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Review
. 2018 Feb:50:88-93.
doi: 10.1016/j.coi.2017.12.003. Epub 2017 Dec 15.

Disease tolerance: concept and mechanisms

J L McCarville  1 , J S Ayres  2
Affiliations
Review

Disease tolerance: concept and mechanisms

J L McCarville et al. Curr Opin Immunol. 2018 Feb.

Abstract

Two distinct defense strategies provide a host with survival to infectious diseases: resistance and tolerance. Resistance is dependent on the ability of the host to kill pathogens. Tolerance promotes host health while having a neutral to positive impact of pathogen fitness. Immune responses are almost inevitably defined in terms of pathogen resistance. Recent evidence has shown, however, that several effects attributed to activation of innate and adaptive immune mechanisms, cannot be readily explained with the paradigm of immunity as effectors of microbial destruction. This review focuses on integrating the concept of disease tolerance into recent studies of immune system function related to the regulation and resolution of tissue damage, T cell exhaustion, and tolerance to innocuous antigen.

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Conflict of interest statement

Conflict of Interest Statement

The authors declare no conflicts of interest

Figures

Figure 1
Figure 1
Overview of host tolerance and resistance measurement. A dose dependent curve can be generated from the relationship between host health (eg. survival) and pathogen burden, where vigor represents uninfected hosts. Host resistance (closed circle) is defined as a decrease in pathogen burden as host health (eg. survival) increases (linear relationship). Increases in host resistance are represented by increasing circle size. In comparison, host tolerance (open circle) is defined as an increase in host health (eg. survival) independently of pathogen burden. Increases in host tolerance are represented by increasing circle size and slope color (red= low tolerance, blue= high tolerance). Adapted from [1,4].
See this image and copyright information in PMC

References

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    1. Ayres JS. Cooperative Microbial Tolerance Behaviors in Host-Microbiota Mutualism. Cell. 2016;165:1323–1331. A perspective that reviews the current literature of disease tolerance to pathogens but also expolores the idea that pathogen behaviour may also be employed by beneficial bacteria (eg. commensal microbiota) in order to promote host tolerance. - PMC - PubMed
    1. Raberg L, Sim D, Read AF. Disentangling genetic variation for resistance and tolerance to infectious diseases in animals. Science. 2007;318:812–814. - PubMed

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