1. Evolutionary Approaches to Combat Antibiotic Resistance: Opportunities and Challenges for Precision Medicine
- Author
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Matthias Merker, Leif Tueffers, Marie Vallier, Espen E. Groth, Lindsay Sonnenkalb, Daniel Unterweger, John F. Baines, Stefan Niemann, and Hinrich Schulenburg
- Subjects
0301 basic medicine ,lcsh:Immunologic diseases. Allergy ,Exploit ,Mini Review ,precision medicine ,Immunology ,Drug resistance ,Evolution, Molecular ,03 medical and health sciences ,Antimicrobial Stewardship ,0302 clinical medicine ,Antibiotic resistance ,Bacterial Proteins ,Drug Resistance, Bacterial ,evolution ,Global health ,Immunology and Allergy ,Animals ,Humans ,AMR ,drug resistance ,Bacteria ,Evolutionary medicine ,Bacterial Infections ,Gene Expression Regulation, Bacterial ,Precision medicine ,Antimicrobial ,Anti-Bacterial Agents ,030104 developmental biology ,Risk analysis (engineering) ,evolutionary medicine ,Sustainability ,Host-Pathogen Interactions ,Business ,lcsh:RC581-607 ,030215 immunology - Abstract
The rise of antimicrobial resistance (AMR) in bacterial pathogens is acknowledged by the WHO as a major global health crisis. It is estimated that in 2050 annually up to 10 million people will die from infections with drug resistant pathogens if no efficient countermeasures are implemented. Evolution of pathogens lies at the core of this crisis, which enables rapid adaptation to the selective pressures imposed by antimicrobial usage in both medical treatment and agriculture, consequently promoting the spread of resistance genes or alleles in bacterial populations. Approaches developed in the field of Evolutionary Medicine attempt to exploit evolutionary insight into these adaptive processes, with the aim to improve diagnostics and the sustainability of antimicrobial therapy. Here, we review the concept of evolutionary trade-offs in the development of AMR as well as new therapeutic approaches and their impact on host-microbiome-pathogen interactions. We further discuss the possible translation of evolution-informed treatments into clinical practice, considering both the rapid cure of the individual patients and the prevention of AMR.
- Published
- 2020