Medicine Science

Nobel Prize predictions vindicated?

Over the last week or so, several of my fellow ScienceBloggers made predictions about who would win the Nobel Prize in Medicine/Physiology. The prize, as we know now, was awarded to Andrew Fire and Craig Mello for their discovery of RNA interference (known as RNAi, for short). I also share some of Jake’s questioning as to why Greg Hannon or Tom Tuschl, both of whom played a role in discovering RNAi and making the early advances in the field, were shut out. Whatever the reasons, this particular award is of great interest to me because it’s the first Nobel Prize awarded for a discovery that was actually made during the time I’ve been a researcher. There’s no doubt that RNAi has revolutionized much of the research that we do in a molecular biology laboratory in a short period of time (less than 8 years), but it has yet to result in feasible treatments. (Of course, in my opinion, Judah Folkman was robbed. Yes, I know, I have a dog in that fight, being an angiogenesis researcher myself. There’s also always next year; sooner or later Judah Folkman should get the Nobel.)

Others besides ScienceBloggers made Nobel predictions before the Nobel Prize in Medicine and Physiology was announced on Monday. Peter Bowditch, in particular, made a few. So I was curious: How did his predictions pan out?

Here’s what Peter predicted:

  • The winner will not be a naturopath.
  • The winner will not be a chiropractor.
  • The winner will not be a homeopath.
  • The winner will not have found a universal cure for cancer
  • The winner will not have found an immediately useful cure for multiple sclerosis or autism.

All of the above predictions were clearly correct. I have to point out, though, that if any scientist ever did find a universal cure for cancer there is no doubt that he or she would be a shoo-in for the Nobel Prize. Certainly no naturopath, chiropractor, or homeopath will ever ever win the Nobel Prize. While alties might say this is because of the “medical establishment” keeping them down, in reality it is because these people do not do good science–or any real science, for that matter.

  • The winner will have published research in legitimate, peer-reviewed journals.
  • The research for which the prize is awarded might not have any immediate practical use but will have increased the sum of human knowledge.
  • The winner will not have a web site selling whatever won him or her the prize.

Alll of these are also correct, although none of this guarantees the post-Nobel Prize behavior of any of the winners. After all, Linus Pauling fell into vitamin C quackery after winning. I also note that earlier this year at the Academic Surgical Congress in San Diego, I attended a talk by Dr. Louis J. Ignarro, who was awarded the Nobel Prize in 1998 along with Robert F. Furchgott and Ferid Murad for their discovery that nitric oxide is a signaling molecule (a discovery, which, by the way, is far more important than just its role in providing a mechanism of action for Viagra and all those other related drugs now used to treat erectile dysfunction). This talk disturbed me greatly. Indeed, I meant to blog about it shortly after it happened, but for reasons that I don’t remember, somehow it got pushed to the side.

Ignarro started by weaving a fascinating story of the experiments, reasoning, and evidence that led to the discovery of nitric oxide and its importance as a signaling molecule. He is a captivating speaker, and I was enjoying the talk immensely. As his talk progressed, I thought he was a great speaker for the American Association for Academic Surgery, one of the two surgical societies sponsoring the Academic Surgical Congress. (The Society of University Surgeons is the other). The AAS is an organization dedicated to encouraging academic and research careers in young surgeons. Indeed, one can only be an active voting member for 10 years after taking one’s first faculty position or until age 45, whichever is longer. After that, AAS members are required to superannuate (become “emeritus” non-voting members). Consequently, at the yearly conferences, one of the goals is to invite scientists of some renown to talk good science and fire up the troops, and usually one of these is a basic scientist rather than a surgeon. Dr. Ignarro seemed to be doing an admirable job.

And then there was a change.

With about 10 or 15 minutes to go in his talk, he changed gears abruptly, and it was like the grinding of metal on metal–to me at least. I saw a few looks of puzzlement among the young surgeons sitting around me, but for the most part everyone took this change without any evidence that it bothered them.

You see, what happened is that Dr. Ignarro started delving into what sounded to me like woo about diet and heart disease, discussing evidence that he had developed that arginine supplementation increases nitric oxide levels and protects against heart disease. It was somewhat interesting, and he might have been on to something. However, he was clearly vastly overselling it, indeed outright advocating that everyone should be taking arginine supplementation because it would greatly reduce the risk of developing heart disease through its generation of nitric oxide. I might not have thought about it much again, but then he did something that I’ve never seen a scientific speaker do before at an invited scientific talk at a conference. He started discussing (almost hawking) a diet book he had written called No More Heart Disease: How Nitric Oxide Can Prevent—Even Reverse—Heart Disease And Stroke. In a single–if you’ll excuse the term–stroke during the last 15 minutes of his talk, Ignarro turned what should have been an inspiring talk given to a bunch of young surgeon-scientists to fire them up to want to be great researchers and push the boundaries of surgical science into little more than an infomercial for his book and a forum to pontificate about his outside the mainstream ideas regarding nutrition. Even if his work on arginine pans out, when he gave his talk it was clearly not ready for prime-time, and it’s not as though alties pushing various nutritional “treatments” haven’t been pushing arginine supplementation for a long time now. Ignarro gave them a seemingly scientific basis for these claims. He might turn out to be right, but even if he is, he had no business making the claims that he did based on the evidence that he had.

I was greatly disturbed and quite disappointed, as I sensed another Linus Pauling in the making. This concern was further amplified when I later heard about his involvement with promoting a dubious dietary supplement with HerbaLife and publishing a PNAS article touting arginine supplementation in which he failed to disclose his financial interest with Herbalife. Seven months later, I also don’t recall him openly hawking his Herbalife supplement Niteworks in his talk, but he definitely pushed a lot of borderline, if not outright, woo. (I don’t recall if he disclosed this interest or not in his talk, but I seem to recall that he did not.) In any case, I was worried at the effect his talk might have on a bunch of idealistic young surgeons who are desperately trying to do good science, even in the face of having to maintain a clinical practice in surgery. Worse, as I found later when discussing the talk with colleagues, many of them didn’t recognize the dubiousness of the last part of the talk. They were a bit taken aback by his peddling of his book, but seemed willing to accept the whole package, including the last part of the talk. The Nobel Prize halo is strong indeed.

Finally, particularly relevant to Dr. Ignarro:

  • If the word “nutrition” or anything like it appears in the citation then the prize and its winner will be mentioned on alternative medicine web sites and forums before the end of the year.

Indeed, but sadly in the case of Drs. Ignarro, the Nobel winners themselves may decide to cash in on the credulity of these alties with regards to nutrition.

Perhaps I should make a Nobel prediction myself. One of the Nobel Prize winners in a scientific discipline will fall prey to woo sometime within the next decade.

It’s likely a safe prediction.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

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