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Oh yeah? Thalidomide! Where’s your science now?

Online discussions on the merits of alternative medicine can get quite heated. And its proponents, given enough time, will inevitably cite the same drug as “evidence” of the failings of science. Call it Gavura’s Law, with apologies to Mike Godwin:

As an online discussion on the effectiveness of alternative medicine grows longer,  the probability that thalidomide will be cited approaches one.

A recent comment on my own blog, regarding the homeopathic product Traumeel, is typical:

If the scientific method is all that separates an accepted claim, ie Thalidomide, Vioxx, Bextra, Darvon, from mere anecdote, of what benefit is the Science?

As a non-scientist consumer, I’ll take the anecdotes and my own experience. Thank you.

If scientists want to be taken seriously, they must stop selling themselves to the highest bidder becoming corporate whores without a shred of decency. To my mind, that’s how the claims for Thalidomide, Vioxx, Bextra, Darvon were accepted, making the scientific method utterly worthless.

To this commenter, “science has been wrong before.” And that invalidates science, and apparently validates homeopathy. It’s a fallacious argument. But does thalidomide actually represent a failing of science-based medicine? No, not even close. It’s so wrong, it’s not even wrong. Thalidomide is good example of the importance of science-based medicine and why allowing alternative medicine to be sold in the absence of good science is a concern.

The broad strokes of thalidomide causing thousands of birth defects are well known. But the details are important to understand the implications to regulation, and to science-based medicine, today.

Thalidomide was first marketed in 1958 in Germany by Chemie Grünenthal. While its developmental origins are somewhat unclear, it was initially marketed as a treatment for seizures, and later as an anti-nauseant and sedative. At the time, barbiturates were frequently used as sedatives. And compared to barbiturates, which were highly toxic in overdose, thalidomide was well tolerated, even in overdose. Based on its apparent safety, no prescription was required. Eventually its attractiveness as an anti-nauseant led to its use in pregnancy for morning sickness.

It wasn’t known at the time, but fetal exposure to thalidomide between days 35 and 48 was causing severe limb and organ defects in 20-30% of children. In the 1950′s it wasn’t even recognized that drugs could cross the placenta and cause adverse effects to the fetus. Thalidomide hadn’t been tested on pregnant animals prior to marketing for use in pregnancy. Regulators didn’t require it. And the consequences were horrific.

Thalidomide became a popular drug because of its apparent safety and effectiveness, and it was marketed alone and in combination with other drugs in Germany, the UK, Canada, and other countries. But within a few years, babies started being born with characteristic limb and organ deformities. In 1961, two independent researchers identified thalidomide as the likely causal agent. The manufacturer sought to undermine and discredit the findings, but it was clear – the drug had caused catastrophic harm to thousands of fetuses. Subsequent animal testing confirmed this.

The USA largely escaped the thalidomide tragedy – due to stronger regulations, and the action of a single employee.

American drug regulations have evolved over time. The Pure Food and Drugs Act (1906) did not require that drugs be tested for safety and efficacy before sale. It was the regulator’s responsibility to demonstrate a product was unsafe. In 1938, the S.E. Massengill company manufactured a liquid version antibiotic sulfanilamide, mixing it with diethylene glycol -a poison more commonly used as antifreeze. When patients started dying, a massive recall was implemented – but not before over 100 people died. The tragedy brought about significant reforms to drug regulations in the form of the Food, Drugs and Cosmetics Act (1938) that required manufacturers to obtain FDA approval for any drug sold, prior to any sale.

Frances Oldham Kelsey was a reviewer with the FDA in 1960, and was responsible for evaluating the thalidomide marketing application. Kelsey refused to approve the drug in the absence of safety data. Her concern was peripheral neuropathy – not teratogenicity, which wasn’t even considered at the time. She described the application process in a paper she published in 1965:

The New Drug Application for thalidomide was presented in September, 1960. The drug had been marketed in Germany since 1957 where it was available without prescription, and in Great Britain since 1958. However, it was felt that the evidence submitted in the application was not adequate to indicate the safety of the drug. In particular, although this drug appeared to be remarkably nontoxic in animals and human beings, little or no information was available concerning its absorption, distribution in the body, or its excretion. Since the possibility existed that the low toxicity of the drug in certain species might be related to poor absorption in those species, and that under certain conditions the absorption in other species might be increased, further work was requested relative to the metabolism of the drug.

