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Updated: Mar 29, 2026

Using a Bacterial Pathogen to Probe for Cellular and Organismic-level Host Responses
Published on: February 22, 2019
Human genetic basis of interindividual variability in the course of infection
1St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY 10065; Howard Hughes Medical Institute, New York, NY 10065; Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Inserm U1163, Necker Hospital for Sick Children, 75015 Paris, France; Imagine Institute, Paris Descartes University, 75015 Paris, France; Pediatric Hematology and Immunology Unit, Assistance Publique-Hôpitaux de Paris, Necker Hospital for Sick Children, 75015 Paris, France jean-laurent.casanova@rockefeller.edu.
Abstract:
The key problem in human infectious diseases was posed at the turn of the 20th century: their pathogenesis. For almost any given virus, bacterium, fungus, or parasite, life-threatening clinical disease develops in only a small minority of infected individuals. Solving this infection enigma is important clinically, for diagnosis, prognosis, prevention, and treatment. Some microbes will inevitably remain refractory to, or escape vaccination, or chemotherapy, or both. The solution also is important biologically, because the emergence and evolution of eukaryotes alongside more rapidly evolving prokaryotes, archaea, and viruses posed immunological challenges of an ecological and evolutionary nature. We need to study these challenges in natural, as opposed to experimental, conditions, and also at the molecular and cellular levels. According to the human genetic theory of infectious diseases, inborn variants underlie life-threatening infectious diseases. Here I review the history of the field of human genetics of infectious diseases from the turn of the 19th century to the second half of the 20th century. This paper thus sets the scene, providing the background information required to understand and appreciate the more recently described monogenic forms of resistance or predisposition to specific infections discussed in a second paper in this issue.
Insights
Understanding why only some people get severe infectious diseases is key. This review explores the history of human genetics in infectious diseases, highlighting inborn factors influencing disease severity.
Area of Science:
- Infectious Diseases
- Human Genetics
- Immunology
- Evolutionary Biology
Background:
- Pathogenesis of infectious diseases remains a central enigma, with only a minority of infected individuals developing severe illness.
- Understanding host-pathogen interactions is crucial for clinical applications like diagnosis, prognosis, prevention, and treatment.
- The co-evolution of eukaryotes with prokaryotes, archaea, and viruses presents complex ecological and evolutionary immunological challenges.
Purpose of the Study:
- To review the historical development of the human genetics of infectious diseases from the late 19th to the mid-20th century.
- To establish the foundational knowledge for understanding genetic predispositions to infectious diseases.
- To set the stage for discussing recently identified monogenic forms of infection resistance and susceptibility.
Main Methods:
- Historical review of scientific literature and theories.
- Examination of the evolution of thought regarding infectious disease pathogenesis.
- Focus on the development of the human genetic theory of infectious diseases.
Main Results:
- The pathogenesis of infectious diseases was a key problem identified at the turn of the 20th century.
- The human genetic theory of infectious diseases posits that inborn genetic variants contribute to life-threatening infections.
- This historical review provides essential background for contemporary research in the field.
Conclusions:
- The historical perspective on human genetics and infectious diseases is crucial for understanding current research.
- Inborn genetic variations play a significant role in determining the severity of infectious diseases.
- Further investigation into genetic factors is vital for advancing clinical and biological understanding of infections.
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