Below is an excerpt from recent piece published in Aeon Magazine, about how the application of evolution and ecology in medicine can help save lives. In this case through the use of phage therapy.
She was only 22 years old, but her attending doctor in Texas was running out of options. The sticky substance coating the patient’s lungs was par for the course with cystic fibrosis (CF); mucus is a signature of this heritable, progressive and incurable disease. So, too, is infection. But this time, a particularly nasty and stubborn bug had taken hold. The persistent presence of bacteria was putting an additional burden on the young woman’s already overtaxed respiratory system, and chronic infection degrades lung function. The best antibiotics Western medicine had to offer had failed.
The Scottish physician Alexander Fleming discovered the first modern antibiotic, penicillin, in 1928. In 1945, Fleming issued a warning: should we misuse or overuse antibiotics, bacteria can and will resist. Today, resistance has become a scourge of modern medicine. Not only did we deploy antibiotics to save lives, but for commercial gain – pumping them into industrial farm animals, from cows and pigs to chicken and fish. Under pressure from this assault, bacterial populations did what they’d done for aeons: evolve or die. Those strains that could survive antibiotics are now winning the evolutionary race, and we are progressively running out of cures.
One solution, according to the late Joshua Lederberg, a Nobel Prize-winning molecular biologist, is to ‘drop the Manichean view of microbes: “We good; they evil”.’ In a 2000 essay in Science magazine, he argued that humans needed to work with nature rather than against it; we needed to take ‘the germs’-eye view of infection’. Modern medicine tends to adopt a somewhat mechanistic approach: fix the flaw, repair the malfunction, extricate and eradicate the invading entity. But the human body and illness do not follow such linear paths; they are influenced by ecological and evolutionary processes, which new treatments might try to manage in a more holistic way.
Read the full article here.