The True Nature of Disease

Over the last few hundred years’ tremendous advances have been made in the treatment and eradication of many diseases, especially in developed countries. Human life expectancies have increased dramatically in many parts of the world. However, infectious diseases are still widespread and there is a continual rise of non-communicable diseases, the so called “diseases of civilization” such as heart disease. Additionally, due to the widespread use and overuse of antibiotics since the introduction of penicillin in 1943, we are experiencing a re-emergence of infectious diseases, with pathogens that are antibiotic-resistant and have the potential to be transmitted on a global scale.

Moreover new diseases are emerging in human populations; for example at least 22 in the last 30 or so years as listed by The Centers for Disease Control including; Rotovirus, Ebola virus, Legionella pneumophila (Legionnaires Disease), Hantaan Virus (Korean hemorrhagic fever), HTLV I, Staphylococcus toxin, HIV, Human Herpes Virus 6, Hepatitis C, and Hantavirus isolates.

Only recently have the ideas of “Darwinian medicine” received serious interest among most evolutionary biologists and students through the introduction of courses in universities and medical schools.  This book will discuss the origin and nature of disease, by taking a holistic view which gives the reader significant insight into the evolution of disease, and provide reasons as to why disease will continue to be part of human existence. Ultimately why diseases can exist and are successful is because all living organisms have a common origin and a common molecular basis. For instance the coevolution of viruses and eukaryotic cell mechanisms such as DNA replication is only just being understood. Viruses may have originated by “escaping” from the cellular environment, eventually becoming selfish self replicating elements. Even more interesting is the suggestion that DNA replicating proteins, and even DNA itself, in eukaryotic cells may have had a viral origin. Although the notion maybe upsetting to some, disease in humans has always been present and probably always will be as a result of our common biological heritage with all other organisms on Earth.

1. Introduction
1.1 What is disease and why are there diseases?
1.2 Origin of Life
1.3 The Spontaneous Generation of Life and the Germ Theory of Disease
1.4 A Short History of the Evolution of Life and a LOng History of You

2. Types of diseases and organisms causing diseases of other organisms
2.1 Diseases caused by organisms
2.2 Diseases with other causes

3. Principles of population genetics and evolution
This chapter will cover quantitatively the principles of population genetics
Topics:
a. Genetic variation in populations.
b. Random mating and the Hardy-Weinberg equilibrium.
c. Mutation; spontaneous vs. induced; target theory; effects of mutagens; examples (humans.)
d. The general model of selection (individual); autosomal and X-linked genes.
e. Balanced polymorphisms; human examples – sickle cell anemia, G6PDH deficiency.
f. Mutation-selection balance; examples of human genetic disorders, e.g. haemophilia, etc.
g. Random genetic drift.
h. The neutral theory of molecular evolution.
i. Selective sweeps – principles and evidence.
j. Population structure.
k. Inbreeding & relatedness.
l. Kin selection and social selection; parent-offspring conflict.
m. Epigenetics and gene imprinting – population genetics; maternal-fetal conflict; viability differences between sexes as causes of imprinting

4. Coevolution of host & disease
a. Principles of coevolution.
b.Parasite-host coevolution.
c. Coevolution between bacteria, bacteriophages and plasmids.
d. Wolbachia
e. Evolution of host specificity
f. Evolution of antibiotic resistance by bacteria

5. Evolution of Virulence
a. Basic epidemiology
b. virulence
c. Evolution of virulence theory
d. examples and test of theory

6. Human evolution and disease
This chapter will explore the coevolution of humans and their diseases, including the role of culture
Topics:
a. Primate divergence times and interpretations.
b. Fossil hominids and trends in skeletal evolution.
c. Emergent adaptive suite in basal hominids.
d. Hypotheses for the evolution of nakedness in Homo sapiens
e. Transmission of diseases and parasites from other primates to humans
f. Cultural transmission in humans, e.g. Kuru through cannibalism
g. Human evolution and the three epidemiological transitions

7. Evolution of Human Diseases
This chapter will cover in detail some important diseases of humans
a. Parasitic
b. Bacterial and viral diseases
c. Inherited
d. Prion diseases
e. environmentally induced diseases and cancer
f. psychological disorders

8. Implications for Medicine
This chapter will cover what are now the "traditional" questions of evolutionary medicine -- why we are vulnerable to disease, why we get sick and die.  Also covered will be the evolution of senescnece.

9. Conclusions: the future of human evolution and disease
This chapter will summarize the major points of the book.  It will also pose the question, what if there were no diseases from now on?  How would human evolution be affected?

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