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====== Successive infection and variability in disease ====== | ====== Successive infection and variability in disease ====== | ||
- | <relatedarticle> [[home: | + | <relatedarticles> [[home: |
Chronic diseases manifest in patients and within patient populations with a high degree of variability. Some people have five chronic diseases, and others have one. Some patients experience symptoms of disease early in life while others not until they are very old. According to the Marshall Pathogenesis, | Chronic diseases manifest in patients and within patient populations with a high degree of variability. Some people have five chronic diseases, and others have one. Some patients experience symptoms of disease early in life while others not until they are very old. According to the Marshall Pathogenesis, | ||
- | Over the course of a lifetime, patients pick up the approximately 90 trillion bacteria to which they play host.(({{pubmed> | + | Over the course of a lifetime, patients pick up the approximately 90 trillion bacteria to which they play host.(({{pmid> |
The process by which a person accumulates the bacteria which drive disease is known as " | The process by which a person accumulates the bacteria which drive disease is known as " | ||
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- | Over the course of their lifetime, humans encounter and accumulate different pathogens and thus develop a unique infectious history. People acquire bacteria from the food they eat, from their mothers during gestation, from injectable medicines, from a family member or friend, etc. Some pathogens are relatively common across different people. For example, approximately half of the human population is infected with //Chlamydia pneumoniae// | + | Over the course of their lifetime, humans encounter and accumulate different pathogens and thus develop a unique infectious history. People acquire bacteria from the food they eat, from their mothers during gestation, from injectable medicines, from a family member or friend, etc. Some pathogens are relatively common across different people. For example, approximately half of the human population is infected with //Chlamydia pneumoniae// |
- | Using high throughput sequencing, one research team found that of bacteria present on the hands of 51 undergraduate students leaving an exam room, there were 332,000 genetically distinct bacteria belonging to 4,742 different species. Each student carried on average 3,200 bacteria from 150 species on their hands. Only five species were found on all the students’ hands, while any two hands – even belonging to the same person – had only 13% of their bacterial species in common.(({{pubmed> | + | Using high throughput sequencing, one research team found that of bacteria present on the hands of 51 undergraduate students leaving an exam room, there were 332,000 genetically distinct bacteria belonging to 4,742 different species. Each student carried on average 3,200 bacteria from 150 species on their hands. Only five species were found on all the students’ hands, while any two hands – even belonging to the same person – had only 13% of their bacterial species in common.(({{pmid> |
However, variability in disease has more to do with how bacteria interact through processes like horizontal gene transfer than merely the sheer number of species present. Horizontal gene transfer is the process by which a bacterium inserts genetic material, usually circular strands of DNA called plasmids, into the genomes of other pathogens. | However, variability in disease has more to do with how bacteria interact through processes like horizontal gene transfer than merely the sheer number of species present. Horizontal gene transfer is the process by which a bacterium inserts genetic material, usually circular strands of DNA called plasmids, into the genomes of other pathogens. | ||
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- | One of the more straightforward | + | One of the more straightforward |
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- | Successive infection is the process by which an infectious cascade of pathogens slow the immune response and allow for subsequent infections (and the diseases which they cause) to proliferate. In a 2004 //Science// paper, Finch and Crimmins proposed that early infection burdened survivors with a " | + | Successive infection is the process by which an infectious cascade of pathogens slow the immune response and allow for subsequent infections (and the diseases which they cause) to proliferate. In a 2004 //Science// paper, Finch and Crimmins proposed that early infection burdened survivors with a " |
