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0:00
My name is John Torday.
I'm a professor of evolutionary
medicine at UCLA.
This lecture is titled,
"Future Directions
in Cellular-Molecular
Evolutionary Biology."
0:12
Given that the evolutionary
approach to medicine
is based on physiologic
first principles,
it can form the basis
for predictive
rather than
post-dictive medicine.
As such, it could be used
to intervene
before the individual
become symptomatic,
avoiding the morbidity
caused by failure to treat.
This approach
would make effective use
of genomic data
in a biologic context.
The current cost of healthcare
using the conventional
and descriptive approach
is approximately
$1.5 trillion per year
in the United States alone.
A predictive approach
would slash such costs
to a fraction of that amount.
0:47
Using conventional descriptive
medicine as the basis
for drug design does not address
the cause of the disease,
merely making
the symptoms go away.
A fundamental understanding
of the cause of disease
offers the opportunity
to prevent
or treat it safely
and effectively
without any side effects.
Using phylogeny
and ontogeny to determine
the etiology of disease
offers novel opportunity
to prevent
and treat complex diseases,
unattainable by the conventional
top-down approach.
1:16
I have mentioned
on several occasions
that the lung and kidney share
common homeostatic mechanisms.
This knowledge could be used
to treat heart attack patients
in the intensive care unit
whose lungs and kidneys
are out of allostatic control,
using a PPAR gamma agonist
acutely to reestablish
such balance
rather than measuring urinary
and electrolyte output
to determine homeostasis
and subsequent treatment.
And the observations regarding
the evolution of endothermy
could be utilized
to monitor patients
put under controlled
hypothermy
based on
their neuroendocrine balance.
In addition
to the conventional vital signs,
biomarkers for evolutionary
homeostasis and allostasis
could be used to determine
if equipoise
could be re-established
by reversing the loss of evolved
homeostatic set points.
Moreover,
monitoring the patient's
response to therapy
as an exercise in evolution
rather than pathology
would be more holistic.
