2013. április 3., szerda

Evolúciós medicina

Az emberi szervezetet alaposan szemügyre véve furcsa kettősségeket, vagy ellentmondásokat tapasztalhatunk. Gondoljunk csak szemünkre: megcsodálhatjuk szinte tökéletes működését, amely a látás képességével ajándékoz meg bennünket. Azonban alaposabb vizsgálódás után csodálatunk tanácstalanságba csap át, mert a szem felépítésében olyan megoldásokat is találunk, amelyek ellentétesek minden logikus tervezői megoldással. Vérerek és idegek hatolnak be a szem belsejébe a látófelület közepén, és a lehető legrosszabb helyen, a lencse és a retina között futnak, éppen a fény útjában. E kettősséghez hasonlóan, minden tökéletesen működő ízületünkre jut néhány könnyen romló fogunk. Az immunrendszerünk képes legyőzni kórokozók ezreit, viszont szinte teljesen védtelen másokkal szemben, amelyek akár meg is ölhetnek bennünket.

Ezek az ellentmondások csak akkor nyernek értelmet, ha az emberi test kialakulását evolúciós szempontból vizsgáljuk. Tulajdonképpen ezt fejezik ki a híres orosz genetikus, Theodosius Dobzhanskynak, az oldal felső részében idézett  szavai: „A biológiában semminek nincs értelme, ha nem az evolúció fényében nézzük”. Az evolúciós értelmezés szerint szerveink és számos tulajdonságunk fokozatos kialakulása túlélési és szaporodási előnyt biztosított őseink számára. Más szóval, ezeket a természetes szelekció alakította ki. A természetes szelekción kívül persze más erők is hatottak tulajdonságaink és testfelépítésünk kialakításában. A véletlen, a faj története, és a már meglévő adottságok teremtette kényszer együttesen hatottak a természetes szelekcióval. Ezek eredménye, hogy szervezetünk kiválóan adaptálódott bizonyos vonatkozásokban, azonban másokban kompromisszumok és szükségmegoldások jellemzik. A különböző evolúciós hatások együttes figyelembe vétele segít megérteni az emberi szervezet gyengeségeit, sebezhetőségét és kóros folyamatait.

Az orvostudomány szinte csak a betegségek közvetlen okainak feltárásával és a betegségek gyógyításával foglalkozott eddig. Az orvosok csak közvetlen magyarázatokat keresnek a betegségekre, vagyis csak az emberi test ma megfigyelhető normális és kóros anatómiai felépítését és fiziológiai működését vizsgálják. Gyógyító munkájukban általában nem keresik a választ arra, hogy miért olyan az emberi szervezet, amilyen, azaz miért tartalmaz „illogikus tervezési megoldásokat” miért sebezhető és miért hajlamos kóros elváltozásokra. Ezt a hiányosságot igyekszik pótolni egy új biológiai tudományág, az evolúciós medicina, amely nem más, mint evolúciós biológiai alapismeretek felhasználása a betegségek megértésében, megelőzésében és gyógyításában. Az evolúciós megközelítés ötvözése a hagyományos orvoslás gyakorlatával szélesebb körű vizsgálódást, és alaposabb megértést tesz lehetővé. Az evolúciós medicina létrejötte elsősorban négy kutatónak, George Williamsnek, Paul Ewaldnak, Ernst Mayrnak és Randolph Nessenek köszönhető, akik lerakták az alapokat, és meghatározták az új tudományág legfontosabb területeit. Ezek közül az egyik legfontosabb terület a betegségekkel kapcsolatos, ebben arra keresik a választ, hogy miért vagyunk hajlamosak betegségekre. 

Az evolúciós medicina megalapítói (balról jobbra): George C. Williams és Paul W. Ewald, amerikai; Ernst W. Mayr német származású evolúciós biológusok és Randolph M. Nesse amerikai orvos és evolúciós biológus.
 
Kiderült, hogy betegségeinkre, testünk fogyatékosságaira adott evolúciós magyarázatok néhány kategóriába csoportosíthatók. Ezek közül az első a betegségeket okozó organizmusokkal folytatott egyenlőtlen küzdelmünkkel kapcsolatos. A második, szervezetünk régmúltban kialakult felépítési és működési jellegzetességeit érinti, amelyek gyakran nem illenek mai modern környezetünkhöz, mert a lassú természetes szelekciós folyamatnak nem volt még elég ideje megfelelő alkalmazkodások kialakítására. A harmadik magyarázat számos jellegünk kompromisszumos mivoltával kapcsolatos, ami az előnyök mellett hátrányokkal is jár. A negyedik magyarázat demonstrálja, hogy a természetes szelekció nem mindenható, mert történeti korlátok miatt gyakran szükségmegoldásokhoz vezet. Végül az utolsó kategória rávilágít arra, hogy több testi gyengeségnek, vagy betegségnek vélt jelenség tulajdonképpen védekezési mechanizmus, amelyeket a természetes szelekció alakított ki. A későbbiekben igyekszem majd ismertetni, és példákkal szemlélteti az említett evolúciós magyarázatokat.

293 megjegyzés:

  1. Szevasz Peter, nagyon erdekes a blogod, ha van idom sokszor idelatogatok. Az emberi fogfajas evolucios elonyeirol irtal mar? P. Laci (volt osztalytarsad)

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    1. Szia Laci! Micsoda meglepetés, hogy éppen itt találtál rám! Lám-lám, mire jó egy blog. Az emberi fogazat evolúciójáról még nem írtam, de (remélhetőleg) hamarosan lesz majd szó a kompromisszumos jellegekről, ezen belül a csontokról is. Üdv. P.

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  2. Ha kiderül egy adott betegségről, hogy az evolúció folyamán miért lett hajlamos rá a szervezetünk, akkor könnyebben gyógyítható is lenne, vagy csak érdekes infókkal bővülne tudásunk? Nem sikerül fejben összeraknom konkrét példát, hogy gyakorlatban hogyan is működik ez a tudományág.
    Krisztián

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    1. Krisztián, az evolúciós medicina elsősorban új, vagy kibővült szemléletet adna az orvosoknak, amely nagyon fontos a betegségek, fertőzések okainak megértésében, és a védekezésben is. Ugyanakkor a gyógyításban is jelentős szerepe van és lehet. Kiderült például, hogy sok kórházban az antibiotikumok helytelen használata eredményeként evolválódtak a multirezisztens baktériumok. A hatékony vakcinálások is evolúciós szemléletet igényelnek. Említhetem Crohn-betegséggel kapcsolatos sikereket is (gondolom, erről olvastál az egyik bejegyzésemben), ami szintén az új evolúciós szemléletnek köszönhető.

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    2. Igen, olvastam, és így már összeállt bennem a kép. Köszönöm a választ!

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