- | Microbial infections make the body a more hospitable environment for other infections via two primary means: affecting both [[home: | + | Microbial infections make the body a more hospitable environment for other infections via two primary means: affecting both [[home: |
- | * **Food poisoning and hemolytic uremic syndrome** – According to a University of Utah team, fully 10% of people who suffered from //E. coli// food poisoning later developed a relatively infrequent life-threatening complication called hemolytic uremic syndrome (HUS) where their kidneys and other organs fail.(({{pubmed> | + | * **Food poisoning and hemolytic uremic syndrome** – According to a University of Utah team, fully 10% of people who suffered from //E. coli// food poisoning later developed a relatively infrequent life-threatening complication called hemolytic uremic syndrome (HUS) where their kidneys and other organs fail.(({{pmid> |
- | * **Respiratory tract or gastrointestinal infection and Guillain-Barre syndrome (GBS)** – Approximately two-thirds of patients with GBS, a suspected autoimmune syndrome, have a history of an antecedent respiratory tract or gastrointestinal infection.(({{pubmed> | + | * **Respiratory tract or gastrointestinal infection and Guillain-Barre syndrome (GBS)** – Approximately two-thirds of patients with GBS, a suspected autoimmune syndrome, have a history of an antecedent respiratory tract or gastrointestinal infection.(({{pmid> |
- | * **Prenatal infection and schizophrenia** – According to Alan S. Brown of Columbia University, " | + | * **Prenatal infection and schizophrenia** – According to Alan S. Brown of Columbia University, " |
- | * **Reactive arthritis following infection** – Reactive arthritis (Reiter' | + | * **Reactive arthritis following infection** – Reactive arthritis (Reiter' |
- | * **Cytomegalovirus and viral déjà vu** – Nobel Laureate Rolf Zinkernagel and team injected cytomegalovirus (CMV) into the brains of mice that were only a few days old. The researchers found that the innate immune systems of the mice were able to eliminate CMV from most of the tissues except for those of the central nervous system. As a result, the virus persisted in the brains of the mice. Later in life, when the same mice were challenged by infection with a similar virus, they developed a condition resembling a type of autoimmune disease and died. The team referred to this concept as viral “déjà vu.”(({{pubmed> | + | * **Cytomegalovirus and viral déjà vu** – Nobel Laureate Rolf Zinkernagel and team injected cytomegalovirus (CMV) into the brains of mice that were only a few days old. The researchers found that the innate immune systems of the mice were able to eliminate CMV from most of the tissues except for those of the central nervous system. As a result, the virus persisted in the brains of the mice. Later in life, when the same mice were challenged by infection with a similar virus, they developed a condition resembling a type of autoimmune disease and died. The team referred to this concept as viral “déjà vu.”(({{pmid> |
- | * **Common infections and stroke** – In a prospective cohort study, a composite measure of //Chlamydia pneumoniae, Helicobacter pylori//, cytomegalovirus, | + | * **Common infections and stroke** – In a prospective cohort study, a composite measure of //Chlamydia pneumoniae, Helicobacter pylori//, cytomegalovirus, |
- | * **prenatal exposure to influenza and cardiovascular disease** – Prenatal exposure to the 1918 influenza pandemic (Influenza A, H1N1 subtype) is associated with >/=20% excess cardiovascular disease at 60 to 82 years of age, relative to cohorts born without exposure to the influenza epidemic, either prenatally or postnatally. These findings suggest novel roles for maternal infections in the fetal programming of cardiovascular risk factors that are independent of maternal malnutrition.(({{pubmed> | + | * **prenatal exposure to influenza and cardiovascular disease** – Prenatal exposure to the 1918 influenza pandemic (Influenza A, H1N1 subtype) is associated with >/=20% excess cardiovascular disease at 60 to 82 years of age, relative to cohorts born without exposure to the influenza epidemic, either prenatally or postnatally. These findings suggest novel roles for maternal infections in the fetal programming of cardiovascular risk factors that are independent of maternal malnutrition.(({{pmid> |
- | * **SARS and mental health problems** – In a 2009 study, many survivors of the severe acute respiratory syndrome (SARS) pandemic of 2003 suffer from persistent mental health problems and chronic fatigue years later.(({{pubmed> | + | * **SARS and mental health problems** – In a 2009 study, many survivors of the severe acute respiratory syndrome (SARS) pandemic of 2003 suffer from persistent mental health problems and chronic fatigue years later.(({{pmid> |
