Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor
In Reply.—I thank Drs Sinkovics and Horvath
and Mr Savitz for their interest in and commentary on my article on apoptosis.
Savitz is concerned that few studies unequivocally prove that dysregulation
of apoptosis plays a significant role in disease. Unequivocal proof in medical
research is rare; the results of correlative studies, however, can steer researchers
in the direction of causal links. For example, a recent study1
found that the expression of antiapoptotic Bcl-x protein in bone marrow erythroid
precursors is significantly higher in patients with untreated polycythemia
vera than in those with other myeloproliferative disorders or secondary erythrocytosis.
Studies like this are correlative and suggestive, not definitive. Forthcoming
gene knockout experiments in mammals will come closer to determining which,
if any, apoptosis-related genes are necessary and sufficient for the induction
or progression of disease.
Steven W. Hetts. Role of Apoptosis in Health and Disease—Reply. JAMA. 1998;279(21):1699–1700. doi:10-1001/pubs.JAMA-ISSN-0098-7484-279-21-jbk0603