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Letters |

Role of Apoptosis in Health and Disease—Reply

Steven W. Hetts
JAMA. 1998;279(21):1699-1700. doi:10-1001/pubs.JAMA-ISSN-0098-7484-279-21-jbk0603.
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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.

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