naturopathydigest.com -- Molecular Cell Biology and Interventional Proteogenomics. Part Two: The Proposed Future of Allopathic Medicine

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Molecular Cell Biology and Interventional Proteogenomics

Part Two: From Biological Science to the Possibilities of Pharmacoeconomic Misappropriation

By Alex Vasquez, ND, DC, Editor, Naturopathy Digest
AVasquez@NaturopathyDigest.com

Whether the genomic revolution and the advancing science of molecular cell biology will serve as menaces or opportunities for the naturopathic profession depends upon the ways in which these sciences and their associated assessments and interventions are applied clinically, socially and politically, as I began to discuss in the first of this three-part series.¹ The suggestion that patient assessment and treatment eventually could hinge on the triad of 1) laboratory tests; 2) financial status; and 3) genomic analysis,² might seem so repulsive that we could be tempted to discard clinical genomics prima facie and thus potentially deny ourselves and our patients the benefits that might lie within these rapidly progressing sciences.³
The "central dogma of molecular biology," which you can find in most modern biochemistry textbooks,⁴ states that information encoded within DNA is transcribed to mRNA and then translated into proteins that are biologically active and which then allow for and orchestrate physiologic processes. If those processes are appropriate and well orchestrated, health is the result. But if the DNA is mutated, the transcription is flawed or the translation is defective, then the orchestra of organelles and physiologic processes and responses will be out of tune, resulting in poor health, at best, and overt disease, at worst. Thus, according to current and widely accepted basic science textbooks used in medical schools, defective genes and/or defective gene products generally result in dysfunction and disease. While some defects are either mild or completely subclinical, many others are - sooner or later - a danger to health and life.
The misappropriation of this science, ripe for pharmacoeconomic exploitation, arises from a simple and subtle reversal of the sequence of what is otherwise a basic science truism. The science states, "Defective genes or defective gene products result in disease." Exploitation of this science states, "Disease results from defective genes or gene products." Read those statements again if you need to; they appear similar but are powerfully different, and the confusion of the former with the latter is what mutates science into pseudoscience.
Again, while we note the subclinical and subpathologic exceptions, we must agree that if the severity and importance are of a given sufficient magnitude, the defective genes or defective gene products will indeed result in dysfunction, at best, and disease, at worst. Examples of this truism include sickle cell anemia (caused by a DNA point mutation that results in the insertion of valine in place of glutamic acid in the betaglobulin chain of hemoglobin) and cystic fibrosis (caused by homozygous gene mutations, often resulting in an absence of phenylalanine from the CFTR protein). Indeed, defective genes can result in defective proteins that impair normal function and cause disease, as these simplistic and stereotypical examples illustrate.
But, when this same linearity is applied to the disorders commonly encountered in clinical practice (such as obesity, hypertension, diabetes, depression and the autoimmune diseases), the vast majority of which are multifactorial, we can see how a subtle modification of a well-established truism can fool doctors and patients alike into believing the common chronic illness they are dealing with is the primary result of defective genes, for which the appropriate treatment is a gene-specific pharmaceutical drug.
The stronger the gene-disease link appears in the research, the easier it will be to convince doctors and patients that drugs should be used for the treatment of those diseases, especially those still codified as "idiopathic" within the medical community. Transitioning from "idiopathic" to "genetic" carries the same therapeutic implications: Generally, it results in a situation in which the patient is disempowered and forced to rely on some exogenously administered drug for the treatment/amelioration/suppression of their condition. Again, in situations in which a drug can effectively, completely, safely and affordably treat a given disease caused by a gene defect, such a drug certainly is an appropriate consideration and might even be the treatment of choice. However, what happens more often, and what is happening on a progressively larger and larger scale, is that subcurative drugs are being used either as monotherapy or in conjunction with other subcurative drugs ("polypharmacy"), simply because a gene association has been identified and this "association" was later mutated into a "causative association" by pharmaceutical companies that have tied their drugs to the links between diseases and various gene defects.
As genomic testing becomes more widely used and as the drug companies focus on linking their drugs with genes (rather than only diseases, as was previously the case), the finding of an associated gene in a patient with a specific disease will be interpreted to mean that the gene-disease relationship is causal and the gene-specific drug is the appropriate treatment. This already occurs today, even when the disease is predominately lifestyle- and environment-induced (e.g., diabetes). The marketing slogan and treatment mantra is, "If you have a disease, it's because you have bad genes, and you need this drug specific for your genes and your disease if you want to survive your disease." This paradigm of genetic determinism, coupled with pharmacologic salvation, increasingly is well engrained in our conceptualizations of nearly all major chronic diseases, and the list of diseases associated with, and therefore, assumed to be caused by gene defects grows every day. When misappropriated, genomic tests will serve as a fulcrum with which to propel the sale of pharmaceutical drugs into the high-profit stratosphere. Conversely, genomics could be a golden opportunity for naturopathic medicine, and this is what we will explore in the next and final article in this series.
References

Vasquez A. "Molecular Cell Biology and Interventional Proteogenomics. Part One: The Proposed Future of Allopathic Medicine." Naturopathy Digest 2006 Oct. Click to view it online.
Roses AD. 2025: The practice of neurology: back from the future. Arch Neurol 2001 Nov;58(11):1766-7.
Cooper and Hausman. The Cell: A Molecular Approach, Fourth Edition. ISBN 9780878932191 www.sinauer.com/detail.php?id=2191. See also www.sinauer.com/cooper/4e/ for samples and animations.
Champe PC, Harvey RA, Ferrier DR. Lippincott's Illustrated Reviews: Biochemistry (Lippincott's Illustrated Reviews Series). Lippincott 2004 ISBN-10: 0-7817-2265-9 and ISBN-13: 978-0-7817-2265-0.