Limiting Damage during Infection: Lessons from Infection Tolerance for Novel Therapeutics.

Vale, Pedro F, Fenton, Andy ORCID: 0000-0002-7676-917X and Brown, Sam P (2014) Limiting Damage during Infection: Lessons from Infection Tolerance for Novel Therapeutics. PLoS Biology, 12 (1). e1001769-.

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Abstract

The distinction between pathogen elimination and damage limitation during infection is beginning to change perspectives on infectious disease control, and has recently led to the development of novel therapies that focus on reducing the illness caused by pathogens ("damage limitation") rather than reducing pathogen burdens directly ("pathogen elimination"). While beneficial at the individual host level, the population consequences of these interventions remain unclear. To address this issue, we present a simple conceptual framework for damage limitation during infection that distinguishes between therapies that are either host-centric (pro-tolerance) or pathogen-centric (anti-virulence). We then draw on recent developments from the evolutionary ecology of disease tolerance to highlight some potential epidemiological and evolutionary responses of pathogens to medical interventions that target the symptoms of infection. Just as pathogens are known to evolve in response to antimicrobial and vaccination therapies, we caution that claims of "evolution-proof" anti-virulence interventions may be premature, and further, that in infections where virulence and transmission are linked, reducing illness without reducing pathogen burden could have non-trivial epidemiological and evolutionary consequences that require careful examination.

Item Type:	Article
Additional Information:	Times Cited: 1 0 1 ## TULIP Type: Articles/Papers (Journal) ## official_url: <Go to ISI>://WOS:000336832200018
Uncontrolled Keywords:	Humans, Bacterial Infections, Virus Diseases, Aspirin, Ibuprofen, Anti-Inflammatory Agents, Non-Steroidal, Bacterial Toxins, Virulence Factors, Drugs, Investigational, Colony Count, Microbial, Viral Load, Models, Statistical, Bacterial Adhesion, Virulence, Immune Tolerance, Quorum Sensing, Host-Pathogen Interactions, Biological Evolution
Depositing User:	Symplectic Admin
Date Deposited:	13 Apr 2016 09:35
Last Modified:	16 Dec 2022 06:46
DOI:	10.1371/journal.pbio.1001769
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3000506