PHILOSOPHY OF APOPTOSIS AND THE MIND AS A SUBJECT OF BIOCHEMICAL REDUCTIONISM?

We are simply all made up of biochemical molecules that mostly act in an altruistic way on behalf of survival of us, the whole "organisms". As described in Stanford Encyclopedia of Philosophy, “an organism behaves altruistically when its behavior benefits other organisms, at a cost to itself”. It is also mentioned that the notion of altruism via a biological-theory based perspective is different from how altruism is perceived in the everyday concept: consciousness is not a prerequisite for altruistic behavior (1).

In case of apoptosis or in other words "the programmed cell death" (2), cells respond to some type of stimuli by making themselves die without any harm to the surrounding cells or tissues. They apply an altruism supporting the favor of the organism rather than themselves without a defined consciousness in accordance with the definition above. As defined in the biology literature, “apoptosis occurs normally during development and aging and as the homeostatic mechanism to maintain cell populations in tissues. Apoptosis also occurs as a defense mechanism when the cells are damaged by diseases or noxious agents” (3). The dictionary definition of apoptosis is “the process by which non-pathological animal cells die and undergo phagocytosis. The molecular mechanisms involved are highly conserved between nematodes and humans, but more complex in the latter” (4).

I ask if this very basic physiological mechanism of homeostasis, the apoptosis, can be considered as a projection of a gross biological concept named altruism. Let's follow the clues that might be helpful to discover. However, please remember that this is neither a philosophy article, nor intended to be one. This is a personal blog. Philosophy of biology covers many aspects regarding life and the features and the origins of today's living organisms like us. However, it is an expertise requiring mastering in Philosophy and I am not a philosopher. It is my personal curiosity to ask questions on biological issues probably happening at molecular or subconscious levels like: what happens if body fails to compensate the loss of cells that undergo apoptosis? How does it still help any organism to survive? How does a cancer cell, for example, succeed to overcome all apoptotic processes in cells and just grow and grow? Hopefully, you will face many questions if you follow my personal blog.

The logic of triggering apoptosis in cancer cells by chemotherapy still makes sense as a therapy option because if left untreated, cancer cells grow too much, they most probably metastasize and the case becomes lethal to the organism they silently develop in. This case is called "carcinogenesis" as a whole (2-a). Apoptosis of the cells that are affected by carcinogenesis is somehow inhibited by those cells themselves, and that is not the sole capability of cancer cells to overcome naturally protective barriers of us in order to just keep growing. They survive, too; but this time, to the cost of the life of the organism, not for an integral benefit to the organism. I need to present that the expertise and all applications of medicine and veterinary science verbally divide bodies into systems to better define, investigate and cure them once diseases evolve to provide a familiarity with the topic for both non-philosophers and non-health personnels. This approach is "reductionist" in nature.

Reductionism in philosophy is defined as: "it encompasses a set of ontological, epistemological, and methodological claims about the relations between different scientific domains. The basic question of reduction is whether the properties, concepts, explanations, or methods from one scientific domain (typically at higher levels of organization) can be deduced from or explained by the properties, concepts, explanations or methods from another domain of science (typically at lower levels of organization)" (5). Also, "reductionists are those who take one theory or phenomenon to be reducible to some other theory or phenomenon". For example, a reductionist regarding mathematics might take any given mathematical theory to be reducible to logic or set theory. In other words, a reductionist about biological entities like cells might take such entities to be reducible to collections of physicochemical entities like atoms and molecules. The type of reductionism that is currently of most interest in metaphysics and philosophy of mind involves the claim that all sciences are reducible to physics. This is usually taken to entail that all phenomena (including mental phenomena like consciousness) are identical to physical phenomena (6).

Another question might be: "can biological altruism be reduced to a cellular level and exemplified by apoptosis"? It is clear that the apoptosis observed in exiled and stained tissue samples is not selfish. It watches the benefit of the whole organism, not of the cells that undergo the apoptotic process. Controversially, cancer cells do benefit on their own at the expense of the organism in which they live. If they are that primitive in nature, then how to they even evolve inside an organism with complex interactions of many types of molecules, especially when this organism has protective mechanisms like apoptosis and other immune barriers? All the organisms have either conscious and unconscious desire of living; so must do their cells as the building blocks on principal (2-b).

As an example of my questions: do the cells that go through apoptosis -kind of- less like to be alive? Or, as an alternative question, how does the cancer more lose the connection with the other parts of the body in such a horrible way that it terminates all the life inside the organism, while it is still in the organism? I mean the organ or organs that cancerous cells invade with the word "cancer".

