Gluckman, Darwin and Medicine

By Fabiana Kubke 18/09/2009

When I started teaching a few years ago, a colleague of mine suggested I should steer away from mentioning evolution in my lectures. So it was with great delight to see that the Liggin’s Institute had organized a series of lectures on Darwin’s Legacy to celebrate the 200th anniversary of Darwin’s birth and the 150th anniversary of the publication of the ’On the Origin of Species’. Last night, Professor Sir Peter Gluckman gave a lecture on ’Darwin and Medicine’.

Professor Sir Peter Gluckman began his talk by answering the question: What is Evolution? He described how evolution was removed from the medical curriculum towards the end of the 19th century, when it was thought to have no relevance or practical value to justify taking time away from an increasingly crowded content within the medical curriculum. Although the basic concepts of evolution remain mainly absent from medical education, it is becoming increasingly clear that they can inform many aspects of medicine. This year, the Howard Hughes Medical Institute (HHMI) and the Association of American Medical Colleges included the understanding of evolution as a fundamental aspect of medical education (see report). Another meeting on Evolution in Health and Medicine which was held on April this year and sponsored by the National Academy of Sciences and the Institute of Medicine also supported the inclusion of evolutionary concepts in the medical curriculum (E Pennisi, Evolutionary Medicine. Darwin Applies to Medical School. Science 10 April 2009: Vol. 324. no. 5924, pp. 162 — 163).

One example provided in the lecture was the persistence of the sickle cell anaemia gene mutation in the human population. Sickle cell anemia results from a mutation in the gene for hemoglobin, the molecule that transports oxygen in the blood cells. The mutated gene is most commonly found in tropical and subtropical regions, with a similar geographic distribution to that of malaria. While the disease is quite severe, individuals carrying a single copy of the gene (heterozygous) show a better resistance to malaria, and thus there is an advantage to maintaining the mutation in tropical and subtropical populations.

Sir Peter Gluckman also discussed how the increases in life span, that are the result of advances in medicine and are happening at a pace so fast, are uncovering the age-dependent limits of the repair systems of the human body. Similarly, we are rapidly evolving different niches in which we grow up and raise our children, environments for which we did not evolve, and this can also have significant effects in our health.

I am currently waiting for the delivery of my copy of  ’Principles of Evolutionary Medicine’ by Peter Gluckman, Alan Beedle and Mark Hanson. Peter Ellison, who reviewed the book  in Science 4 September 2009: Vol. 325. no. 5945, p. 1207,  states that this book:

“brings students to a point where they can meaningfully engage in debates on the issues at a very sophisticated level.”

It is refreshing to hear someone of Gluckman’s caliber voicing the need to consider evolutionary theory in medicine, especially at a time when anti-evolution views continue to raise their voices. (The latest controversy has surrounded the release of the British film ’Creation’ about the life of Darwin, and you can read about that here. An interesting discussion on Reconciling Religion and Science can be seen here.) I am confident that as his book becomes popular among medical students and educators, we will be able to engage in fruitful discussions about the relationship between evolution and human physiology and to form a new generation of medics that are better equipped to tackle human health and disease.