orogenicman
Darwin was a pastafarian
- Jul 24, 2013
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What one reader (David Gorski) had to say about your last article:
Im going to have to disagree with you strongly here, Harriet. Until pretty recently, evolutionary thinking has never been an integral part of medicine, except in distorted forms like eugenics and nonsense like the paleo diet. In particular, I would take issue that doctors regularly think about evolution. Practicing doctors, in my experience, rarely, if ever, think about evolution with respect to medicine. Although evolutionary considerations have been (and continue to be) important in some areas of research, before the last few years, there were really only two areas in medicine where evolutionary thinking has played a significant role in actual clinical practice. Thats in infectious diseases (the evolution of antibiotic resistance in bacteria) and in medical oncology, where, as Ive discussed before, the evolution of different subclones in cancer is one of the major hurdlesif not the single most insurmountable hurdlein designing systemic cancer therapies. I note that the latter of these has only come to the fore in a big way over the last few years. So, while its true that evolution undergirds virtually every aspect of the genomics revolution, because evolutionary theory is the very basis we use to compare genes, identify mutations, and infer function, that thinking, sadly, has not filtered down to actual clinical practice very much yet, even now.
I also have to echo Emils comment. Nesses book is old. Its practically ancient. 18 years is an eternity in biomedical research. Back when that book was written, we did not know the sequence of the human genome because the Human Genome Project was in its infancy. Its final results were six years away. In 1994, it was not possible to do whole genome expression profiling, thus analyzing the expression of every gene in the genome simultaneously. Our most recent techniques, next generation sequencing sequencing techniques that allow us to sequence entire genomes and transcriptomes and identify every transcribed sequence, non-coding sequence, and chromosomal alteration were well over a decade away. The sophisticated computer algorithms and bioinformatics approaches that allow us to infer these evolutionary relationships from sequence and proteome data did not exist.
In other word, Nesses book, while prescient, was probably premature. Id be much more interested in a discussion of much more recent work. In fact, Id even argue that 2008 is a bit long in the tooth for this discussion, particularly when its a textbook were talking about given that most textbooks are a couple of years behind the times when they are published. Even four years ago, next generation sequencing techniques were only just starting to become available outside of huge genomics research institutes. These days, this is more what evolutionary medicine looks like:
Evolutionary medicine. Darwin applies to medical sch... [Science. 2009] - PubMed - NCBI
Evolutionary medicine and chronic inflammat... [J Mol Med (Berl). 2012] - PubMed - NCBI
Evolutionary biology within medicine: a perspective of growing value | BMJ
And heres a 2012 article by Nesse himself:
Evolutionary molecular medicine - Springer