Today, differing from the taught medical education materials of 1997-2003, a cancer microenvironment as a condition that promotes a cell's evolution into a "cancer cell" is questioned as well. The components and interactions within this microenvironment are of interest of researchers as potential targets for cure. However, it is not always simple to define the microenvironment as the same or similar structure for all types of cancer. A brain tumor and a liver tumor will have different grounds that the cancer cell can develop over. Besides, they will still be sharing the same nerve innervations and blood circulation and other systems in common once they develop, considering the general, reductionist classification of organs and systems in our body. Søren Ventegodt et al. present individuals with cancer who experienced a decrease in size of their tumors via discussions.

Please remember again that I am not intending to bring a new solution or proposal to an old problem here: scientists consider cancer cells to be present even in ancient Egyptian people depending on the findings protected by mummification. I am personally presenting an answer; a working, already-known answer to the -still unsolved- question of development of a defined "normal cell" to a "cancer cell" at the paragraph below as also an observational researcher and biomedicine specialist. This answer is focusing on changing the consequence of this evolution though, rather than investigating deeply the underlying biochemical mechanisms and trying to prevent the possible mechanisms involved in the process. It seems that the mechanism can be reverted back at the organismal level in us, the people, provided with an additional effort accepting a differential belief in the first place.

“The recovery of the human character and purpose of life with consciousness-based medicine seems to be able to induce spontaneous remissions in several diseases. On two different occasions, we observed breast tumors reduced to less than half their original diameters (clinically judged) during a holistic session, when working with the patients in accordance with the holistic process theory of healing, the life mission theory, and the theory of human character”…”The reduction of tumor size is in accordance with the holistic point of view that many types of cancer are caused by emotional and existential disturbances. From a holistic perspective, cancer can be understood as a simple disturbance of the cells, arising from the tissue holding on to a trauma with strong emotional content". More conclusively, as the authors outline: "the reduction of the tumor in the two cases happened when old painful emotions were identified in the tissues, in and around the tumor, and processed into understanding; when the patients finally did let go of negative beliefs and attitudes that had kept the feeling(s) repressed to that part of the body, the tumor first softened and then disappeared, presumably by apoptosis" (7).

Therefore, we are returning back to the crucial point of verbally-modified micro-or-in this case macro-environment of the tumor and the foreseen protective role of apoptosis, without any damage to non-cancerous cells. Cancer is an old problem, not only medically but also in terms of philosophy based on ethical discussions or the growing, speculative bodies of information on alternative therapies that mention the lethality of chemotherapies, but also do not simply cure the disease themselves. This situation can leave the people suffering from cancer unprotected by both two sides: the known chemotherapies on one side and the cancer on the other side.

I personally do not find any ethical problem at traditional cancer therapies, as people are taking these therapies on their own wish and risk and with an awareness. It is also not clear that emotionally undisturbed bodies do cope with carcinogenesis and metastasis processes better with verbal, psychological approaches that do target solely the "accumulated negative and hurting emotions around the cancer cells". Such therapies are also working very well at the early stages in combination with surgical approaches. Yet, the cancer cells did gain a type of awareness with the mentioned holistic approaches through the research published by Søren Ventegodt et al. Such approaches involve discussions on emotions, life experiences and aim of life with the patients diagnosed with cancer. We were normally unfamiliar to the belief of targeting to reduce the ratio of abnormal growth of cancer cells in patients by mainly discussions in the first place during classical medical education. I am not an oncologist and by no means intending to give any medical advice hereby. I just know that cancer is not a contagious disease, does not improve our life quality and brings death in many cases. Meantime and most importantly we are unsure about the decisions of individuals who would neither accept nor refuse the standard chemotherapy regimens (2-c) provided that they have information on possible consequences of both, shortly regarding both sides of the coin, as the clinical trials and drugs on various laboratories to be developed are not always beneficial to the "life" on Earth in general.

Do I know this because I believe in this? Beliefs are strong components in our daily life. They define how we act, how we make our decisions. They do not always have to be the "known" facts. We rely on our beliefs for almost everything and do rarely attempt to change them unless we are obliged to. They are not what we "think" or "decide", they do not necessarily have to be scientific facts either... They are what we usually presume to be "correct" just because we prefer to find them correct; so just simply believe. It is always possible to adopt or believe in an alternative belief, better to say "change our mind", but do we do easily this?

Do we easily change our preferences in life, like the preference of the food we consume or the way we live or in choosing any material that we regularly need to purchase? Do we simply "like or wish" to have any emotional or sexual experience just by thinking that we "must" change our partners namely boy friends or girl friends? The latter question has been a subject of Sociological Biology so far and the discussions even led to a dangerous headline called "evolutionary psychiatry" and far before it, "the evolution of menopause". The second topic has a relatively feasible background though: why did menaupose evolve in females? "All the individuals of all species have to survive by sexual intercourse in terms of human beings" (9). I strongly recommend the book "Why is Sex Fun" for readers who will like to have an idea on the answer. My answer to my first question is: we can easily act in the ways based on our usual habits and previous experiences. We do accept all the presented disease and therapy definitions, possible explanations, protocols that are presented during the medical education as "facts" and we believe in them as both the health personnels, most of the scientists and the patients or consultants. We believe in the statistical information on cancer survival via chemotherapy, surgery, radiotherapy as patients diagnosed with cancer and as the medical doctors diagnose it. I would like to repeat that there is nothing wrong with either believing in anything and preferring by both verbal and written consent, hopefully simultaneously, on a specific treatment for any defined disease if you are defining yourself a patient.

