A new day for integrative physiology

Since the days of Albrecht von Haller (1708-77) and Claude Bernard (1813-78), physiologists have studied regulatory homeostatic mechanisms that adapt internal with external environments. Today, physiology reaches its highest level of efficacy and complexity by investigating the functioning of the body as a whole; but, as Wolfgang Walz indicates in his preface to Integrative Physiology in the Proteomics and Post-Genomics Age, ‘physiology is in crisis… despite undeniable and spectacular success of molecular biology, the lack of, and need for, an integrative perspective has become evident.’ This book, authored by 19 expert contributors, introduces its reader to that fresh enlightening viewpoint. It should help design curricula and identify learning objectives of both medical students and professional physiologists.In Integrative Physiology in the Proteomics and Post-Genomics Age, David Mattson (Medical College of Wisconsin) explores the significance of the integration of the sequencing of the human genome into human physiology as it contributes to proteonomics, bioinformation and computational biology. His insight supports the enviable position of modern physiologists in being able to understand how 35,000 genes operate in organ structure and function. That insight can be expected to enable ‘true high-throughput phenotyping’ to develop methods and models of functional information suitable for both research and clinical application.Meghan Taylor (St. Louis University) analyzes electrolyte and acid–base physiology, focusing on genomic and nongenomic effects of aldosterone on hydrogen transport, signaling of nitric oxide and molecular dissection of bicarbonate regulation. This study not only suggests that ‘molecular examination of acid–base balance’ promotes an understanding of its overall physiologic significance but also gives insight into clinical acid–base disorders and their management.In his chapter, Arthur Guyton emphasises the need, when studying circulation and fluid volume control, to consider the entire system as a whole and to use a quantitative approach at all levels of physiologic organization because ‘not all control mechanisms are of equal importance…and…individual mechanisms change with time and circumstance.’ A discussion of neuroendocrine networks follows, highlighting their ‘complex regulatory functions that involve processing and modulation of signaling at every point of communication between and within …(those) network(s).’Moving into the broader realm, Michel Cabanac (Laval University, Quebec) correlates human physiology with behavior, integrating individual function into social functioning, including conflicts in motivation, response to environmental change and alteration of the environment for human purpose. The following chapters consider the neural circuits that control behavior, physical activity, biochemical adaptation to extreme environments and human repair systems (focusing, for example, on lung). As a physiological model, Alicia Novak and Angeles Ribera suggest using the zebrafish to demonstrate integrative application suitable for classroom use.Finally, Dee Silverthorn and Penelope Hansen introduce a fresh curriculum design, using the integrative techniques explored in the rest of the book to provide practical instruction for medical students as well as for professional physiologists. They carefully reconsider the aims and requirements of the course (what students must master), identify appropriate educational resources and establish learning objectives. In assessing the learning objectives, they try to match what is being taught with what is being tested. They write: ‘physiologists should approach their teaching with the same scholarly strategies that they use in bench research… ‘backward design’…the opposite of the traditional method for developing a course…examination…afterthought…how can we decide what information is essential and what can be ignored?’As a conclusion, ‘this book represents the leading edge of an exciting development in biological science: the re-emergence of integrative physiology as an organizing principle.’ I agree.