EEB325–EvolutionaryMedicineDepartmentofEcology&EvolutionaryBiology,UniversityofTorontoWinter2016CoursedescriptionHow evolutionary principles can help us better understand health and disease. Concepts from evolutionarybiology(e.g., lifehistorytheory,coevolution,genomicconflict,constraintsandtrade-offs)willbeappliedtokeyproblemsinmedicineandpublichealth, includingantibioticresistance,aging,cancer,autoimmunedisease,andpathogenvirulence.

CourseobjectivesBytheendofthecourse,wewillanswer(i)howdoesunderstandinghumanevolutionaryhistoryinformusofthecauses of common diseases? (ii) What are the consequences of pathogen evolution for disease outcomes,treatment, and control? (iii)What are some strategies for overcomingor circumventing pathogen evolution inresponsetomedical intervention?(iv)Canwepredictthenextdiseasethatwillemergeinhumans?(v)Whydoweage?(vi)Whatroledoesevolutionplayinchronicdiseasesandreproductivehealth?PrerequisitesBIO130H1,BIO220H1CourseinstructorProfessorNicoleMideo,Ecology&EvolutionaryBiologynicole.mideo@utoronto.caOfficehours,Monday9:30-11am,ESC2063.TeachingAssistantsDavidSmith,TsukushiKamiya,AmberHoiTimeLecture Tutorials Mon11-12,SS1069Wed11-1,SS1069

Wed3pm

T0101,SS1080T0102,SS2101

TsukushiKamiyatsukushi.kamiya@mail.utoronto.caDavidSmithdrm.smith@mail.utoronto.ca

Thurs1pm T0201,SS1080T0202,SS2101

AmberHoiamber.hoi@mail.utoronto.caDavidSmithdrm.smith@mail.utoronto.ca

CoursepolicyonemailusageYouremailmessagemust include in theSubject linethecourse identifierandaconciseandclearstatementofpurpose(e.g.,“EEB325:Iwouldlikemorebackgroundreading”)otherwiseitislikelytobedeleted.

AccessingcourseinfoLectureslides,additionalinformation,andrequiredreadingswillbeavailableviatheUofTPortalonBlackboard.YouwillneedtouseyourUTORIDtologinonlineathttp://portal.utoronto.ca.OnlystudentswhoareenrolledinEEB325onROSIhaveaccesstothissite(within24-48hoursofenrolling).

ReadingsEachweekyouwillberequiredtoreadoneorafewpapersfromtheprimaryscientificliteratureand/orpopularpress,orlistentoapodcast.Thesearelistedinthesyllabus,andlinksorpdfswillbepostedonBlackboard.Someof the readings must be accessed through the library website. You may be tested on the content of thesereadings.

Additional readings (clearly labeled as “Further reading”) will be posted on Blackboard for those who areinterested in diving deeper into a topic. These readings arenot required and youwill not be tested on theirspecificcontent,butreadingthemwouldcertainlybolsteryourgeneralunderstanding.Forthosewhoarereallykeen on this subject, you may be interested in this textbook (NOT required): Stearns, S.C. and Koella, J.C.EvolutioninHeathandDisease,2ndEdition.OxfordUniversityPress.

CourseorganizationThiscourseconsistsof23lecturesrelatedtothereadingsoforiginalscientificandpopularpressarticles.Thethirdlecturehoureachweekwillbeusedforin-classquizzes,anin-classmidtermexam,lecturecontentspillover,andquestion/reviewsessions.Additionally, therewillbe5TA-ledtutorial sessions throughout theyearallowing forsmallgroupdiscussions.

ChangestothesyllabusEvolutionaryMedicineisagrowingfield,andnewfindingsandideasariseconstantly.Thus,Ireservetherighttomodifythesyllabusinordertoincorporateanynewandinterestingresearchortodelveintoparticulartopicsinmoredetail,dependingonneedsandinterestsoftheclass.Withthatsaid,thetopicsintheschedulebelowwill(probably)becoveredandthecoursewilllargelybestructuredasfollows.

