Panacea, daughter of Asclepius: a cure for all diseases
In ancient times, in the Middle Ages and in the Renaissance, the search for a panacea was akin to the search for a philosopher's stone. A more or less scientific basis in medicine began to appear on the strength a couple of hundred years ago. Then the first serious candidates for the title of "panacea" appeared.
One of the first to play the role of an "all-healing technique" was homeopathy. But since there is still no rational explanation for treatment with a solution of water (and with large dilutions that homeopaths love so much, there will be nothing other than water in the solution), as well as no reliable scientific evidence of the effectiveness of homeopathy in general, this application for a panacea is unlikely whether it can be considered serious.
In the XX century, several synthetic chemotherapeutic agents appeared (starting with acetylsalicylic acid and sulfanilamides), which initially made a real sensation in medicine and also quite seriously began to claim the proud title of panacea. Only later it turned out that acetylsalicylic acid has a lot of side effects, and bacteria quickly get used to sulfonamides and develop resistance (and viruses are completely immune to these drugs). Antibiotics that appeared in the mid-20th century also suffer from the same drawback: while in the 1940s the effective dosage was 10-15 thousand units, then by the 1990s the standard doses had reached a million of the same units. Yes, and without side effects is not complete.
In fact, according to modern medical ideas about the human body, no matter how scientists would like to create a panacea, this is basically impossible. And that's why.
Theoretically, drugs act on different levels of regulation, but almost all the drugs are used as receptors: with very few exceptions, no one can influence cells and tissues in a different way. There are many receptors, they are constantly discovering more and more. They are located throughout the body, in some organs there are more, in some less. Based on this knowledge, doctors are trying to regulate certain life functions and indicators.
A stem cell that received a certain “signal” from the outside is able to give life to several different “branches”. There are SC ancestors - totipotent. They are able to generate body cells of any kind. Next, the process of differentiation occurs - the structure and functions are complicated, and the ability to transform is reduced. The next branch will be pluripotent SC, which include, for example, embryonic. They can create cell lines of various kinds. The main hopes are laid on them: when introduced into the body, they themselves recognize the problem foci, get to them and, on the spot, turn into cells of a myocardium damaged by a myocardial infarction, replace brain cells affected by a stroke, patch “holes” in blood vessels, etc. More specialized SC that are formed at the following levels of "branching" can give life to an already limited number of cells, therefore they are called multipotent. For example, from the stem cell of the blood only formed elements can be formed - red blood cells, white blood cells, platelets. And finally, there are unipotent SCs that can turn into only one type of cell (for example, spermatogonia can turn only into spermatozoa). Most of all, multi- and unipotent cells are currently studied. They are easier to “manage”, but the range of their application in medicine is quite narrow. The main problem with pluripotent SCs is how to make them differentiate exactly into what doctors need, and not break into disordered undifferentiated division. So far, this has been possible only in laboratory animals, and even then, unfortunately, not always.
For example, after adrenoreceptors that respond to adrenaline and norepinephrine became known, drugs appeared that mimicked the action of these hormones (adrenergic agonists) or caused the opposite effect (andrenolytics, or adrenergic blockers). It would seem that everything is simple: if you need to raise blood pressure, you need an adrenomimetic, and reduce it - an adrenolytic. True, for some reason the desired effect is not always achieved. And at the same time, in addition to pressure, a lot of parameters change, often not for the better, because adrenoreceptors, it turns out, are in the heart, and in the bronchi, and in the arteries, and in the liver, and many more where. In addition, as research has shown, these receptors are different (there are at least four types of adrenoreceptors, they can differ greatly in localization and effects).
Therefore, to get the main effect with a minimum of side effects, you need a highly specialized drug that affects a specific type of receptor, cell or enzyme. Otherwise, it will be firing at sparrows with a missile with a nuclear warhead.
But what about the stem cells that have been actively studied in recent years? And they, too, will not be “all-healing, ” even if all the hopes placed on them are justified. Even if it is possible to properly stimulate them and control their growth, preventing breakdown in random division, which in medicine is called a malignant tumor.
But is a panacea necessary at all? After all, each person is unique and his illnesses are also individual. And the ideal medicine is one that is suitable for a particular patient in his particular condition. This is at this stage in the development of medicine and will be the key to healing.
The author of the article is a doctor, scientific editor of the medical journal "ABC" (www.abc-gid.ru)The article was published in the journal Popular Mechanics (No. 5, May 2010).