Perhaps surprisingly, FitzGerald doesn't think Vioxx, which was reported to be linked to thousands of heart attacks and deaths, should have been pulled. He would prefer a scientific investigation to separate the risks from the benefits. He's working in a consortium of dozens of groups investigating who are the people for whom particular anti-inflammatory drugs are most likely to work, and for whom they are most likely to cause a problem.
This 10-year research effort is chasing the dream of personalized medicine -- the idea that a person's individual genetic makeup can reveal which specific medical treatments are best for him or her.
Because pain isn't a disease, understanding how different pain medications work differently in different people is a big challenge -- but it's what FitzGerald would like to see happen in the next decade.
"I think it would not only provide incredible benefit to how we treat pain and inflammation, but I think it would also potentially be a sort of paradigm that we could then extrapolate to other large classes of drugs that are used to treat these syndromes or disease," he said.
"And if we had done it once, we could do it much faster than over a decade for the next class of drugs."
The cell clock tango
FitzGerald's other major research interest is called molecular clockworks. This is a fairly new science that can be applied to many areas of physiology, based on the idea that the body has within it 24-hour clocks, regulated by genes that operate in these daily cycles.
There's a master clock in the brain, and FitzGerald and colleagues identified a possible signal from the brain to instruct clocks in the vascular system. They have also investigated the role of various genes that are relevant to the clock in determining the oscillation of blood pressure.
The heart clock can send messages to the brain clock, too. It's like an orchestra, says FitzGerald, in which musicians not only follow the conductor, but can also function independently, and -- according to his unpublished research -- even influence each other.
An exciting area of exploration is how these clock networks interact across different tissues, he said. Could the clocks be manipulated so as, for example, to slow down the progress of Alzheimer's while not messing up metabolism?
"I think it's the beginning of an era as far as this field is concerned," he said.