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0:00
Hello, this is Steve Stearns.
I was a professor of
ecology and evolutionary
biology at Yale.
I am now retired.
Welcome to this talk on
evolutionary medicine.
0:13
I'd like to begin by discussing
what evolution contributes
to medical science.
I think its most
important contribution
is its integration of
insights across levels.
Having a framework like that
makes it easier
for physicians to
remember and integrate
the vast amount
of information that
they have to learn.
Evolutionary insights also
stimulate new questions
for research and suggest new
therapies in the clinic.
We'll be following up on both of
those points during this talk.
0:44
The issues that evolutionary
insights impact
include those listed
here on the slide.
I would like to make a few
remarks about some of them.
Mismatch means we're better
adapted to past environments
than to the new conditions
that were created
by civilization.
These new conditions impose
ongoing natural selection.
Insight into aging
is basically that
the vulnerabilities in
the design of our bodies
that lead to aging are there
because there are
trade-offs between
reproduction and
survival early in
life and survival later in life.
Aging itself is
not an adaptation.
Insight into pathogen
evolution is,
I suppose, the fact that
we're very lucky
to be here at all
because we are locked in
a co-evolutionary arms
race with our pathogens.
They have the advantages
of short generation times,
huge populations, and
higher mutation rates.
We'll be looking at
the COVID pandemic as
a dramatic case study in
rapid pathogen
evolution in real-time.
Our microbiota had been with
us since the origin of life, and
its many roles are being
increasingly appreciated,
but we're not going to
be discussing them in
this talk, that would
take too much time.
There are a number of interesting
insights into cancer.
Every individual cancer is
a novel evolutionary process and
our vulnerability
to cancer is built
into ancient features of
our organismal design.
Cancer appears to be inevitable.
Insight into reproductive
medicine stems from the fact
that reproduction is so central
to evolutionary success.
We will be exploring
the connections between
mammalian reproduction
and cancer
metastatis later in this talk.
In terms of applications,
evolutionary
medicine has already
produced insights that are
shaping both clinical practice
and public health policies.
We're going to look
at one of them in
some detail - phage therapy.