“… there is a stable order in the world as well as a well-established connection, constant norms and fundamental laws. In this sense, the world is analogous to a clock or a well-designed machine. Every single wheel, every single screw, every single nail not only has a role in order of a machine and an impact in its final benefit but also positive consequences for all living beings, especially for humans.” (Signs of Miraculousness, Seven Heavens, p. 186)

There is a strong parallel between the general principles to be observed for a healthy social structure in a society and the necessary conditions that enable cells to make up a healthy tissue. The laws prevalent in the universe present amazing parallels since they derive from the same divine source. In order to have healthy development in societies, it is necessary to have healthy connections, reciprocal understanding, and correct information transfer between people. Similarly, having healthy cells, which can be considered as micro-societies, also depends on the cells’ continual use of complex signal connection networks and their maintenance of connections with their environments. In order to maintain a harmonious and healthy life in the cell, there must be dense information transfer (through chemical molecules) at all levels with neighbor cells. Thanks to the connection networks that start at their membranes, cells can recognize warnings coming to them and produce responses. Through such information networks, a continuous connection is established in living organisms, starting from their lowest level mechanisms (i.e. molecules in cells and organelles) to their highest level mechanisms (i.e. organs, systems, organisms, populations, ecosystems), in order to ensure a healthy and harmonious processes of development, reproduction, differentiation and aging. Organized as a tissue (micro-society), one of the most amazing features of cells is the way they behave in accord with the society they live in, rather than acting as individualistic beings. Cells behave in a way to make micro-societies possible. In cytology (study of cells), this feature is known as “contact inhibition” (i.e. maintenance of healthy and harmonious operation and development that is based on connection), and its damage may lead to cancer. Every cell is sensitively programmed to receive all signals, coming from inside and outside, and to manage the proper responses to them. Here, the question arises whether a lack or disorder of connection is caused by pathological conditions in cells or whether the emergence of pathological conditions is caused by connection problems. It is generally assumed that, molecular changes in the cell occur first (i.e. mutation) and then this mutation leads to abnormalities and connection problems at the levels of tissue, organ, and even organism. Damage to communication or connection and disorders in this system are a very important reason for the appearance of some pathological conditions (such as an abnormal increase of cells, cancer and death). Thus, diagnosis and treatment of many diseases today depends on knowledge of how biological communication and connection are harmoniously established.

Cells are designed to control their behavior through special signal molecules that can themselves function as stimulatory. For instance, using signal molecules, cells can establish colonies or biofilms. Moreover, plant cells, through channels known as plasmodesmata, maintain their connection with neighboring cells and trade certain materials. In the state of illness, the density (among cells) of signal molecules that are transferred in the plasmodesmata changes.

Hormones, reproduction factors and neurotransmitters are charged with ensuring transportation and communication at different levels. Cell and tissue elasticity and their adaptability are increased by this diversity in signal operations. Different ways are used to transmit signals into the cell depending upon the characteristics of the signals. For example, hydrophobic (water-avoiding) molecules like steroid hormone pass directly through the cell membrane and connect to their receptors in the cell. The receptors that are responsible for decoding genes stimulate the decoding of related genes. If a problem (mutation) occurs in the molecules that are responsible for transportation and communication, the transportation and communication breaks down and the cancer process is triggered. The existence of continuously reproducing cells in inappropriate times and places is an important symptom of cancer initiation. For example, in colon and rectum cancer, if a mutation occurs on the Ras protein, which is one of the signal proteins that takes the “Reproduce!” message from the cell membrane the cutting off of the GTP molecule, which is responsible for turning the signal molecule on and off, is blocked, and since the molecule stays permanently active a signal like “Reproduce!” is permanently sent inside the cell. Thus, the benefits of the medicines that are used in cancer treatment and that show their effects by hindering signals on the cell membrane level are observed in the non-existence of this mutation on Ras proteins. If the mutation happens the medicines mentioned above cannot be effective. Today, the presence of the mutation can be determined by a biopsy taken from the patient, thus, it has become possible to choose the type of therapy that will be most helpful to that person.

