Biomedical science is becoming a roller coaster

As the years pass, I am amazed at how much ophthalmic practice has changed since my residency, and I think about how things will be even better in the future. Do you remember when glaucoma treatment was pilocarpine, epinephrine, acetazolamide, or surgery? Do you remember when all we could offer someone with macular degeneration and choroidal neovascularization was a low-vision referral? How about 12-mm extracapsular cataract incisions and rigid IOLs without viscoelastics, with each operation taking about 45 minutes of surgical time?

As the years pass, I am amazed at how much ophthalmic practice has changed since my residency, and I think about how things will be even better in the future. Do you remember when glaucoma treatment was pilocarpine, epinephrine, acetazolamide, or surgery? Do you remember when all we could offer someone with macular degeneration and choroidal neovascularization was a low-vision referral? How about 12-mm extracapsular cataract incisions and rigid IOLs without viscoelastics, with each operation taking about 45 minutes of surgical time?

But if you think things are better now, wait until the future of neuroprotective agents, gene therapy, and stem cells!

Oops-ignore that comment about stem cells. In case you missed the sad story of Hwang Woo Suk, we may now be a bit farther off from offering those to our patients than we thought a few weeks ago.

In December Dr. Hwang resigned from his position. Reported features of the investigations included: stem cell lines that were supposedly created do not exist, hush money was paid to an associate, ethical guidelines were ignored, a cloned dog may not be a clone at all, photographs were "doctored." In fact, the Los Angeles Times2 reported that all of the 11 customized cell lines were make believe. This definitely qualifies as a black eye for biomedical science.

Scientific misconduct has probably been with us for centuries, but rarely is such a high-profile instance uncovered. Presumably the pressure to be successful, obtain grants, and bring honor to his country led this individual to make what appears to have been a series of mistakes.

In hindsight, it would be hard to imagine that extremely high-profile work like this would not be copied in laboratories around the world, such that discrepancies would quickly come to light.

Is the real victim here the lay public, including our loved ones with diseases such as Alzheimer's disease, Parkinson's disease, paraplegia, and Type I diabetes, who read newspaper accounts of scientists hyping the therapeutic benefits of stem cells, when, in fact, such benefits are yet to be proven?

Although the vast majority of scientists in the field of stem cell research are certainly honest and ethical, is the public being misled that practical therapeutic uses are right around the corner?

In my own department, faculty have been working in this area for years, and experiments in patients are thought to still be at least a few years away. If we don't cool down the rhetoric and stop overpromising, how long will it be before the public demands to know "where's the beef?"

Peter J. McDonnell, MD is director of The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, and chief medical editor of Ophthalmology Times. He can be reached at 727 Maumenee Building, 600 North Wolfe St., Baltimore, MD 21287-9278 Phone: 443/287-1511 Fax: 443/287-1514 E-mail: pmcdonn1@jhmi.edu

References

1. Kim S. Hwang, Drawn and Quartered? The Wall Street Journal, Dec. 29, 2005, p. A10.

2. Kaplan K, Maugh TH. All stem cell data fake, South Korea panel finds. Los Angeles Times, Dec. 30, 2005, p. A8.