the genetic studies, i do not think they are a waste. if it had become the case that we identified a true genetic basis for the disease, better treatments would have followed. and it would have been considered a great success. But perhaps you mean in consideration of properly interpreting the existing evidence to determine what strategies might yielded quicker results, then perhaps a more complete investigation to identify some environmental toxin exposure woudl have found a common cause then i suppose it could have turned out differently.Thanks for posting Xiaofa ~
I made a thread here about the lack of NOD2 mutation in the Asian CD population: http://www.crohnsforum.com/showthread.php?t=45141
My worry is that so much money is going to genetic studies and studies trying to unravel the human microbiome, they are super expensive studies that have no direct practical implications.
So now we know where the answers arent, so we have eliminated some possibilitys and are certain the answer lies somewhere else, and that is progress, but not success.
Does finding the cause tell us how to treat currently existing cases?
probably not, but it would sure help avoid creating new ones. different strategies will provide different benefits for different people then it seems.
i agree decades could go before any benefits are realized.The genetic link in crohn's disease seems rather weak. The microbiome studies might lead to discoveries but decades will go by before they unravel the millions of commensals and how they relate to crohn's disease, to this day these studies have not helped a single person with crohn's disease and billions have been spent on them.
but i would have to say that knowledge about how these bacteria work has already benefited me. if i didnt know how bacteria fermented short chain fatty acids from certain dietary fibers mainly soluble fibers, which i agree are very basic facts and maybe not a direct result from the microbiome project, it has given me insight as to the benefits of a high fiber diet can do for crohns disease, i eat about 1250 of my 1800-1900 calories a day from oats, wheat and beans, i attribute these whole grains to staying relatively complication free for 4 years now, never been in the hospital and never had any surgery, in fact, medication free as well, but that is not solely due to a high fiber diet, but lack of complication i believe are due to high fiber diet the more i know about these bacteria, the better. i acknowledge this only my testimony and not a scientific demonstration, therefore perhaps it is purely chance i have done so well doing the things i do and does not apply to other crohns cases, and the consumptions of whole grains has nothing to do with my success. in all sense of rationality, its likely got something to do with it though.
im not sure about the billions for the microbiome project, its more in the 300-400 millions i believe. While The united states defense budget is in the 600 billion's, hows that for comparison of a waste.
yes,i agree disease models suck. but thats where the microbiome project would come into use i believe, the better defined the disease becomes, the better models we have for it. EDIT- consider this, learning how to eliminate distinct bacterial species so that the flora are identical to the pathological changes in ibd, and seeing if that would be sufficient to create a form of chronic colitis, we cant do that without knowing alot more about the bacteria.There are almost no etiology studies that go out there and look at the environment and behavioral patters of people who get crohn's disease, whatever is triggering this disease is out there, it's not in the genes nor in the microflora I think. Genetic susceptibility to crohn's disease in exact twins with genetic markers is sub 50 percent.
Even the murine model that is used where colitis in KO mice is induced with DDS has very little to do with crohn's disease, the inflammation in crohn's disease is transmural and deep and is nothing like colitis mice at all.