They can combine to form cassettes of genes that confer resistance to multiple antibiotics and are transferred like a unit. The problem of resistance is not limited to bacteria. it comes from the perspectives gained from having taught several courses and having resolved a wide range of audiences. Evolutionary medicine is not a field, like genetics or biochemistry. It is usually a set of concepts and approaches with which to analyse many different parts of medical science. Evolution is basic. It permeates biology, combining with physics and chemistry to generate explanations for all those biological phenomena. However, we do not now speak of physical medicine or chemical medicine. Why then are we now discussing evolutionary medicine? There are two reasons. It has, relative to physics and HEAT hydrochloride (BE 2254) chemistry, been neglected and recent work shows that evolutionary insights can enhance our ability to understand, diagnose and heal. When at some future date evolutionary insights have been accepted and integrated into the training of doctors, epidemiologists, nurses and veterinarians, they will then be so familiar that the term evolutionary medicine will disappear from use. It will be taken for granted that one considers evolutionary insights into medical issues. That day is not yet here, but the rate at which it is approaching is accelerating. Papers like this have a temporary function; they advance a project whose success will eliminate the need for them. Evolutionary medicine thus consists of all areas in which evolutionary thought productively informs medical and epidemiological issues. Those issues are surveyed next. I then discuss priorities for translational research, priorities for basic research, priorities for health management, exciting recent discoveries and places where evolutionary biologists can learn from medical science. My selection of topics and assessment of priorities are my own. Others would choose differently. See Ellison [13] around the evolution and ecology of human reproductive endocrinology, Nesse [14,15] and Keller & Nesse [16] on mental illness, Gluckman [5,17] and Kuzawa [18] around the developmental origins of adult health and disease, Litman & Cooper [19] and Cooper & Herrin [20] Rabbit polyclonal to GNRHR around the evolution of the immune system, and Trevathan on breast-feeding and co-sleeping, Smith [21] on dependency and Eaton [22] on nutrition and exercise in [3], and Leonard [23] on nutrition and exercise. 2.?The range of issues (a) Medically significant genetic variation The more than seven billion humans currently on the Earth contain a huge amount of genetic variation whose historical roots extend deep into the past. For example, that we share genetic polymorphisms in some MHC genes with chimpanzees implies that they have been maintained by selection during at least the 5C7 million years since our last common ancestors [24]. Modern humans originated more recentlyabout 200 000 years agoin Africa, where they HEAT hydrochloride (BE 2254) have maintained large populations that accumulated considerably more HEAT hydrochloride (BE 2254) genetic variation than is now found in all the descendants of the emigrants that left Africa about 100 000 years ago. Those emigrants exceeded through a populace bottleneck on the way out that left most of the genetic variation behind [25,26], but some of those leaving Africa hybridized with an other hominid lineage, the Denisovans, from which they acquired variants of HEAT hydrochloride (BE 2254) immune genes (HLA alleles) that are now found in more than half of Eurasians and are starting to move into Africans [27]. As humans multiplied and spread across the planet, they encountered thousands of local variations in diet and disease that generated diverse selection pressures. Those selection pressures wrote varied signatures around the locally diverging genomes; drift and founder events added to the genetic divergence of local populations. These genetic variations, many of which have important implications for health and disease, have long been investigated by human geneticists, who have accumulated impressive information on genetic diseases and genetic causes of birth defects [28]. Perhaps the most important message of human genetics is that most human genetic variation is usually accounted HEAT hydrochloride (BE 2254) for by differences among individuals (89%); relatively little can be ascribed to differences among geographically or ethnically defined groups (9%) [25]. Thus the concept of race is usually primarily culturally, not genetically, defined. Nevertheless, because of the immense size of the human genome, some genetic variants associated with ethnic groups are useful in diagnoses [28], even though little of the standing variation is usually accounted for by ethnicity. Three types of human genetic variation are particularly important for medical science: variation for disease resistance, well.