Biochemistry Class and Arteriosclerosis
This post could also be titled “The Value of Basic Sciences.”
As I have mentioned before, the curriculum at New York Chiropractic College starts with a heavy load of basic science classes. In the first three trimesters, this includes Cell & Tissue Biology, Gross Anatomy, Neuroscience, Microbiology, and Biochemistry classes. This is widely regarded- across many medical professions- as the most difficult time in school. For many, this is not necessarily due to difficulty of material, but rather to sheer volume of information. Here many professors compare it to “drinking from a firehose.” Indeed, with our first midterms approaching, most students have scrapped any vestigial social plans in favor of a weekend at the library.
And yet, despite non-clinical origins, this payload of cells, neurotransmitters, and molecular structures has already begun to show signs of practical application. Take, for example, this week’s Biochemistry class. We have spent the past several weeks studying organic chemistry and learning the chemical structure, function and classification of proteins, carbohydrates and lipids. Here’s a taste of what that is like:
This week’s lecture included lipoproteins, which are involved with transporting fats around the body. They may be part of high-density lipoproteins (HDLs) or low-density lipoproteins (LDLs), often known as ‘good’ cholesterol and ‘bad’ cholesterol, respectively. Receptors throughout the body interact with a class of proteins in this molecule, allowing other tissues to absorb the HDL or LDL-carried cholesterol. In our Cell Biology lab we became familiar with some of the tissues that carry these receptors, including lymphocytes, fibroblasts, smooth muscle cells and liver.
Fortunately, these LDL receptors are not found in the layer of endothelial cells that lines the blood vessels, so cholesterol cannot typically accumulate. However, when stress, high blood sugar, high blood pressure or other factors cause damage to this lining, underlying smooth muscle cells are exposed- cells which, as we learned, are among the primary locations for LDL receptors. With no protective layer, the blood vessel walls are then free to absorb cholesterol from LDLs. Thus begins the process of plaque buildup which leads to arteriosclerosis, setting the scene for heart attack and stroke.
And that’s just the simplified version.
As the professor completed a sketch of the process and delivered the implications, suddenly the clinical connection became immediately clear. With heart disease as the leading cause of death in the United States, understanding the molecular mechanisms behind the ailment will be essential for us, the healthcare providers, to draw a line from cause to disorder to treatment, or- preferably- to explain to patients how to prevent such an issue from occurring1. The same will be true for every other condition that we may encounter.
It is no wonder that we are subject to such a firehose of information.
Though sometimes daunting, we are forging connections every day between our current classes, continuing to enlarge a base laid by our undergraduate degrees, and setting up a framework for what will very soon be our practice. Nothing less than this sometimes overwhelming amount of information would satisfy us.
1Nutritional therapy is part of the chiropractic scope of practice in many areas.
Hardening of the Arteries. A.D.A.M. Medical Encyclopedia. U.S. National Library of Medicine. June 3, 2012. Available at: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001224/. Accessed October 5, 2012.
King, Michael W. Lipoproteins. The Medical Biochemistry Page. Available at: http://themedicalbiochemistrypage.org/lipoproteins.php. Accessed October 5, 2012.
Leading Causes of Death. FastStats. Centers for Disease Control and Prevention. January 27, 2012. Available at: http://www.cdc.gov/nchs/fastats/lcod.htm. Accessed October 5, 2012.