The complexity of cellular biochemistry is why the most effective near-term approaches to medical biotechnology involve sidestepping the need to learn very much

The complexity of cellular biochemistry is why the most effective near-term approaches to medical biotechnology involve sidestepping the need to learn very much more about how it all works in detail. They are engineering rather than scientific efforts. This is most apparent in aging research, though the principle applies to most medicine. The idea is to identify the root cause differences between normal and diseased metabolism, a task that is a lot easier than figuring our how exactly those root causes propagate and expand into the disease state over time. Root causes are those that have no other cause beyond the normal operation of cells. You then intervene to revert the root cause differences and see what that does to metrics of disease state and progression. The goal is to return metabolism to its normal state, a state that we don't fully understand, but that we know works. A practical example is the presence of senescent cells. They cause problems, they are not present in large numbers in young, healthy people, so remove them. Removing them sidesteps the whole involved process of trying to understand exactly how they cause problems, in detail, at the level of cellular mechanisms. Researchers are working on that goal of full knowledge, but it will be years until that slowly starts to produce useful therapeutic options, and there are probably decades yet in any research program or combination of research programs that seeks to alter the behavior of senescent cells to make them less harmful. Meanwhile, removing senescent cells works reliably to improve health and turn back disease, and you don't need to know why that happens in order to obtain the benefits, beyond the high-level sketch of "less harmful signaling". Unfortunately most medical research takes an entirely different approach, which is to start with analysis of the disease state (complex, expensive, slow) and then work back through proximate causes of disarray. At each point at which a therapy might be attempted, try to adjust the proximate cause. Since this doesn't touch on root causes, it is usually marginal, and even the successes just postpone the inevitable.