As the FDA studied the side effect profile, the teratogenicity of the drug became clear as and the application for licensure was discontinued. Kelsey was hailed as hero. Yet despite the refusal to formally approve the product for sale, millions of doses had been administered as part of “clinical trials” (in name only). Yet due to Kelsey’s refusal to approve the drug, the drug was not widely used, and only 17 children were born in the USA with thaldomide-induced effects.

Regulators worldwide acted to ensure another thalidomide tragedy would not occur. In 1962 the Kefauver-Harris Drug Amendments were passed, increasing the rigor of the drug approval process, requiring the demonstration of safety and effectiveness via objectively designed and executed clinical trials. These amendments also implemented the requirement for adequate preclinical trials before any human studies, including animal studies to evaluate fetal risks. Marketing requirements were also implemented, restricting manufacturers from making unfounded, unsubstantiated claims of safety and efficacy. Finally, the amendments ushered in the requirement for manufacturers to collect and report all adverse events associated with drug use – measures designed to capture any events not otherwise identified in pre-marketing clinical trials. Similar actions occurred in other countries. Today, over 100 countries now collaborate with the World Health Organization to pool adverse event reporting and look for signals of drug harms.

Lessons Learned
The worldwide disaster of thalidomide led to most of the current framework we have in place today to evaluate the safety and efficacy of drug products. Ironically, these are the same requirements that manufacturers of supplements and other “alternative” medicine products have been largely successful in circumventing. In the USA, it’s DSHEA, which (as blogged about regularly at SBM) removed the onus of demonstrating safety and efficacy from the manufacturer and put the requirement to demonstrate harm on the FDA – exactly the same scenario as drugs in the early 1900′s. In Canada, the Natural Health Product regulations has introduced a lowered bar for non-drug supplements: Today even homeopathic remedies are deemed safe and effective and approved with unique recommended uses.

The Resurrection of Thalidomide

Almost 30 years after thalidomide was withdrawn, it’s back on the market in the United States, Canada and many other countries. It’s been found to be effective for a number of conditions including erythema nodosum leprosum, multiple myeloma, and is being investigated for efficacy in an array of other conditions. There’s an analog of thalidomide now marketed, lenalidomide, also used to treat cancer. To minimize the teratogenicity risk,  intensive programs are in place to minimize any possibility of use in pregnancy. So while the drug has known harms, it seems to be highly effective for some medical conditions where few effective alternatives exist. Access, therefore, is based on a careful evaluation of the risks and benefits.

Does Thalidomide Invalidate Science-Based Medicine?
Cases like thalidomide provide a good example of why SBM authors argue against regulatory double-standards, and advocate for a single, science-based standard for evaluating all products: drugs as well as supplements.  There is no intrinsic reason to think any product, regardless of its source, is safe or effective – we must evaluate it, objectively. Thalidomide’s history is a cautionary tale reminding us that assumptions without good evidence can lead to terrible consequences.

And that leads to the logical fallacies that the thalidomide retort represents.  Thalidomide is an effective drug for some conditions – but it is a teratogen. It’s not alone in this regard – other drugs have been identified as teratogens. The sale of any drug is based on an evaluation of the known benefits and risks.And getting back to the comment I received at the top, those that support alternative medicine will reject the science-based approach: This is the system that gave us thalidomide (and Vioxx, etc). Therefore, it’s a failure, and we should reject it. This is the perfect solution fallacy.

