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Perspectives On Medical Research
Volume 4, 1993
Contents
Scientific Problems with Animal Models
Stephen R. Kaufman
Historian and philosopher of science Thomas Kuhn notes that every scientific
age has its "paradigms," theories nearly universally regarded
as true that form the framework for ongoing scientific investigations.(1)
Paradigms are rarely challenged until overwhelming contradictory evidence
forces their revision or rejection. A currently dominant paradigm is
that animal "models" are necessary for medical progress.(2-4)
For most members of the current scientific establishment, the issue is
not whether animal models should be used but which models are most useful.
However, critics of animal models argue that they are inherently flawed
(5-7) and point out the frequency with which animal models provide misleading
information.(8-12)
All species differ; animal-model conditions never exactly mimic
human ones. Animal models are only analogues of human conditions
because they share certain characteristics. Philosophers Hugh LaFollette
and Niall Shanks observe that animal models are used primarily for two
functions--to predict human responses to stimuli (such as infectious,
traumatic, or toxic conditions and therapeutic drugs or devices) and
to offer new ways of conceptualizing human anatomy, physiology, or pathology.
Researchers who use animal models employ the following reasoning: a given
animal model resembles an analogous human condition in some of its features
(say, A, B, and C); therefore, it is reasonable to proceed as if an additional
feature (D) found in the animal model--for example, a physiological function
or a drug response--can be expected to be a feature of the human condition
as well. As LaFollette and Shanks point out, this assertion is logical
only if feature D is causally related to A, B, and C--in both
the animal model and the human condition. That is, A, B, and C must be
causal factors of feature D. The following reasoning illustrates a failure
to recognize the importance of causal relationships:
Two dogs bark, love bones, and wag their tafls when
their human companions arrive home; because the two
dogs are similar in these respects, they can also
be expected to be of the same breed. If we know the
first dog's breed, we can reliably predict the second's.
Breed, however, is not causally related to the three features that the
two dogs are already known to share. If we know a dog's breed and we
also know that a second dog has the same parents as the first, then we
can reliably predict the second dog's breed--even if the two dogs differ
in many other respects, such as coat color or temperament.
LaFollette and Shanks distinguish between weak and strong models. Strong
animal models are identical to the analogous human features in all causally
relevant respects, and research using such models can be confidently
applied to humans. Although many animal research advocates assert that
animal models faithfully reproduce human conditions, LaFollette and Shanks
argue that most animal models are weak models of little direct applicability
to humans. Neverthe- less, LaFollette and Shanks do not reject animal
research's value. They maintain that animal models may be helpful but
are probably not necessary for medical progress.(5)
In public, animal research proponents often suggest that weak causal
models are in fact strong. For example, the Stanford Committee on Ethics
states, "Cancer kills humans and animals alike.(13) At any buf the
most simplistic level, the comparison immediately begins to break down.
For example, malignancies that are experimentally induced in nonhuman
animals and malignancies that occur spontaneously in humans significantly
differ in their causes.(14-16) Other important differences include
the greater virulence of most experimental cancer strains and differing
mechanisms of tumor growth and metastasis. Even nonhuman cancers that
apparently share many characteristics with human cancers make unreliable
research models, since human and nonhuman cancers inevitably differ in some relevant
causal factors. Viewed in this light, an animal model such as the mouse-leukemia
model is a poor means of attempting to identify potential anti-cancer
drugs, and this model has, in fact, proved grossly inadequate.(17)
Even if a disease's main causal factors were well understood--and were
alike--in both humans and other animals, animal models would still be
undermined by systemic differences between animal models and
human conditions. Because of evolutionary divergence, species show differences
in virtually every aspect of organ and tissue function. All organ subsystems
interact, so every physiological difference between a given "laboratory"-animal
species and the human species necessarily affect every causal factor.
Consequently, all tissues of an animal model will tend to react to an
experimental manipulation differently from a supposedly analogous human
condition. Animal models of human conditions tend to provide only the
most obvious and general information, such as that cancers kill; in order
for them to provide reliable and specific information, the model and
the human condition must have identical causal factors and have no significant
systemic differences that affect these causal factors. This is impossible,
since there are always differences in causal factors between the model
and the human condition and because systemic differences are an inevitable
consequence of evolutionary divergence.
In theory, then, animal modeling is unreliable in predicting human responses
to stimuli; and it has proved so in practice. Animal tests of acute lethal
toxicity,(18) eye irritancy,(19-21) skin irritancy,(22-24) teratogenesis
(birth defects),(25-27) and carcinogenesis (28,29) have generally provided
inconsistent results and failed to correspond to human experience. R.
Heywood has estimated that only about 5-25 % of toxic effects found in
animal experiments occur in humans.(30) Of course, animal models can
serve as strong models when researchers attempt to predict gross toxicological
effects, such as the ability of strong acids to burn the eye's surface;
however, such effects could readily be predicted from the most rudimentary
knowledge of chemistry. Most animal tests are supposedly intended to
identify subtle effects, and they perform poorly in this regard.
