A Matter of Degree

The difference between you and a trained technician when it comes to a recalcitrant computer is just a matter of degree - the technician knows more about the internals than you do, and has the tools to get in and look around - but quite profound. Knowledge of the internal processes and mechanisms of any system brings with it a completely different way of viewing and resolving problems. You see confusing symptoms at the most obvious level, and perhaps you have one or two experience-taught tricks that might or might not help; the technician can dive in and obtain a true picture of the situation.

So too with medicine; where the scientists are today is a matter of degree distant from the near past and near future. The past few and next few decades form a transition from the non-technical to technical for the complex, drawn-out conditions and transitions that come with aging. Therapies move from chance discoveries that may or may not work for individuals to precise attempts to understand and address specific dysfunctions in the complex systems of your cells and tissues.

A good example of this process can be found in a recent release describing one strand of rheumatoid arthritis research:

Early on in the rheumatoid arthritis research game, when HLA popped out as a major genetic player in the condition in the 1980s, Dr. Gregersen discovered that there was a shared bit of DNA that traveled in the disease. What took two years to identify in the laboratory -- shared bands of genetic material -- would take two days today. And that speed is what excites Dr. Gregersen. "We have the tools to get at these genes rather quickly now," he said. "The more patients and controls that we have, the more power we will have to pull out new genes and make associations."

In another major breakthrough, scientists have discovered the importance of a substance called citrulline as a target for immune attack in rheumatoid arthritis (RA). This immune system antibody associated with rheumatoid arthritis recognizes citrulline, which seems to be a key player in the condition. Indeed, the HLA associations with RA have now been shown by Dr. Gregersen and others to directly regulate the immune response to proteins containing citrulline. Citrulline is formed when a specific enzyme comes in contact with arginine, one of 20 common amino acids in proteins. When one of the enzymes is present, nitrogen is removed from the chemical structure of arginine and it converts into citrulline.

Laboratories have developed a test to measure for anti-cyclic citrullinated peptide antibody, or anti-CCP. It is now being used as a diagnostic for rheumatoid arthritis. Scientists are now finding that patients have CCP antibodies months or years prior to the illness, suggesting a way to identify the disease before it starts and perhaps offer treatments to stave off the symptoms. It turns out that those with these antibodies who also have a particular variety of HLA, a complex of genes that regulate immune function, have a 30 times higher risk of developing rheumatoid arthritis than those without these genetic risk factors.

This is, of course, one small sample of the wider space of work on arthritis. In the years ahead, the changes of aging will be laid open at the most fundamental level under the light of modern biotechnology - each moving piece available on the bench for study and manipulation.

Just how well you can repair an aging system is all a matter of degree - how much you know, the quality of your tools. Medicine and biotechnology are accelerating rapidly on all counts in these early days of the 21st century; the future is promising indeed. The flying cars may be late, but the life of years is coming down the line faster than many thought possible.

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