conscious of the slight pitch and roll of the ferryboat. She was a Ph.D. biologist who headed a lab devoted to pharmacological research for treatment of dermatological disease.
“Thirty years ago,” she continued, “we treated the pain of rheumatoid arthritis with almost no thought to attacking the disease at the root of the problem—autoimmune inflammation. Now we have mapped the biochemical cascade of the inflammatory response—cytokines, prostaglandins, interleukins, components of complement—and we are in the process of designing drugs to block these agents to prevent tissue destruction. It is all so fascinating.”
We were returning to Hyannis from a weekend medical conference devoted to soft science on Nantucket Island. Ironically, here we sat discussing the benefits of basic medical research. There is always more than one perspective when it comes to the practice of medicine.
How much of what we experience as disease is in reality the result of the human body’s response to certain agents, such as viruses, bacteria, and other toxic agents?
A recent article in the New York Times spoke to this very idea.
A new insight in cold science: the symptoms are caused not by the virus but by its host — by the body’s inflammatory response. Chemical agents manufactured by our immune system inflame our cells and tissues, causing our nose to run and our throat to swell. The enemy is us.
The inflammatory response: a potent cocktail of the so-called inflammatory mediators that the body makes itself — among them, cytokines, kinins, prostaglandins and interleukins, powerful little chemical messengers that cause the blood vessels in the nose to dilate and leak, stimulate the secretion of mucus, activate sneeze and cough reflexes and set off pain in our nerve fibers.
Listening to my colleague speak, I thought back to a patient I had recently evaluated, someone diagnosed with bipolar disorder, a different kind of inflammatory response, where labile emotions flare in the limbic system of the human brain.
Perhaps one day basic medical research will enable us to delineate specific biochemical pathways that trigger such responses; and, in turn, help us to formulate pharmaceutical agents to block the cascade that results in the downward spiral of major depression.
With our current state of basic medical research we stand poised to micromanage these medical maladies.
What’s good for the cell is ultimately good for the soul.