Section1 focusesonthebasicprinciplesofevolutionarymedicine,emphasizingdifferencesbetweenproximateandultimateexplanations.Thissectionprovidesanintroductiontohumandefensestoinfectiousorganisms,anddescribesmajorculturaltransitionsinhumanhistorythatalteredexposuretoinfectiousdisease.

Section2focusesonhealthproblemsthatarelargelyaconsequenceofevolutionaryprocessesactingonhumans.Wewill focusondegenerativediseases, chronicdiseases,and reproductivehealth,andwewilldiscusshowanevolutionaryperspectivecaninformtreatmentandpreventionstrategies.

Section 3uses the evolutionarymedicine approach to examine infectious diseases. Here,wewill focus on theunique challengesof fightingdisease-causingorganisms that are themselves subject to evolutionary changeaswellasevaluatingthepotentialfordifferentinterventionstrategiestowithstandpathogenevolution.

EvaluationThiscoursehas6gradedcomponents:1. Midtermexam 22%2. Finalexam 33%3. Tutorials 10%(basedonattendanceandparticipationindiscussions)4. In-classquizzes 10%(best4outof5)5. Blogpost#1 5%(dueWednesdayFebruary3)6. Blogpost#2 20%(dueWednesdayMarch23)

Plussomeopportunitiesforextracredit:(1) Individualblogpoststhatareparticularlylucid,stimulating,orlateral(max5%).(2) Suggestedexamquestions(max3%).Theseshouldbemultiplechoice(IwillpostanexampleonBlackboard)

ande-mailedtomebytheendofJanuaryforthemidtermorMarchforthefinal.IftheyaredifferentfromquestionsI’vealreadyused,andIusethem,yougetextracreditat1.5%perquestion.Sendinglotsof(good)questionsincreasesyourchancesofhittingononeI’lluse.Plus,you’llknowtheanswer!

Exams-Allexamswillconsistofmultiplechoiceandshort-answerquestions,emphasizingtheunderstandingofconcepts.Nostudyaidsofanytypearepermitted.Themidtermwilllast~2hoursandthefinalwillbe3hours.

Quizzes-Quizzesareintendedtohelpyoustayontopofthecoursecontentandreadings.Thus,theywillconsistofshortanswercomprehensionquestions(ratherthanapplications).Quizzeswillbeshort,max.10minutes.

Blog-Thepointoftheseassignmentsistogiveyouanopportunitytoapplywhatyoulearninthiscourse.WhatIhope you learn is away of looking at theworld: through case studieswewill explore contemporary issues inhealthanddisease–ones thatweconfrontona regularbasis–andaskhowevolutionaryconceptshelpus tounderstand/mitigate/combat those issues. I also want you to remember to be critical. Telling ‘adaptationist’storiesiseasy;evaluatingthescientificevidenceforthosestoriesiscriticallyimportant,especiallywhenitcouldshapeclinicalcare.

So,findanissueortopicthatreallyresonateswithyouandblogaboutit.(Infact,you’llneedtofindtwotopicssinceyou’rewritingtwoblogs.)Topicscanbeoneswecoverinclass,butonwhichyouputsomeuniquespin,ortheycanbesomethingelsetodowithhealthanddiseasethatwedon’ttalkaboutatall.Whateverreallyinterestsyou.Ifyouneedinspiration,readthescienceorhealthsectionofyourfavouritenewssource,seewhatisgoingonatscienceblogs.com,orcheckoutNationalGeographicandScientificAmericanonline.

Agoodblogpostcanconveyanideain400-600words.Wewillacceptamaximumof700words.Thetwoblogassignmentsarestructuredsothatthefirstoneisworthlittle(5%),butwillreceivelotsoffeedbackfromyourTA.This feedback should help you improve your second blog post (worth 20%). Write for an educated, but layaudience (imaginewriting for your friend in linguistics rather than, say, your grandparents). Thismeans you’lllikelyhavetoexplainsomeevolutionaryconcepts.

