The oxidative stress theory of disease: levels of evidence and epistemological aspects

Abstract

The theory stating that oxidative stress is at the root of several diseases is extremely popular. However, so far, no antioxidant is recommended or offered by healthcare systems neither approved as therapy by regulatory agencies that base their decisions on evidence-based medicine. This is simply because, so far, despite many preclinical and clinical studies indicating a beneficial effect of antioxidants in many disease conditions, randomised clinical trials have failed to provide the evidence of efficacy required for drug approval. In this review, we discuss the levels of evidence required to claim causality in preclinical research on OS, the weakness of the oversimplification associated with OS theory of disease and the importance of the narrative in its popularity. Finally, from a more translational perspective, we discuss the reasons why antioxidants acting by scavenging reactive oxygen species might not only prevent their detrimental effects but also interfere with essential signalling roles. We propose that ROS have a complex metabolism and are generated by different enzymes at diverse sites and with different timing. Aggregating this plurality of systems in a single theory of disease may not be the best way to develop new drugs, and future research may need to focus on specific oxygen-toxifying pathways rather than on non-specific ROS scavengers. Finally, similarly to what is nowadays required for clinical trials, we recommend making unpublished data available in repositories, as this will allow big data approaches or meta-analyses without the blinders of the publication bias.

Links

PhilArchive



    Upload a copy of this work     Papers currently archived: 76,442

External links

Setup an account with your affiliations in order to access resources via your University's proxy server

Through your library

  • Only published works are available at libraries.

Similar books and articles

The role of basic science in evidence-based medicine.Adam La Caze - 2011 - Biology and Philosophy 26 (1):81-98.
The origins of medical evidence: Communication and experimentation.Joachim Widder - 2004 - Medicine, Health Care and Philosophy 7 (1):99-104.
Ethics and evidence based surgery.G. M. Stirrat - 2004 - Journal of Medical Ethics 30 (2):160-165.
Clinical trials: deliberations on their essence and value.Franz A. Schelling - 2004 - Journal of Evaluation in Clinical Practice 10 (2):291-296.

Analytics

Added to PP
2016-07-04

Downloads
47 (#251,586)

6 months
2 (#301,800)

Historical graph of downloads
How can I increase my downloads?