Admittedly, medicine is not perfect. Regulators don’t identify all the harms before a drug is licensed. Drug manufacturers can behave badly. And drugs don’t always work the way we want them to, and they can cause harms. They commenter I cite above took objection to an evaluation of homeopathy.  Yes, homeopathy has no toxic side effects (usually) and causes no teratogenicity – but it also has no demonstrated efficacy beyond placebo effects. The harms and problems of science-based approaches add no support to the efficacy claims of any alternative medicine system.  Homeopathy, acupuncture, and reiki don’t become effective because drugs can have side effects. SBM may not be perfect, but it delivers the goods.

More generally, comparing science-based medicine to any alternative medical system a is false dichotomy. Unlike the different alternative medicine systems (homeopathy, naturopathy, reiki, etc) which are typically based around a fixed set of rules, the only thing that science-based medicine interventions have is common is that they work. SBM is not immutable to change – treatment shown to be safe and effective become medicine, and those that are not, are discarded.  So although thalidomide causes birth defects, it is also an effective medication when used properly. We don’t have to make a choice between a system that produced drugs that cause birth defects, and alternative medicine. We choose to use treatments where the expected benefits outweigh the known risks.

Citing thalidomide as an argument against science-based approaches is also a straw man argument. The way drugs are regulated today bears little resemblance today to when thalidomide was licensed and sold. Safety standards are far more rigorous, in part because of the lesson of thalidomide. Today, the only products that are not subject to these same strict safety and efficacy standards are usually the alternative medicine treatments.

Citing thalidomide is also an appeal to fear. We hear the word and we immediately think of children born with birth defects. We don’t want that to happen. But like the perfect solution fallacy, the catastrophic side effects of thalidomide in pregnancy add no merit to to claims of efficacy of any alternative medicine treatment or system. We still need the evidence.

Conclusion
Thalidomide was a very real tragedy with a huge human cost. It’s most important lesson is that assumptions of safety and efficacy, in the absence of evidence, can be catastrophic.  Citing thalidomide as a a reason to reject science-based medicine is not only fallacious, it reflects a fundamental lack of understanding of the lessons learned.

Posted in: History, Pharmaceuticals, Politics and Regulation, Science and Medicine

Leave a Comment (29) ↓

29 thoughts on “Oh yeah? Thalidomide! Where’s your science now?

  1. WilliamLawrenceUtridge says:

    Absolutely beautiful. What an excellent post.

    And you just know, if the exact same molecule was found in mint and could be extracted, concentrated and sold in pill form, there would still be nutjobs proclaiming it nature’s bounty that should be free to all laetrile.

  2. WilliamLawrenceUtridge says:

    Oops, laetrile is supposed to be between HTML “cough” tags.

    SBM COMMENTS NEEDS A PREVIEW OPTION!!!!

  3. ConspicuousCarl says:

    Such mistakes as thalidomide are proven to be mistakes not by rumor and reference to the ramblings of DD Palmer or Samuel Hahnemann, but by people doing scientific investigation properly.

    Even ignoring the fact that these supposed examples of failures of science often trace back to the lack of scientific study, the critics of science have an absolutely absurd point of view: being careful and smart does not always work, therefore we should be reckless and stupid.

  4. weing says:

    Thalidomide is an example of a drug that can definitely cause irreparable damage, phocomelia, yet need not be banned, because it can be useful, in the right hands and for the right indication, to do good and not harm. Who knows? Maybe in the future Vioxx, Zomax, troglitazone, and others will find their niches too.

  5. majkinetor says:

    Thalidomide was/is useful definitely, without it we wouldn’t know bunch of stuff – that drugs cross placenta, that there is a protein named cereblon that affects limb creation, that anti-angiogenesis is not enough to cure cancer etc…

    Just as many other failed drugs. Its legal way to experiment on people witch positively affects science and negatively affects specific individuals. This is generally good, unless you are unlucky specific individual who was affected by it, but even in that case you can sey that you ‘took one for the group’ …

  6. tmac57 says:

    ConspicuousCarl-

    Even ignoring the fact that these supposed examples of failures of science often trace back to the lack of scientific study, the critics of science have an absolutely absurd point of view: being careful and smart does not always work, therefore we should be reckless and stupid.

