For what a marvelously informal and amazingly clear talk.

Just beautiful our customers to allow the other channels to have the first opportunity to ask questions.

We have anyone on the panel with a question.

Dr Keller.

I remember back in the 1977 times, the famous position writer Lewis Thomas proclaimed the end of infectious disease, and we were soon conquer the diseases of aging.

Of course, that didn't happen.

He died of cancer, I guess.

Like my question is, what are we supposed to learn from evolution?

It would seem to meet with the difficulty with cancer.

The diseases of aging is we seem to be actually fighting evolution, which appears to want us dead sooner or later.

And the question is, it seemed a fundamental question is to what extension that process go on.

Should we resist?

Is it a lesson to be learned from evolution?

Or can we ignore the lesson even if it's there?

Weather many lessons to be learned from evolution?

I'm not evolutionary biologist, but I think it's generally agreed that the central tenet of revolutionary quote the theoretical part is that evolution is a care kid cares how well we reproduce.

And once we reproduced, we're left to our own devices.

Uh, so the interesting question becomes, Is that genetic?

I took the line out of my talk.

There was a line of my talk with says there was literally a genetic program for aging.

That's a Mrs Apprehension.

Actually, I think these jeans are there to serve other purposes.

There.

There sustain a vital organ is so that it can reproduce.

And once it's true, reproductive age has got nothing to protect us against you, which is a disease of the aging.

Nor has it done a whole lot to protect us against cancer, which is primarily a disease of the agent.

So the lesson we learned revolution, I think, is simply that we're going to do things to the human organism that would extend its reproductive life.

Then we have to take her seriously species.

But I worry less about the impact on the evolution of the species, and I worry about the impact on our society.

Some of the things I talked about, your the incident and who is Thomas made a lot of predictions ever wrong and also a little straighter in my own from Amenable East, which eyes violating a couple times this morning.

I just should not make predictions any others.

Dr Foster home.

Thank you it in the terms that you slayed out today.

It's exciting.

I'm from the standpoint of thinking or immortality or potential thereof.

And it's ironic coming from the medical profession as you do that.

The one thing that's really given, then, I guess, depending on your religious beliefs, this has been true that death is never death is going to be an eventual outcome.

Everyone in this room will die one day.

Given that I would like you maybe to think about our respond to the issue that, in fact we're trying to avoid death at the cost of possibly creating a different death may be much worse than the death we might otherwise have anticipated.

Meaning the top 10 causes of death exist today.

If we eliminate them every 10 new ones and wrestle Sure, some of the new ones are gonna be a lot worse than the ones we have now.

How do you see the construct of genetic engineering that whole issue talking about playing into that discussion of Maybe it is our time.

Navy does the way we want to go, and therefore we shouldn't monkey with it.

I have reservations about monkeying with.

That's why I raised the issue at the end of a very telegraphic way.

Do we really want to interfere with the natural human cycle of youth, reproductive life on aging?

Because we don't know what would lie ahead if we extend our life spans served dramatically.

But of course we're doing that now.

The incidents of mortality rate for cardio Baxter diseases dropping failed dramatically and will probably continue to do so.

Gradual way.

Do you really do see the prospect of both being able to more effectively treat and eventually prevent major cancer killers, which is the second most common killer in developed world?

So we're going to face that under current circumstances, and so we're going to have a population that is increasingly aging into the range of civility.

Now, one thing I didn't mention about well, I didn't mention it, but I didn't, uh, extrapolate.

This, of course, is highly speculative.

So much of us, I just wanted to double strength, possible prospects that did you make your razors uh, the worm and the fruit fly.

Although it's not easy to assess their quality of life, there are certain features of them.

Certain properties that desert make their aging.

You can tell if you take a random population is alert worms.

You can tell the ones that are aging and nearing death.

Manipulating these aging genes The animals that live longer do not display them.

Properties of impending death until very close to death remain properties, impending death.

And very recently, there's been some work just one paper to paper so far published in the journal Nature, which clearly link cancer with the aging program.

And so the fort is that it's a very provisional thought that if you if you were to extend life span in a certain way, you could do it without these dreadful expects that we associate with without premature agent.

If you know what would become premature aging.

But it's we just don't know enough to eat to answer your question with any assurance.

It's clearly on our minds on dhe.

I think we have quite a bit of time to think about it.

Frankly, Dr West, okay, The question from the audience here is 30,000 genes enough to coat for human beings besides multifactorial inheritance and multiple protein and coding?

Is there another source for biological variability?

Well, I mentioned the M P G no, which is a very dramatic source for biological variation that we don't fully understand yet.

But it's it's goingto greatly increase The capacity for diversification of genetic program of expression of genetic program were also coming upon other features of the genetic apparatus that are totally unanticipated.

So the simplest answer, your question is, yeah, 30,000 genes is not enough.

Confounded people absolutely puzzled them when it was first discovered, but bit by bit, we're finding it's only that is only part of the story.

So, in essence, the puzzle where our perplexity, how our complexity arises is unsolved.

Okay, we have another question here.

If we target adult stem cells that maybe cancers are pre cancerous, what about the susceptibility to normal adult stem cells?

