Parija Subhash Chandra, Khurana Sumeeta
Professor Emeritus, National Academy of Medical Sciences, New Delhi, India.
Department of Medical Parasitology, PGIMER, Chandigarh, India.
Trop Parasitol. 2025 Jan-Jun;15(1):8-11. doi: 10.4103/tp.tp_2_25. Epub 2025 Apr 5.
Koch's postulates have long served as a foundational framework in microbiology for establishing causal relationships between microorganisms and diseases. However, when applied to parasitic infections, these postulates often reveal limitations due to the unique complexities associated with parasites. The intricate life cycles, diverse clinical presentations, and interactions between hosts and parasites necessitate a reformed approach. This paper proposes a set of postulates specifically designed for parasitic diseases. The revised criteria underscore the consistent identification of the parasite, its correlation with clinical manifestations, the specificity and sensitivity of diagnostic methods, experimental infections in appropriate animal models, therapeutic responses, host-parasite dynamics, and molecular epidemiology. By integrating these elements, the postulates provide a more comprehensive framework for establishing causality in parasitic diseases. As our understanding of these infections evolves, so must our approaches to defining causation, especially with technological advancements and research on host-parasite interactions. This adaptability will help maintain an accurate and current understanding of parasitic diseases.
科赫法则长期以来一直是微生物学中用于建立微生物与疾病之间因果关系的基础框架。然而,当应用于寄生虫感染时,由于与寄生虫相关的独特复杂性,这些法则常常显示出局限性。复杂的生命周期、多样的临床表现以及宿主与寄生虫之间的相互作用需要一种经过改革的方法。本文提出了一套专门为寄生虫病设计的法则。修订后的标准强调对寄生虫的持续识别、其与临床表现的相关性、诊断方法的特异性和敏感性、在合适动物模型中的实验性感染、治疗反应、宿主 - 寄生虫动态以及分子流行病学。通过整合这些要素,这些法则为确定寄生虫病的因果关系提供了一个更全面的框架。随着我们对这些感染的理解不断发展,我们定义因果关系的方法也必须如此,特别是随着技术进步以及对宿主 - 寄生虫相互作用的研究。这种适应性将有助于保持对寄生虫病的准确和最新理解。