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Harnessing evolutionary biology to combat infectious disease

Nature Medicine volume 18, pages 217–220 (2012)Cite this article

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Pathogens have remarkable abilities to flout therapeutic intervention. This characteristic is driven by evolution, either as a direct response to intervention (for example, the evolution of antibiotic resistance) or through long-term co-evolution that generates host or parasite traits that interact with therapy in undesirable or unpredicted ways. To make progress towards successful control of infectious diseases, the concepts and techniques of evolutionary biology must be deeply integrated with traditional approaches to immunology and pathogen biology. An interdisciplinary approach can inform our strategies to control pathogens or even the treatment of infected patients, positioning us to meet the current and future challenges of controlling infectious diseases.

Over the last century, considerable progress has been made in controlling infectious diseases, but this success has been far from universal. Pathogens remain a major health burden, with over 9.8 million people per year globally dying from infections (comprising over 16.5% of all annual deaths), half of which are children1. Thus, despite intense investment of effort and money in the development of vaccines and therapeutics in the twentieth century, old (existing and resurgent) and new (emerging) pathogens remain a major threat. Some treatments or pathogen control efforts begin effectively and then lose ground. Other diseases are associated with control problems that seem to be intractable, and pathogen control programs fail at an early stage. What causes such failures? What underlies the variability in the short- and longer-term successes of control measures? A major factor is evolution. And evolution, aside from being pervasive, often works in complex ways and results in outcomes that are difficult to predict.

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Figure 1: A central aim of all biomedical research is to elucidate the mechanisms associated with infectious disease.

Katie Vicari

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Authors and Affiliations

  1. Centre for Immunity, Infection and Evolution, School of Biological Sciences, University of Edinburgh, Edinburgh, UK

    Tom J Little, Judith E Allen, Simon A Babayan, Keith R Matthews & Nick Colegrave

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  1. Tom J Little
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  2. Judith E Allen
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  3. Simon A Babayan
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  4. Keith R Matthews
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  5. Nick Colegrave
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Correspondence to Tom J Little.

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Little, T., Allen, J., Babayan, S. et al. Harnessing evolutionary biology to combat infectious disease. Nat Med 18, 217–220 (2012). https://doi.org/10.1038/nm.2572

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