The Center for the Biology of Chronic Disease

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Atif Zafar, MD

Clinical Professor of Medicine, Indiana University School of Medicine

REVIEW

This is a remarkable work. A process for the genesis of chronic diseases, whose etiologies are very poorly understood, is postulated and substantiated with evidence from the biological literature (from microcellular events to their phenotypic expression). The author creates the forest from the trees and presents us with a picture of a cohesive, unique, biologically plausible phenomenon, which may be the root cause of many of the afflictions of humankind.

A detailed quantitative biophysical model of biochemical competition, cell motility and cell signaling is presented as the framework within which the processes of disease pathogenesis are described. Evidence from human and animal studies is then used as examples of the various stages within this process of disease development.

The unique feature of this work is that the author presents a testable model for his hypothesis. Although ample supporting literature is provided to substantiate his ideas, further, directed research which tests the microcompetition phenomenon can now be performed. An understanding of this process at the subcellular level can then provide the impetus to develop highly targeted drug therapies aimed at reversing the respective microcellular events leading to phenotypic disease.

This work will undoubtedly stimulate new thinking and generate new insights and new classes of drug therapies can be developed. It is useful as a graduate text in an advanced biological sciences or biophysical sciences curriculum. The mathematical models presented could potentially be "computerized" to generate a "working digital model" of the physiology. These models could then be verified by comparison with empirical data from real experiments and tweaked as necessary.

I was particularly intrigued by the sections on atherosclerosis and autoimmune disease, which helps to fuel my own suspicions that many of the common rheumatologic and autoimmune diseases are actually chronic viral or prion infections from as yet undetected agents.

BIOGRAPHY

Dr. Atif Zafar holds a Bachelor of Science degree in Biological Sciences and Mathematics from the State University of New York at Buffalo and completed medical school in 1994 at the same institution. He trained in Internal Medicine at the University of Cincinnati from 1994 to 1997. He then completed a fellowship in Medical Informatics at the Regenstrief Institute for Health Care in Indianapolis, IN. He is a Board Certified Internist currently in practice at the Indiana University Medical Center and is the Information Technology Director of a national Primary Care research support group funded by a subsidiary of Health and Human Services called the Agency for Healthcare Research Quality. His research interests include electronic capture of patient-physician encounter data, improvement of medical errors and patient safety through information technology and electronic medical education. His clinical research involves novel treatment approaches to sepsis syndromes, including HELLP, early Gram Negative septicemia and multi-organ failure states. He is also involved with research aimed at addressing the epidemic of HIV and AIDS in the rural West African state of Kenya, where he is applying information technology strategies to assist physicians with the care of HIV-infected patients by providing point-of-care guidelines, results and advice. He was the 2001 recipient of the prestigious George W. Thorn Award from the University at Buffalo, given to a graduate under 40 who has made important national and international contributions in his or her field. Dr. Zafar makes his home in Carmel, Indiana.

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