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Sunday, May 19, 2013
Basic science research provides the foundation for discoveries that improve lives. It is how medical scientists uncover the specific circumstances that lead to health and those that cause disease. These circumstances are made up of individual cellular and molecular events. By identifying these events researchers can find new ways to prevent, treat, and cure disease.
Imagine going inside a dark hotel room where you have never been before, unable to find your way around the room until turning on the light. Although everything in the room is just the same as it was before you flipped the switch, suddenly you can see the room. Now you know where the bed is, where to hang your clothes and where to find the phone. You know what to do. Basic science research is the way that biomedical research finds the light switch. By seeing events related to cells, molecules, or genes that we couldn't see before, scientists can then find ways to prevent, treat, and cure disease.
Just like doctors, medical research scientists become specialists to most effectively understand a particular area of science. In medical practice doctors specialize in areas like heart disease, cancer, surgery, women's health, children's health, and much more, so they can know about and most effectively treat people needing that kind of care. Science researchers need the same kind of specialization so that they can make progress in the fields that contribute to health and disease. Examples of basic science fields are:
Like clinical doctors, basic research scientists sub-specialize, applying their research focus to a specific research area such as:
Frequently, subspecialties are combined. For example, a pharmacologist might study molecular events related to DNA function, combining fields of pharmacology, genetics and cancer biology.
As discoveries are made, new knowledge gradually comes to light. We slowly start to see the whole picture. Let's go back for a minute to that hotel room. Before we "flip the switch" the room is dark and afterwards we can see everything. In scientific research the process occurs step-by-step, like having a dimmer on the light switch.
Imagine walking into the same room with a switch having a dimmer and rather than turning the light on full, you turn it on slowly, a bit at a time. Instead of seeing everything in the room at once, you would see things gradually. First, you would see the dark outline of the bed, table and television, then a little more detail and finally, you would be able to walk over to the phone and dial. Basic science research is very much like having a light on a dimmer switch: discovery happens gradually.
In most rooms, there is more than one light to see things in each part of the room: in the entry, on the desk, by the chair, and on the night stand. Basic science discoveries are like that, too, with answers coming together from several fields of science. For example, geneticists (scientists who study genes) learn about certain events while cell biologists (scientists who study cells) learn about others and as these lights are turned on, the full picture starts to appear. The geneticist, for example, might find the exact set of genes that causes a certain disease and passes that on from parent to child. The cell biologist could study what the gene causes at a cell level that is abnormal. Knowing this chain of events from each field brings the picture of disease to light.
Basic science is a two stage process. Once it has the picture, or model for a disease, the dimmer is only up halfway. That picture of events tells us how disease happens, but it does not tell us what to do about it: what would improve the health of people. That happens in the second stage of basic science. Using the model of disease events from stage one, researchers design experiments to change them. They look for ways to limit those events (treat disease) and ways to stop those events (cure it). In this second stage, basic scientists discover and test things like new screening tests, drugs, and surgeries. An important part of this stage is to be sure that these discoveries are safe and effective in a laboratory setting. Once that process is complete, these discoveries are ready for the next phase of testing in clinical research studies with people. At that point the dimmer is up full. We can see the whole room and apply those discoveries.
An Example: From basic science to cure
Peptic ulcers are a serious condition. A peptic ulcer is a sore that develops on the inside lining of the digestive system, usually the upper part of the small intestine and sometimes in the stomach or esophagus. Peptic ulcers are a serious condition. Affecting about 25 million people in the United States, they can cause symptoms like pain and bleeding. While doctors have known about peptic ulcers for many years, the cause was thought to be stress or eating spicy food which would lead to irritation and cause the sore.
In the 1980s, two research scientists discovered that peptic ulcers were caused not by stress or spicy food, but from infection with a specific kind of bacteria called H. pylori. Basic science had discovered a whole new model for the cause of peptic ulcers: a different set of events! With bacteria as the cause, the peptic ulcers can be treated with antibiotics. While there are a few other causes, like some over-the-counter and prescription drugs, we know that at least 90% of peptic ulcers are caused by bacteria.
Without basic science, showing the actual events, we could only treat the symptoms, like pain and bleeding. Now that science has shown the cause, we can cure the disease!
Doing clinical research without basic science would be like trying to unpack and live in a hotel room without turning on the light. You could make some progress but you would be working in the dark, unable to see the big picture. You could use the trial-and-error approach: guessing at ways to prevent and cure disease and trying things out without a rational basis. You could only make progress by chance.
Basic science is how breakthroughs happen to move discovery forward. It illuminates an extended landscape of what we can know and points the way to cures.
This article is a NetWellness exclusive.
Last Reviewed: May 13, 2011
John J Mieyal, PhD
Professor of Pharmacology
School of Medicine
Case Western Reserve University
Susan Wentz, MD, MS
Director, Area Health Education Center
School of Medicine
Case Western Reserve University