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.

The Good and the Bad: Ecological Interaction Measurements Between the Urinary Microbiota and Uropathogens

“…Future studies are required to include all factors that can affect population dynamics to obtain full understanding of the urinary microbiota, which will require in vivo models to ecologically define the characteristics of these communities. This will in turn lead to a better understanding of the urinary pathobiome (Vayssier-Taussat et al, 2014), and whether colonization of a pathogen leads to infection is dependent on the ecological background and the commensal microbiota (Andersen et al, 2019;Bass et al, 2019).…”

Loss of a pyoverdine secondary receptor in Pseudomonas aeruginosa results in a fitter strain suitable for population invasion

“…Selective interventions steering the evolutionary dynamics of microbial communities with the main goal of reducing antibiotic usage are at the core of microbial evolutionary medicine [29]. In this work we have investigated the effect of interfering with the reception of pyoverdine in P. aeruginosa as a way to engineer strains with the potential of invading wildtype populations.…”

Antibiotics in microbial communities: an ecological frame of resistance

“…To date, efforts to address this global health problem have primarily concentrated on restricting unnecessary prescriptions, the development of new drugs, and the use of novel combinations of existing drugs 2 . Now, however, with emerging insight into the critical role the host and environmental microbiomes play in regulating health and diseases, there is growing consensus that we need to look beyond one-to-one host-pathogen relationships and consider the complex web of competitive interactions within which individual pathogens are embedded [3][4][5][6][7][8] . This expanded ecological perspective holds promise not only for our fundamental understanding of resistance evolution, but also for the identification and development of novel treatment strategies.…”