Different views of Evolutionary Medicine

The different views of Evolutionary Medicine. Levels of adaptation and the origin of disease

Alvaro Daschner, José-Luis Gómez Pérez & María-José Trujillo Tiebas

Evolutionary Medicine remains an interesting and emerging approach that brings together the knowledge of Medicine and Biology, which nevertheless has its difficulties precisely in pluridisciplinarity. This chapter offers an analysis of the current and pioneering currents in this field, but also of its criticisms. A second step provides a study of the different mechanisms of adaptation to changing environments, which may explain the variability of traits and thus of disorders or diseases. It is considered relevant to take into account the genetic adaptive changes that underlie the concept of Darwinian Medicine, along with other levels of adaptation. An analysis of disease from the evolutionary point of view must initially include the search for the proximate and evolutionary causes. However, if the disease is interpreted as a mismatch to the environment, it must take into account the different levels of adaptation that should include genetic inheritance, epigenetics (fetal programming and transgenerational epigenetic inheritance) and cultural inheritance, as well as the possibility that in the hologenome context bacterial genes adapt very quickly (horizontal transfer and very fast natural selection). Understanding these levels of de-adaptation will facilitate for illustrative purposes the search for treatments, changes in lifestyle, modification of our habitat selection as examples, and finally transform Evolutionary Medicine into an area of practical application, required by practising physicians.

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