Fighting microbial pathogens by integrating host ecosystem interactions and evolution

• Published in: BioEssays 2021-03, Vol.43 (3), p.e2000272-n/a
• Main Authors: Burmeister, Alita R., Hansen, Elsa, Cunningham, Jessica J., Rego, E. Hesper, Turner, Paul E., Weitz, Joshua S., Hochberg, Michael E.
• Format: Article
• Language: English
• Subjects: Biochemistry, Molecular Biology; Biological Evolution; cancer; Ecosystem; Ecosystems; Evolution; Health services; infectious disease; Life Sciences; Medical treatment; Microorganisms; nonlinear dynamics; Pathogenesis; resistance; System effectiveness; systems approach; therapies
• ISSN: 0265-9247; 1521-1878
• DOI: 10.1002/bies.202000272

Successful therapies to combat microbial diseases and cancers require incorporating ecological and evolutionary principles. Drawing upon the fields of ecology and evolutionary biology, we present a systems‐based approach in which host and disease‐causing factors are considered as part of a complex network of interactions, analogous to studies of “classical” ecosystems. Centering this approach around empirical examples of disease treatment, we present evidence that successful therapies invariably engage multiple interactions with other components of the host ecosystem. Many of these factors interact nonlinearly to yield synergistic benefits and curative outcomes. We argue that these synergies and nonlinear feedbacks must be leveraged to improve the study of pathogenesis in situ and to develop more effective therapies. An eco‐evolutionary systems perspective has surprising and important consequences, and we use it to articulate areas of high research priority for improving treatment strategies. In health and disease, the human host is an ecosystem comprising resources, pathogenic micros, immune systems, microbiota, microhabitats, and anti‐micro therapies. We leverage this view for improved treatment of human illness through a systems‐based approach.