Blogsmustbesubmittedtotwolocations:Turnitin.comANDBlackboard.Wewillbemarking4maincomponents:(1) is thecontentrelevantandnovel? (2)arethe ideasclearandcommunicatedwell? (3) is itwell-referenced?and (4) have you demonstrated a clear understanding of evolutionary concepts and how they apply to yourchosen topic? A more detailed marking rubric will be posted on Blackboard. More guidance for blog posts(includinganopportunity to readanddiscussexampleposts, aswell asmoredetails about formatting)will beprovidedinthesecondtutorialsession,inweek3.

Turnitin.comNormally,studentswillberequiredtosubmittheircourseessaystoTurnitin.comforareviewoftextualsimilarityanddetectionofpossibleplagiarism.Indoingso,studentswillallowtheiressaystobeincludedassourcedocumentsintheTurnitin.comreferencedatabase,wheretheywillbeusedsolelyforthepurposeofdetectingplagiarism.ThetermsthatapplytotheUniversity’suseoftheTurnitin.comservicearedescribedontheTurnitin.comwebsite.Studentsarepermittedtoopt-outofusingTurnitin.Ifyouwishtoopt,pleasecontactmebeforeFriday,January29toindicatethatyouwouldliketomakealternatearrangementsandgetmoreinformation.MissingatestStudents who have a legitimate reason for missing an exam (consult University guidelines for details) shouldinformtheinstructorwithin24hours.Intheeventofillness,youmustprovidemewithawrittenstatementfromtheuniversityhealthserviceoranoutsidemedicalprofessional (i.e.,MD,RN) inordertobeallowedtowriteamake-upexam.Ifyourabsenceiscausedbyapersonalorfamilycrisis,youmustprovideawrittenstatementtothat effect fromyour college registrarorhis/her representative.Make-upexamsmaybeof adifferent formatthanthein-classexam.There areNOmakeupquizzes for this course. I’ll bedropping the lowestquizmark for each student and thequizzesarespacedpredictablythroughoutthesemester.Donotmissclass–andthusquizzes–lightly.AccessibilityneedsTheUniversityofToronto iscommitted toaccessibility. Ifyourequireaccommodations foradisability,orhaveany accessibility concerns about the course, the classroom or course materials, please contact AccessibilityServicesassoonaspossible,disability.services@utoronto.caorwww.accessibility.utoronto.ca/

AcademicIntegrityAcademicintegrityisfundamentaltolearningandscholarshipattheUniversityofToronto.Participatinghonestly,respectfully,responsibly,andfairlyinthisacademiccommunityensuresthattheUofTdegreethatyouearnwillbevaluedasatrueindicationofyourindividualacademicachievement,andwillcontinuetoreceivetherespectandrecognitionitdeserves.All students are expected to know and respect the University of Toronto’s Code of Behaviour on AcademicMatters(http://www.artsci.utoronto.ca/osai/students).Casesofacademicmisconductaretreatedveryseriously.All suspected cases will be investigated following the procedures outlined in the code. Consequences can besevere,includingafailureinthecourseandanotationonyourtranscript.Potentialoffensesinclude,butarenotlimitedto,

- Lookingatsomeoneelse’sexamorquizanswers.- Providingunauthorizedassistancetoanotherstudent(e.g.,lettingsomeoneelselookatyouranswers).- Submittinganalteredtestforre-grading.- FalsifyingoralteringanydocumentationrequiredbytheUniversity(e.g.,doctor’snotes).- Usingorpossessinganunauthorizedaidinanytestorexam.- Misrepresentingyouridentity.

ThereareotheroffencescoveredundertheCode.Pleaserespectallrulesandthevaluesthattheyprotect.AudiorecordingoflecturesIfyouwish,tapinglectureswithapersonalrecorderispermitted.Ifyoubringarecordingdevicetothefrontofthe room, you do so at your own risk and you assume responsibility if it is lost or stolen. Lecture materialsincluding audio recordings are for personal use only by the students enrolled in EEB325. The distribution,transmission,reproduction,orre-postingoftheEEB325lecturematerialsincludingaudiorecordings,inpartorwhole,isstrictlyprohibitedwithoutthewrittenpermissionoftheinstructor.Studentsareadvisednottotreatrecordingsasasubstituteforattendinglecturesandtakingnotes.

