Tuesday, November 23, 2010
Dr. Ian Lipkin and XMRV
The Patient Advocate was reading the NY Times Science section this morning when he noticed the front page article on Dr. Ian Lipkin. The PA had seen the online version yesterday but was pleased to see this in the real paper. The first question that came to the Patient Advocate's mind was - why this extensive profile of Dr. Lipkin and why now? It was only when the PA got to the last paragraph of the article that the PA understood what this article is about. Dr. Lipkin has been selected as our "big daddy" for the rough ride ahead. A few well-place telephone calls and Dr, Lipkin is given the highest exposure in the NYTimes. Someone has to do this job and Dr. Fauci of the NIH has selected Dr. Lipkin, who credentials are sky-high. It is going to be Dr. Lipkin's job to try to convince the rest of us that everything is "going to be alright" in this "virus thing" with XMRV and other MLV-related viruses and their association with ME/CFS, breast cancer, prostate cancer, etc. Dr. Lipkin will be the voice of calm reassurance. He will convince us that science will triumph, and that there is nothing about which to panic. We will be seeing Dr. Lipkin again very soon when the results of the blood working group phase II are made public. Then we will see him again when Dr. Ila Singh's research is published. We will be seeing alot of Dr. Lipkin. Get used to him.
Meanwhile Dr. Lipkin's real job will be to substantiate what has already been substantiated. Under normal circumstances (but for the CDC errant study) the Lo/Alter paper would have been accepted as a confirmation of the October Science study of Lombardi et al. But these are not normal circumstances. Because the CDC failed at their task, either diliberately or through magnificent incompetence, Dr. Lipkin's job will be to "reconcile the irreconciliable". So his tasks are two-fold - sustantiate the substantiated, and reconcile the irreconcilable. The first part will be easy. The second part less so. The Patient Advocate cannot imagine the explanation that will have to be invented for the second part - but one thing is certain - it will be a doozy.
Substantiating the Science paper will be easy. The Patient Advocate, or any semi-competant person, could do this job. It is a set up. Dr. Lipkin, using the right tests and having the blood of real ME/CFS patients (samples from Komaroff, Levine, Montoya, Bateman and Klimas and probably others) will find 80-90% of them positive for XMRV ( if not more). Dr. Lipkin will get another feather in his cap, and be a local hero - at least at Columbia.
Meanwhile, for the rest of us, the real heros will have been passed over, and the real scientific discovery neutralized. But for the hopeless failings of the CDC, the research into XMRV and it's association to neuro-immune illness would be sailing along. Instead the NIH is involved in the final solution for XMRV, which involves great delays which are not without consequences. This maneuver also allows a shift away from the real scientists in this XMRV association with ME/CFS - Dr. Vincent Lombardi and Dr. Judy Mikovits of the Whittemore Peterson Institute.
This entire situation is nauseating. (This has very little to do with Dr. Lipkin, who the Patient Advocate imagines is "top notch".) It characterizes the most lethal of academic prescriptions: create a tangle in some fashion, create uncertainty, create delay - and then bring in an outside high profile consultant - an expensive hired gun - to straighten everything out. This is obviously a desperate measure to "take control" of this issue. As with all "control issues", one thing lies in the background: venality and/or malice.
The Patient Advocate quickly fashioned a letter to the NYTimes this afternoon summarizing the situation:
"Thank you for your article on Dr.Ian Lipkin. Dr. Lipkin is obviously a remarkable researcher. It did not escape the attention of this reader that the gist of the article is left to the last paragraph. Dr. Lipkin has been hired by the government to straighten out the discordant research regarding the new human retrovirus XMRV in its association with ME/CFS. This is a set up. Dr, Lipkin has been put in charge of substantiating what has already been substantiated by the Lo/Alter paper of September 2010. This task, the outcome of which is entirely predictable, will be another feather in Dr. Lipkin’s cap. Meanwhile the NY Times has missed the main story. The article should have been written about Dr. Judy Mikovits and Dr. Vincent Lombardi of the Whittemore Peterson Institute who wrote the Lombardi et al in the October 2009 Science magazine. It was these scientists who did the original astonishing work in the association of the retrovirus XMRV with ME/CFS (and potentially other neuro-immune illnesses.) They are the real heroes of this unfolding disease drama."
The Patient Advocate wishes to point out the difference between overseeing a support study and doing original research. While running a confirmation trial takes some delicate skills, it is nothing like the intensity and creativity necessary to scope out a complex problem and go to the root of it. The former situation involves standing on the back of others, the latter involves standing alone. And yes there is a difference.