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Universities evolve, looking to darwin for new medical insights
Universities evolve, looking to Darwin for new medical insights
Humans are the products of mil ions of years of
evolution through natural selection. Yet when
But evolutionary biologist Stephen Stearns,
it comes to the treatment of disease, physicians
another pioneer in the field from Yale University
and biomedical researchers have long neglected
in New Haven, Connecticut, notes that both new
our evolutionary pasts. Now, a number of
centers are narrowly focused—primarily on the
research institutes are attempting to remedy that
study of infections in ancient contexts in the case
by launching new research centers dedicated to
of Zurich, and on phylogenomics in Arizona.
the burgeoning field of evolutionary medicine.
“I’d say that each of those [areas] is one fiftieth
The newly minted Center for Evolutionary
of evolutionary medicine,” Stearns says, arguing
Medicine at the University of Zurich opened
that the discipline reflects a much broader
its doors in late October. Backed by a $10
application of basic evolutionary thinking to
million donation from the private Zurich-
clinical practice and public health. “Evolution
based Mäxi Foundation, the center wil focus
touches medical issues at many points.”
on analyzing ancient DNA and bones as wel as
Although neither new center is focused on
dissecting microevolutionary changes in human From finches to flu: Medical research adapts.
medical or graduate training, many institutions
around the world have created stand-alone
diseases. “It’s medical research, but it’s looking on understanding disease through retracing the courses to teach students about evolutionary
ved. from an evolutionary perspective,” says the evolution of DNA sequence changes. “I think medicine (Nat. Med. 15, 1338, 2009), and Case
center’s director Frank Rühli, a physician who evolutionary medicine is exciting because of Western Reserve University in Cleveland is
eser has studied ailments such as atherosclerosis in genomics,” says Kumar. “Genomics al ows one taking the education approach one step further.
to ask ultimate causes of disease—like, why do According to Glenn Starkman, an astrophysicist
In the US, the Center for Evolutionary some people get sick and others do not?”
and director of Case Western’s interdisciplinary
Medicine and Informatics—one of ten research
Randolph Nesse, a psychiatrist at the Institute for the Science of Origins, the university
All r centers at Arizona State University’s Biodesign University of Michigan–Ann Arbor who plans to launch a formal graduate program in
Institute in Tempe—has been up and running coined the term ‘Darwinian medicine’ nearly evolutionary medicine in September 2012. “It’s
Inc. since the beginning of the year. Under the two decades ago, applauds the new centers’ time that medical education gets more focused ica, direction of molecular evolutionary biologist efforts. “The field really needs recognition on evolution,” he says.
Sudhir Kumar, the center is primarily focused that evolution has many different uses in
Elie Dolgin Half-century-old TB drugs get a facelift in new cocktails
The first-line regime of tuberculosis drugs has remained virtually
unchanged for a half century. But instead of improving on these
What could potentially be even more important about the trial,
medications, some researchers say it’s time to scour the lists of
however, is the streamlined form it is taking, Ginsberg says.
already-approved drugs for other indications or start from scratch to
Typically, introducing any single one of the drugs into a TB trial
curb the more than 1.7 million deaths from tuberculosis (TB) each
would take the form of swapping the drug out with one of the four
most commonly used first-line drugs. By simply jumping to testing
In early November, for example, the New York–based TB Alliance
an entirely new combination, what could have been more than a
announced the launch of a clinical trial to test a radically different
three-decade-long process of trial and error could potentially be
drug cocktail. “We see this as a paradigm shift in methodology,”
reduced to eight to ten years, Ginsberg adds.
says Ann Ginsberg, the organization’s chief medical officer, “And it’s
Other researchers are taking a different approach to finding fast-
been one that industry as well as regulators at institutions like the
track TB treatments. A team from the University of California–San
[US Food and Drug Administration] have been very supportive of.”
Diego and the University of Leeds in the UK has examined the
Standard first-line treatment for TB consists of a cocktail of at
known proteome of the TB pathogen to find drug targets linked to
least four drugs mixed and matched over six months. Because of
hundreds of FDA-approved drugs (PLoS Comp. Biol. 6, e1000976,
side effects such as nausea, many people fail to properly adhere to
this regime. And because 90% of the disease is typically cleared in
“There may be a great TB treatment out there that is already
the first few weeks, patients quickly see the medicine as causing
approved and could be repurposed to a TB market very quickly, if
more strife than the condition, says Mario Raviglione, director of
only we can find it,” says Philip Bourne, a pharmacologist with the
the Stop TB Department, an international organization housed by
University of California–San Diego and lead author of the study.
There’s still a lot of searching to be done before the work
The recently announced phase 2 drug trial run by the TB
produces hits, Bourne says. The group’s paper cites one drug
Alliance will test a three-drug combination, dubbed NC001. It
currently used for neurodegenerative diseases that has some impact
contains PA-824, an entirely new chemical compound, along
on TB but would have to be used in too-high doses.
with moxifloxacin (commonly used to treat pneumonia) and the
Stu Hutson
VOLUME 16 | NUMBER 12 | DECEMBER 2010 NATURE MEDICINE
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