Centre for Immunity, Infection and Evolution Institute of Evolutionary Biology, School of Biological Sciences, University of Edinburgh, Edinburgh EH9 3FL, UK
Centre for Immunity, Infection and Evolution Institute of Evolutionary Biology, School of Biological Sciences, University of Edinburgh, Edinburgh EH9 3FL, UK.
Evol Med Public Health. 2016 Apr 18;2016(1):148-57. doi: 10.1093/emph/eow012. Print 2016.
The antibiotic pipeline is running dry and infectious disease remains a major threat to public health. An efficient strategy to stay ahead of rapidly adapting pathogens should include approaches that replace, complement or enhance the effect of both current and novel antimicrobial compounds. In recent years, a number of innovative approaches to manage disease without the aid of traditional antibiotics and without eliminating the pathogens directly have emerged. These include disabling pathogen virulence-factors, increasing host tissue damage control or altering the microbiota to provide colonization resistance, immune resistance or disease tolerance against pathogens. We discuss the therapeutic potential of these approaches and examine their possible consequences for pathogen evolution. To guarantee a longer half-life of these alternatives to directly killing pathogens, and to gain a full understanding of their population-level consequences, we encourage future work to incorporate evolutionary perspectives into the development of these treatments.
抗生素领域的研发进展正逐渐枯竭，而传染病仍然是对公众健康的重大威胁。为了在快速适应的病原体面前保持领先地位，一种有效的策略应该包括替代、补充或增强现有和新型抗菌化合物效果的方法。近年来，出现了许多无需借助传统抗生素而直接对抗病原体的创新方法。这些方法包括削弱病原体的毒力因子、增加宿主组织损伤控制，或改变微生物群以提供定植抵抗、免疫抵抗或对病原体的疾病耐受。我们讨论了这些方法的治疗潜力，并研究了它们对病原体进化的可能影响。为了保证这些替代直接杀死病原体的方法的半衰期更长，并充分了解其在群体水平上的后果，我们鼓励未来的研究将进化视角纳入这些治疗方法的开发中。
