mGem: A quarter century with the Pirofski-Casadevall damage response framework-a dynamic construct for understanding microbial pathogenesis
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Updated: Jul 26, 2026

Using a Bacterial Pathogen to Probe for Cellular and Organismic-level Host Responses
Published on: February 22, 2019
1Department of Medicine (Division of Infectious Diseases), Albert Einstein College of Medicine, New York, USA.
Abstract:
A quarter of a century ago, Liise-anne Pirofski and Arturo Casadevall shared their concepts of microbial pathogenesis through the lens of a damage-response framework (DRF), which characterizes disease by assessing the dynamic interactions between the host and pathogen as reflected by damage as the readout. This framework has evolved to be a powerful tool for understanding the biology of complex infectious diseases, analyzing emerging and reemerging microbes, and developing therapeutic approaches to combat infections. The DRF is also frequently used to explain research at scientific meetings and to teach microbial pathogenesis to diverse learners. This mGem reviews how the DRF came to be and provides an overview of how it is used. Without a doubt, the scientific community will continue to leverage the DRF to advance research and innovate therapeutic approaches, which is especially important as new and reemerging infectious diseases threaten global health.
Insights
The damage-response framework (DRF) offers a dynamic view of host-pathogen interactions in infectious diseases. This influential model aids research, therapeutic development, and education in microbial pathogenesis.
Area of Science:
- Microbiology
- Immunology
- Infectious Diseases
Background:
- The damage-response framework (DRF) was introduced 25 years ago by Pirofski and Casadevall.
- It conceptualizes disease as a result of host-pathogen interactions, with damage as the key outcome.
Observation:
- The DRF has become a vital tool for understanding complex infections.
- It is instrumental in analyzing emerging and reemerging microbial threats.
- The framework facilitates the development of novel therapeutic strategies.
Findings:
- The DRF provides a robust lens for studying microbial pathogenesis.
- Its application extends to scientific communication and pedagogical purposes.
- The framework's utility is demonstrated in its widespread adoption and continued relevance.
Implications:
- The DRF is crucial for advancing research in infectious diseases.
- It supports innovation in developing new treatments against microbial threats.
- Continued use of the DRF is essential for addressing global health challenges posed by new and reemerging infections.
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