Microbial Evolutionary Medicine – from theory to clinical practice

Abstract

Bacteria and other microbes play a crucial role in human health and disease. Medicine and clinical microbiology have traditionally attempted to identify the etiological agents that causes disease, and how to eliminate them. Yet this traditional paradigm is becoming inadequate for dealing with a changing disease landscape. Major challenges to human health are noncommunicable chronic diseases, often driven by altered immunity and inflammation, and persistent communicable infections whose agents harbor antibiotic resistance. It is increasingly recognized that microbe-microbe interactions, as well as human-microbe interactions are important. Here, we review the “Evolutionary Medicine” framework to study how microbial communities influence human health. This approach aims to predict and manipulate microbial influences on human health by integrating ecology, evolutionary biology, microbiology, bioinformatics and clinical expertise. We focus on the potential promise of evolutionary medicine to address three key challenges: 1) detecting microbial transmission; 2) predicting antimicrobial resistance; 3) understanding microbe-microbe and human-microbe interactions in health and disease, in the context of the microbiome.

Microbial Evolutionary Medicine – from theory to clinical practice

“…promoters and intergenic regions) and in coding sequences (30). In E.coli ST131, the uptake of mobile elements involved in resistance was found to lead to selection for compensatory mutations in the genome (56). Extraintestinal pathogenic ST131 clones may further be ecologically separated in different niches, as drug susceptible ST131 clones incorporate different phages or plasmids compared with drug resistant ST131.…”