Might they also be susceptible?

Well, no, not if we're using targeted therapy.

It's the same principle I illustrated for you with those four examples.

Uh, the cancer stem cell in principle.

Again, this is provisional, but we have good evidence for it.

In Kenya, the cancer stem cell is different than the normal adult stem cell.

It's carrying, at least if not one, if not more than one genetic abnormality.

And just as with the mature tumor cells, the the idea is to develop therapies that attack the genetic abnormality in the cancer stem cell, the adult and not the normal adult stem cells.

So it's the same principle just applied to the cancer stem cell rather than to the mature cancer.

So okay, you have another question.

Your lecture focused heavily on the genetic components of cancer and cancer treatment.

Can you comment on the immune system research being conducted A.

CZ, both a causative agent and potential disease therapy.

Um, the only rule the immune system plays that we know, sir can play in the genesis of cancer is when it is deficient on dhe.

I can demonstrate that with patients who are immuno suppressed because they received transplanted organs, they're susceptible to certain tumors that are caused by viruses.

And they're susceptible because their new system is not counter acting the viral infection.

One of these is a form of lymphoma that caused by a virus called Epstein Barr virus that many of us air carrying in ourselves from the rest of our lives, and it doesn't bother us.

But if our immune system is suppressed, then this virus can cause a woman in a certain number of us.

The other example is Kaposi's sarcoma, which occurs mainly in patients with the AIDS and because the immuno suppression of those patients has affected the ability of a certain herpes virus to infect them and elicit this tumor.

Same thing is true of cancer of the cervix, which is the incidence of cancer of the cervix is elevated in women with AIDS.

And that's because cervix cancer the cervix, has caused by infection with papilloma virus on.

These individuals are more susceptible to the infection and the consequences of the infection because their immune system is suppressed, using the immune system as a therapeutic.

It's been a dream for five generations, and until now it doesn't approach a practical reality.

I think that's all I need to say.

It's still under Abbott and makes the press about once a year used the same two or three people with yet another way to do it.

But it is doesn't approach a practical reality.

Okay, that's another question.

Our disease bearing jeans present for a reason.

Well, elimination of these genes possibly have a military is effect.

I would think that's unlikely.

They're not that common.

There's no evidence they've been selected for factors from the from their rarity in the human population.

It would appear that they encounter selected.

So I got very much that eliminating these jeans is gonna have anything but a beneficial effect.

And let me repeat that we can eliminate this kind of gene in ways that are, for much of our population, entirely acceptable because it's done.

It's already done bye as part of what's called preimplantation diagnosis.

If fertilization is done in vitro as an assisted reproduction when little embryo has reached the size of about eight cells, this has been in the press recently because people are making stem cells trying to make themselves this way.

21 The M E reaches about itself the reproductive scientist.

Our position just takes one of themselves and can do the diagnostic test for hemophilia.

Gene.

If he a fool, he's in the family.

And if if if it's present, and it's acceptable to the parents.

That embryo could be discarded in another one, tested until one has found that doesn't have Del Interiors gene.

So that's already a practice preimplantation diagnosis, so sort of repeat if you look.

If you look at all the evidence, it would appear that disease genes like that have been counter selected rather than positively selected.

There are a few exceptions.

For example, there are certain blood diseases they best being sickle cell anemia that provides some protection against malaria infection.

And indeed, the frequency of that disease is of sickle.

Cell is higher in areas where malaria infection is endemic.

But we have ways to get rid of malaria.

If we were just willing to apply them universally and bear the expense, and then I believe probably that there would be no further a selection of advantage to having sickles own name.

It's a dreadful disease, and it's been countered, selected those populations that don't have to bear a malarial burden.

Dr Osterholm.

No, actually, I The comment Dr Bishop just made about a good example of sickle cell in malaria.

There are those very rare instances where the military is.

Jean does have a benefit, and part of our job is going to be understanding when that occurs, but I agree with him.

It's a very, very rare situation, and it usually is an evolutionarily evident kind of jean situation.

Let me point out that all of this you're questioning and the answer's indicates how, how, even in the consideration of disease, disease susceptibility something, it seems so pragmatic.

Evolution, existence of evolution and our understanding Revolution is so important as a theoretical underpinning.

There's a wonderful book written.

They remember Jim about Theo, evolution of disease in the role of evolution in generate disease and preventing it.

Evolution underpins everything in biology and medicine.

It was John skill when said that you can't think about biology without without thinking about evolution is just impossible.

And in fact, just one follow up on that.

When you think about it, if you trace back our human ancestry, we go back about 80,000 generations to the caves.

And throughout that time, many evolutionary selections occurred that related large into a world of infectious diseases, a life expectancy of less than 40 and it's only been in the last really 100 years that we've had this major change who we are as humans.

And yet that program has already been there.

And I think that what Dr Bishop is really pointing out to us is very important.

That in fact were monkeying with a lot of history that we don't really understand.

Yet that occurred for a very specific reason, and now it's our job to figure that out, even though we live in a world very different.

And we did even 5 10 or 15 generations ago.

Well, I think it's about time to get one last round of applause for our Panelists.

Way will break for lunch and we will reassemble here at one o'clock.