Series: Evolution and Medicine

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Fundamentals of Evolution and Medicine

1. Evolution: Medicine's Missing Basic Science (59 mins)

Prof. Randolph Nesse – University of Michigan, USA

TOPICS COVERED IN THIS TALK

How evolution is useful to medicine
Why doctors don't know evolution
The body: perfect and pathetically flawed
Proximate and evolutionary explanations
Explain vulnerability, not diseases
Six reasons for vulnerability
Darwinian medicine growing fast

2. Evolution and Medicine: From the Perspective of an Evolutionary Biologist (38 mins)

Prof. Stephen Stearns – Yale University, USA

TOPICS COVERED IN THIS TALK

How we are mismatched to modernity
Birth control and cancer risk
Impact of early-life events on late-life obesity and diabetes
Hygiene and autoimmune disease
Evolutionary conflicts that produce reproductive problems
Evolutionary technologies used in medicine
The evolutionary principles and mechanisms underpinning these examples

3. Developmental Plasticity, Evolution and the Origins of Disease (31 mins)

Dr. Mary Jane West-Eberhard – Smithsonian Tropical Research Institute, Costa Rica

TOPICS COVERED IN THIS TALK

Developmental plasticity
Genes and environment in development
Adaptive developmental decisions and their betrayal if conditions change
Phenotypic accommodation
Multiple pathways
Myth of single gene control
Blueprints and programs as false metaphors
Cross-generational continuity of the phenotype
Origins of novel phenotypes including disease

Evolutionary Genetics

4. Genetic Variation and Human Disease (47 mins)

Dr. David Houle – Florida State University, USA

TOPICS COVERED IN THIS TALK

Proximal vs. ultimate causation
Causes of death in modern societies
Quantifying genetic causation
Relative risks of common diseases
Fitness
Why do genetic diseases exist?

Selection can maintain disease
Mutation-selection balance
Evolutionary lag
Gene flow and genotypeenvironment interactions
Co-evolutionary arms races
Why evolution matters

5. Evolutionary Genetic Epidemiology (52 mins)

Prof. Nicholas Schork – Scripps Genomic Institute of Medicine of La Jolla, USA

TOPICS COVERED IN THIS TALK

What is 'evolutionary genetics'?
Evolution, genetic variation and association analyses
Withinspecies diversity and population genetics
Human genetic diversity and phenotypic variation
Human community 'metagenomics'

6. Evolutionary Genetics: The Detection of Natural Selection Using Molecular Data (65 mins)

Dr. Mark Thomas – University College London, UK

TOPICS COVERED IN THIS TALK

Mutation and variation in populations
The fate of mutations under random genetic drift and natural selection
Measures of variation
Detecting signatures of natural selection in genomic data

7. Ecogenetics, Evolutionary Biology and Human Disease (46 mins)

Prof. Gilbert Omenn – University of Michigan, USA

TOPICS COVERED IN THIS TALK

Ecogenetics of nutrition and cultural sensitivity
Is lactose intolerance/lactase persistence a disease or an evolutionary normal variant?
Assessment, management and communication of health risks and genetic susceptibility to environmental chemicals

8. Race in Genetics and Medicine (24 mins)

Prof. Jeffrey Long – University of Michigan, USA

TOPICS COVERED IN THIS TALK

Questions about race
Fundamentals of DNA and the genome
Human genome sequence
DNA sequence variation
Three essential features of human genome diversity
Expected nucleotide diversity
STR analysis

Relationships among human populations
Major long-range human migrations
Definition of race
Allocation of individuals to genetic clusters
Principal pathway of ethanol metabolism
Allele frequencies at ALDH2 locus
European ancestry and diabetes risk

9. Health Disparities in Common Complex Diseases: A Role for Genetics? (46 mins)

Dr. Kathleen Barnes – Johns Hopkins University, USA

TOPICS COVERED IN THIS TALK

Genetic epidemiology of common, complex and chronic diseases
Evidence of a role for a genetic basis of health disparities
Genetic studies on asthma and allergic disease and ethnicity
Geneenvironment interactions
Biogeography and the hygiene hypothesis
Innate vs. adaptive immunity and the common variant/multiple disease hypothesis
Antagonistic pleiotropy