Communication inside the cell can be carried out through ion channels (such as sodium, potassium, and calcium). These channels in membrane behave selectively for every different ion. For example, while voltage-gated channels open and close according to electric charge ligand, (key)-gated (receptor) channels let ions transfer when ligands are tied up. Sodium and potassium ions and the molecular channels that these two passes are responsible for organizing the changes that effect the communication of nerves in the membrane potential. The calcium channel, on the other hand, plays an important role in muscle contraction, and biological incidents like the formation and deformation of bone.

In recent years, the proteins (matrix) that fill the vacancies among cells have been shown to be the main actor in the general control of communication between cells and in the integration of signals coming from their surroundings by hundreds of proofs. It has been pointed out that CCN proteins, which are one of the adaptors, as well as proteins with multiple modules that are responsible for the connection between cell membranes and matrix proteins have a regulatory role at different levels in the control of signal transfers in ion channels, cell differentiation, adherence of cells to each other, cell collapse, programmed cell-death, cartilage formation and the synthesis of new veins. The multi-dimensional and dynamic communication and connections mentioned above related to cells also apply to people. When individuals develop a healthy connection between their inner world and other people, a healthy society emerges. Every individual is granted these potential connection points, which make the existence of an individual possible. The development of a healthy person depends upon activating these connections, organizing them dynamically and keeping them active.

If we place human beings at the center of creation, the first connection that the individuals should make between their Creator and their ego (nafs) is called worship. The ego is both a help and a hindrance to the construction of this connection. The second connection, which is between individuals and their friends, is ensured by good morals, good conduct, and personal virtue. The construction of a healthy social life depends on how many people have good morals, good conduct and virtuous character in a society. If virtue is not accompanied by knowledge, it is highly unlikely that knowledge will raise an individual to a standard of human perfection.

The third essential, the individual’s healthy connection with their surroundings is established through the “ecological dimension of ego,” which is sensitive to the external world. It is very difficult for people whose dimension of ego, which is sensitive to ecological problems and the environment, has not developed to keep the environment clean and take precautions against pollution. The fourth connection that individuals should establish is the connection with their internal world (heart-consciousness, transcendental ego, real self). “O Man! Know yourself first!” and, “The one that knows himself knows his God,” are expressions pointing out the importance of this connection.

For individuals, groups, and societies to have a healthy life as well as to maintain their health at all levels depends on activating these four connections, in other words, establishing coordination and harmony among them and then maintaining this state. When one ignores one of the connections or some of them, or when the coordination between these connections is defective, troubles and illnesses at various levels emerge. Hence, the links that a healthy individual establishes may include those in civil society organizations, and through these further networked and reciprocal communications. Like our cells, which maintain their connection with their environment and neighboring cells via the “contact inhibition” mechanism so that we feel healthy, for people to become healthy at personal and societal level, individuals should actively join civil society organizations and service-centered communities that can enable activation of these four connections and ensure harmony and coordination among them. The Islamic scholar, Bediüzzaman Said Nursi paid special attention to connection in the letters he wrote to his students (the Kastamonu letters) and highlighted it as a point of progress that should be reached:

Since, in today’s world, saving people’s belief for the sake of God is a very important mission that is above everything; since quantity is not very significant compared to quality; since transient and changing political worlds are trivial compared to everlasting, constant, stable services in the name of God-they should not be even compared; they can never be objectives; therefore, we should be satisfied with valuable positions that are granted in the circle of Risale-i Nur. Instead of having extremely well-thoughts about other people or seeing them at high positions superfluously, we need to have extreme loyalty and steadfastness, and utmost connection and sincerity. We should have progress on these points.

Hamza Aydin has a PhD in bio-medicine. He is a freelance writer from Izmir, Turkey.

