Dances with worms: the ecological and evolutionary impacts of deworming on coinfecting pathogens.
Dances with worms: the ecological and evolutionary impacts of deworming on coinfecting pathogens.
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DOI：
10.1017/s0031182013000590
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发表时间：
2013-08
期刊：
影响因子：
2.4
通讯作者：
Fenton A
中科院分区：
文献类型：
--
作者：
Fenton A
寄生蠕虫在包括人类在内的大多数寄主群体中普遍存在。蠕虫经常改变感染微寄生病原体（病毒、细菌、原生动物）的可能性和疾病进展，将驱虫纳入许多主要疾病（如艾滋病毒、结核病、疟疾）的控制方案非常有意义。然而，这样的呼吁是有争议的；研究表明，驱虫的后果对病原体的严重程度和传播是高度可变的。因此，除虫的好处，虽然在减少因蠕虫感染本身引起的发病率方面是明确的，但在合并感染和合并症的结果方面尚不清楚。我发展了一个理论框架来探索寄生虫与其他病原体的共同感染如何影响宿主死亡率和病原体在不同种间寄生虫相互作用下的传播和进化。在所有情况下，共同感染的结果高度依赖于环境，取决于蠕虫-病原体相互作用的机制和蠕虫感染的数量水平，而驱虫的效果可能会根据蠕虫负担从有益到有害转变。这种环境依赖性可能解释了在不同研究中看到的驱虫益处的一些差异，并强调了在现实寄生虫感染范围内获得寄生虫相互作用定量理解的必要性。然而，尽管存在这种复杂性，该框架揭示了蠕虫影响的可预测模式，这可能有助于制定更有效的综合管理战略，以在这个共同感染的世界中对抗病原体。
Parasitic helminths are ubiquitous in most host, including human, populations. Helminths often alter the likelihood of infection and disease progression of coinfecting microparasitic pathogens (viruses, bacteria, protozoa), and there is great interest in incorporating deworming into control programmes for many major diseases (e.g. HIV, tuberculosis, malaria). However, such calls are controversial; studies show the consequences of deworming for the severity and spread of pathogens to be highly variable. Hence, the benefits of deworming, although clear for reducing the morbidity due to helminth infection per se, are unclear regarding the outcome of coinfections and comorbidities. I develop a theoretical framework to explore how helminth coinfection with other pathogens affects host mortality and pathogen spread and evolution under different interspecific parasite interactions. In all cases the outcomes of coinfection are highly context-dependent, depending on the mechanism of helminth-pathogen interaction and the quantitative level of helminth infection, with the effects of deworming potentially switching from beneficial to detrimental depending on helminth burden. Such context-dependency may explain some of the variation in the benefits of deworming seen between studies, and highlights the need for obtaining a quantitative understanding of parasite interactions across realistic helminth infection ranges. However, despite this complexity, this framework reveals predictable patterns in the effects of helminths that may aid the development of more effective, integrated management strategies to combat pathogens in this coinfected world.