Complex disease, why are they so hard to solve.

[Dislayer]

I wanted to start a discussion about complex diseases (atherosclerosis, asthma, multiple sclerosis, etc.) and why we have had a difficult time figuring them out. Is it because we are searching for that one cause (either gene or exposure) that we hope can explain the prevalence of the disorder, like cystic fibrosis. Or is it because we group people with similar symptoms under there syndromes but in fact their diseases have different etiologies and are not the same disorder.

 

I do research on the genetics of asthma and the field is shifting towards better phenotyping of patients to better understand how different asthmas come to be. There is a general belief that large scale genome wide association studies (GWAS) have a hard time turning up results because the 'disease' group is a heterogeneous mix of different disease. I believe there is a need to better integrate research disciplines (molecular, physiology, modelling and epidemology) in order to start understanding these disorders better in the hopes of one day developing a cure. The reductionist approach taken thus far (that worked well for simple Mendelian disorders) probably will not bring us answers or meaning full cures.

 

What does everyone else think? Why have we not been able to make significant progress in understanding complex disorders?

[Lightmeow]

I think the reason why we can't understand the disorders is because they are complex, and might have a million variables to it.

[Dislayer]

I think the reason why we can't understand the disorders is because they are complex, and might have a million variables to it.

 

While that is true it does not add to the discussion about this topic. How must we approach the problems in order to gain better understanding of them.

[Prometheus]

I think you alluded to it: the multi-disciplinary approach. Something like the Crick Institute hopefully.

[Lightmeow]

 

While that is true it does not add to the discussion about this topic. How must we approach the problems in order to gain better understanding of them.

 

You should of said how should we approach the problems, I thought you were asking why complex diseases are hard to solve. Ok, so thinking.

 

Here are some things we can do:

Observe them(which we already do)

Test different things, see if the disease is connected to another part of our body.

I honestly can't think up of any ways... The scientists trying to figure this stuff out have been doing a great job at it(I MEAN NO SARCASM!!!), they really have been trying their best. Eventually they will figure something out. Just as now we know the solution to making a headache better is not to drill a hole in their head, but to give them the pills, or have them hold down on a pressure point. I think we just need a different tool set then what we have been trying to use. You know, you can't fix a china cup with a hammer, if you know what I mean... But, don't ask me for solutions.

 

I'm going to use an example. Humans as of now try to fix mental illness with pills. As it looks like it works, it really doesn't, its more of a patch, you know, because the problems still there. But now, they also use therapy, and therapy works in some cases, and then the people don't need to take pills anymore. That's what I mean by a different tool set.

 

Hope that added something. Sorry if I offended you...

[CharonY]

There is no magic bullet to solve complex biological processes. Often a reductionistic approach is the simplest way to approach these types of problems. However in biology there are many cases of emergent properties which are not explainable by looking at things in isolation. In the long run we need to invest into novel approaches and find a way to utilize complex data and generate models that can assist in their interpretation.

However, funding tend to be conservative and approaches that are aimed to find a cure to a disease now are easier to propose than long-term fundamental studies that may, or may not enhance our knowledge in the long run.

[Dislayer]

 

You should of said how should we approach the problems, I thought you were asking why complex diseases are hard to solve. Ok, so thinking.

 

Here are some things we can do:

Observe them(which we already do)

Test different things, see if the disease is connected to another part of our body.

I honestly can't think up of any ways... The scientists trying to figure this stuff out have been doing a great job at it(I MEAN NO SARCASM!!!), they really have been trying their best. Eventually they will figure something out. Just as now we know the solution to making a headache better is not to drill a hole in their head, but to give them the pills, or have them hold down on a pressure point. I think we just need a different tool set then what we have been trying to use. You know, you can't fix a china cup with a hammer, if you know what I mean... But, don't ask me for solutions.

 

I'm going to use an example. Humans as of now try to fix mental illness with pills. As it looks like it works, it really doesn't, its more of a patch, you know, because the problems still there. But now, they also use therapy, and therapy works in some cases, and then the people don't need to take pills anymore. That's what I mean by a different tool set.

 

Hope that added something. Sorry if I offended you...

No offence taken, just hoping to stimulate discussion. I research asthma and find this question provides interesting talking points in our center. Just wanted to gauge others opinion on the topic.

There is no magic bullet to solve complex biological processes. Often a reductionistic approach is the simplest way to approach these types of problems. However in biology there are many cases of emergent properties which are not explainable by looking at things in isolation. In the long run we need to invest into novel approaches and find a way to utilize complex data and generate models that can assist in their interpretation.

However, funding tend to be conservative and approaches that are aimed to find a cure to a disease now are easier to propose than long-term fundamental studies that may, or may not enhance our knowledge in the long run.

 

On the note of funding, I think one of the problems is this desire to have a tangible patient benefit by the end of a grant or fellowship when in reality it would take many grant cycles to get to the point of having a relevant treatment developed. The government wants science to move quickly but my experience is that science is slow and methodical. It needs time to be precise so we avoid problems with retraction.