The revival of interest in mechanisms of bacterial pathogenicity.
1. After a long barren period, the study of bacterial pathogenicity is now one of the most popular subjects in microbiology. This is because bacterial diseases remain a major problem in public health despite the advent of antibiotics, and the subject is a fertile field for the application of genetics and molecular biology. 2. Pathogenicity is a multifactorial property. The biological requirements are abilities to: infect mucous surfaces; enter the host through those surfaces; multiply in the environment of the host; interfere with host defences; and damage the host. Each requirement has many facets all of which can be accomplished by a variety of processes. 3. The molecular determinants of the five requirements for pathogenicity can be identified and the relation between their structure and function obtained by a seven step procedure. Genetic manipulation and observations on organisms grown in vivo play major roles in this procedure. Other vital aspects are the availability of good animal models and the design of biological tests for virulence determinants in vitro that are pertinent to the situation in vivo. 4. A survey of the state of studies on bacterial pathogenicity has highlighted some areas of immense erudition and exposed others that need more attention in the future. Research is often at the highest level of molecular biology for: adherence to and entry of epithelial cells; interference with humoral and phagocytic defences; toxins; and direct induction of cytokines and inflammation. The major gaps are: the determinants of competition with commensals on mucous surfaces; spread into deeper tissues; the host supplied nutrients and metabolism underlying growth rate in vivo; the determinants of interference with the immune response in important chronic diseases and carrier states; the determinants of immunopathological reactions that cause damage in chronic disease; and the determinants of change from carrier to invasive state. Areas that are receiving some attention but are worthy of more are: moving through mucus to gain access to mucous surfaces; opportunistic infections; the determinants of mixed infections; and the determinants of host and tissue susceptibility to infection. 5. Current interest in the regulation of production of virulence determinants and the influence on it of environmental factors has raised speculation on the role these factors play in vivo. However, it has not yet provided much information on the host factors specifically involved in particular bacterial infections. The individualistic concept of community, as a relative latecomer to discussions of animal community, is sometimes misconstrued as holding that communities are random assemblages of organisms without biotic interactions among species. Nevertheless, it has increasingly been accepted as supported by studies of diverse taxa and habitats. However, many other ecologists continue to argue for integrated, biotically controlled and evolved communities.(ABSTRACT TRUNCATED AT 400 WORDS)
Smith
H
H
Medical School, University of Birmingham, UK.
D000818:Animals; D001419:Bacteria / Q000472:pathogenicity*; D001422:Bacterial Adhesion / Q000502:physiology; D001424:Bacterial Infections / Q000382:microbiology* / Q000503:physiopathology; D018407:Bacterial Physiological Phenomena; D004195:Disease Models, Animal; D006801:Humans; D014774:Virulence