Dr. Neil deGrasse Tyson, the director of the Hayden Planetarium, is one of the foremost public intellectuals of our time. He has been described as a popularizer of science, and in that role he combines vast knowledge with wit and charm. Unfortunately, his very best aphorism is, if not wrong, at least open to a friendly argument: “The good thing about science is that it’s true whether or not you believe in it.” The issue is what you mean by “science.” Science isn’t truth, it’s the search for truth. There was a time when science said that the Earth is flat, that male pattern baldness was caused by wearing tight hats, and that moles, birthmarks and scars were evidence that a person is a witch. The good thing about science is that it’s willing to admit when it’s wrong. According to the State Library of Massachusetts, in 2005, Ann Pudeator, Bridget Bishop, Susannah Martin, Alice Parker, Margaret Scott and Wilmot Redd had their convictions of witchcraft reversed. Just give science enough time and it will get to the truth.
One of the bigger “aha” moments seems to have been reported in the Proceedings of the National Academy of Science, January 2013 with the title “Genomic Responses in Mouse Models Poorly Mimic Human Inflammatory Diseases”. The list of authors has 39 names and then adds “and the Inflammation and Host Response to Injury, Large Scale Collaborative Research Program.”
The hideously oversimplified bottom line is this: mice are not good models for human inflammatory disease, and using them for drug testing leads to inaccurate conclusions and tremendous waste of resources. This has been going on for decades. Chemists would come up with a molecule that seemed to have promise as a drug, and it would be subjected to some basic lab tests. If it worked, it would be tried on mice, and if it worked on mice, it would be cleared for further testing. The authors write “... few of these human trials have shown success. The success rate is even worse for those trials in the field of inflammation, a condition present in many human diseases. To date there have been nearly 150 clinical trials testing candidate agents intended to block inflammatory response in critically ill patients, and every one of these trials failed.”
While a number of researchers had raised the question of whether there might not be something wrong with using mice as the model for human drug response, it continued to be used as long as there was no clear evidence that there was anything wrong. This study provides convincing evidence that for all this time, the method of preliminary drug testing has been all wrong.
In the short term, this means a lot more work for researchers. The first step will have to be to identify the genetic responses to various conditions in humans – to get a better understanding of what happens in a burn or an infection. Then, various animal species will have to be studied to find which, if any, have a response mechanism that actually mimics the human response. This translates into the classic line “stay in school, get a good job.” This study examined the response to burns, trauma, and bacterial toxins, but it raises questions about the nature of response to every type of injury.
In the long term, this also has major implications for health care and politics. The costs of health care have been an 800-pound gorilla when it comes to budgeting, and this study, and the studies that follow it, will lead to better and cheaper drugs. The high cost of drugs has been at least partly justified by the expense of preliminary research. Profits on the drugs that made it to the market had to be high enough to offset the costs of those drugs that failed earlier studies.
While the pharmaceutical manufacturers have overstated the importance of these failed studies in their defense of drug costs, a recent report by F.M. (Mike) Scherer, a Harvard Professor Emeritus, “R&D Costs and Productivity in Biopharmaceuticals” does confirm that research and development costs influence the final price of drugs. While Professor Scherer focuses on costs due to regulations, and other reports tend to focus on the marketing and pricing strategies of the pharmaceutical companies, and still others look at the methods of cost estimation and creative accounting used by the drug manufacturers, the costs of following up on mouse studies are real and shouldn’t be discounted just because there are other factors which reflect poorly on the drug industry. As it is said, hypochondriacs get sick too.
The impact of the study on mouse models means that less money will be wasted on false leads, and potentially fewer good drugs will be rejected because they didn’t work on mice. This will cut the costs of drug research and development and improve drug therapy, and lower the costs of health care. The fear of the long term expenses of Medicare, Medicaid and Obamacare can be scaled back a notch, and there’s a bit less to worry about in terms of long term deficit projections.
Science isn’t always the truth, but it is always the search for truth, and this study is an impressive step in the right direction.
Sam Uretsky is a writer and pharmacist living on Long Island, N.Y. Email firstname.lastname@example.org.
From The Progressive Populist, March 15, 2013
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