So-called ‘new’ viruses most probably derive from existing viruses; in general, viruses of today have ancestors and relatives. However, as viruses show great variety, and many of the viruses of gravest concern mutate rapidly and unpredictably, it is not always possible to trace their ancestry with any great confidence. A ‘new virus may be genuinely new or a major evolutionary variant arising from genetic processes such as mutation or recombination. Their rate of mutation is so high that controlling them, or predicting their behaviour, is well-nigh impossible. High mutation rate means that no RNA (ribonucleic acid) virus population is a single entity, but rather a ‘quasi species’. Introduction of a virus from one species to another and dissemination from a smaller to a larger population are also among the basic mechanisms by which viruses emerge.

The emerging viruses are surfacing from ecologically damaged parts of the earth. When viruses come out of an ecosystem, they tend to spread in waves through the human population. Among the most notorious are: Lassa, Rift Valley, Oropuche, Rocio, Q. Guanarito, VEE, Monkeypox, Dengue, Chikunganya, the Hanta viruses, Machupo, Junin, the rabies like strains Mokola and Duvenhage, LeDantec.

AIDS: Acquired Immunodeficiency Syndrome

Human immunodeficiency virus (HIV) is a more difficult case compared to, for example, influenza, itself a great killer – the influenza pandemic of 1918-9 in China caused some 20 million fatalities. We do not know the origin of HIV, but a probable primate origin is often suggested, and appears highly plausible. HIV-2 (one of the major strains of HIV) may be a mutant that jumped into humans from an African monkey known as the sooty mangabey, perhaps when monkey hunters or trappers touched body tissue. HIV-1 (the other strain) may have jumped into man from chimpanzees – perhaps when hunters butchered chimpanzees.

HIV attacks the type of lymphocytes known as helper T-cells that stimulate the activity of B lymphocytes that produce antibodies. After an HIV infection sets in, helper T-cells begin to decline in number and the person becomes more susceptible to infections.

The AIDS virus mutates rapidly and constantly. It is a hyper-mutant, a shape-shifter, spontaneously altering its character as it moves through individuals. It mutates even in the course of one injection.

The drug AZT has been found to be helpful in prolonging the lives of AIDS patients. Also, it has been shown that administration of Interleukin-2 and AT-538 can prevent viral replication in cells in the early stages of the infection.

The Filoviruses

Marburg and Ebola viruses were recently elevated to family status as the Filoviridae. The name, ‘thread viruses’, is based on their morphology. These viruses made their appearance in the 1960s and 1970s in the form of frightening nosocomial and occupational outbreaks, initially among polio vaccine production workers in contact with Ugandan green monkeys and their kidney tissues, then in independent hospital epidemics of devastating proportions during 1976 in the Sudan and Zaire. Mortality from these infections can range to nearly 90%, that is 90% of infections, not just of clinical illnesses.

The incubation period of a filovirus in a human being, is from 3 to 18 days during which time the number of virus particles climbs steadily in the bloodstream. Then the suffering begins.

Marburg was the first filovirus to be discovered. It erupted in a factory producing vaccines using kidney cells from African green monkeys. Thirty-one people caught the virus. Seven infected persons died in pools of blood in just two weeks. This fatality rate of one in four makes Marburg an extremely lethal agent, yet it is the mildest of the filoviruses. No vaccine is available.

Ebola Sudan

The next indication of the existence of filoviruses came from an extraordinary pair of epidemics in 1976. In the Sudan the initial focus was a cotton factory in Nzara, and several of the earliest recognized cases worked there in a single room. Travel to nearby Maridi introduced the virus into the medical care system, with subsequent latrogenic dissemination that devastated the Maridi hospital. In this outbreak, 150 out of 280 infected people died.

In 1979, it recurred in Nzara, Sudan. The index case had worked in the same room in the cotton factory identified in the earlier epidemic. Twenty-two out of 34 infected patients died. When it first erupted, the medical stuff had used dirty needles which facilitated the spread of infection. Again, no vaccine is available.

