Inspired by my revision of regenerative medicine, molecular medicine, protein structure, and parasitology these past few weeks, here are some things I would like to see in the future:

First, a return of well-run trials for GDNF infusion into the striatum for Parkinson’s Disease. GDNF (glial cell line derived neurotrophic factor) is effective at reducing neuron death following axotomy, making it potentially useful for spinal injuries, as well as slowing neural decline in Parkinson’s. The first trial was fantastic, but bad management by the second trial led to funding withdrawal. This would be helped by a tighter definition of PD, which is currently defined only pathologically. Partly because of this, diagnosis is wrong about 10% of the time, making trial results misleading (if you don’t have at least 10% failure, something aint right). It would also be helped by a natural model of PD.

Secondly, I would like to see a replacement drug for praziquantel (PZQ). Although having such an effective broad spectrum drug for all digenean and cestode diseases continues to be of immeasurable worth, some natural resistance has been discovered among schistosomes in Senegal and Egypt. There is currently no alternative drug for many of the platyhelminth infections (including schistosomiasis), so determining the mechanism of PZQ and either creating functional derivatives or a new line of drugs is essential. Not only will it put eradication of certain human infections on our can-do list, but it will be necessary to preventing epidemics in the not-too-distant future.

Of most clinical importance, I would like to see a shift in the experimental approaches to both drug design and therapeutic development. Funding issues and politics these days curtail many trials that could lead to excellent treatments, given a little more practice and good management. The truncation of so much work has really led to a reluctance to explore things, and that’s the same as cutting out the heart of science. As one of my lecturers noted, the extensive work and experimentation that went in to bringing organ transplantation into use wouldn’t happen today. It would be scrapped after the first failed operation, with no one trying to figure out what needed improvement. Today there are some fields that tend to try to be thorough, but they are, unfortunately, not in the majority.

As for drug design, in the attempt to lose as little time and money as possible in the research and development stages, much of pharmaceutical research consists of throwing random chemicals in dish and seeing if it kills the cells you’re looking at. While some of the greatest discoveries of the world have been accidental (penicillin, doughnuts), most medical progress is achieved by figuring out what needs doing and detailing possible pathways for getting it done. TRND may help us refine the process, but trusting to chance isn’t usually a good substitute for knowing your biochemistry, and Mr. T would surely have a few select words for the industry.

In terms of protein analysis and application to medical concerns, it would be useful to determine the infective agent of prion diseases, which evidence suggests (to me, at least) is not the pure aggregate. In fact, it seems quite possible that the protein aggregates are a side effect of genetic or steric inhibition of, say, chaperonins. In a more academic vein, I would appreciate a revised model for cooperative binding in hemoglobin. Really, it seems to me that the most likely accurate model would involve the a-ß interfaces, and I think there would be a fairly simple experiment to corroborate that, if I had tools and a lab on me, that is. Then again, that may be thesis level work that just doesn’t fall under my lab’s specialties.

At any rate, in order to not go into scientific withdrawal after my last exam, I will have to diligently read Science or Nature even while I’m in Japan and trying not to speak English. The wonderful thing about science is that you’re never through with it, even when you think you understand something. That said, I’m ecstatic to be finished with exams! This morning we dealt with a table saw on the glass roof and two bouts of recess fromt the adjacent primary school during the two hour test. But it was the last day of exams, and I subsequently went and did this with my afternoon:

New York won by just one point! Tomorrow we'll see if they can level London.

New York won by just one point! Tomorrow we'll see if they can level London.