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Medicine's Most Intriguing Mysteries

KU Medical Center experts give some insight into seven medical mysteries that continue to perplex researchers and clinicians.

colorful line art depicting human cloning, schizophrenia, human lifespan, migraines, common cold, pandemics and asthma

Some medical questions are so tough to answer that they can arguably be classified as “medical mysteries.” Despite decades of scientific investigation, there is still so much unknown about hundreds of medical conditions, diseases and global health care dilemmas.

We asked the experts at the University of Kansas Medical Center to give some insight into seven medical mysteries that continue to perplex researchers and clinicians.

Could humans ever be cloned?

“The short answer is yes,” said Patrick Gonzales, Ph.D., clinical associate professor in the University of Kansas School of Medicine.

Remember Dolly, the Scottish sheep that was cloned in July 1996?

“Dolly showed us that whole mammals can be successfully cloned from an individual somatic (non-sperm or non-egg) cell,” Gonzales said. “But Dolly also showed us that the technique is imperfect at best. Dolly aged and died very prematurely due to shortened telomeres, which are the repetitive sequences that serve as the protective ‘caps’ at the ends of chromosomes.”

colorful line drawing that depicts human cloningIs the answer to fix the telomeres to make them more protective?

“Manipulation of telomeres to extend the sequences is a possible solution but conferring extra telomere sequences to a cell could effectively ‘immortalize’ that cell, or in other words, cause cancer. Cloning from cells taken from younger humans may circumvent part of that problem, but then we have to ask, ‘How young is young enough?’”

Even if the technical problems are solved, Gonzales pointed out the ethical and legal concerns of cloning are problematic.

“Would these cloned humans constitute an elite class of humans based on some desirable attributes, such as intelligence or strength?” he asked. “And with the global population already over 8 billion people, why would we add yet more people as an experiment?”

Why don’t we have a clear cause or cure for schizophrenia?  

Schizophrenia is a severe, long-term mental health condition that affects around 1 in 100 people worldwide. Symptoms include hallucinations, delusions, disorganized thoughts and social withdrawal. After decades of research, there still isn’t a definitive cause or cure for the disease.

graphic line art depicting schizoprhrenia“How our genes play out in schizophrenia is extremely complicated,” said Matthew Byerly, M.D., professor of psychiatry and behavioral sciences and associate dean for research at KU School of Medicine-Wichita.

First, more than 100 genes that have been associated with schizophrenia, and no single gene causes the disorder alone. Second, the genes interact differently at various brain-development stages, which complicates the ability to identify the underlying causes of the brain changes that lead to schizophrenia.

Smaller brain volumes have consistently been found in patients with schizophrenia, particularly in gray matter. And then there are environmental factors to consider.

“Research suggests that a combination of genetic factors and aspects of a person’s environment and life experiences may play a role in schizophrenia, especially things that affect early brain development, like influenza infection of the mother during pregnancy or a difficult birth,” Byerly said.

Byerly said while there is currently no cure for schizophrenia, treatment for the condition has come a long way.

“Dramatic advances have been made in the treatment of the disease,” he said. “The key is to have a strong support system in place and get the right treatment to support people towards their recovery goals.”

Does the human lifespan have a limit?  

graphic line art depicting human lifespan with an elderly person using a caneIf you are hoping for immortality in your lifetime, odds are you are out of luck. Bruce R. Troen, M.D., professor and chief of the Division of Geriatrics at KU School of Medicine, director of the Landon Center on Aging and physician investigator for the U.S. Department of Veterans Affairs, has spent years studying the functional capacity of older adults.

Troen said that while science can lengthen the amount of time before our expiration dates, nothing in the scientific frontier will make those dates disappear.

“We know that only 1 of 10,000 people will actually make it to the age of 100,” Troen said. “That is a rapidly growing group, but it’s still very unusual for someone to live that long.”

To reach supercentenarian status— living much past 100 — is rarer still.

“The good news is that many centenarians, even up to 110 years old, are living very healthy and functionally capable lives,” he said.

Much scientific research has gone into that quality-of-life issue of functional health instead of simply elongating life.

“It’s unlikely that many people would like to live for 100 years but spend the last 25 of them in bed,” Troen said. “In other words, as many have said before me, ‘It’s not the years in your life but the life in your years that matters’ because everyone wants to stay cognitively and functionally intact until very near the end of their lives.”

The research tackling the finiteness of the life span hasn’t gotten far, and genetics and epidemiology haven’t yielded an answer.

“Practically speaking, there is a limit for us all,” he said.

What causes migraine headaches?

Migraines affect more than 10% of people worldwide, occurs most often among people aged 20 to 50 years, and is about three times more common in women than in men. In a large U.S. survey, 17.1% of women and 5.6% of men reported having migraine symptoms.

graphic depiction of a man holding his head to indicate that he's having a migraineBut what causes these often-debilitating headaches?

“I can give you the Twitter version, but it’s not that simple,” said Ryan Lay, M.D., clinical assistant professor of neurology in KU School of Medicine. Just like schizophrenia, a complex interplay of genetics and environmental factors is the likely cause for the crippling headaches labeled migraines.