Two months after the start of the Sudan emergence in 1976, an even more lethal filovirus emerged. The Ebola Zaire, a new strain was nearly twice as lethal as Ebola Sudan. The fatality rate of Ebola Zaire is 9 out of 10. Staff at a hospital which had been at the epicenter of the epidemic were almost all wiped out: 13 out of 17 of the doctors and nurses died. The disease erupted more or less simultaneously in fifty-five villages near the headwaters of Ebola River.

This epidemic was clearly dependent on the use of unsterilized needles and syringes for its major dissemination between villages, although multiple later generations of cases occurred among family contacts without any defined exposure route.

Ebola is distantly related to measles, mumps and rabies. It is also related to certain pneumonia viruses, to the parainfluenza virus which causes colds in children, and to the respiratory syncytial virus, which can cause fatal pneumonia in a person who has AIDS.

Ebola kills a great deal of tissue while the host is alive. It triggers a creeping, spotty necrosis that spreads through all the internal organs. The liver bulges up and turns yellow, begins to liquefy and then it cracks apart. The kidneys become jammed with blood clots and dead cells, and cease functioning. As the kidneys fail, the blood becomes toxic with urine. No vaccine is available.

Ebola does in ten days what it takes AIDS ten years to accomplish. In principle Ebola-like viruses could spread out all over the world in just one month and a half. Richard Preston, the author of Hot Zone argues that AIDS may be the first step in a natural process of clearance. What is being cleared is human beings: the earth’s immune system, so to speak, has recognized the presence of our species and is starting to kick in and signal its potential to rid itself of an infection by human beings. There can be no excuse for failing to reflect radically on the way we manage our economies, our societies and our lifestyles. We have no absolute right of tenure of this planet, nor does our collective intelligence or our science and technology afford a reliable immunity from vulnerability, whether as individuals or as a species. We do need to be fearful perhaps, though not to panic – so that we redress the balance in favour of humility in our attitudes and activities, so that we become more caring and careful in using our God-given faculties to prevent the worst before it happens.

References

• MADER, S. S. (1992) Human Biology, WCB Group.
• PRESTON, R. (1993) Hot Zone, Random House, New York.
• MORSE, S. 5. (1993) Emerging Viruses, Oxford University Press, New York.
• DOWDLE, W. (1993) ‘The Origins of Plagues’, Science, 261 (September 17).
• GRIFFIN, B. E. (1994) ‘Live and Let Live’, Nature, 368 (March 3).

Cancer is a major cause of illness and death in developed countries. The risk of death from cancer has also been increasing in the less developed countries. As improvements in medical care have reduced deaths from infectious diseases and increased life expectancy, cancer has become the leading cause of death in many societies. For example, according to the American Cancer Society, about one in three people in the USA will develop cancer at some point in their life, and about one in four will die from it. Each year about 500,000 individuals die of cancer, a rate of about one death per minute, and more than one million new cases of cancer are diagnosed annually in the US. Currently more than 10 million individuals are receiving medical treatment for cancer in US hospitals and medical centres.

What are the causes of cancer?

Scientific evidence gathered over the last hundred years has dispelled the superstition, once prevalent, that cancer is a contagious disease. But, despite significant advances in the last decade, its underlying mechanisms are still a mystery.

The link between cancer and genetic mutation was shown early in this century: normal cells mutate into malignant ones because of changes in chromosome constitution.

There are four points which support the idea that cancer has a genetic origin:

1. More than 50 forms of cancer are known to be inherited to one degree or another
2. Some tests detecting mutations have shown that most environmental toxic agents which are called carcinogens are also mutagens.
3. Work with cancer-associated viruses has revealed the presence of some mutant genes, known as oncogenes, that promote and maintain tumour growth.
4. The chromosomal abnormalities found in particular forms of cancer, especially leukemia.
5. The environment and behaviour can also play a significant role in the genesis of cancer.