Infectious Disease

10. Bacteria and Virus Evolution: A Model for the Study of Natural Selection (44 mins)

Dr. Paul Turner – Yale University, USA

TOPICS COVERED IN THIS TALK

Experimental evolution
Classic experiments using bacteria and viruses
Evolution of antibiotic resistance in bacteria
Evolution of higher and lower virulence in pathogens
Evolution of pathogen emergence

11. Evolutionary Arms Races (39 mins)

Prof. Mark Pagel – University of Reading, UK

TOPICS COVERED IN THIS TALK

Arms races and evolutionary arms races
What are they and how are they defined
Features of arms races
Who wins?: the Red Queen and the life-dinner principle
Common arms races in nature
Predators and prey, sexual selection, parent offspring conflict and host-parasite coevolution
HIV evolution, parent-infant resemblance in humans and genomic imprinting

12. Antibiotic Resistance and Hospital-Acquired Infection (43 mins)

Dr. Carl Bergstrom – University of Washington, USA

TOPICS COVERED IN THIS TALK

Rates and consequences of hospital acquired infection
History of antibiotic resistance
The process of natural selection
Mutation as a source of resistance
Lateral gene transfer

The bacterial ecology of a hospital
Resistance in the community
Agricultural use of antibiotics
Modeling resistance in a hospital
Antibiotic cycling

13. Evolution of Virulence: Malaria, a Case Study (34 mins)

Prof. Andrew Read – Edinburgh University, UK

TOPICS COVERED IN THIS TALK

Why are infectious agents virulent?
Evolutionary and mechanistic explanations
Natural selection on malaria virulence
Why are malaria parasites so virulent?
Why not more virulent?
Possible selective effects of public health interventions
Other infectious diseases
Why evolutionary explanation matters

14. Infection and Chronic Disease (38 mins)

Prof. Paul Ewald – University of Louisville, USA

TOPICS COVERED IN THIS TALK

Chronic diseases (cystic fibrosis, atherosclerosis, tuberculosis)
Risk factors
Primary and secondary causes
Categories of disease causation
Risk factors and disease causation

The e4 allele and the thrifty genotype hypothesis
Geographical variations in allele frequencies
Pathogen vulnerability hypothesis
Environmental causations (smoking, high fat diet, alcohol, garlic, iron)
Drug treatment and atherosclerosis

Defenses

15. Fever and Related Defenses (36 mins)

Prof. Matthew Kluger – George Mason University, USA

TOPICS COVERED IN THIS TALK

Evolutionary history of fever
Role of fever in disease
Role of related host defenses in disease
Concept of Darwinian Medicine

16. The Evolutionary Ecology of Immunity (45 mins)

Prof. Paul Schmid-Hempel – ETH Zurich, Switzerland

TOPICS COVERED IN THIS TALK

Why immune defense matters
Asking for evolutionary reasons and constraints
Using immune defenses is very costly for the individual
The nature of the costs
Differences among the sexes
Specific defenses and their impact
What would be the best defense
Parasites are interfering
The consequences for medicine

17. Mapping Motivations: Evolutionary Health Promotion (26 mins)

Dr. Valerie Curtis – London School of Hygiene and Tropical Medicine, UK
Dr. Robert Aunger – London School of Hygiene and Tropical Medicine, UK

TOPICS COVERED IN THIS TALK

Most of today's health problems can be prevented by changes in behavior
How understanding behavior, and behavioral motivation in particular, from an evolutionary perspective can provide new avenues for health promotion
Example of how an evolutionary insight into the disgust motivation led to an effective handwashing campaign in Ghana

Novel Environmental Factors

18. What did humans evolve to eat? evolutionary perspectives on human nutritional health (39 mins)

Prof. William R. Leonard – Northwestern University, USA

TOPICS COVERED IN THIS TALK

Relevance of Evolutionary Perspective for the Study of Nutrition
Evolution of key human differences with the emergence & early evolution of Homo at ~2.0 mya
Dietary regimes in traditional human societies
Human Activity Patterns in Comparative Perspective
Conclusions