- | * **Mortality and airborne infectious disease at birth** – Using 150 years of demographics data from the period spanning 1766 to 1894, Bengtsson and Lindström showed that Swedish children severely exposed to airborne infectious diseases during their birth year had a much higher risk of dying of airborne infectious diseases at ages 55–80.(({{pubmed> | + | * **Mortality and airborne infectious disease at birth** – Using 150 years of demographics data from the period spanning 1766 to 1894, Bengtsson and Lindström showed that Swedish children severely exposed to airborne infectious diseases during their birth year had a much higher risk of dying of airborne infectious diseases at ages 55–80.(({{pmid> |
- | * **Infant diarrhea and cardiovascular disease** – Diarrhea as infant (the primary cause of which is microbial pathogens) has been associated with cardiovascular disease later in life.(({{pubmed> | + | * **Infant diarrhea and cardiovascular disease** – Diarrhea as infant (the primary cause of which is microbial pathogens) has been associated with cardiovascular disease later in life.(({{pmid> |
- | * **Chronic pharyngotonsillitis and chronic bacteria** – A 2008 Berlin study used fluorescence in situ hybridization (FISH) with group and species-specific 15/23S RNA based probes to search for invasive bacteria in 90 patients who were surgically treated for recurrent inflammation of the pharynx and tonsils. Abundant foci of invasive bacteria were found in 86% of the resected tonsils, //despite previous treatment with antibiotics// | + | * **Chronic pharyngotonsillitis and chronic bacteria** – A 2008 Berlin study used fluorescence in situ hybridization (FISH) with group and species-specific 15/23S RNA based probes to search for invasive bacteria in 90 patients who were surgically treated for recurrent inflammation of the pharynx and tonsils. Abundant foci of invasive bacteria were found in 86% of the resected tonsils, //despite previous treatment with antibiotics// |
- | * **Obsessive compulsive disorder and childhood infections like strep** – A 2010 team of researchers developed a new animal model to show how exposure to strep affects the brain and leads to a number of physical and mental ailments. According to one of the collaborators, | + | * **Obsessive compulsive disorder and childhood infections like strep** – A 2010 team of researchers developed a new animal model to show how exposure to strep affects the brain and leads to a number of physical and mental ailments. According to one of the collaborators, |
* **Mice exposed to an airborne pathogen develop sub-chronic lung inflammation** – Repeated low dose aerosol exposures to //Bacillus thuringiensis// | * **Mice exposed to an airborne pathogen develop sub-chronic lung inflammation** – Repeated low dose aerosol exposures to //Bacillus thuringiensis// | ||
- | * **Bacterial infection causes stress-induced memory dysfunction in mice.** – Mice were infected with the non-invasive intestinal pathogen, // | + | * **Bacterial infection causes stress-induced memory dysfunction in mice.** – Mice were infected with the non-invasive intestinal pathogen, // |
- | * **Bacterial vaginosis and HIV** – Bacterial vaginosis is associated with a greater than three-fold risk of female-to-male transmission of HIV.(({{pubmed> | + | * **Bacterial vaginosis and HIV** – Bacterial vaginosis is associated with a greater than three-fold risk of female-to-male transmission of HIV.(({{pmid> |
- | * **Prenatal infection and autism** – A population-wide study from Denmark spanning two decades of births indicates that infection during pregnancy increases the risk of autism in the child. Hospitalization for a viral infection, like the flu, during the first trimester of pregnancy triples the odds. Bacterial infection, including of the urinary tract, during the second trimester increases chances by 40 percent.(({{pubmed> | + | * **Prenatal infection and autism** – A population-wide study from Denmark spanning two decades of births indicates that infection during pregnancy increases the risk of autism in the child. Hospitalization for a viral infection, like the flu, during the first trimester of pregnancy triples the odds. Bacterial infection, including of the urinary tract, during the second trimester increases chances by 40 percent.(({{pmid> |
- | * **Childhood infections and asthma** – Children who experience repeated rhinovirus-induced wheezing episodes in infancy have a significantly increased risk of developing asthma.(({{pubmed> | + | * **Childhood infections and asthma** – Children who experience repeated rhinovirus-induced wheezing episodes in infancy have a significantly increased risk of developing asthma.(({{pmid> |
