Evolution: Medicine's Missing Basic Science Prof. Randolph ...

"Evolution: Medicine's Missing Basic Science" Prof. Randolph M. Nesse

"Evolution: Medicine's Missing Basic Science"

Randolph M. Nesse, M.D. The University of Michigan

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Medicine Uses Some Evolution

? Anti bi oti c resi stance ? Evoluti onary geneti cs ? Human phylogeny

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The screen versions of these slides have full details of copyright and acknowledgements

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"Evolution: Medicine's Missing Basic Science" Prof. Randolph M. Nesse

But Much Is Missing

? Co-evoluti on and arms races ? Subtle evoluti onary geneti cs ? Evoluti on and behavi or ? Evoluti onary epi demi ology ? Aski ng w hy natural selecti on has left the body

so vulnerable

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Some General Principles?

? Imperfections cannot be eliminated because natural selection is too weak and random

? Selection shapes traits to benefit the species ? Pathogens evolve to co-exist with hosts

They are all false ? Natural selection shapes health and longevity

? Genetic disease results from mutations that natural selection can't eliminate

? Aging results because body parts wear out ? Natural selection cannot influence anything

after reproduction ends

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General Principles Corrected

? Imperfections are present for 6 reasons ? Natural selection shapes traits for genes ? Pathogens evolve to maximize replication ? Natural selection shapes the body

to maximize reproductive success ? Common genetic disease results mainly

from quirks interactin g with novel environments ? Aging results because of pleiotropy ? Natural selection continues after reproduction

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The screen versions of these slides have full details of copyright and acknowledgements

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"Evolution: Medicine's Missing Basic Science" Prof. Randolph M. Nesse

Percent of schools that include t opic in medical curriculum (n = 55) Nesse & Schiffman, 2 000

100% 90% 80% 70% 60% 50% 40% 30% 20% 10%

0% A ntib iot icVreirsuilsentacnPeceoepvuollaSutietooil.nnfogredneisteicassMeugteantieoLsnevseelHlso. sobatf-lp.saeMtelhciostmi.oaanrtmchsoraf cbeosdDye-seiCngovnimr.tpraadraet-iovfefDseafennatsoemr eygLuilfaetihoisntPoar tyhtrdaietspHeunmdeanncep hPylrooKxgiienmnasyteeleulcttiimonate dis...

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Evolutionary Biology Faculty in Medical Schools

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Std. Dev = 1.76

Mean = 1

0

N = 33.00

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Gertrude Stein on Her Deathbed

" The answ er, the answ er, w hat i s the answ er? The answ er, the answ er, w hat i s the answ er?... No, no that' s not i t What is the question?"

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The screen versions of these slides have full details of copyright and acknowledgements

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"Evolution: Medicine's Missing Basic Science" Prof. Randolph M. Nesse

Why Has Natural Selection Left the Body So Vulnerable?

Parts of the body are exquisite

Others are botched

WHY?

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The Old Answer: Natural Selection Is Just Too

Weak to Make the Bodily Machine Better

Flaws are inevitable because natural selection is a random process of limited power

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The New Answer

There are six reasons w hy natural selecti on leaves the body vulnerable to di sease

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The screen versions of these slides have full details of copyright and acknowledgements

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"Evolution: Medicine's Missing Basic Science" Prof. Randolph M. Nesse

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Disease and Evolution

Di sease i s not shaped by selecti on But vulnerabi li ty to di sease i s

Natural selection can help explain maladaptation as well as adaptation

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The screen versions of these slides have full details of copyright and acknowledgements

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