Evolutionary medicine – the quest for a better understanding of health, disease and prevention

Abstract

Clinical medicine has neglected the fact that the make-up of organs and body functions, as well as the human-specific repertoire of behaviors and defenses against pathogens or other potential dangers are the product of adaptation by natural and sexual selection. Even more, for many clinicians it does not seem straightforward to accept a role of evolution in the understanding of disease, let alone, treatment and prevention.Accordingly, this Editorial seeks to set the stage for an article collection that aims at dealing precisely with the question of why evolutionary aspects of health and disease are not only interesting, but necessary to improve clinical medicine.

Evolution of the human pelvis and obstructed labor: new explanations of an old obstetrical dilemma

“…ajog.org prolonged labor, etc) can facilitate research on medical disorders, including the development of models for their prediction and strategies for prevention. [96][97][98][99] For example, the idea that distinct pelvic disorders can result from a pelvis that is either too broad for some functions or too narrow for others can refine research questions and help to predict and interpret research outcomes. Contingency on pelvic architecture may also explain some of the variation associated with mutations affecting connective tissue and associated PFDs.…”

Causes and consequences of coagulation activation in sepsis: an evolutionary medicine perspective

“…In addition, although we do not argue against the presence of some degree of systemic hypercoagulability in sepsis, a concept supported by the recent demonstration of sepsis as an independent predictor of venous and arterial thrombosis [ 39 , 40 ], the presence of this phenomenon in the early stages of sepsis has been challenged by data generated using global hemostasis tests, which pointed to a consistent down-regulation of thrombin generation in the early stages of sepsis [ 41 , 42 ]. In this context, a reappraisal of old and new data using an evolutionary medicine framework [ 43 ] can refine our understanding about the ultimate and proximate causes of hemostasis activation during sepsis.…”

Using Evolutionary Theory to Guide Mental Health Research

“…Most researchers and clinicians accept that natural selection has played some role in shaping ''normal'' behaviour, but they are not trained to study abnormal behaviour from an evolutionary perspective. 12 This article briefly summarizes evolutionary accounts of psychiatric disorders as they are currently defined. Examples are typically theoretical and remain to be rigorously tested.…”

“…A common misconception is that natural selection leads to perfectly designed traits. 12 In fact, natural selection responds to trade-offs to find the best compromise for the propagation of genetic material. Selection for one trait can maintain risk for disorder as a by-product.…”