Natural Selection: Uncovering Mechanisms of Evolutionary Adaptation to Infectious Disease

In the 1940s, J. B. S. Haldane observed that many red blood cell disorders, such as sickle-cell anemia and various thalassemias, were prominent in tropical regions where malaria was endemic (Haldane, 1949; Figure 1). Haldane hypothesized that these disorders had become common in these regions because natural selection had acted to increase the prevalence of traits that protect individuals from malaria. Just a few years later, Haldane's so-called "malaria hypothesis" was confirmed by researcher A. C. Allison, who demonstrated that the geographical distribution of the sickle-cell mutation in the beta hemoglobin gene (HBB) was limited to Africa and correlated with malaria endemicity. Allison further noted that individuals who carried the sickle-cell trait were resistant to malaria (Allison, 1954).

Figure 1: Worldwide distribution of malaria

The worldwide distribution of Plasmodium falciparum malaria in 2003.

© 2003 Modified with permission from the World Health Organization. All rights reserved.

Allison's confirmation of Haldane's hypothesis provided the first elucidated example of human adaptation since natural selection had been proposed a century earlier. Today, this and other demonstrations of natural selection help point researchers toward biological mechanisms of resistance to infectious disease. Moreover, such examples also shed light on the ways in which pathogens rapidly evolve to remain agents of human morbidity and mortality.

Since Allison and Haldane's work, the action of natural selection on genetic resistance to malaria has been shown in a multitude of contexts (Kwiatkowski, 2005). Indeed, the sickle-cell variant (i.e., the HbS allele) has been identified in four distinct genetic backgrounds in different African populations, suggesting that the same mutation arose independently several times through convergent evolution. Beyond HbS, other distinct mutations in the HBB gene have generated the HbC and HbE alleles, which arose and spread in Africa and in Southeast Asia, respectively.

The various HBB alleles aren't alone in offering protection against malaria, however. The geographic distributions of several other red blood cell disorders, including a-thalassemia, G6PD deficiency, and ovalocytosis, correlate to malaria endemicity, and the diseases also are linked to malaria resistance. An even more striking worldwide geographical difference exists for a mutation in the Duffy antigen gene (FY), which encodes a membrane protein used by the Plasmodium vivax malaria parasite to enter red blood cells. This mutation disrupts the protein, thus conferring protection against P. vivax malaria, and it occurs at a prevalence of 100% throughout most of sub-Saharan Africa yet is virtually absent outside of Africa. Moreover, through convergent evolution, an independent mutation in FY that decreases this gene's expression has also become prevalent in Southeast Asia.

So, why has malaria exerted such strong selective pressure? Scientists now know the answer. Malaria is arguably one of the human population's oldest diseases and greatest causes of morbidity and mortality. Research indicates that the malaria-causing parasite Plasmodium falciparum has occurred in human populations for approximately 100,000 years, with a large population expansion in the last 10,000 years as human populations began to move into settlements (Hartl, 2004). P. falciparum, together with the other malaria species, P. vivax, P. malariae, and P. ovale, infects hundreds of millions of people worldwide each year, and kills more than 1 million children annually (World Health Organization, 2000). Because this disease is so devastating, humans have had to evolve adaptive traits to survive in the face of this infectious condition over the past few millennia (Kwiatkowski, 2005).

While malaria is the best-understood example of an infectious disease that has driven human evolution, numerous other infectious diseases have also acted in human populations over generations, thus allowing resistance alleles to emerge and spread over time (Diamond, 2005). Based on historical records from the last millennium, these diseases might include smallpox in ancient Europe and in Native American populations, as well as cholera, tuberculosis, and bubonic plague in Europe. Many diseases in Africa have likely been endemic for even longer, such as numerous diarrheal diseases, yellow fever, and Lassa hemorrhagic fever.

Today, with access to heretofore unprecedented data sets for the study of human genetic variation, researchers can exploit the genetic signatures of natural selection using novel analytical methods. In this way, they can identify genetic variants conferring resistance to infectious diseases that have spread through human populations over time. These studies will help elucidate natural mechanisms of defense and perhaps uncover novel evolutionary pressures. Moreover, the same tools that have revolutionized the study of natural selection in humans will also make unprecedented studies of pathogens possible.

Investigating the signatures of natural selection can help elucidate the evolutionary adaptations that have allowed humans to withstand some of our most complex and challenging selective agents. In particular, researchers can look for variants that might be readily detected in genetic association studies; for distinctive, detectable patterns of genetic variation in the human genome; and for clues as to how pathogens themselves evolve so rapidly.

Investigation of the links between natural selection and disease resistance has revealed some of the forces that have shaped our species, and the findings of these studies have direct implications for human health. However, research thus far represents just a first glimpse of a vast new landscape. In the years to come, new technologies and analytic methods will enable researchers to learn even more about the genetic basis of evolutionary adaptations that have allowed humans to withstand a wide variety of complex and challenging selective agents.