February 9, 2008; Day 478. Ah, yes, where were we? Disease states. So, basically, to state an obvious truism, the biochemical reactions in our bodies are complicated! Moreover, we are not a soup can. That is to say, you cannot predict what is going to happen simply by putting all the chemicals we contain into a soup can because we have “architectural pathways” to keep things somewhat organized or separate. One well-known example is that we have arteries to take blood from the heart and veins to take blood to the heart. So, oxygenated blood is pumped around to allow oxygen to get “virtually everywhere” in our bodies and the same system picks up carbon dioxide, gathers it together and allows exchange out into the air by exhalation. Of course, this same system can also be used to pump other relative small molecules throughout the body…alcohol comes to mind as one such example. If you drink alcohol, it pretty much ends up everywhere throughout your body. So, the body, rather than being a soup can has various channels that organize and direct chemicals. But these channels are not “equal-service providers” for all substances. For instance, if you put grain alcohol on the back of your hand, your skin will pretty much keep it from being absorbed into your body long enough for it to evaporate. On the other hand, if you put WOOD alcohol on the back of your hand, it (a much more deadly neurotoxin even than grain alcohol) it WILL be absorbed by your skin and course throughout your body. Enough may cause permanent damage such as blindness or death. Some chemicals may exhibit gradient properties under certain conditions. Others may or may not be transferred throughout the body depending on other state conditions within the body, or be transferred at different rates. Again, to take an obvious example from the world of drinking, if you drink alcohol on an empty stomach, the alcohol will end up throughout your body more quickly than if your stomach is full of rich food. But this is just one obvious example. The more general point is that you have hundreds of chemicals coursing through your body at various rates. Moreover, many of the chemical reactions that take place are also part of more complex systems that involve negative (or more rarely, positive) feedback loops. These reactions themselves take place at various rates. For example, drinking a lot of alcohol (a sedative) may actually make you more jumpy or nervous a lot of the time because your body is reacting with chemical that attempt to counter-act the sedative effect (to put a teleological spin on it).
So, now, let’s consider. We have thousands of chemical reactions going on, in at least partially “protected” places in the body, going on at different rates and part of complex patterns of interacting systems that include feedback loops. Unfortunately, this complexity means that for many medicines, pharmaceutical companies only know what the first order effects are of a drug. How do drugs interact with each other? How does rate of absorption affect the various feedback loop timings? Although it would be incorrect to say nothing is known about these subjects, it would be fair to say, that a huge amount remains to be discovered. No-one has anything like an accurate overall picture of how things interact over time and space.
Now, consider these kinds of phenomena at a more microscopic level. There seems to be an often unstated assumption in genetics that you either “have” a gene or you do “not” have a gene for something and that the effects of genes are independent of where they are on a chromosome. In many cases, this may indeed be true. But there is a bias in the method of discovery of cause and effect here. If genes produce or fail to produce an effect because of variations in the relative gene locations of two or more genes and these locations vary, it may be very difficult to ever discover that these genes are having an effect. Thus, there may well be diseases that have a “genetic” cause but these diseases are only caused in a small percentage of the population who have the genes because of locational issues. One person might have genes A, B and C and they are too far apart to cause a significant enough negative chemical interaction while another person could have genes A B and C close together and as a consequence, too much of a “bad” chemical is produced to be dealt with by the normal negative feedback loops that try to “get rid” of this “bad” chemical. To complicate matters further, it might be that there is a further interaction with environmental chemicals. A person with genes A B and C far apart might have to be exposed to 1000 times the dosage of a pollutant to cause a problem as the person with genes A B and C close together. Of course, in this example, having A B and C far apart as “good” is entirely arbitrary. In other cases, exactly the opposite could be true.