Instituto Gulbenkian de Ciência, Rua da Quinta Grande, 6, 2780-156 Oeiras, Portugal.
Nat Rev Immunol. 2017 Feb;17(2):83-96. doi: 10.1038/nri.2016.136. Epub 2017 Jan 3.
The immune system probably evolved to limit the negative effects exerted by pathogens on host homeostasis. This defence strategy relies on the concerted action of innate and adaptive components of the immune system, which sense and target pathogens for containment, destruction or expulsion. Resistance to infection refers to these immune functions, which reduce the pathogen load of an infected host as the means to preserve homeostasis. Immune-driven resistance to infection is coupled to an additional, and arguably as important, defence strategy that limits the extent of dysfunction imposed on host parenchymal tissues during infection, without exerting a direct negative effect on pathogens. This defence strategy, known as disease tolerance, relies on tissue damage control mechanisms that prevent the deleterious effects of pathogens and that uncouples immune-driven resistance mechanisms from immunopathology and disease. In this Review, we provide a unifying view of resistance and disease tolerance in the framework of immunity to infection.
免疫系统可能是为了限制病原体对宿主内稳态的负面影响而进化的。这种防御策略依赖于免疫系统的先天和适应性成分的协同作用，这些成分可以感知和靶向病原体，以进行控制、破坏或驱逐。抗感染的抵抗力是指这些免疫功能，它们通过减少感染宿主的病原体载量来维持内稳态。免疫驱动的抗感染抵抗力与另一种防御策略相关联，这种策略可以限制感染过程中宿主实质组织功能障碍的程度，而不对病原体产生直接的负面影响。这种防御策略被称为疾病耐受，它依赖于组织损伤控制机制，这些机制可以防止病原体的有害影响，并将免疫驱动的抵抗机制与免疫病理和疾病脱钩。在这篇综述中，我们在感染免疫的框架内提供了对抵抗力和疾病耐受的统一观点。