Week MondayLecture WednesdayLecture Tutorial1

Jan11Syllabus&organizationWhyarewevulnerabletodisease?Nesse&Stearns2008

Jan13HumanevolutionandmismatchtomodernityDiamond2003Nuwer2013

2

Jan18 HumanevolutionandhostdefenseMcCullough2015

Jan20GeneticsofdiseasesusceptibilityQuintana-Murci&Barreiro2010QUIZ!

þ

3Jan25 Aging

Kirkwood&Austad2000 Jan27ReproductionSaini2014QUIZ!

þ

4Feb1

Between-individualconflictanddiseaseHaig2014

Feb3

Cancer(orwithin-individualconflict)Zimmer2007Gallagher2015BLOG#1DUETODAY

5Feb8

CancerandchemotherapyZimmer2013Jansenetal.2015

Feb10 In-classMIDTERM(2hours)

Feb15–Feb19READINGWEEK–NOCLASSES

6Feb22 Virulenceevolution,Part1:why

somebugsgobad Feb24 Virulenceevolution,Part2:opportunisticpathogens þ

7Feb29 Emergingdiseases,Part1 Mar2

Emergingdiseases,Part2QUIZ!

8Mar7

HIV:pathogenandhumanadaptation Mar9 Drugresistance þ

9 Mar14 AdiscussionwithDr.RobertWoods&Prof.AndrewRead

Mar16 Influenza:acasestudyonemergenceQUIZ!

10Mar21 Vaccines,Part1:Evolutionarycauses Mar23 Vaccines,Part2:Evolutionaryconsequences

BLOG#2DUETODAY þ

11Mar28 Evolution-proofcontrol Mar30

STUDENTCHOICELECTUREQUIZ!

12 Apr4 Microbiomes&disease Apr6 ReviewSession(2hours)

PleasewatchBlackboardforfurtherrequiredreadings.Thesyllabuswillcontinuallybeupdatedthereaswell.

READINGLIST(sofar)Diamond2003.Thedoublepuzzleofdiabetes.Nature423:599-602

Gallagher2015.Elephants’lowcancerratesexplained.BBCNews(9October2015)http://www.bbc.com/news/health-34466220

Haig2014.Troubledsleep:Nightwaking,breastfeedingandparent-offspringconflict.Evolution,Medicine,andPublicHealth32-39.

Kirkwood&Austad2000.Whydoweage?Nature408:233-238

Jansenetal.2015.Controlvs.eradication:applyinginfectiousdiseasetreatmentstrategiestocancer.ProceedingsoftheNationalAcademyofSciences112:937-938.

McCullough2015.Ironrestriction.Evolution,Medicine,andPublicHealth1:149.

Nesse&Stearns2008.Thegreatopportunity:Evolutionaryapplicationstomedicineandpublichealth.EvolutionaryApplications1(1):28-48.

Nuwer2013.Wormtherapy:Whyparasitesmaybegoodforyou.http://www.bbc.com/future/story/20130422-feeling-ill-swallow-a-parasite

Quintana-Murci&Barreiro.2010.TheroleplayedbynaturalselectiononMendeliantraitsinhumans.AnnalsoftheNewYorkAcademyofSciences.1214:1-17.

Saini2014.Menopause:nature’swayofsayingolderwomenaren’tsexuallyattractive?TheGuardian(30March2014)http://www.theguardian.com/society/2014/mar/30/menopause-natures-way-older-women-sexually-attractive

Zimmer2007.Evolvedforcancer?ScientificAmericanhttp://carlzimmer.com/articles/2007.php?subaction=showfull&id=1173216962&archive=&start_from=&ucat=10

Zimmer2013.Studyingtumorsdifferently,inhopesofoutsmartingthem.TheNewYorkTimes.http://www.nytimes.com/2013/06/27/science/studying-tumors-differently-in-hopes-of-outsmarting-them.html?_r=0