The Intriguing Relationship Between Ancient Philosophy and Modern Diseases

        One of the miracles of the human body is its ability to maintain balance among the cacophony of reactions that take place on a minute by minute level. This balance is what allows us to be able to live. In our eyes, our neurons are able to interpret not only the way light interacts with the aromatic functional groups that can absorb the photons, but which allows us to process and interpret the information, and even associate emotions with the sensation. For digestion, a constant balance is needed to allow for pH changes within the different areas of the body to ensure safe absorption of nutrients. This involves signal relays, enzymatic pathways, and chemical gradients, all of which are implemented to feed the amalgamation of cells that make up an individual. One could say that it achieves the cellular equivalent of the inner balance that most individuals seek after. As humans have tried to better understand health and illness, they sought after reestablishing this balance. In the case of Ayurveda, a form of medicine originating from Easter cultures. In its early practices, the philosophy behind it focused on bringing together five elements within a person’s body to alleviate sickness (Parasuraman et al., 2014). Though the original means through which these cultures sought to cure these ailments might seem less sophisticated than the current methods used to treat illnesses, the philosophy might have been ahead of its time. In order to maintain proper function within a person’s body, this ideal balance must be maintained.

            Closely following this idea of internal balance within a system is the process of metabolism. Metabolism is the consummation of processes that a cell or organism undergoes in order to provide energy for said cell or organism. Two of the processes most familiar to those who study the human body are aerobic and anaerobic respiration. Aerobic respiration is the process by which glucose is broken down into pyruvate molecules that are then used to fuel the citric acid cycle and provide electrons to the electron transport chain. From there, proteins within the cristae of mitochondria pump out protons against a gradient which are used to power ATP Synthase as they follow their gradient back into the inner membrane space. This is the respiration that is predominant in humans.

            Alternatively, there is another pathway that is accessible to humans should we find ourselves in short supply of oxygen. This can occur when a person is exerting themselves, oftentimes in the form of exercise. When there isn’t enough oxygen present, a person’s muscles break down sugars through glycolysis. However, because they do not have a sufficient amount of the terminal electron acceptor used in aerobic respiration, the 2 NADH molecules produced in this process do not deposit their electrons onto the electron transport chain. Instead, they return to their NAD+ state by dumping their electrons onto the pyruvate molecules generated during glycolysis. This converts pyruvate into the fermented product lactate and frees up NAD+ molecules to once again accept electrons. This overall process produces 2 more ATP than it requires which is a pittance compared to the 30 ATP molecules produced during aerobic respiration. Still, this process can allow an organism to continue to function even during stressful conditions.

            With one able to provide an at least functional summary of these two processes in the space of two paragraphs, it would be understandable if another were to be given the impression that metabolism is a relatively straightforward process. However, this would be an erroneous assumption. The above summaries provide a surface level explanation merely of how these systems produce energy. We have not discussed how the human body processes other macromolecules that it ingests, such as proteins, lipids, and nucleic acids. We have not discussed how the body has its own pathways that regulate how the body both stores and utilizes that which it stores. From there, we would be remissed to ignore the bodily systems involved in the processes hinted at above, such as digestion, circulation, and hormonal regulation. When one considers these additional aspects of metabolism, one begins to truly appreciate how complex a system it is, and just how many things have the potential to go wrong.

            With this in mind, it is not surprising to learn that science is still seeking to better understand this complex process. As new processes of understanding the human body at a cellular level have become available, new breakthroughs in understanding certain cellular processes have emerged. Such was the case with metabolic processes in humans as the human genome has been sequenced. As our understanding of the purpose of many different genes expanded through this process, we discovered that there were genes for metabolic enzymes that we did not understand the function of (Metallo & Heiden, 2013). It is possible that these enzymes are targets for pathogens that alter their function, leading to some of the metabolic diseases that have been observed.

There have been a number of recent discoveries that give us a better idea of how metabolism functions outside of the general framework of how aerobic and anaerobic respiration. Among some of the metabolism components that have been identified as our understanding of metabolism has increased are the metabolites responsible for transporting pyruvate into the mitochondria (Metallo & Heiden, 2013). Similarly, it has been noted that while the metabolic pathway is comparable across cells, the metabolic requirements of each cell is dependent on the tissue it is a part of in addition to the environment in which it is found. Demands that can require a great deal of energy include rapid cell division, rapidly polarizing and depolarizing of cells, and operations to maintain homeostasis.

            Maintaining homeostasis in such a complex system seems to follow closely the philosophy of Ayurveda. Though this philosophy was first documented in written healing practices and some of its earliest remedies focused on achieving balance among five elements, the basic philosophy clearly has relevance, even today (Parasuraman et al., 2014). Often times diseases, particularly metabolic diseases, occur because of a loss of homeostasis, or an internal imbalance within the system. Though Allopathic medicine typically attempts to treat diseases through prescriptions, these treatments often seek to treat symptoms, and often overlook how to correct the imbalance that exists within an individual. Though allopathic treatments in metabolic diseases often are better about seeking to restore balance to a person’s metabolic system, arguably because failing to do so will result in their immediate death, through only providing prescriptions for these diseases, they often still fail to take a balanced approach to the illness, which can lead to these treatments acting as temporary fixes to chronic issues.

