Mackowiak P A
Department of Veterans Affairs Medical Center, Baltimore, Maryland.
Ann Intern Med. 1994 Jun 15;120(12):1037-40. doi: 10.7326/0003-4819-120-12-199406150-00010.
Considerable data indicate that fever and its mediators have the capacity both to potentiate and to inhibit resistance to infection. It is difficult to reconcile these apparently contradictory observations if they are viewed solely from the standpoint of the individual. However, when viewed from the perspective of the species, both fever's salutary effects on mild to moderately severe infections and its pernicious influence on fulminating infections become teleologically plausible. If one accepts preservation of the species, rather than survival of the individual, as the essence of evolution, fever and its mediators might have evolved as mechanisms both for accelerating recovery of individuals from localized or mild to moderately severe systemic infections in the interest of continued propagation of the species and for hastening the elimination of fulminantly infected individuals who pose a threat of epidemic disease to the species.
大量数据表明,发热及其介质既有增强抗感染能力的作用,也有抑制抗感染能力的作用。如果仅从个体角度来看,很难协调这些明显相互矛盾的观察结果。然而,从物种的角度来看,发热对轻度至中度严重感染的有益作用及其对暴发性感染的有害影响在目的论上都变得合理了。如果接受物种的保存而非个体的存活是进化的本质,那么发热及其介质可能已经进化为这样的机制:一方面为了加速个体从局部或轻度至中度严重的全身感染中恢复,以利于物种的持续繁衍;另一方面为了加速清除那些对物种构成流行病威胁的暴发性感染个体。