Department of Plant Pathology, University of California, Davis, California, USA; email:
Annu Rev Phytopathol. 2024 Sep;62(1):31-47. doi: 10.1146/annurev-phyto-121423-042021. Epub 2024 Aug 22.
The disease triangle is a structurally simple but conceptually rich model that is used in plant pathology and other fields of study to explain infectious disease as an outcome of the three-way relationship between a host, a pathogen, and their environment. It also serves as a guide for finding solutions to treat, predict, and prevent such diseases. With the omics-driven, evidence-based realization that the abundance and activity of a pathogen are impacted by proximity to and interaction with a diverse multitude of other microorganisms colonizing the same host, the disease triangle evolved into a tetrahedron shape, which features an added fourth dimension representing the host-associated microbiota. Another variant of the disease triangle emerged from the recently formulated pathobiome paradigm, which deviates from the classical "one pathogen" etiology of infectious disease in favor of a scenario in which disease represents a conditional outcome of complex interactions between and among a host, its microbiota (including microbes with pathogenic potential), and the environment. The result is a version of the original disease triangle where "pathogen" is substituted with "microbiota." Here, as part of a careful and concise review of the origin, history, and usage of the disease triangle, I propose a next step in its evolution, which is to replace the word "disease" in the center of the host-microbiota-environment triad with the word "health." This triangle highlights health as a desirable outcome (rather than disease as an unwanted state) and as an emergent property of host-microbiota-environment interactions. Applied to the discipline of plant pathology, the health triangle offers an expanded range of targets and approaches for the diagnosis, prediction, restoration, and maintenance of plant health outcomes. Its applications are not restricted to infectious diseases only, and its underlying framework is more inclusive of all microbial contributions to plant well-being, including those by mycorrhizal fungi and nitrogen-fixing bacteria, for which there never was a proper place in the plant disease triangle. The plant health triangle also may have an edge as an education and communication tool to convey and stress the importance of healthy plants and their associated microbiota to a broader public and stakeholdership.
疾病三角是一个结构简单但概念丰富的模型,用于植物病理学和其他研究领域,以解释传染病是宿主、病原体及其环境之间三向关系的结果。它还为寻找治疗、预测和预防此类疾病的方法提供了指导。随着基于组学的证据表明,病原体的丰度和活性受到其与定植在同一宿主的多种其他微生物的接近度和相互作用的影响,疾病三角演变成了一个四面体形状,其中增加了第四个维度,代表宿主相关的微生物组。疾病三角的另一个变体源自最近提出的病理生物群范式,该范式偏离了传染病的经典“单一病原体”病因学,转而支持疾病代表宿主、其微生物组(包括具有潜在致病性的微生物)和环境之间复杂相互作用的条件结果的情景。其结果是原始疾病三角的一个变体,其中“病原体”被“微生物组”取代。在这里,作为对疾病三角的起源、历史和用法的仔细而简洁的回顾的一部分,我提出了其进化的下一步,即用“健康”一词代替宿主-微生物组-环境三联体中心的“疾病”一词。这个三角强调健康是一个理想的结果(而不是疾病作为一种不受欢迎的状态),并且是宿主-微生物组-环境相互作用的一个涌现属性。将其应用于植物病理学学科,健康三角为植物健康结果的诊断、预测、恢复和维持提供了更广泛的目标和方法。它的应用不仅限于传染病,其基础框架更包括所有微生物对植物健康的贡献,包括菌根真菌和固氮细菌,它们在植物疾病三角中从未有过适当的位置。植物健康三角作为一种教育和沟通工具也具有优势,可以向更广泛的公众和利益相关者传达和强调健康植物及其相关微生物组的重要性。