One of the most common chronic metabolic illnesses is diabetes mellitus. This disease is characterized by ineffective control over the body’s glucose levels. There are two main reasons why a person’s body can no longer maintain control over their glucose levels. One of these two hormonal issues occurs when a person cannot produce insulin, a hormone that allows an individual’s cells to absorb glucose. At first, this lack of insulin was thought to simply be caused by an adverse autoimmune response that sees T-cells attack pancreatic B-cells. This definition has since been expanded to include endocrine diseases, hereditary predisposition, drugs and chemical toxins, autoimmune diseases, viruses and infections, damage or removal of the pancreas, and unfavorable environmental factors. All of these possible issues result in a sudden onset of diabetes classified as type one diabetes. While this is most often seen in children, as many of them are experiencing the effects of an adverse autoimmune response, it is not exclusive to children. Adults have been documented to have a sudden onset of diabetes caused by the pancreas failing to produce insulin and the body’s cells subsequently starving from lack of glucose. It is this lack of glucose that often results in ketoacidosis as the body tries desperately to burn whatever fuel it has to keep its systems alive, even as it lowers the pH to dangerous levels. This process is far less common in the second type of diabetes.

The other predominant form of diabetes, coined type II diabetes, is one that sets in gradually. It is associated with a sedentary lifestyle, unregulated diet, high blood pressure, and high cholesterol. In this type of diabetes, there is plenty of insulin present in the body. However, insulin fails to bind as effectively to cells, which means that glucose is plentiful in the cells’ environment, but they have no means of taking that glucose in. As a result, these cells also start to starve.

It should be noted that both forms of the disease are very costly to the individuals who experience them as well as the United States’ healthcare system. In 2012, the total cost of diabetes was $245 billion dollars, with the majority of those costs coming from hospital inpatient care. It was estimated that represented 43% of the total previously sited cost (American Diabetes Association, 2013). To put it into the perspective of the individual cost, it is slightly more than twice as expensive to treat someone who has diabetes mellitus as it is to treat an ordinary patient. This figure can also be inflated by the costly end-of-life treatments that they often require (Ward et al., 2012). Without an individual balance in place for this vital system, it creates a financial imbalance that is detrimental to a nation’s economy as well as the individual in question.  

Between these two forms of diabetes, there are enough cases in the United States that it is now considered an epidemic. In terms of Ayurveda, it is clear that there is a distinct imbalance in both cases that results in this disease. In terms of type one diabetes, there is an imbalance in the number of b-cells and the amount of insulin produced by an individual’s pancreas. In order to effectively treat these issues, current practices seek to introduce insulin into a patient’s lacking environment. This helps to restore balance to the patient’s system temporarily. However, a truly ideal solution to this form of diabetes mellitus would be a treatment that sought to permanently restore balance to that individual's b-cell count through correcting the harmful autoimmune response and reversing any damage to the system. In the case of type II diabetes, there are often a few imbalances with a person’s lifestyle in addition to genetic predispositions. Current treatment emphasizes restoring balance to that same lifestyle. Other treatments seek to re-establish the balance that has been interrupted by correcting the signaling pathway. Both of these diseases exemplify the importance of balance within a human body to prevent or correct issues that may arise, the very idea around which Ayurveda was based. It’s small wonder that focusing on this philosophy has been able to help people over many centuries determine methods of treating individuals. With the technology available to us now, we can better identify exactly what imbalance is taking place within the body. With this knowledge and a focus on how to return the body to a state of balance, I believe that we can find more lasting treatments to such diseases that will help to mitigate the cost chronic diseases like diabetes have on individuals as well as the overall economy.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

References

 

American Diabetes Association. (2013). Economic costs of diabetes in the US in 2012. Diabetes care, 36(4), 1033-1046.

Metallo, C. M., & Vander Heiden, M. G. (2013). Understanding metabolic regulation and its influence on cell physiology. Molecular cell, 49(3), 388–398. https://doi.org/10.1016/j.molcel.2013.01.018

Parasuraman, S., Thing, G. S., & Dhanaraj, S. A. (2014). Polyherbal formulation: Concept of ayurveda. Pharmacognosy reviews, 8(16), 73–80. https://doi.org/10.4103/0973-7847.134229

Ward A, Alvarez P, Vo L, Martin S. Direct medical costs of complications of diabetes in the United States: estimates for event-year and annual state costs (USD 2012). J Med Econ. 2014 Mar;17(3):176-83.