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Related Experiment Videos

Pathogenicity and virulence: another view.

H D Isenberg1

  • 1Long Island Jewish Medical Center, New Hyde Park, New York 11042.

Clinical Microbiology Reviews
|January 1, 1988
PubMed
Summary
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Microbial pathogenicity and virulence concepts overlook host factors in disease. Host reactions are crucial determinants in infections, including genomic parasitism, shifting focus from microbes to host-parasite equilibrium.

Area of Science:

  • Microbiology
  • Immunology
  • Infectious Diseases

Background:

  • Traditional concepts of pathogenicity and virulence, rooted in Pasteur and Koch's work, focus on microbial agents causing disease.
  • Koch's postulates attribute harmfulness solely to microbes, a view challenged by complex infections like polymicrobic, nosocomial, legionellosis, and acquired immunodeficiency syndrome.

Purpose of the Study:

  • To re-evaluate the traditional understanding of microbial harmfulness by emphasizing the host's role in disease determination.
  • To explore the host-parasite equilibrium, as proposed by Theobold Smith, as a more accurate model for understanding infections.
  • To highlight the significance of host reactions and microbial-host interactions in the emergence of novel infectious diseases.

Main Methods:

  • Review of historical concepts of pathogenicity and virulence.

Related Experiment Videos

  • Analysis of recent clinical observations of complex infections (polymicrobic, nosocomial, legionellosis, AIDS).
  • Consideration of microbial attributes (attachment organelles, exopolysaccharides) and their interaction with host cells.
  • Examination of the impact of therapeutic agents on microbial adaptation and host colonization.

    • Main Results:

    • Host factors are increasingly recognized as major determinants of disease severity and outcome.
    • Microbial interactions with host cells, such as attachment to glycocalyces, are critical in infection dynamics.
    • Therapeutic interventions can inadvertently promote the adaptation of environmental organisms to the human host.
    • The concept of genomic parasitism, involving nucleic acid interactions between parasite and host, represents a subtler form of infection.

    Conclusions:

    • The host's immune response and intrinsic factors are pivotal in determining the outcome of infections.
    • A shift from a purely microbe-centric view to a host-parasite equilibrium model is necessary for a comprehensive understanding of infectious diseases.
    • Emerging infections may involve complex interactions at the genomic level, underscoring the dynamic interplay between host and pathogen.