Animal tests have also proved inadequate as a means of identifying potentially
useful drugs. U.S. law requires that drugs be found effective and safe
in animal testing before they are tested on humans. This law fails to
reflect animal tests' poor predictive value: Ronald Hansen found that
only about 12% of drugs that passed Phase I animal tests and entered
human testing reached the market;(31) earlier, Samuel Irwin had found
that only 2.3% of drugs selected for clinical trial were eventually marketed.(32)
Most new drugs are similar to existing drugs, and so their clinical effect
can be at least partially predicted based on structural analogy. Also,
modern biochemical methods can help characterize specific drug-receptor
interactions, and these interactions can suggest specific drug effects.
Therefore, it is debatable whether animal tests help identify which drugs
are most suitable for human clinical trials (the critical step in determining human safety
and efficacy).
In addition to having failed to accurately predict drugs' efficacy and
toxic side-effects, animal tests have, no doubt, prompted researchers
to abandon numerous drugs and therapies that proved ineffective or toxic
in nonhuman animals but would have benefitted humans. It is impossible
to determine how many valuable therapies were discarded on the basis
of misleading animal studies.
Are animal models worthless, then? Although causal dissimilarities and
systemic differences undermine animal models, they are not necessarily useless.
For example, animal data need not accord perfectly with human data to
be relevant. For example an animal test that correctly identified carcinogens
90% of the time could help formulate reasonable public health guidelines.
However, as noted above, most animal tests do not accurately identify
subtle toxic effects. Therefore, animal toxicity data may be valuable
in theory, but in practice it is generally inconsistent and misleading.
Although most animal models are weak models, certain strong ones can
reliably predict gross toxicological effects. For example canaries were
once used to test for carbon monoxide in coal mines because canaries
are much more sensitive to this toxic gas than humans are. Although animal
models cannot reliably elucidate mechanisms of disease induction and
spread in humans, they have, in the past, afforded strong models for
research on the organisms themselves. To illustrate, rats infected with
the syphilis spirochete yield little insight into human syphilis infection.
Nevertheless, Erhlich discovered arsenobenzol as a treatment for syphilis
by infecting rats with the spirochete and then trying different compounds
for possible anti-syphilis effect. In Ehrlich's studies, rats served
primarily as reservoirs to harbor the organism, facilitating research
on the organism itself. Today, in vitro cultures have
replaced animals as mere reservoirs for almost all infectious agents.
Also, animal models may provide information about the species under
investigation, because there are generally few major differences in physiological
parameters among individuals of the same species. Most animal experimenters,
however, claim to address human health issues.
Many philosophers of science have distinguished between validating (or
disproving) hypotheses and formulating them. (33-35) An animal model
cannot be used to test a hypothesis about humans because differences
in causal factors between the animal model and the human condition render
the animal model invalid as a predictor. The only way to support or disprove
a hypothesis about human anatomy, physiology, or pathology is by studying
human beings. Animal-model conditions are analogues, and it is impossible
to validate or disprove any hypothesis by analogy. Therefore, logically animal
models cannot directly contribute to medical discovery. Medical historian
Brandon Reines maintains that animal models primarily "dramatize" hypotheses
about humans without actually validating or disproving them.
Although animal models cannot validate or disprove hypotheses, they
may function as heuristic devices that assist the process of
discovery.(5-7) That is, they may suggest different ways of conceptualizing
problems and thereby help generate new hypotheses. In this regard weak models
have potential value. An unexpected finding during animal experimentation
(including experimentation that was poorly conducted or that failed to
accomplish its original objectives) may lead to an insight.
Such insights, however, can also arise via other research approaches,
such as observing human patients, conducting epidemiological studies,
performing in vitro tests, or engaging in computer or mechanical
modeling. Once again, then, animal models do not appear to be necessary for
medical progress. In fact, medical historian Brandon Reines (36,37) and
physician Paul Beeson (38) consider the role of animal models as heuristic
aids very limited.
In a review of hepatitis research, Beeson writes: "progress in
the understanding and management of human disease must begin, and end,
with studies of man."(38) Although much hepatitis research has used
animals, Beeson has found that hypotheses about hepatitis have derived
from clinical observations, and that clinical studies have been necessary
to test their validity.(38)
Reines observes that nearly all hypotheses about human conditions derive
from human clinical research.(36,37,39) Animal experimenters, he contends,
perform the, superfluous and irrelevant function of experimenting with
different animal models until they find one that accords with the clinical
findings; typically they then claim that their model has "validated" the
clinically derived hypothesis. Often, Reines observes, animal modelers
highlight confirmatory animal data while discounting animal data that
contradict their findings.
