The biological side of randomness. A starting point to rethink causation of diseases and prevention as a strategy

Abstract

It's time to rethink prevention as a strategy to fight diseases? In this opinion I'll try to Diseases, prevention and fate.A recent paper (1) supporting the concept that "the majority of the variation of cancer risk is due to random mutations" and "the minority is attributable to environmental factors or inherited predispositions", by lengthening the shadow of randomness on the cause of diseases, provides a unique opportunity to rethink the prevention as a strategy: if the disease is caused by a random mutation, what would be the utility to insist on prevention of environmental risk factors? Indeed, as we have read in many relevant comment in PubMed Commons (2), the article is very questionable in many respects, and, in particular, in this attempt to separate in biology the environment from genetic factors in that life is, exactly, the result of the continuous interaction between internal/external stimuli and genome which results in the epigenetic regulation of gene expression b . Notwithstanding the paper, that have

Time arrow in published clinical studies/trials indexed in MEDLINE: a systematic analysis of retrospective vs. prospective study design, from 1960 to 2017

“…Since it is impossible to reverse the course of events, living organisms must adapt reproduction, development and evolution to cope time and its rhythms by committing specific biological resources that are the matter of chronobiology, making time a measure of the cyclical and stochastic changes in biology rather than an absolute physical quantity. Biological life with aging is invariably associated with the experience of disease, whose incidence seems to be ruled by chance (Ciulla, 2015b) but when clinical researchers study diseases, generally, to preserve human life and avoid unnecessary suffering, what they actually do of the time variable, namely, how the variables are followed, or sampled, in time, backward or forward? Indeed any study on diseases might takes into account the “point of view” which might suggest misleading cause–effect relationship (Ciulla, 2015a).…”