“Migraines simultaneously involve the vascular system, the autonomic nervous system, the pain receiving system and the pain interpreting system,” Lay said. “We initially thought of migraines as a vascular or blood vessel disorder. But a lack of response to this line of treatment caused us to dive deeper into other possible contributors." 

That has led researchers to study neurotransmission, or how nerve impulses travel from neuron to neuron in the brain and throughout the body. Migraines might be happening because these neurons are either hypersensitive or hypervigilant, even in their resting state, according to Lay. So why do some people have this sensitivity and others don’t? It could be genetics.

“We don’t have a quick and easy answer for the question of what causes migraines,” he said. “But with this hypersensitive brain activity, as you go through life and are exposed to normal stressors, sleep deprivation, weather changes and health issues, the brain is more likely to respond with a migraine.”

Will we ever find a cure for the common cold?

“The answer is probably no, but the reason why is multifaceted,” explained Dana Hawkinson, M.D., assistant professor of infectious diseases at KU School of Medicine.

graphic depiction of the common cold“There are so many different viruses that cause the common cold, and not every virus is the same,” he said. “You have things like rhinovirus, human metapneumovirus, para influenza virus, and that’s just to name a few. But even within these groups, there are so many subsets.”

Even if virologists were able to identify every virus that causes cold and flu symptoms, that information would be incomplete the moment it was released. That’s because viruses replicate, and the replication process allows the virus to morph into a newer version that may or may not respond to any treatment created to take down its viral ancestor.

“The virus has almost unlimited chances to try and resist antivirals created to treat it,” Hawkinson said.

And since viruses need the hosts’ cells to replicate, coming up with a safe drug to combat viruses is tough. The resulting damage could be devastating.

“That’s why it’s so difficult coming up with drug targets within the virus in the genome that is also safe for us to consume and use on our bodies as well,” he said.

Hawkinson pointed out that the good news is that most cold viruses are an inconvenience, not a death sentence.

“Since birth, we’ve been exposed to these common cough and cold viruses. Yes, we get a little ill, but then it usually resolves in five to seven days, and we go on with our daily lives. That’s probably why not a lot of research or resources are going into developing a vaccine for the common cold.”

Can we prevent future pandemics?

“Ultimately, no. They are probably going to happen,” said Amanda Cackler, director of quality and safety for The University of Kansas Hospital. “The ease at which we can travel by road, air and water makes it incredibly likely that organisms will travel with us across the world.”

graphical depiction of a pandemicCackler added that many countries are growing in population, oftentimes becoming overcrowded and creating environments where infectious diseases can thrive.

The reasons why future pandemics are likely doesn’t stop there.

“We see that evolving interactions between animals and humans and even climate change can affect the emergence of new pathogens,” she said. “Add to those problems the looming crisis of a lack of health care workers. These individuals when properly trained can respond to an infectious disease and keep it from spreading. But across the globe, fewer individuals are able to address that challenge.”

The good news is that the prevention strategies we learned during COVID-19 can help in upcoming pandemics, Cackler said. Wash your hands, avoid touching your face, disinfect surfaces and wear a mask.

“We can’t ignore how masking can help prevent the spread of COVID and other respiratory illnesses, despite the controversy over mask mandates,” she said. “I advise people to keep wearing one if you want to continue to reap the rewards, especially when you are in crowds.”

One last strategy would be for countries to communicate better on monitoring emerging pathogens and teaming up on prevention strategies.

“We need to continue to develop a stronger, worldwide approach for current and future vaccines.”

Why have asthma rates jumped dramatically over the past 20 years?

graphic depiction of asthmaAsthma is a common respiratory condition marked by spasms in the bronchi of the lungs, causing difficulty in breathing. It usually results from an allergic reaction or other environmental or behavioral factors.

There has been a steep rise in cases of asthma in the United States over the past few decades. According to the American Lung Association, 41.9 million people in the United States had at one point received an asthma diagnosis. And the rate appears to be on the rise. Since 1999, this number has grown by 43%. The Centers for Disease Control and Prevention (CDC) estimates about 8.4% of U.S. adults now have asthma.

There’s no one explanation behind why asthma is on the rise. However, there are a few possible theories, including the increase in allergens in the environment and rising levels of obesity. Sowjanya Duthuluru, M.D., an assistant professor of pulmonary, critical care and sleep medicine at the KU School of Medicine, has another theory as well.

“I think one reason we are seeing a rise in the number of asthma cases is that there has been an increase in the rates of smoking and vaping among teens and young adults,” Duthuluru said. “Asthma does affect people of all ages, but it most commonly starts in childhood, and children from ages 5 to 17 have the highest rates of asthma than any other age group.”

Duthuluru said the good news is that treatments for asthma have greatly improved over the past two decades.

“With the introduction of biologic medications, along with several newer and more effective inhalers, patients are able to better manage their symptoms and can reduce exacerbations.”

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