Only the conclusions might change according to our preference in such a favorable case: if people living close to a volcano which is active from time to time believe that lava is not much hot but it just looks like hot, and is therefore harmless they might be late to escape when the lava eruption occurs. That is why the final benefit received from therapies will primarily be affected from the ideas of individuals that are medically believed to be created by the "beliefs" in the first place independent from the therapy type.

In summary, it has been evidently shown that a philosophical point of view triggers a recovery in carcinogenesis. This recovery is known as spontaneous remission. As an end-point in my questioning, I am curious if the cells in our bodies or bodies of other eukaryotic organisms have their own minds, too or not. Could any kind of awareness be triggered by more holistic, and/or more organism-based approaches (because the factor which reduced tumor size at this research was basically the mind of the individuals; no emotions can be defined without a mind, as they need to be perceived and interpreted by people; and we do perceive things by our sensory organs that serve for our brains. From a positivistic point of view the concept of mind refers to and requires the presence of the organ named brain). If it is reasonable to ask or discuss the mind of cells, then is there or can there be a philosophical concept which is adoptable to involving the mitochondria, or even a “mitochondrial mind”, too? "Mitochondria" is a little bit smaller level of -hypothetically intracellular consciousness- as it has to live and work rather independently inside our cells.

"Apoptosis" is a function of the organelle named mitochondria, the sole intracellular-level organelle that is able to use the inhaled oxygen throughout the body in organisms that utilize aerobic respiration to live. Mitochondria are the intracellular organelles with their own DNA called the mitochondrial DNA in addition to the cellular genomic DNA. Their roles are multiple; involving supplying energy from dietary intake and apoptosis. They are busy organelles as they continuously have to provide the energy for us in a consumable chemical structure. If the mechanisms of apoptosis did not require the contribution of mitochondria, wouldn't we benefiting from more efficient ways of oxygen consumption as this organelle was going to be dealing with the "providing energy to the organism-part only? We normally have repair mechanisms for specific disruptions in the cellular genome, but the mitochondrion does not have time for repairs; it has to work so hard that its genome is supposed to be under more threat of disruption. I will focus more on mitochondral dieases, too, later in this page. It is not clear that carcinogenesis is a mitochondrial disease.

In addition, Salvatore Dimauro published a review on mitochondrial medicine and defined a neglected mitochondrial feature: "the dynamic nature of these organelles as in reality, mitochondria fuse, split, and move within the cell. In non-muscle cells, such as neurons, mitochondria form tubular networks, which favor a uniform distribution of energy within the cell. Mitochondria move on microtubular rails propelled by motor proteins called kinesins, one of which (KIFB-alpha) is specific for mitochondria" (8).

Does the KIFB-alpha molecule, for example, have a mind, too? Can I comfortably say that within a cell, the components surrounded by the membrane of the cell can act independently on their own benefit as if they have separate minds? Can I just say, we human beings can act so independently in a society that we live in though we have our minds? Could we exist even without a society in the first place? Honestly, I believe that almost all the proteins including KIFB-alpha can be synthesized in laboratory conditions, and theoretically, wherever we put the proteins that we synthesize they will serve their functions given the chemical circumstances they naturally have. A cellular-respiratory protein will serve for respiration, a motility protein will serve for the motility of the cell etc. Why would this even require consciousness at all? We know that the genes are real and they define the function of the proteins to be constructed. I can specify the function of a protein as long as I know the gene sequence that will be transcribed into the protein. Do we, humans as organisms, behave in the same way in all the places, environments, atmospheres that we can hypothetically be put inside?

By the way, the mitochondrial genome which is lack of specific repair pathways and enzymes is different from the cellular genome that has these "adaptive-to-differing-conditions" repair pathways and enzymes. When we mention a "mitochondrial disease", we ignore the part of cellular genome and the general repairing ability. We assume that an improper mitochondrial protein or similar proteins do cause the disease.

