Medics and veterinarians have a long history of working closely together on diseases of mutual interest which can be traced backed into the late 18th century. Read on to find out how such collaboration is more important than ever.
Despite the history of collaboration, there has been a growing concern about the development of ‘stubborn silos’ where interdisciplinary interactions between medics and veterinarians is the exception rather than the rule. The ‘One Health, One Medicine’ movement has emerged out of these concerns and embraces a cross-discipline, collaborative approach between medics, veterinarians and scientists to address diseases of importance to both scientific communities.
Over recent years, the emergence of important zoonotic diseases has been a key driver in the development of such collaborations as the wider biomedical community develops management approaches for diseases such as severe acute respiratory syndrome (SARS), rabies and H5N1 influenza. These diseases, which have caused significant global morbidity and mortality, highlighted the need to understand disease biology in one species in order to develop rational therapeutic and preventive approaches for another. There are numerous other examples beyond zoonotic diseases where an integrated, multi-discipline ‘One Heath, One Medicine’ approach has been strongly advocated, from topics as diverse as antibiotic resistance to the biology of obesity.
Spontaneous models of human diseases
Aside from the need to control zoonotic diseases, another major driver of the ‘One Health, One Medicine’ agenda is the lack of progress which has been made on understanding, and subsequently developing novel therapies for, many human disorders. The numerous recent medical advances in these fields have frequently only allowed for more effective palliation of the clinical signs and often complete resolution of the underlying pathology is not achieved. This failure has promoted reflection amongst scientists as to whether new approaches are required in order to make clinically relevant advances in patient care. Although lack of funding for scientific research is frequently cited as a major barrier in the drive to develop novel therapies, the failure to make significant, step change advances in the treatment of many diseases has occurred despite an expansion of global biomedical research.
This paucity of major advances in clinical treatments has, in part, driven a large increase in the number of animals, particularly mice and rats, which are used in experimental models of human diseases. Paradoxically, it is the increasing reliance on murine models that has been implicated as one of the reasons why so many treatments fail in human trials. Firstly, there are concerns that mouse physiology is so significantly different from humans that it is invariably unreasonable to assume that humans and mice will respond in a similar fashion to the same physiological challenge or novel therapy. Secondly, there are increasing concerns that murine models themselves simply do not accurately mimic human disease. There are also continuing concerns amongst the public about the morality of inducing disease in healthy animals.
Can a ‘One Health, One Medicine’ approach improve the health of companion animals and humans?
How can a ‘One Health, One Medicine’ approach involving companion animal veterinarians address these problems and provide a framework to further understanding of human and animal diseases? Arguably, companion animal veterinarians are now uniquely placed to help overcome these challenges and, at the same time, allow a deeper understanding of common canine disorders to emerge. There is an expanding evidence base that the biology of many spontaneous disorders in companion animals closely mimics human disorders including a wide range of developmental, autoimmune, degenerative and neoplastic conditions. Companion animals also develop diseases which are almost analogous to the experimental models which are created in healthy animals. Other reasons to support more common place collaborations between vets and medics include the increasing numbers of longitudinal cohorts and consortia of academic institutes and primary care practices involving large numbers of client owned dogs. This has facilitated studies which have defined the risk factors involved in disease development with a degree of rigour that was not possible until very recently. Furthermore, the dramatic advances in companion animal genomics afford opportunities to understand the role of genotype on the development of illnesses in both highly inbred breeds and more genetically diverse cross breed populations. In addition, the more widespread availability of advanced diagnostic imaging equipment such as MRI and CT has greatly enhanced the ability of companion animal veterinarians to precisely phenotype diseases.