- | * **Enterovirus and type I diabetes** – A 2010 Norwegian paper showed that progression from islet autoimmunity to type 1 diabetes may increase after an enterovirus infection, characterized by the presence of viral RNA in blood.(({{pubmed> | + | * **Enterovirus and type I diabetes** – A 2010 Norwegian paper showed that progression from islet autoimmunity to type 1 diabetes may increase after an enterovirus infection, characterized by the presence of viral RNA in blood.(({{pmid> |
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Long-term observation, | Long-term observation, | ||
- | //**Richard L. Siegler**, et al.// (({{pubmed> | + | //**Richard L. Siegler**, et al.// (({{pmid> |
It would be wrong to assume that there are no long-term effects of acute infections, especially given the fact that chronic pathogens are slow-growing and build up over the course of decades: | It would be wrong to assume that there are no long-term effects of acute infections, especially given the fact that chronic pathogens are slow-growing and build up over the course of decades: | ||
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Folks often assume once you’re over the acute illness, that’s it, you’re back to normal and that’s the end of it. The long-term consequences are an important but relatively poorly documented, poorly studied area of foodborne illness. | Folks often assume once you’re over the acute illness, that’s it, you’re back to normal and that’s the end of it. The long-term consequences are an important but relatively poorly documented, poorly studied area of foodborne illness. | ||
- | //**Robert Tauxe, MD**//, Centers for Disease Control and Prevention, [[http:// | + | //**Robert Tauxe, MD**//, Centers for Disease Control and Prevention |
O’Connor and team at the Centers for Disease Control and Prevention have identified the time before and around birth as times when acute infections seem to have their most devastating impact. | O’Connor and team at the Centers for Disease Control and Prevention have identified the time before and around birth as times when acute infections seem to have their most devastating impact. | ||
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A person’s age at the time of infection—from intrauterine [occurring within the uterus] or perinatal (the time period surrounding birth), through childhood and adolescence, | A person’s age at the time of infection—from intrauterine [occurring within the uterus] or perinatal (the time period surrounding birth), through childhood and adolescence, | ||
- | // | + | // |
==== Can chronic infections really cause disease? ==== | ==== Can chronic infections really cause disease? ==== | ||
There does not seem to be any reason why chronic pathogens do not cause disease just as easily as acute infections. (One reason why L-form bacteria, for example, have not been more widely identified as the cause for chronic disease is that the fastidious organisms have difficult-to-master culturing requirements.) | There does not seem to be any reason why chronic pathogens do not cause disease just as easily as acute infections. (One reason why L-form bacteria, for example, have not been more widely identified as the cause for chronic disease is that the fastidious organisms have difficult-to-master culturing requirements.) | ||
- | Consider Alzheimer' | + | Consider Alzheimer' |
- | In at least one respect, chronic forms of infections have an advantage over acute forms. Virulence factors required for acute infection are often repressed during chronic infections for species capable of causing both types of infection. Acute virulence factors can stimulate the host immune system and cause damage to host tissues, while establishing chronic infection necessitates avoiding the host immune response and maintaining a stalemate with the host, where invasive tissue damage is minimized.(({{pubmed> | + | In at least one respect, chronic forms of infections have an advantage over acute forms. Virulence factors required for acute infection are often repressed during chronic infections for species capable of causing both types of infection. Acute virulence factors can stimulate the host immune system and cause damage to host tissues, while establishing chronic infection necessitates avoiding the host immune response and maintaining a stalemate with the host, where invasive tissue damage is minimized.(({{pmid> |
==== Role of chronic pathogens ==== | ==== Role of chronic pathogens ==== | ||
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- | //**Claire Fraser-Liggett, | + | //**Claire Fraser-Liggett, |
</ | </ | ||
