Expert: Dr.Paul Skett - 3/25/2010

Question
I am a student in highschool, and I am curious to know from an expert, which field of medicine would lead to the best cure: genetics, biochemistry, pharmaceutics, etc. Please give me a sincere answer, because I, as an asthmatic, am sincerely devoted to finding that cure.

Answer
Hi, Drake,

Thanks for your question.

The idea of a "cure"  is actually quite a difficult one. You need to identify the defect causing the disease state and then see if that defect can be fully rectified.

For example, most drug treatment just treats the symptoms of the disease and not the underlying defect - and, thus, is a treatment and not a "cure". You might think that insulin treatment of diabetics is a cure but actually it isn't as there is a lot more going on in diabetes than just a lack of insulin - pancreatic islet transplant is more like a "cure".

In that sense then if the disease state is caused by a genetic defect the cure would be to replace the defective gene with a good copy i.e. gene therapy.  This is all well and good for a disease state with a known, single gene defect (might work for example for multiple sclerosis (MS)) but few diseases are of this type (the big ones like heart disease, stroke, obesity, cancer are all multiple-gene or environmental).

In your case, some of the causes of asthma are known but the full underlying mechanism is unclear - there are certainly environmental factors involved (how do you get a "cure" for those?).

Sorry the answer to your question cannot be more clear cut but that's medicine for you!! We only know a small bit of how diseases occur - you might be the one to find out the decisive bit for the effective treatment of asthma - maybe a "cure"!!

Best of luck,

Paul