    This was so nice,that it needed to be said twice :)

    Great article Scott!

  7. Ray Greek MD says:

    re: majkinetor
    Actually, it was known in the 1800s that drugs / chemicals cross the placenta. The notion that thalidomide proved this is a myth. I wrote a review article on thalidomide that is being published by the Journal of Philosophy, Science and Law. It should be available on line next week at
    http://www6.miami.edu/ethics/jpsl/

  8. aeauooo says:

    @Ray Greek:

    I recently read the paper you coauthored, “Are animal models predictive for humans?” which includes a page-long discussion of thalidomide:

    “Could the use of animal models have predicted thalidomide’s adverse affects? Even if all the animals mentioned above were studied the answer is no. Different species showed a wide variety of responses to thalidomide.”

    http://www.peh-med.com/content/4/1/2

    Thanks!

  9. S.C. former shruggie says:

    I often see thalidomide used in ad hominem tu quoque arguments. Sure, the altie says, ayurvedic medicine is full of lead and poisons people, but thalidomide was awful too, therefore I don’t need proof my treatments are safe or effective. As if failure to adequately test one drug excuses refusing to adequately test others.

  10. majkinetor says:

    Thx Ray for that and paper about animal models. When I did read it, the drug TGN1412 was popping out of my mind rather then thalidomide:

    See Animal tests may have missed danger because monkeys ‘too clean

  11. mike150160 says:

    @aeauoo

    I’d refer you to a review by Dr Gorski’s friend for an analysis of Dr Greek’s views on animal research:

    http://scienceblogs.com/insolence/2010/03/answering_scientific_arguments_of_an.php?utm_source=networkbanner&utm_medium=link

  12. Composer99 says:

    Alt-med boosters take away the opposite conclusion from the thalidomide (& Vioxx &c &c) scandals.

    The dangers of thalidomide to fetuses, the harms of Vioxx, and the like, arose because there was not enough science & research behind them, not (contra the alt-med claim) because there was too much.

    Also, some drugs’ adverse effects will not always come to light in clinical trials, due to the limits of sample sizes. That is what makes post-licensure surveillance so important. If something comes to light which leads to a withdrawal of the product, this is because of (a) proper research and (b) proper regulation.

    Imagine, if you will, if, say, Vioxx had the same requirements for post-licensure surveillance as your average alt-med “therapy”. It might well still be on the market.

  13. aeauooo says:

    @mike150160

    Thanks for that!

    I’ve used Greek et al. and van der Worp et al. (http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000245) to counter claims of benefit from CAM based on the results of animal studies.

  14. Tell it like it is says:

    Mendel’s ‘Law of Independent Assortment’ informs us that a mutation in a single gene causes changes to happen that are then inherited. Some mutations might confer an advantage, but equally, it might leave a person pre-disposed to some ‘disease’ or other malfunction. Such modifications are inherited. Inherited diseases include beriberi, cystic fibrosis, asthma, and sickle-cell anaemia; and predispositions include short/long sightedness, bi-polar neurosis, and migraine. These conditions affect all races, and have no sexual disposition.

    In 1953 James Watson the American prodigy and the British genius Francis Crick discovered DNA and established that inheritance happens through a process called myosis (gene shuffling) to create a new ‘being’.

    To comprehend this, think of chromosomes as bookshelves. On each bookshelf is an encyclopaedia of ‘instruction manuals’ – called genes. The instructions contained in each gene are ‘read’ by the ‘Master gene’ ‘EEF1 Alpha 1’* – a gene that lives about a third of the way down our sixth chromosome; and a gene that is present in every single living thing.

    The ‘Master gene’ acts like a microprocessor. As the Master gene goes to work, the genetic ‘instructions’ contained in all other genes, physically create what those instructions define – an eye – a tooth – colour vision …

    As we have discovered, drugs such as thalidomide cause adverse genetic mutations to take place – but should we be concerned?