Although Beeson doesn't share Reines' conclusion that animal experimenta-
tion is largely irrelevant to medical discovery, he agrees that most
insights derive from human studies. Beeson writes, "The initial
observations of manifestations and courses of human disease must be made
in human beings. The important contributions of epidemiology depend on
accurate clinical definitions. The occurrence of rare sequels or late
manifestations is beyond any feasible approach through experiments on
other species."(38) Beeson cites progress in understanding hepatitis,
appendicitis, rheumatic fever, typhoid fever, ulcerative colitis, and
hyperparathyroidism as representative of most medical progress in having
occurred almost exclusively through the study of humans.(38) Nevertheless,
like other researchers who have acknowledged the primary importance of
clinical investigation yet remain lodged in the animal-model paradigm,
Beeson continues to maintain the importance of animal experimentation.(40-45)
The history of polio research illustrates many of animal experimentation's
strengths and limitations. Proponents of animal research frequently claim
that animal experiments were crucial in controlling polio.(4,46) John
R. Paul's review of polio research indicates that animal experimentation
facilitated some insights but delayed others.(47)
In the 1800s, polio's clinical presentation and natural history were
deduced from bedside observation and postmortem studies of human victims.
Ivar Wickman's detailed epidemiological analyses of two Swedish epidemics
in the early 1900s revealed that mild or even subclinical cases contributed
to contagious spread of the disease. Most investigators, focusing on
polio's life-threatening paralysis, considered polio a central nervous
system disease. But Wickman found that polio affects the alimentary tract
(throat, stomach, and intestines) and suggested that the gastrointestinal
system may be the initial site of infection. (48,49)
By contradicting Wickman's observations, animal data delayed understanding
of polio's true pathogenesis and natural history. The first animal model
of polio was developed by Simon Flexner, who induced polio-like paralysis
in rhesus monkeys after placing infected human tissue into their noses.
Convinced that his animal model precisely paralleled the human disease,
he concluded that human polio was introduced to the brain via the nose
and confined to the central nervous system. For decades, most scientists
adhered to this erroneous theory, and this led to misguided therapeutic
measures.(47)
While animal studies remained the principal focus of polio research
in the United States, Swedish clinical investigators continued to make
important contributions. They tested for the presence of polio in tissues
of human polio victims and family members by inoculating monkeys with
test samples. If a test monkey contracted polio, the sample was determined
to be infected. The investigators found that polio carriers could have
polio virus present in their throats and intestines up to seven months
after exposure. (Here, monkeys were used as bioassays, in which
researchers sought a gross effect. Today, few animals are used as bioassays,
because more reliable non-animal bioassays exist.)
Meanwhile, Flexner and other animal researchers continued to study rhesus
monkeys infected with viruses obtained from other rhesus monkeys. This
process selected for more virulent polio strains that tended to infect
nervous tissue. Consequently, the animal model increasingly diverged
from human polio in pathogenesis and natural history. Systemic differences
between humans and rhesus monkeys undermined Flexner's animal model as
a causal model of human polio.
In the 1940s researchers found that polio infection in chimpanzees accords
more closely to the human disease. Like humans and unlike rhesus monkeys,
chimpanzees were found to harbor the polio virus in their alimentary,
tracts. Researchers were now more willing to accept the clinically derived
hypothesis that polio infects the human alimentary tract. But this response
merely demonstrates the research establishment's reluctance to accept
clinical findings in humans until parallel findings have been produced--however
artificially--in the laboratory in another species.
Animal models of polio were not very helpful as causal models, and they
significantly delayed development of an effective vaccine. After clinical
studies showed that polio virus infects gastrointestinal tissue, decades
of experimentation on rhesus monkeys suggested that the virus infects
only neural tissue. Vaccine researchers mistakenly believed that polio
would only grow in neural tissue, but vaccines derived from these cultures
were too dangerous. In 1948, John Enders, Thomas Weller, and Frederick
Robbins grew polio on human intestinal tissue, which led to a safe vaccine.
Albert Sabin, who developed the Sabin oral polio vaccine, has written, "the
work on prevention was long delayed by an erroneous conception of the
nature of the human disease based on misleading experimental models of
the disease in monkeys."(50)
Nevertheless, animal experiments may have served a heuristic function
by inspiring new ways of thinking about polio. For example, studies of
TO virus encephalitis in mice revealed that animals infected early in
life tend to have a more benign course: after initial exposure to TO
virus, mice become immune.(51) According to Paul, this may have helped
researchers derive a theory to explain the clinical observation that
major epidemics tended to occur in remote areas. Because sparse or isolated
populations did not permit an endemic state of polio infection, few children
were exposed earlier in life, when the disease tended to have a more
benign course. This insight did not require animal studies;
it could have been derived entirely from clinical investigations, including
population studies. The TO virus model illustrates the limited utility
of weak models.
Some strong models were also used in the fight against polio. Swedish
investigators used monkeys to test for the presence of polio virus in
tissue samples; later, researchers used the mouse neutralization test
for similar purposes. In addition, monkeys were used in immunological
studies that demonstrated multiple distinct viral strains. In these cases,
however, researchers merely assessed whether or not the animals became
infected under different conditions. Today the absence or presence of
a virus in human tissue can be more reliably determined using in
vitro methods.
In theory and practice, animal models generally fail to reliably predict
human responses to stimuli. While some strong animal models exist, most
are weak models of human responses to stimuli. Weak animal models may
serve as heuristic devices and help to inspire new ways of conceptualizing
clinically relevant issues, but they are not indispensable analogues
that are directly applicable to humans. As merely heuristic devices,
animal models are not necessary for progress in human medicine.
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