Map of life expectancy at birth from Global Education Project.

Tuesday, October 06, 2009

The Nobel Prize in Physiology or Medicine . . .

and why I have somewhat mixed feelings about it. For those of you who don't already know, the prize this year was awarded to researchers who have elucidated the functioning of structures on chromosomes called telomeres. As a crude analogy, they are like those little plastic doodads on the ends of your shoelaces that keep them from unraveling. (I believe I once read somewhere that there is actually a name for them; if anybody knows it, let me know.)

Anyway, whenever your cells reproduce the telomeres have to be rebuilt on the new chromosomes, but there's bad news: they get a little shorter each time and eventually, the chromosomes degrade and the cell line gets old, tired, and useless. This turns out to contribute to the inevitably fatal, incurable disease with which we are all born, which typically gets us sometime after three-score years and ten. So, if we could preserve those telomeres, our shoelaces -- I mean our chromosomes -- would be immortal, and maybe we'd have one more key to curing the disease of aging.

But there's more bad news: evolution gave us this telomere shortening, and there is what appears to be a very good explanation for it. Immortal cell lines are dangerous, because they just might be cancer. Most of our cell lines have to divide only a few times during our reproductive years, so evolution has no reason to preserve those telomeres; indeed, it has a good reason to see them erode, because that is one more hurdle cancer cells have to overcome in order to become malignant. In other words, this component of the aging process protects us against cancer, which otherwise might get us early in life.

So far, our understanding of telomeres has not yielded anything useful, but it might eventually. We might be able to use it to prevent the immortalization of cancer cells, and so cure or prevent cancer; and we might be able to use it to prevent or even reverse elements of the aging process. On the other hand, these two goals might be largely irreconcilable and the knowledge might not turn out to be very useful after all.

But what if all this does lead to more effective cancer treatments, or even the Fountain of Youth? As I wrote earlier about another potential treatment for aging, resveratrol and similar compounds, there could be downsides. But more than that, a vast investment in basic biomedical research -- probably many tens of billions of dollars, at least -- lies ahead in pursuing this particular grail. If it leads anywhere, comparable sums will be spent on turning knowledge into safe and effective treatments, and providing those treatments to those people wealthy enough to afford them, whose benefit will consist of exceeding the natural life span.

Meanwhile, I shouldn't have to tell you but I probably do that today, on planet earth, 20% of all deaths are of children under five years old. Life expectancy at birth right now in Afghanistan is 41 years, and in most of Africa it's under 60 and even under 50 years. We're far from number 1 but we're already up to 78 years. Those tens or hundreds of billions of dollars could wipe out those inequities and save all those kids. Yes they could. But instead we'll invest them in trying to get rich people to live to be 100-120 instead of just 80-100. I dunno about that.

14 comments:

Bix said...

I was going to comment along the lines of your last paragraph, specifically your last sentence, but you beat me to it.

Yes, it would be nice if money spent on life extension research would be directed to the millions around the world who aren't making it past puberty, whose quality of life is nightmarish . We have the technology and the dollars right now to extend these lives, we just lack the will.

I don't begrudge researchers their grants. I'd just like to see more compassion.

roger said...

i believe that the word is aglet.

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