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The process of successive infection does not just occur in sick people or people who are symptomatic. In healthy subjects, subclinical infection is not the exception, but the rule. For example: | The process of successive infection does not just occur in sick people or people who are symptomatic. In healthy subjects, subclinical infection is not the exception, but the rule. For example: | ||
- | * 30% of healthy people are carriers of the pathogen // | + | * 30% of healthy people are carriers of the pathogen // |
- | * A 2011 pyrosequencing study looked at 16S rDNA amplicons of eight culture-negative healthy female urine specimens.(({{pubmed> | + | * A 2011 pyrosequencing study looked at 16S rDNA amplicons of eight culture-negative healthy female urine specimens.(({{pmid> |
- | From even before birth, every human is // | + | From even before birth, every human is // |
< | < | ||
We find that despite stable differences between body sites and individuals, | We find that despite stable differences between body sites and individuals, | ||
- | //**J. Gregory Caporaso** et al.// (({{pubmed> | + | //**J. Gregory Caporaso** et al.// (({{pmid> |
</ | </ | ||
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{{tag> Pathogenesis}} | {{tag> Pathogenesis}} | ||
+ | < | ||
===== Notes and comments ===== | ===== Notes and comments ===== | ||
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How strep attacks the brain</ | How strep attacks the brain</ | ||
- | < | + | < |
- | Common Infection Increases Risk of Transmitting HIV: A common bacterial infection that affects many females may ... http:// | + | Common Infection Increases Risk of Transmitting HIV: A common bacterial infection that affects many females may ... https:// |
</ | </ | ||
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Rewrite this: | Rewrite this: | ||
- | http:// | + | https:// |
Several studies show that people who migrate from one area of the globe to another at some stage before puberty, take on the incidence of the area to which they migrate. On the other hand, people who move after this point carry with them the incidence of the area from which they migrated. Countries like Israel and South Africa have a much higher incidence than would be expected from their latitude, presumably because they have such high immigration levels of first generation Europeans [Acheson, 1977; Alter M et al, 1966, 1971, 1978; Dean & Kurtzke, 1971; Kurtzke et al 1976 & 1985; Detels R et al 1978; Dean G et al 1997]. Conversely, first generation African, Afro-Caribbean and Indian immigrants to Britain have a much lower incidence of multiple sclerosis than their second generation counterparts [Elian M, 1990]. | Several studies show that people who migrate from one area of the globe to another at some stage before puberty, take on the incidence of the area to which they migrate. On the other hand, people who move after this point carry with them the incidence of the area from which they migrated. Countries like Israel and South Africa have a much higher incidence than would be expected from their latitude, presumably because they have such high immigration levels of first generation Europeans [Acheson, 1977; Alter M et al, 1966, 1971, 1978; Dean & Kurtzke, 1971; Kurtzke et al 1976 & 1985; Detels R et al 1978; Dean G et al 1997]. Conversely, first generation African, Afro-Caribbean and Indian immigrants to Britain have a much lower incidence of multiple sclerosis than their second generation counterparts [Elian M, 1990]. | ||
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- | Streptococcus pneumoniae coinfection is correlated with the severity of H1N1 pandemic influenza.(({{pubmed> | + | Streptococcus pneumoniae coinfection is correlated with the severity of H1N1 pandemic influenza.(({{pmid> |
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< | < | ||
- | Effect of measles-virus infection and interferon treatment on invasiveness of Shigella flexneri in HEp2-cell cultures.(({{pubmed> | + | Effect of measles-virus infection and interferon treatment on invasiveness of Shigella flexneri in HEp2-cell cultures.(({{pmid> |
Bukholm G, Modalsli K, Degré M. | Bukholm G, Modalsli K, Degré M. | ||
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Not sure if this is true, based on the Knight/ | Not sure if this is true, based on the Knight/ | ||
- | * **At least portions of microbial load change relatively little over the course of time** – Reyes //et al.// showed that the same individual harbors very similar fecal viral communities over at least a one-year period(({{pubmed> | + | * **At least portions of microbial load change relatively little over the course of time** – Reyes //et al.// showed that the same individual harbors very similar fecal viral communities over at least a one-year period(({{pmid> |
+ | |||
+ | ===== References =====</ | ||
- | ===== References ===== |