SUBJECT 2016

LIFE’S STAGES

There is a widespread debate today about the short term perspective of a “personalized medicine”, or better a “precision medicine”: but how many “people” are we, or how much do we change during our life course? How many different “ages” do we live, from the stage of a fertilized egg up to the conclusive ones of old age, more or less senescent?

The first edition of Bologna Medicina, the Festival della Scienza Medica focused the scientific and clinical attention on the “long life” condition. Any evidence shows that – at least in the wealthier and more advanced societies – the life expectation of human biological adventure on the Earth reaches out towards a hundred years. The second edition, which will take place from 19th to 22th of May 2016, shall instead focus on the different stages of this exciting and precarious adventure: how many “life stages” are there?

Prenatal, neonatal, infancy, childhood, juvenile, puberty, adolescence, adult life, old age and senescence. Human biologists who study the transitional physiological changes of our body-mind complex count at least ten different stages, each one with specific features. Although we take for granted that we are always the same person from the cradle to the grave, in reality each one lives as many lives a number of physiological stages, therefore we encounter different potential pathologies according the specific life stage we are in. This means that medicine has to use new ideas and creative strategies to pursue scientific and technological advancements to explain, prevent and cure diseases in an effective and functional way while taking into consideration the different stages of each human life: how many and which interventions can be applied at the different “ages of life” to prevent the health consequences from the lack of awareness that, during human life, our “person” goes through so many relevant physiological modifications? In fact, each specific growth process changes our body-mind and also the individual predisposition to fall ill.

Certainly, many dangers do not strictly depend on age – such as the most common ones, like infectious diseases – but for many of the more common diseases medicine has to keep on evolution and development, as it has already started to do, and always more scientifically reliable methods, in order to come up with pertinent explicative models, effective prevention strategies and tailored therapies.

Nothing makes sense in Biology [so neither in Medicine] except in the light of evolution – said the evolutionary geneticist Theodosius Dobzhansky. The human species phylogeny has been lasting millions of years, and as for other higher organisms, natural selection favoured our investments and adjustment abilities rather than only the reproductive ones: it is because of the natural selection process that we acquired a species specific Life Cycle. This means that the resources for growing, for staying alive and for reproducing, related to age or size, are distributed so that they can maximize the potential to adapt during the individual life stages. The evolution of the Human Life Cycle, in particular of specific pre-adult characteristic of this cycle (all the many and long stages preluding adult life, from the prenatal one to adolescence) allowed for the acquisition of the mental capacities needed and sufficient for evolution and for the diffusion of “higher” human traits. It is because we live many lives that our life was so efficient in the colonization of the world.

Understanding the evolutionary meaning of the Ages of Life means to better qualify the aim of personalizing medicine, by making it more precise. Nonetheless, the Festival della Scienza Medica can only look far ahead.

In Bologna, medicine has a great future.

Gilberto Corbellini and Pino Donghi