Book Review

Karin Hollricher

Stephen Stearns and Jacob Koella (eds.):
Evolution in Health and Disease.

Paperback: 368 pages
Publisher: Oxford University Press, USA; 2 edition (January 10, 2008)
Language: English
ISBN-10: 0199207461
ISBN-13: 978-0199207466
Price: 65.00 EUR

Medicine Needs Evolution

A new book about the influence of evolutionary ideas on medical problems emerges as a veritable treasure trove, according to our Lab Times reviewer.

Imagine that Charles Darwin, Alexander Fleming, Louis Pasteur and George Williams met at a round table. What would emerge from the discussion of those masterminds? Would they come up with answers to notorious medical ‘why?’ questions? Why do (or don’t) we get sick. Why does vaccination (not) work. Which aspects of modern life are pathogenic? And would – at last – evolutionary thought be introduced into the education of medical doctors, as some doctors and evolutionary biologists have advocated for at least ten years?

Why add new courses to the already overfilled curriculum of medical doctors? “Evolutionary thinking provides insight and saves lives when one is prescribing antibiotics, managing virulent diseases, administering vaccinations, advising couples who have difficulty conceiving and carrying offspring to term, treating the diabetes and high blood pressure of pregnancy, treating cancer, understanding the origins of the current epidemics of obesity, diabetes and autoimmune diseases, and answering patients’ questions about aging,” argue Stephen Stearns et al. in the first chapter of Evolution in Health and Disease. Lots of arguments. Are they convincing though? Find out for yourself; its worth it.

Evolutionary ideas were introduced into the medical world in the early 90s when Randolph Nesse and George Williams published their lucidly written book Why we get Sick. The physician and the evolutionary biologist teamed up to elaborate on the evolutionary backgrounds of health and disease.

Darwinian medicine on the rise

Since then, Darwinian medicine has been coming along nicely as a comparison of the two books, written in 1994 and 2007 respectively, reveals. The evolution of genomic research offered formerly undreamt-of-possibilities. The analysis of DNA sequences allows glimpses into the history of human populations and the involvement of humans’ genetic variation in health and disease. Sequencing whole pathogens’ genomes indicated their history and enabled the design of new hypotheses about the selective pressures that have shaped and continue to shape the pathogens’ genomes.

The book is a veritable treasure trove. Care for an example? Read about how Bordetella pertussis, the cause of whooping cough, changed its niche from many hosts to humans alone purely through gene loss and how it has recently increased in virulence by loss of regulation of virulence factors. Or how vaccination works, though evolution allows pathogens to develop new antigens that could outmaneuver the immune systems’ memory. New perspectives on the evolution of virulence are discussed as well as how biological processes contribute to the emergence of cancer.

The book was written by 47 scientists and some issues are picked up on repeatedly, for example in the part about pathogens. Here, the editors could have exercised more care. The book is written in an extremely clear, mostly nontechnical style, ranging from basic evolutionary principles and genetic variation all the way to the evolutionary context of human aging and degenerative disease.

Of course, evolutionary biology is not going to provide easy answers to medical problems; nor does it provide a simple guide for intervention. And whether doctors and researchers who learned a substantial amount about evolution would be more effective than a control group is an open question. But introducing evolutionary ideas into medicine and medical issues into evolutionary biology will benefit both disciplines. Ecogenetics and pharmacogenetics reveal spectacularly how, together, evolution and medicine could cultivate new perspectives.

Letzte Änderungen: 19.07.2013