    From our mapping of the genetic makeup of humans – cracked in 2001, we have gone on to unravel the code of hundreds of species and decoded the DNA on nearly every branch on the ‘tree of life’.

    Our nearest relative is the chimpanzee. There is a one-letter difference between our gene (PRMD9 on chromosome 5) and the same gene on the chimpanzee. This one letter difference gives the chimpanzee stronger muscles than us – but it gives humans colour vision in the green spectrum.

    A two-letter difference on another gene means that humans cannot survive on raw food. The food will not kill us but we will starve to death within 3 months because we are unable to extract all of the required nutrients from raw food. Luckily we have an external stomach – the cooking pot.

    So what did this two-letter change bestow upon us? We gained a mind.

    So here’s the thing: from what scientists have so far ascertained, it would seem that gene codes contain complex instructions that cannot be accounted for by a random chance occurrence because they are both pre-defined in their function, inextricably linked to the creature ‘assembled’ from the ‘instructions’ contained within the gene set, and repeatable.

    So – as human species – did we simply ‘get lucky’? Or must we accept the confirmation that everything about us is pre-destined?

    It is said that Moses had a staff and also a tablet upon which was engraved the ‘double helix’ symbol – clearly showing the prescription for existence and describing what all life is made of.

    It is recorded that from a distance, the motif on Moses staff looked like a snake – a symbol that represented healing and rejuvenation to the ancients, and revered by Hippocrates. Close-up the ‘snake’ forms a double-helix, spiralling in the correct direction – linked by rods which give the ‘snake’ its ‘pattern’. Does this add meaning to the ancient expression ‘Thy rod and thy staff’?

    As we have discovered, drugs such as thalidomide cause adverse mutations to take place – but on the positive side, knowing we can change things at the foetus stage paves the way for the development of genetic ‘interventions’ that can bring positive improvement – setting us free to conquer and eradicate hereditary diseases and disabilities, and eventually devise appropriate treatments for every ailment: from cancer to mental disorders.

    Right now we remain with pills, potions, and placebos until someone makes a stand and devotes their life’s energies to resolving this paradox.

    *The bee is the ‘keystone insect’ to ALL life. Without the bee to do the pollinating of crops, every creature on the planet would starve to death.

    When Mendel asked the Abbot for permission to move onto insects to see if the ‘gene patterns’ were the same, Mendel chose the one insect he kept well away from his glass-house garden of purple and white sweet peas – the honey bee.

    To aid his observations, Mendel re-designed beehives from the traditional round tubs fitted with stacked ‘honey shelves’ to a type that suspend the honey-combs perpendicular (like hanging drapes). This design permitted single removal of any one honey-comb to examine and categorise the bees, without the need to dismantle the entire hive and possibly kill the Queen. A construction we continue to use to this day.

    What happened astonished Mendel. Yes the same trait pattern appeared in the offspring of the bees – but the ‘in-bred’ variety produced a ‘killer bee’! All of Mendel’s bees (luckily, meticulously contained within his green-houses) had to be destroyed for fear of the killer strain getting outside and causing untold havoc.

    There is a ‘bee bug’ that is swarming (literally) through America which kills honey bees; and a bee strain from Africa has been introduced in an attempt to eradicate the bug. The offspring from the American-Afro cross are – guess what? Yep – killer bees!

    Mendel moved onto cats – same result. On the way he determined for the most part that ginger cats are ‘toms’ (male) and tortoise-shell cats are predominantly ‘queens’ (female).

    But – his in-breeding of house-cats produced some with emaciated fur; some which displayed very odd behaviour (dippy); and others that were as wild as tigers.

    What Mendel also observed, was that if the biblical ‘rules of marriage’ were maintained – i.e. no in-breeding takes place between parents and their siblings or their offspring, then unfavourable ‘predispositions’ such as a violent temper do not manifest themselves.

  15. Damien says:

    TILII, WTF are you on about?

