Unbalanced research

Abstract

Researchers who reduce diseases to molecules promise unlimited therapeutic progress. With such claims, molecular biology, which is foremost represented by genetic determinism, commands a major portion of funded medical research 1 Strohman R.C. The coming Kuhnian revolution in biology. Nat. Biotech. 1997; 15: 194-199 Crossref PubMed Scopus (206) Google Scholar . This novel biotechnology does bring new modes of discovering biological mechanisms, testing hypotheses and manufacturing drugs. However, the many promises of novel therapies disagree with actual possibilities and the results of genetic research 1 Strohman R.C. The coming Kuhnian revolution in biology. Nat. Biotech. 1997; 15: 194-199 Crossref PubMed Scopus (206) Google Scholar , 2 Le Fanu J. The Rise and Fall of Modern Medicine. Little, Brown & Co, 2000 Google Scholar . The shortcomings of the new biology during the past 25 years seem particularly evident by comparison with the success of medical research carried out between 1935 and 1975 ( 2 Le Fanu J. The Rise and Fall of Modern Medicine. Little, Brown & Co, 2000 Google Scholar , 3 Wurtman R.J. Bettiker R.L. The slowing of treatment discovery (1965–1995). Nat. Med. 1995; 1: 1122-1125 Crossref PubMed Scopus (49) Google Scholar ). Genetic determinism and reductionism emerge as significant research traps and a chasm-like separation might arise between molecular medicine and the sick patient 1 Strohman R.C. The coming Kuhnian revolution in biology. Nat. Biotech. 1997; 15: 194-199 Crossref PubMed Scopus (206) Google Scholar , 2 Le Fanu J. The Rise and Fall of Modern Medicine. Little, Brown & Co, 2000 Google Scholar , 3 Wurtman R.J. Bettiker R.L. The slowing of treatment discovery (1965–1995). Nat. Med. 1995; 1: 1122-1125 Crossref PubMed Scopus (49) Google Scholar . Furthermore, the newly added ‘translational research’ and ‘functional genomics’ cannot remedy this dichotomy. Reflecting a molecular-biology-driven imbalance, several ‘inflammatory’ mechanisms (allegedly related to asthma and allergic rhinitis, among others), now under intense investigation molecularly in vitro and in mice, might not occur in human tissues in vivo 4 Erjefält J.S. Persson C.G.A. New aspects on degranulation and fates of airway tissue eosinophils. Pulmonary Perspective. Am. J. Respir. Crit. Care Med. 2000; 161: 2074-2085 Crossref PubMed Scopus (112) Google Scholar ; conversely, true inflammatory events in vivo are being ignored (Fig. 1). Although our examples are subjective and limited, they might represent a general trend. Patient-oriented discovery research, which is function-cognizant and independent of reductive paradigms, seems urgently needed.