19. The Original Human Diet: What was it and should it be a Model for Contemporary Nutrition? (45 mins)

Prof. S. Boyd Eaton – Emory University, USA

TOPICS COVERED IN THIS TALK

Human evolution
Contemporary genetic-lifestyle discordance
Ancestral nutrition as a model for the present
Current American nutrition
Successes (life expectancy) and failures ('afflictions of affluence')
The paradigm concept

20. The Paleolithic Lifestyle and Prevention of Chronic Disease (42 mins)

Prof. S. Boyd Eaton – Emory University, USA

TOPICS COVERED IN THIS TALK

Stone Age genes and Space Age lives
Chronic degenerative diseases
Case illustrations: from dental caries to diabetes
Paleolithic health promotion: deviation from the basics of ancestral life increases disease risk whilst reversion reduces it

21. Early Nutrition, Development and Health: Evolutionary Perspectives on the Metabolic Syndrome (49 mins)

Dr. Christopher Kuzawa – Northwestern University, USA

TOPICS COVERED IN THIS TALK

The Developmental Origins of Health and Disease
The thrifty genotype hypothesis
Metabolic scaling in mammals
Energy partitioning in humans
The developmental bottleneck of weaning
Baby fat as a brain buffer
How fat and insulin resistance protect the brain
Why prenatal undernutrition induces the metabolic syndrome
Implications for adaptation and global disease change

22. The Hygiene Hypothesis (42 mins)

Prof. Graham Rook – University College London, UK

TOPICS COVERED IN THIS TALK

Definition of the hygiene hypothesis
Gene-environment interactions
Protection from allergic disorders by the farming environment
Changing incidences of allergic disorders, autoimmunity and inflammatory bowel disease
Deficient regulatory T cell activity in chronic inflammatory disorders
Environmental microorganisms, immunoregulation and mammalian evolution

Changing microbial exposure in developed countries
Regulatory T lymphocytes and regulation of inflammation
Animal models
Cellular mechanisms
Clinical trials

23. Diseases of Civilization: An Evolutionary Legacy (31 mins)

Prof. Alan Weder – University of Michigan, USA

TOPICS COVERED IN THIS TALK

There is a mismatch between what we were originally selected for and our modern environment
The 'diseases of civilization' result from this mismatch
Hypertension is a prototypic disease of civilization
Many factors mediate the interaction between genes and the environment to promote hypertension

Problems Arising From Constraints and Trade-Offs

24. Aging and Evolutionary Medicine (51 mins)

Prof. Linda Partridge – University College London, UK

TOPICS COVERED IN THIS TALK

Declined mortality in industrialized societies
Maximum human longevity
Werner's syndrome
Common age-related pathologies
The force of natural selection declines with age
Mutationaccumulation theory
The pleiotropy or trade-off theory

Evolutionary theories of aging
Aging in different organisms
Testing the theories
Interventions that slow aging in diverse organisms
Insulin/IGF-like signaling
Genetic effects on lifespan
Extension of lifespan by dietary restriction

25. Human aging and menopause (46 mins)

Prof. Kristen Hawkes – University of Utah, USA

TOPICS COVERED IN THIS TALK

Aging (senescence) our evolved life history
Global maximum life expectancy
Women living past fertility in different populations
Effects of longevity
Depending on mothers & grandmothers

Comparing humans and chimpanzees
Age-specific fertility rates
Female fertility in mammals
Germ cells by age
Parity decline

26. Why we Cook with Spices: Preventative Darwinian Medicine (32 mins)

Prof. Paul Sherman – Cornell University, USA

TOPICS COVERED IN THIS TALK

Evolution of chemicals that give spices their unique flavors
All spices have antimicrobial properties
Use of spices in human cultures
Foodborne illnesses
In every country and culture, people learn to enjoy the tastes of the spices that are most effective because of their beneficial (antimicrobial) effects on food safety and thus health

