The 1999 Crafoord Prize lectures. An evolutionist's perspective.
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Tithonus asked Aurora for eternal life, when he meant eternal youth. Modern gerontological research makes the same mistake in its preoccupation with death, as if it were a programmed event in an organism's life history. Gerontology ought instead to investigate senescence, the decreasing effectiveness of mechanisms by which adult organisms avoid death or loss of fitness. Such studies should measure rates of decline in a diversity of adaptations and compare them within and between individuals and relate these rates and their correlations to genetic and environmental factors. The death of a studied organism must necessarily end its usefulness in providing valuable data. It is of little scientific significance.
The 1890s and the first decades of the twentieth century saw a vigorous debate about the mechanisms of evolutionary change. On one side, August Weismann defended the selectionist hypothesis; on the other, Herbert Spencer defended neo-Lamarckian theory. Supporters of Spencer, notably the American paleontologist and evolutionary theorist Henry Fairfield Osborn, recognized that the questions raised by Weismann and Spencer could only be settled experimentally. They called for the application of experimental methods, and the establishment of a new institution for the purpose of confirming the inheritance of acquired characters. To a great extent, the experimental program championed by Osborn and others was implemented and, although it failed to reveal soft inheritance and was soon eclipsed by Mendelian and chromosomal genetics, it did make significant and lasting contributions to evolutionary biology. Thus the importance of methodological and institutional innovation and theoretical pluralism to the progress of science is illustrated and underscored.
Computational biology, a term coined from analogy to the role of computing in the physical sciences, is now coming into its own as a major element of contemporary biological and biomedical research. Information science and computational science provide essential tools for next generation biological science efforts, from focusing the direction of experimental studies to providing knowledge and insight that can not otherwise be obtained. Going beyond the revolution in biology reflected in the successes of the genome project and driven by the power of molecular biology techniques, computational approaches will provide an underpinning for the integration of broad disciplines for development of a quantitative systems approach to understanding the mechanisms in the life of the cell.
Interferons (IFNs) remain the most broadly active cytokines for cancer treatment, yet ones for which the full potential is not reached. IFNs have impacted positively on both quality and quantity of life for hundreds of thousands of cancer patients with chronic leukemia, lymphoma, bladder carcinoma, melanoma, and renal carcinoma. The role of the IFN system in malignant pathogenesis continues to enhance understanding of how the IFN system may be modulated for therapeutic advantage. Reaching the full potential of IFNs as therapeutics for cancer will also result from additional understanding of the genes underlying apoptosis induction, angiogenesis inhibition, and influence on immunologic function. Food and Drug Administration (FDA) approval of IFNs occurred less than 20 years ago; after 40 years, third-generation products of early cytotoxics, such as 5- fluorouracil (5FU), are beginning to reach clinical approval. Thus, substantial potential exists for additional application of IFNs and IFN inducers as anticancer therapeutics, particularly when one considers that their pleiotropic cellular and molecular effects have yet to be fully defined.
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Since the time when I was a postdoctoral fellow under the supervision of Dr. Howard Green, then at the Massachusetts Institute of Technology, I have been interested in understanding the molecular mechanisms underlying growth, differentiation, and development in the mammalian ectoderm. The ectoderm gives rise to epidermal keratinocytes and to neurons, which are the only two cell types of the body that devote most of their protein-synthesizing machinery to developing an elaborate cytoskeletal architecture composed of 10-nm intermediate filaments (IFs). Our interest is in understanding the architecture of the cytoskeleton in keratinocytes and in neurons, and in elucidating how perturbations in this architecture can lead to degenerative diseases of the skin and the nervous system. I will concentrate on the intermediate filament network of the skin and its associated genetic disorders, since this has been a long-standing interest of my laboratory at the University of Chicago.
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The optimal nutritional support of critically ill patients should be based on the metabolic response. Therefore, we performed a series of experiments in patients using stable isotopic tracers designed to elucidate the responses of glucose, fatty acids, and protein metabolism in severely burned patients. Glucose production was elevated above normal as a result of an increase in glucagon concentration. The peripheral hypoglycemic action of insulin was diminished, as was its effectiveness in suppressing endogenous glucose production, but the intracellular capacity to oxidize glucose was not impaired. Lipolysis was stimulated by beta 2-adrenergic stimulation to a much greater extent than was fatty acid oxidation, with the result being an increase in the recycling of fatty acids secreted in very-low-density lipoproteins. Muscle protein catabolism was accelerated in severely burned patients, leading to a progressive loss of lean body mass that was not prevented by nutritional support alone. The ineffectiveness of nutritional support for muscle was due to alterations in amino acid transmembrane transport kinetics that favored efflux. Treatment with exogenous insulin stimulated inward amino acid transport and muscle protein synthesis. Extrapolation from our current knowledge of metabolism to clinical treatment indicates that nonprotein energy should be provided largely in the form of carbohydrate. If hyperglycemia ensues, exogenous insulin will further increase the anabolic response in muscle. Protein requirements can be met with 1.5 g protein.kg-1.d-1. Treatment with anabolic hormones may ultimately be the most effective way in which to optimize the response to nutritional support.
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The title of this presentation is derived from a national bestseller that defines the moment when an idea, trend, or social behavior crosses a threshold, "tips," and becomes widely disseminated. Three key tipping-point factors are discussed in the context of medical nutrition education. The Law of Few has to do with the essentiality of role models in directing educational curricula and clinical programs. The Stickiness Factor describes the quality and the content of the message that enable the information to have prolonged meaning. The Power of Context refers to the conditions and risk factors that are directly affected by diet and nutrition. Examples of these key factors are provided with a look to the future of medical nutrition education.
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