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Old 04-14-2003, 08:07 PM   #1
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Default Disease and the year 2100

One night a couple of weeks ago I asked a few of my friends if they thought, by the year 2100, whether ALL diseases/cancer/etc. would be cured. I said yes b/c I figured that by then, we would have figured out complex things such as protein folding, and also our computing power would have multiplied to ridiculous levels (not to mention the power of distributed computing.) Now by "cured" I mean that if a new disease were to evolve and be discovered, we would be able to make a cure within, say, a week.

What are your thoughts on this?

-Roma
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Old 04-15-2003, 11:20 AM   #2
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One thing comes to mind: understanding the etiology of a disease certainly helps with developing treatments, but does not ensure that it can be treated or cured. There are already plenty of diseases whose causes are well-understood, yet are not currently curable or even treatable. For example, there is a growing number of diseases known to result from rather minor DNA base-pair changes, but only a few of these diseases are good candidates for gene therapy, because of the difficulty of introducing DNA to the right cells. Of course, our ability to do this will improve as well, but its possible that many diseases will prove virtually intractable as a practical matter, even if we understood all there was to understand about the disease. That said, I think amazing things are going to happen in this century in the treatment of disease.

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Old 04-15-2003, 04:37 PM   #3
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I think we need to look at the track record for treating disease in the year 2003.

We already have the "cure" for diseases such as dysentery and cholera: this is simply hydration with uncontaminated water. Prevention of these diseases (as well as many others) is just as simple, and again revolves around hygenic water sources.

Given that the world's supply of clean fresh water is under increasing pressure, I think that it's clear that the state of global public health in 2100 will be much worse than it is now.

New diseases susceptible to curing with quick techno-fixes will be the least of our problems.
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Old 04-15-2003, 04:49 PM   #4
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I was one of the few in Nacogdoches who knew that Tom Ames would not come to some bad end,
despite his being caught stealing chickens and such.
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Old 04-16-2003, 01:12 AM   #5
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Well now, I can't help but recall how they nearly gave me a ticket for speeding in Fort Smith, Arkansas.
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Old 04-16-2003, 02:54 AM   #6
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I doubt disease will ever be fully eradicated from human existence. While many disease conditions have been eradicated, this is largely due to "old public health" measures being introduced (i.e. physical infrastructure such as clean water supply, sanitation). Most of the current level of diseases can only be alleviated through "new public health" initiatives (mainly lifestyle diseases and such lovelies as AIDS, Ebola, and SARS). Unfortunately, "curing" is too cost-prohibitive and is unlikely to be widely available enough to matter at the population level. Prevention and management is about the best we're likely to get.
Interested in further readings in health promotion?
Here's a great place to start.
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Old 04-16-2003, 06:42 AM   #7
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Quote:
Godot:
Unfortunately, "curing" is too cost-prohibitive and is unlikely to be widely available enough to matter at the population level. Prevention and management is about the best we're likely to get.
I agree, and I think that 'cyborgization,' to whatever extent it becomes feasible, is also unlikely to be available to more than a handful of people.

One form of prevention that will become increasingly attractive, and is also likely to be more affordable, is germline genetic manipulation. Its may well be possible in the not too distant future to use DNA microarrays to quickly and cheaply assay thousands of disease-predisposing alleles in an embryo, and manufacture small artificial chromosomes containing a specialized mixture of genes and 'anti-genes' (genes that silence other genes) that interact with the host genome so as to reduce the risk for all sorts of illnesses, such as heart disease and cancer, not to mention numerous 'genetic diseases' with known genetic basis that so far are untreatable.

EDIT: No sooner did I post this than I read that scientists with the National Institute of Allergy and Infectious Diseases (NIAID) found an immune system receptor variant that strongly influences risk for atherosclerosis. This is one of the first alleles to be identified which is a risk factor for heart disease.

McDermott et al, 2003. Chemokine receptor mutant CX3CR1-M280 has impaired adhesive function and correlates with risk of cardiovascular disease in humans. J. Clin. Invest. 2003 111: 1241-1250.

Quote:
The chemokine receptor CX3CR1 is a proinflammatory leukocyte receptor specific for the chemokine fractalkine (FKN or CX3CL1). In two retrospective studies, CX3CR1 has been implicated in the pathogenesis of atherosclerotic cardiovascular disease (CVD) based on statistical association of a common receptor variant named CX3CR1-M280 with lower prevalence of atherosclerosis, coronary endothelial dysfunction, and acute coronary syndromes. However, the general significance of CX3CR1-M280 and its putative mechanism of action have not previously been defined. Here we show that FKN-dependent cell-cell adhesion under conditions of physiologic shear is severely reduced in cells expressing CX3CR1-M280. This was associated with marked reduction in the kinetics of FKN binding as well as reduced FKN-induced chemotaxis of primary leukocytes from donors homozygous for CX3CR1-M280. We also show that CX3CR1-M280 is independently associated with a lower risk of CVD (adjusted odds ratio, 0.60, P = 0.008) in the Offspring Cohort of the Framingham Heart Study, a long-term prospective study of the risks and natural history of this disease. These data provide mechanism-based and consistent epidemiologic evidence that CX3CR1 may be involved in the pathogenesis of CVD in humans, possibly by supporting leukocyte entry into the coronary artery wall. Moreover, they suggest that CX3CR1-M280 is a genetic risk factor for CVD.

Patrick
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