Sex and Reproduction

27. Evolutionary Obstetrics (44 mins)

Prof. Wenda Trevathan – New Mexico State University, USA

TOPICS COVERED IN THIS TALK

Human evolutionary history
Human evolution and childbirth
Birth in other primates
How anatomical changes for bipedalism impact birth
Birth in early human ancestors
The helpless human newborn
The evolutionary legacy of birth
Why women benefit from assistance at birth
Value of emotional support during labor and delivery

28. Sex Differences in Mortality (41 mins)

Dr. Daniel Kruger – University of Michigan, USA

TOPICS COVERED IN THIS TALK

Senescence
Reproductive strategies and mortality
Contemporary and historical sex differences in mortality rates
Male competition and sex differences in mortality rates within a society, across societies and across time in societies undergoing socio-economic changes

29. The Endocrinology of Human Life History Transitions (46 mins)

Prof. Peter Ellison – Harvard University, USA

TOPICS COVERED IN THIS TALK

The energy allocation model of life history evolution
Quantitative variation in energy allocation to reproduction
Endocrine control of qualitative, state transitions in human life history
Three example transitions: postpartum resumption of ovarian function, puberty, birth

30. Genetic Conflicts in Human Pregnancy (43 mins)

Prof. David Haig – Harvard University, USA

TOPICS COVERED IN THIS TALK

The association of maternal provisioning of a fetus and opportunity cost
The relationship between maternal investment in fetus to the benefit to the fetus and the cost to its siblings
The maternal-fetus unit: genes and their direct benefit to the fetus and indirect cost to its siblings
Syndromes associated with the imprinted cluster of genes of human chromosome 11p15.5: Beckwith- Wiedemann syndrome and Silver-Russell syndrome
3 potential areas for conflict during pregnancy: whether to carry/miscarry the embryo, nutrient quality of maternal blood and the volume of blood reaching the placenta
Placental hormones and fetal attempts to manipulate maternal physiology for fetal benefit
Maternal carbohydrate metabolism: glucose and insulin levels in the maternal blood, and maternal insulin sensitivity
The maternal-fetus blood circulation during pregnancy and the systemic blood supply shared between them

31. Environmental Effects on Human Reproduction (47 mins)

Prof. Gillian Bentley – University of Durham, UK

TOPICS COVERED IN THIS TALK

Environmental effects on human reproduction
Measuring reproductive ability
Hormonal variation and ovarian function in different populations
Effect of nutrition on reproductive function
Effect of energetics on reproductive function
Effect of genetics on reproductive function
Developmental effects on reproductive function
Immunological effects on reproductive function
Hormones and health implications

Cancer

32. A Darwinian Eye View of Cancer (54 mins)

Prof. Mel Greaves – Institute of Cancer Research, UK

TOPICS COVERED IN THIS TALK

The prevalence of cancer: man vs. animals
The proximal causes of cancer: mutations and genotoxic exposures
Limitations of evolutionary adaptation by natural selection
Vulnerability to cancer from an evolutionary perspective
Lack of perfection in evolutionary 'engineering': faults/trade-offs
Evolutionary adaptation 'has no eyes to the future': mismatches between genetics and lifestyle
Natural selection will happen: evolution of robust cancer clones
The only fitness test of 'natural selectability' in evolution is survival and reproductive success: cancer risk escalation in old age

33. Viruses and Cancer (56 mins)

Prof. Robin Weiss – University College London, UK

TOPICS COVERED IN THIS TALK

Oncogenic viruses of animals and humans have given us insights into cancer in general
Specific genes involved in cancer such as oncogenes and tumor suppressor genes were first discovered through research on tumor viruses
Only a subset of viruses cause cancer
For cancers caused by viruses, the viruses are a necessary but insufficient cause of the disease
Cancer is multifactorial and different risk factors act together
Vaccines hold great promise to reduce the cancer burden
The incidence is higher in immunodeficient people
Transplant recipients and AIDS