The existence of high rates of specific cancers in particular families has been known since early in the 19th century. Many explanations have been offered for this phenomenon, including multiple gene inheritance, environmental agents or even mere chance.

Hereditary forms of cancer

Recent advances in cancer research have provided some clues about the relationship between mutant genes and the cellular events that lead to tumour formation. Experimental evidence suggests that as few as two mutational events may be sufficient to cause a cell to become cancerous (see Figure I). In those forms of cancer that show a heritable predisposition, the first mutation is present in the germ cells and is transmitted genetically. The second mutations are acquired by somatic cells through spontaneous replication errors or exposure to environmental agents that cause genetic damage, resulting in cancer. On the other hand, not all individuals who inherit the first mutation will develop cancer.

If the second mutational event does not occur, then no tumour will develop. Research has focused particularly on two classes of genes in carcinogenesis: tumour suppressor genes which normally function to suppress cell division, and proto-oncogenes which normally promote cell division. 

Tumour suppressor genes

Tumour suppressors are detected in the form of chromosomal deletions (or other inactivating mutations) that are tumorigenic. The strongest evidence for their nature is provided by certain hereditary cancers. There is also now evidence that changes in these genes may be associated with the progression of a wide range of cancers. About 10 tumour suppressors are known at present. These genes act at certain points to inhibit cell division. These and or their gene products must be absent or inactive for normal cell division to take place. If tumour suppressor genes become deleted or inactivated by mutation, control over cell division is lost, and the cell can proliferate in unchecked fashion. The example of breast cancer illustrates how mutations in tumour suppressor genes are involved in the development of cancer:

The genetic link to breast cancer

In the USA, the ratio of women getting breast cancer is approximately 1 in 8. It is the most common form of cancer in women: 46,000 women die and 182,000 new cases are diagnosed each year. Epidemiological factors may also be involved in breast cancer, but geneticists have focused on the question – Is there a genetic predisposition to breast cancer? Their answer, for the present, is Yes: though involved in only about 5% of all eases, a particular gene has been identified and located on chromosome 17. It is responsible for susceptibility to a form of breast cancer that appears in the third and fourth decades of life. About one in 200 females inherits this gene, and 80% to 90% of these will develop breast cancer. Besides breast cancer, a gene has been found on chromosome 17 in sufferers from astrocitoma (brain tumours), colon, lung and bone cancers. This finding suggests that there is a mutation on this gene (called p53), and as a result the cells start growing abnormally.

The Future

Investigations into the tumour suppressor genes are an example of the recent progress in molecular aspects of cancer research. A better understanding of molecular carcinogenesis and molecular epidemiology will eventually decrease the quantitative and qualitative uncertainties associated with the current state of cancer risk assessment. It may be possible to immunize patients against their tumours by using these findings about genes-cancer relationships. Indeed, determination of the type and number of mutations in p53 and other cancer-related genes in tissues from ‘healthy’ individuals may allow the identification of those at increased cancer risk and their consequent protection by preventive measures.

Although there have been many and most welcome developments in the diagnosis and treatment of diseases, including cancer, there is a definite and reliably cure only for some of the infectious diseases. However, we firmly believe there are definite remedies for all diseases in the universe except death.

References

• HARRIS, ADRIAN L. (1990) ‘Mutant p53-The commonest genetic abnormality in Human Cancer?’ The Journal of Pathology.
• HARRIS, CURTIS C. (1993) ‘p53: At the Cross-roads of Molecular Carcinogenesis and Risk Assessment’, Science, 262.
• CUMMINGS, M. (1994) Human Heredity, West Publishing Company, St Paul. Lewm, B. (1994) Genes 5, Oxford University Press, New York.
• LEWIN, B. (1994) Genes 5, Oxford University Press, New York.