The dynamic interactions between cellular-molecular physiology and the environment - future directions in cellular-molecular evolutionary biology
A selection of talks on Clinical Practice
Trauma-informed care (TIC)
- Dr. Gina Touch Mercer
- University of Arizona College of Medicine - Phoenix, USA
The history and foundations of medical research ethics
- Prof. Dr. Christian Lenk
- Ulm University, Germany
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."
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.
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.
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.