Specific Body Systems

34. Hard Tissue Biology in Human Health and Evolution (50 mins)

Prof. Timothy Bromage – New York University, USA

TOPICS COVERED IN THIS TALK

Dental development
Enamel structure and anti-crack propagating characteristics
Global climate change and human tooth evolution
Dental and facial health issues
Bone structure and mechanical factors with aging
Bone health issues
Bone health in space

35. Lung Biology and Lung Disease (53 mins)

Prof. John Torday – Harbor-UCLA Medical Center, USA

TOPICS COVERED IN THIS TALK

The evolution of the vertebrate lung
Vertebrate evolution from unicellular organisms is reflected in lung development
Stretch-regulated pathways of lung development leading to homeostasis can fail, leading to chronic lung disease
The cell/molecular pathways that integrate lung development and homeostasis can serve to effectively diagnose and treat chronic lung disease

36. Evolutionary Considerations and the Endothelium (32 mins)

Dr. William Aird – Harvard Medical School, USA

TOPICS COVERED IN THIS TALK

The endothelial organ
Proximate mechanisms of endothelial cell heterogeneity
Evolutionary mechanisms of endothelial cell heterogeneity
Hagfish as a model for early endothelium

Mental Disorders

37. Mental Disorders in the Light of Evolutionary Biology (65 mins)

Prof. Randolph Nesse – University of Michigan, USA

TOPICS COVERED IN THIS TALK

Psychiatry is just now recognizing the need for evolutionary explanations
Same six origins of vulnerability as the rest of medicine
Emotional disorders are dysregulated defenses
Research and treatment implications
Towards a fully biological foundation for psychiatry

38. Evolutionary Behavioural Genetics and Mental Disorders (48 mins)

Dr. Matthew Keller – University of Colorado, Boulder, USA

TOPICS COVERED IN THIS TALK

Ways of assessing heritability in humans: twin and adoption designs
The evolutionary paradox of common, heritable mental disorders
Possible resolutions to the paradox: balancing selection, neutral mutation and polygenic mutation-selection balance

39. Evolutionary Biology of Depression (16 mins)

Prof. Lewis Wolpert – University College London, UK

TOPICS COVERED IN THIS TALK

Depression has a genetic component and can be triggered by stress
It is a common mental illness
Why has it not been selected out?
Sadness is adaptive but depression is probably not
Depression can be thought of as sadness becoming excessive and malignant

Questions and Answers

40. Audience Questions about Evolution and Medicine (57 mins)

Prof. Randolph Nesse – University of Michigan, USA

TOPICS COVERED IN THIS TALK

Certain questions always come up
They reveal deep interest in the evolutionary medicine and substantial ignorance about evolution
Answering them fills some gaps in the rest of the lecture series
The future of Darwinian Medicine

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Editor(s)

Prof. Randolph Nesse

EDITOR BIOGRAPHY

Prof. Randolph Nesse – University of Michigan, USA

Randolph M. Nesse, MD, is Professor of Psychiatry and Professor of Psychology at the University of Michigan, where he directs the Evolution and Human Adaptation Program. He collaborated with George Williams to write several seminal works on Darwinian Medicine, including Why We Get Sick: The New Science of Darwinian Medicine. His early research on the neuroendocrinology of anxiety has been transformed into a focus on how selection shapes mechanisms that regulate defenses such as pain, fever, anxiety and low mood. He is devoted to the mission of helping to organize the growing Evolution and Medicine community via writing, speaking and EvolutionAndMedicine.org.

Publication Date / Last Updated

October, 2007 / March, 2011

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Is there a role for academia in drug discovery

Dr. Adrian J. Ivinson

TOPICS COVERED IN THIS TALK

Increasing numbers of neurological disorders correlates with the growing numbers of elderly
Paucity of drugs that treat these neurological disorders
Reasons for this failure
Need to reassess the traditional division of labor between the for-profit sector and the not-for-profit academic sector
Transfer of the discovery phase to academia?
Other aspects of the heretofore-failed neuro drug discovery pipeline e.g. large-scale genetic studies aimed at unearthing new targets
The need to redefine the precompetitive space
The need to build new collaborations between companies, and between the commercial and academic sectors

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Series: Evolution and Medicine

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