Limiting damage during infection: lessons from infection tolerance for novel therapeutics.

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...

Full description

Saved in:
Bibliographic Details
Main Authors: Pedro F Vale, Andy Fenton, Sam P Brown
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2014-01-01
Series:PLoS Biology
Online Access:https://doi.org/10.1371/journal.pbio.1001769
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849332387147677696
author Pedro F Vale
Andy Fenton
Sam P Brown
author_facet Pedro F Vale
Andy Fenton
Sam P Brown
author_sort Pedro F Vale
collection DOAJ
description 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.
format Article
id doaj-art-9cccae26b0d44df8b066c4efba79e9e1
institution Kabale University
issn 1544-9173
1545-7885
language English
publishDate 2014-01-01
publisher Public Library of Science (PLoS)
record_format Article
series PLoS Biology
spelling doaj-art-9cccae26b0d44df8b066c4efba79e9e12025-08-20T03:46:12ZengPublic Library of Science (PLoS)PLoS Biology1544-91731545-78852014-01-01121e100176910.1371/journal.pbio.1001769Limiting damage during infection: lessons from infection tolerance for novel therapeutics.Pedro F ValeAndy FentonSam P BrownThe 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.https://doi.org/10.1371/journal.pbio.1001769
spellingShingle Pedro F Vale
Andy Fenton
Sam P Brown
Limiting damage during infection: lessons from infection tolerance for novel therapeutics.
PLoS Biology
title Limiting damage during infection: lessons from infection tolerance for novel therapeutics.
title_full Limiting damage during infection: lessons from infection tolerance for novel therapeutics.
title_fullStr Limiting damage during infection: lessons from infection tolerance for novel therapeutics.
title_full_unstemmed Limiting damage during infection: lessons from infection tolerance for novel therapeutics.
title_short Limiting damage during infection: lessons from infection tolerance for novel therapeutics.
title_sort limiting damage during infection lessons from infection tolerance for novel therapeutics
url https://doi.org/10.1371/journal.pbio.1001769
work_keys_str_mv AT pedrofvale limitingdamageduringinfectionlessonsfrominfectiontolerancefornoveltherapeutics
AT andyfenton limitingdamageduringinfectionlessonsfrominfectiontolerancefornoveltherapeutics
AT sampbrown limitingdamageduringinfectionlessonsfrominfectiontolerancefornoveltherapeutics