  16. Nescio says:

    TILII,

    Why do you insist on flooding a science blog with irrelevant misinformation? Your post should probably be ignored, but I feel I should point out for the benefit of casual readers that most of what you wrote above is again factually incorrect.

  17. Nescio says:

    I should have added that the most important inaccuracy in TILII’s comment is this:

    As we have discovered, drugs such as thalidomide cause adverse genetic mutations to take place – but should we be concerned?

    Thalidomide does not cause genetic mutations, it interferes with the regulation of limb development, which is not the same thing at all.

  18. mike150160 says:

    Great jumping Judas on a stick..!!

    TILII inter alia….

    beriberi is a thiamine deficiency not an inherited illness.

    Mutations most likely to be silent and even if overt may be over-ridden by the other “functional” allele.

    It’s mitosis and meiosis (not discovered by Crick and Watson).

    I’m not sure which planet you got the “Master gene” stuff from but I hope it has nice weather.

    See Nescio’s comment for thalidomide.

    Bee’s always produce vertical combs even in the traditional round skeps.

    What bee bug? Do you mean Varroa? It’s a mite.

    Mendel and cats? Bullshit.

  19. Nescio, thanks for the correction on thalidomide. My son has congenital malformations of the ear, lip and palate. Genetic testing has shown no irregularities. The relationship between genetics and congenital malformations is often confusing to those of us who are not scientists. Good to have someone clear up one misconceptions.

  20. jre says:

    Imagine, if you will, if, say, Vioxx had the same requirements for post-licensure surveillance as your average alt-med “therapy”. It might well still be on the market.

    Just so. The popular impression of Vioxx and its history is at variance with the facts in several interesting ways. Vioxx did not cause a large number of adverse cardiovascular events: events in excess over control numbered in the dozens among clinical trial populations numbering in the thousands. In fact, it was precisely the large size of the trials that permitted such a small effect to be detected to statistical significance. Had Merck reported those AEs honestly and promptly, there is every likelihood that Vioxx would have been approved with a black-box warning. It was corporate sleaze, not anything dramatically scary about the drug itself, that made Vioxx noteworthy. And if anyone thinks that alternative medicine manufacturers are more honest than real drug makers, please get in touch: I have a truckload of Zicam that I’ll let go at a great price.

  21. Tell it like it is says:

    The postulation in this topic is (quote): “Does thalidomide actually represent a failing of science-based medicine? No, not even close. It’s so wrong, it’s not even wrong. Thalidomide is good example of the importance of science-based medicine and why allowing alternative medicine to be sold in the absence of good science is a concern.” (unquote)

    Thalidomide modifies the foetus – ergo – the active components of such drugs have the potential to modify disorders – and in so doing – create a ‘better’ being that can pass on its modifications – thus eradicating those disorders – which was the point I chose, to destroy the facetious fallacy that thalidomide cock-ups validates homeopathy – which is utter nonsense.

    I did not say that Watson and Creek ‘discovered’ mitosis – I said “established” … Because Watson and Creek discovered the ‘pairing’ relationship of the four DNA bases – Adenine (A) always pairs with Thymine (T) and Cytosine (C) always pairs with Guanine (G) – they established why DNA reproduces itself with dutiful accuracy – like father – like son.

    The design of Mendel’s bee hives fully exploited the vertical honey-combs that bees construct to facilitate swift observation whilst preventing the inadvertent destruction of the Queen Bee.

    Varroa is a parasitic bug – a creepy crawly. It weakens and eventually kills the bees by living off them, and if left unchecked, will ultimately lead to the extinction of the honey bee. Then where would we bee?

    The inability to make sufficient thiamine is a genetic disorder. Beriberi is the name given to the condition.

    Some of you may not have heard of the ‘EEF1 Alpha 1’ gene and what eminent scientists believe it does. Have you heard of the DNA sequence ‘CCGCCGTATCCTC’? This is the ‘shuffling code’ that triggers mitosis – the ‘shuffling code’ that decides whether sperm genes or egg genes are transferred into the next beings chromosome – the code that defines what the next being will inherit. The number of occurrences of this sequence and whereabouts it appears on the DNA ladder is different in every species.

