No Cell Sings Alone

An organism is  a chorus. Through an invisible song book its cells follow an omniscient conductor who directs them when to open their mouths and utter a note or a phase;  when the concert concludes, the effects suggest cosmic regulation. Ervin H. Epstein, Jr., MD and Anthony Eugene Oro, MD, PhD investigate how cells work and interact to make normal epithelial organs, such as skin and hair follicles: cells follow molecular conductors, pick up brief nuanced clues, nods, and signals, and they interact with other cells, hormones, and tissues. Sometimes a cell and its progeny follow discordant paths; then cacophony, discomforting rhythms, and disease occur, leaving the chorus a jumbled racket.

Epstein described how  small molecules could be used to correct these aberrant voices and make them rejoin the chorus; alternately, they could be made to abate their shouting and go away completely; or, perhaps, they could be made to wither away and allow other singers to continue on in tune. It can take decades to first identify the squeaky voice in a disease and then to develop an effective and safe means   for silencing it or training it.  Outstanding examples for new and effective treatment for the basal  cell nevus syndrome and the more common basal cell carcinomas of the skin were presented.

Oro discussed how cells could be returned to their youthful, pristine voices and directed to produce clear  tones in harmony with their sister cells.  Dermatologists in the audience perceived how drugs could take the place of surgery or ionizing radiation for treating of skin tumors, and how devastating genetic diseases could be ameliorated with a new set of an individual’s own cells.   Work in progress will focus on preventing resistant clones from growing in tumors undergoing treatment and developing drugs with fewer side effects, or maybe evolving completely new therapeutic modalities.

The final song will be worth the effort.


Epstein, EE Jr:  Twacking the Hedgehog

Oro, AE:  Heal Thyself: Using Stem Cell Biology for Skin Disease


Presented at the Plenary session of the 75th Annual Meeting of the American Academy of Dermatology, Sunday March 23, 2014, Denver CO, USA.

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