How Genetic Engineering Fixed My Stupid Back
Around the age of 15, I began experiencing periodic bolts of searing pain shooting down the outer sides of my legs and up through my shoulder blades. The pain would occasionally grow so debilitating that I was forced to walk with a cane and could barely manage a flight of stairs. For sleepless months at a time, I would limp and grimace through my day. The worst part was that doctor after doctor was not able to diagnose the problem, and I resigned myself to a life of making the best of it.
Once I hit my mid-30s, I couldn't take it anymore and decided I had to do something about it. I tasked myself to keep seeing doctors until somebody could tell me what the problem was. After plowing through a series of specialists, I eventually found my way to a rheumatologist who diagnosed me with an inflammatory condition, which isn't exactly fully understood by science, called Ankylosing spondylitis (spells just like it sounds).
Now, this condition can be treated somewhat with a special diet (please don't send me any info on the subject -- I know), but the food restrictions are pretty harsh and results in my case weren't always consistent. But as it turns out, modern science has another fix.
My rheumatologist recommended that I begin a regimen of a type of medicine known as a biologic (or sometimes a "biopharmaceutical"), which is seeped directly from living organisms. I put a lot of trust in science and technology's ability to make the world a better place, so I was open to seeing what this cutting-edge treatment could do for me.
And I am happy to say that after a month or so, the treatments worked -- in fact, they worked far better than I could have possibly imagined. I've been almost totally pain-free for the past two years and even taken up running. (I should note that the medication I was on came with some serious potential side effects -- most notably, they decrease your body's immune system, including the ability to fight certain cancers. Just speaking for me, the trade-off was worth it.)
Now, this medication was unlike any other I had taken -- I had to inject it. Most second-generation biologics used to fight inflammatory conditions have to be introduced directly into the body through a syringe or via an IV. I had to learn to use a disposable epi-pen like contraption, which I keep stored in my refrigerator. There was a learning curve, but not a sharp one (and it certainly helped that I am not at all squeamish when it comes to needles).
So, what is this magic goop I inject into my body? It comes from natural sources, but at the same time -- there's really anything natural about it.
Scientists have been deriving medicines from living organisms since forever -- just about every vaccine you've taken can be considered a biologic. However, the scope of these medicines have boomed in recent years with the advent of genetic-manipulation techniques.
While the exact definition of "biologic" varies from regulatory body to regulatory body, the term is often used today to refer to newer classes of drugs resulting from techniques that tweak cells at their fundamental genetic level to turn them into living factories.
According to the FDA's own description, "In contrast to most drugs that are chemically synthesized and their structure is known, most biologics are complex mixtures that are not easily identified or characterized." Many of these second-generation biologics (ones that have popped up in the past 15 years or so, as opposed the first-gen ones like vaccines) are not recreatable -- by humans. We just don't know how. However, scientists can use modern genetic-manipulation techniques to cajole living cell cultures to do it for them. Therein lies a wrinkle to the biologic story -- they can be insanely expensive.
The manufacturing of these medicines is a complex undertaking -- particularly on an industrial scale. Not only is there gene manipulation, but the cellular cultures are particularly susceptible to contamination and must be maintained under very aseptic and strictly temperature-controlled environments -- all of which must take place under the supervision of a highly trained workforce. When you consider that the patient pools are relatively small, prices inevitably rise.
Why we seek to answer stupid questions
I can only speak for myself and say that these drugs have been a godsend and truly improved my quality of life. But I'm also fascinated (and even humbled) to consider how this treatment would not be possible without decades of scientific inquiry that took place before it.
The line of scientific history -- down through Darwin, Mendel and the team of Watson & Crick -- had no idea it would one day help a middle-aged tech blogger not have to limp in pain for months at a time. They all just wanted to know the answers to weird and impractical questions.
This is why I get annoyed when I hear politicians wanting to balance budgets on the backs of scientific research. While there are ways to best use research dollars, their benefit is invaluable -- just not always immediately (quantum physics took decades to find a use in the function of smartphones, as it took years for Einstein's theories to be used in satellite configuration).
There is no way we can predict how the impractical research of today will affect some major breakthrough years down the line. That's why we should all want our tax dollars to fund inquiry into weird, unnecessary questions like "Do gravitons exist?," "What does Pluto look like?," or "Is the whole universe a hologram?" Answering those questions might not necessarily bring us a new breakthrough today -- in fact, they probably won't. But they leave us with the promise that they will someday.