Returning back to the inspiring topic of this article, grossly looking, a bird working as an observer of predators while the other birds in the group are eating, may be considered as the altruist given that it will sing or shout when a predator approaches to the group Will it most likely become the hunt? Joseph D. Robinson discusses aims and achievements of the reductionist approach in his response to Kincaid; and sets the definition as: “the significant meaning of reductionism, for biologists such as Darnell et al., is a research strategy that proposes to explain biological phenomena in terms of underlying chemical and physical entities and processes, thereby establishing molecular causal chains and revealing the generality of mechanisms in structural and functional terms" in his article of the year 1992 (Unlisted in the References). My answer could be something like: then I may reduce all our behaviors into the cellular, subcellular or even atomic levels; I do not have to deny causality in all the processes. I can also question the basic assumption of "defining the body as pieces of systems", too, and just say; no, the body is a whole, and no anatomical tissue is present to classify a body as separate systems that different medical expertise deals with". This generalization can also include our preferences in life: why not? If we have consciousness, then somehow, our cells must have it, too. Whatever components they have or don't have, they must be considered as "clever "entities, because they can have minds", why not? Whatever we cannot demonstrate is how they will act in other, possibly unfavorable circumstances. It might not be sane to think and believe that a heart cell's mitochondria will live and function with the same efficiency inside a liver cell. How does the change in microenvironment affect behaviour, the phenotype as a simpler definiton? Isn't it because of the opposite of that reason that the traditional cancer therapies have been targeting cells, the ones defined as cancer cells, as "independently, unconsciously proliferating selfish cells" inside a body? If they were -kind of- conscious, could we do this to them? How could we try to kill(!) any conscious living thing just because it doesn't act in the way that we, the organisms, need it to act? In reality, what both sides of the coins say and teach(!) us is that we have to kill the cancer cells, otherwise they will kill us if once they develop at a stage and then metastasize, and they sure will.

However, spontaneous remission of cancer was successfully triggerred by discussions on the purpose of life. Yes, cells must sure have minds, too, even the ones named as cancer cells. They must be less clever than the rest though, as they even cannot resist to the signals directed or affected by the individuals diagnosed with cancer; but did show reduction in their size mainly through the discussions focusing on emotions. I must repeat that emotions are real, physically existing molecules or at least what we regularly sense are converted to physical beings in our bodies. It doesn't make any sense to ignore or disregard emotions, and to totally reduce living "us" to uncounsciously-acting beings, basically because the human body is not a laboratory. It is a natural condition where all the cellular AND biochemical processes happen.

As the last but not the least, I want to repeat that this page is not a place of any medical recommendation or a proposal of a cure. This is not a discussion of why or how a disease evolves. Maybe we can ask why cancer evolves in some people and not in the others? Do these differentiated cells called cancer cells have their own mind, different than the other cells' minds? We are free to ask questions and I am personally interested in different cultures and languages and all the languages address the beliefs of people living in a society or another, as sounds or sign language do reach our beliefs or interpretation of the senses as auditory or visual inputs. We have a strong tool of communicating through speech to try to resolve our issues, even the ones that seem to be unresolvable.

As the last example on behavioral concepts, thirst and water drinking do affect the hypothalamus, and so the signals that regulate the drinking (water) behavior differently. Being pregnant might affect all the females to feel differently. Emotions have physical equivalences though we do not see them as we see the objects by our eyes, sensory organs in this example. I have shared this article with almost whom I hear that is diagnosed with cancer since I heard of it (7). Thank you to the authors.

REFERENCES

1) Stanford Encyclopedia of Philosophy-online, revision Jul 21, 2013. http://plato.stanford.edu/entries/altruism-biological/

2) Istanbul University Cerrahpasa Medical School, taught Medical Biology lecture notes, 1997 (common course with MD and Biomedical Sciences students).

2-a) Istanbul University Cerrahpasa Medical School, taught Oncology lecture notes, 2003 (a course specific to Biomedial Sciences students).

2-b) Adapted from the reference information "Cells are the building blocks of tissues, and tissues are so of the organisms" of Istanbul University Cerrahpasa Medical School, taught Histology lecture notes, 1997.

2-c) Mentioning Pharmacology lecture notes of the abovementioned school (common course with MD and Biomedical Sciences students) and TUSDATA, the private medical education reviews education center for TUS Exam (the national analog of USMLE Exam for specialisation in medicine).

3) Susan Elmore. Toxicol Pathol. 2007 ; 35(4): 495–516. Apoptosis: A Review of Programmed Cell Death

4) Penguin dictionary of biology, 2001. M Thain and M. Hickman.

5) https://plato.stanford.edu/entries/reduction-biology/

6) https://iep.utm.edu/eds/

7) Ventegodt, S., Morad, M., Hyam, E., and Merrick, J. (2004) Clinical holistic medicine: induction of spontaneous remission of cancer by recovery of the human character and the purpose of life (the life mission). TheScientificWorldJOURNAL 4, 362–377.

8) Salvatore DiMauro (2004) Mitocohondrial medicine. Biochimica et Biophysica Acta 1659: 107-114.

9) Bogaziçi University Lecture Notes of Prof. Andreas Furman's "Evolutionary concepts in ecology", adapted from the concept "survival of the fittest", 2005.