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Comment by chiefalchemist | Hacker News Reader

"Scientists have been unclear about why apoE4 is so much more damaging to brain cells than other versions of the protein."

Without a solid why, doesn't this constitute correlation, and not cause?

I'm curious where the line gets drawn, and why that's so.

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The first step is often to notice a correlation. The causation was found here:

> Treating human apoE4 neurons with a structure corrector eliminated the signs of Alzheimer’s disease, restored normal function to the cells, and improved cell survival.

The actual mechanism is not necessarily important for a treatment to be successful.

Yes. But what about unintended consequences? What if this cures a symptom but creates something else?

Well, lots of people don't have the apoE4 morphism, and have the normal apoE3 version. So fixing the gene could have other bad consequences in theory, but probably not as bad as Alzheimer's.

I’ve personally learned about many medications without a known functional path, but with eons of use. As for side effects, those are often similarly documented. You’re basically pointing at a part of the medical field.

It will; chemistry is complicated. But you won't have Alzheimer's. So life is tough choices, but lacking any clear downside its a chance lots of us would take.

That's why we have Phase I trials.

...and preclinical work. These are exciting results, but tons of additional work is needed before this goes anywhere near an actual human.

It's definitely a roll of the dice but I'd venture to say that, aside from constant pain and suffering, pretty much anything else is better than Alzheimer's.

I agree. It makes sense.

This was probably not the best example given the context. None the less, without a clear and proven why any "cure" could be risky.

> None the less, without a clear and proven why any "cure" could be risky.

The "why" is not as important as you might think. There are many drugs for which we don't know why they work, but we have clinical trials to test for their effectiveness and safety.

And clinical trials are more important than knowing the "why". For example, if you know why a drug inhibits such and such genes, then that is nice to know, but that doesn't tell you what other effects the drug has.

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