Known Unknowns

Denise Caruso recently made the interesting point that "in many respects scientists know less today about these mechanisms [that govern living organisms] than they did even just five years ago." That may seem counterintuitive, given the undeniable advances in genomic sequencing technology, but in a vaguely Socratic sense, this can be counted as a useful development: At least we are beginning to understand how little we understand.

Several recent reports, from different areas, underscore this:

• In Carl Zimmer's lovely phrase, the gene is having an identity crisis. The Encode project is, to put it mildly, raising as many questions as it answers.
• A study published on November 24th in the Archives of Internal Medicine suggests that a significant number of cancers may disappear on their own, without treatment.
• An article in the November 20th New England Journal of Medicine suggests that genetic tests for diabetes are scarcely better than "traditional risk factors" such as family history, blood pressure and weight.
  
• Meanwhile, the New York Times on November 27th describes a classic scenario in which "the lab says heart attack, but the patient is fine." (Distance runners and exercise specialists are not surprised.) A new Canadian study on breast cancer reinforces the known fact that "a negative test doesn't provide reassurance." And a study published last month in Human Reproduction reported that IVF treatment seems to be associated with a somewhat increased risk of birth defects.
  

All this may seem like bad news for those whose approach to research is driven by the impulse to market products immediately. It's not necessarily: As Prof. Michael Chapman points out, "if your only way forward is IVF, then an increase in risk from one in 100 to two in 100 for most people is an acceptable risk." It's worth remembering also that bone-marrow transplants, for example, became treatments before the mechanism behind the therapy was understood at all.

But anomalies are good news for science: more problems to solve! And basic science -- whose funding need not and should not be dependent on specific applications -- is what is needed to produce real cures in the long run.