(Roughly) Daily

Background becomes foreground: Jean-Laurent Casanova on how we might better think about infectious diseases…

In 1955, René Dubos famously expressed his “second thoughts on the germ theory”, attributing infectious diseases to various “changing circumstances” that weaken the host by unknown mechanisms. He rightly stressed that only a small minority of individuals infected by almost any microbe develop clinical disease. Intriguingly, though, he did not mention the abundant and elegant findings reported from 1905 onward that unambiguously pointed to host genetic determinants of infection outcome in plants and animals, including human inborn errors of immunity. Diverse findings over the next 50 y[ears] corroborated and extended these earlier genetic and immunological observations that René Dubos had neglected. Meanwhile, the sequential advent of immunosuppression- and HIV–driven immunodeficiencies unexpectedly provided a mechanistic basis for his own views. Collectively, these two lines of evidence support a host theory of infectious diseases, with inherited and acquired immunodeficiencies as the key determinants of severe infection outcome, relegating the germ to an environmental trigger that reveals an underlying and preexisting cause of disease and death…

The full essay: “From second thoughts on the germ theory to a full-blown host theory,” from @PNASNews.

Pair with: “The World Is Toxic. Welcome to the Metabolic Era,” from @k_pendergrast in @WIRED.

* Louis Pasteur (who was clearly already having second thoughts)

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As we contemplate the clinical, we might sending healing birthday greetings to Charles Mayo; he was born on this date in 1865. A medical doctor (surgeon) and philanthropist, he co-founded  the Mayo Clinic and it’s supporting/governing body, the Mayo Foundation. Within Mayo’s lifetime, it registered one million patients. As of today, Mayo Clinic has ranked number one in the United States for seven consecutive years in U.S. News & World Report‘s Best Hospitals Honor Roll, maintaining a position at or near the top for more than 35 years.

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