    Just as John Watson was the catalyst for Sherlock Holmes, so James Watson was the catalyst for Francis Crick – neither Watson comprehending the obtuse thought processes of their ‘odd’ associates – but often triggering a notion in the mind of the other that aided the delivery of positive results – here – food for thought and genuinely stimulating dialogue.

    Observations from Michele’s astute mind are often the catalyst to others – myself included – to drive a discussion beyond simply stating the obvious, reiterating the article, condemning the comments, or agreeing with each other.

    Maybe MicheleofMichigan should adopt the pseudonym ‘Miss Lemon’– the female catalyst that stimulates ‘the little grey cells’ of Agatha Christie’s famous detective ‘Poirot’ (she was his secretary – an emancipated women living in an age where many women were employed as dutiful maids).

    On the oxymoron ‘alternative medicines’ – maybe this is the approach needed:

    http://www.randi.org/site/index.php/swift-blog/1388-randi-challenges-top-qpsychicsq-after-nightline-episode.html

  22. “The inability to make sufficient thiamine is a genetic disorder. Beriberi is the name given to the condition”

    qibble – Genetic Beriberi is the name you are looking for. Beriberi is the general name for the disease caused by thiamine definciency for any reason (including diet, alcoholism, etc)

    http://www.nlm.nih.gov/medlineplus/ency/article/000339.htm

  23. TILIS, Thanks… I think. :)

  24. mike150160 says:

    Is This Worth It?

    Nope, not true: the importance of meiosis in gametogenesis was Weismann (1890s), pairing of CG, AT was Chargaff.

    Mendel did not design the frame beehive, the main contributor was Langstroth (though he was around the same time as Mendel).

    Please supply a reference for this “shuttling code” ? I believe scientists (eminent or not) believe elongation factors are important in translation but as far as I’m aware (though I’m breathless in anticipation of your corroborating references) has no role as a microprocessor.

    I’m sure Jim Watson would be thrilled at being compared to the fictional, slightly slow foil of a fictional detective.

  25. Nescio says:

    TILII,

    Thalidomide modifies the foetus – ergo – the active components of such drugs have the potential to modify disorders – and in so doing – create a ‘better’ being that can pass on its modifications – thus eradicating those disorders – which was the point I chose, to destroy the facetious fallacy that thalidomide cock-ups validates homeopathy – which is utter nonsense.

    I fear you still miss the point – to the best of our knowledge thalidomide does not cause modifications to the foetus that can be passed on*. People affected by thalidomide have normal offspring, so thalidomide has no relevance at all to genetic mutation or inheritability.

    * There have been a few cases where those affected by thalidomide have have similarly malformed offspring, but the consensus is that these may be cases where thalidomide was wrongly blamed for an inherited condition. There is, of course, a maverick doctor who disagrees (Bill McBride, who was one of the first doctors to notice thalidomide’s effects).

  26. 2Healthy says:

    I agree that Thalidomide treatment when you have to choose between bad or worse but when science has to come back on time to find uses for this kind of dangerous substances it’s a bad sign. Sometimes if feels like science follows the old modern cinema formula: stick with the known, make like variations, reuse, don’t try to be a revolutionary, make more physical than mental effort, repeat the method instead of improve it.
    I don’t mean this isn’t a path to follow but I think the alternative path it too rarely followed.

    For funding, research and peer finding please refer to the non-profit Aging Portfolio.

  27. Harriet Hall says:

    @2Healthy,

    You characterize thalidomide as a dangerous substance. Please note that it is ONLY dangerous to a developing fetus and ONLY between days 35 and 48 of gestation. Otherwise, it is a very safe and effective drug, so devoid of adverse effects that it was available over the counter in Europe and used for many diverse indications until its teratogenicity was discovered. The fact that science was able to objectively re-evaluate thalidomide and find it useful for conditions with few or no other treatment options is surely not “a bad sign” but a good one.

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