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Friday, February 22, 2013

Implications of Missing The Complex

The paradigm of the single causative agent - single receptor antagonist, is one possible reality in the quest for new drugs. If so, this is a complicated system. The journey from complicated to complex:
  • Complicated, in which the relationship between cause and effect requires analysis or some other form of investigation and/or the application of expert knowledge.
  • Complex, in which the relationship between cause and effect can only be perceived in retrospect, but not in advance.
In a clinical trial, we are studying the relationship between cause and effect in retrospect. However, we have blurred the lines between complicated and complex. We begin pharma research by creating a cause, linking protein X to disease state Y. We have reduced our research to a complicated project. We hire experts to conduct the analysis that validates our cause and effect assumption. Our scientists know that their career aspirations lie on providing evidence that the drug intervenes on the cause and alters the effect, the disease. 

Look at health in a different way. Look at it in a complex way. In many disease states, it has been shown that diet and exercise works much better than the pharmaceutical interventions. In the documentary "Forks Over Knives" several very sick people were restored to health. The intervention was not simply that protein X causes disease Y. Some combination of the wrong food at the wrong quantities was causing a disease state. Changing diet and exercise habits brought about real change. But what was the cause, on the molecular level? A single target protein that was attacked by a barrage of vegetables? 

Let's replace the Forks Over Knives success stories with the curse of baldness. Have we ever changed a diet and exercise routine to reverse baldness? If we had, men all over the world would make the change. They do it to sculpt their bodies. Why wouldn't they take the advice seriously to stop losing their hair? What is it then that prevents people and scientists from learning more about the complexity of the human body and the relationship to diet and exercise? Is is because it is too hard, too complex? The madness of Resveratrol comes to mind. Someone noticed that the French had longer life spans than the rest of Europe. They focused in on red wine. They wanted to find one single molecule that they could make into a pill. A few years later Resveratrol. N-Rays in a capsule. Once again, a single agent that provides a key to long life. But it didn't work. 

So we really ought to look into theories that don't work, and
science that isn't science.

1 comment:

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