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Proc Natl Acad Sci U S A. 2014 Nov 4;111(44):15780-5. doi: 10.1073/pnas.1409968111. Epub 2014 Oct 20.

Role of disease-associated tolerance in infectious superspreaders.

Author information

1
Departments of Microbiology and Immunology.
2
Chemical and Systems Biology.
3
Comparative Medicine, Stanford University School of Medicine, Stanford, CA 94305.
4
Departments of Microbiology and Immunology, dmonack@stanford.edu.

Abstract

Natural populations show striking heterogeneity in their ability to transmit disease. For example, a minority of infected individuals known as superspreaders carries out the majority of pathogen transmission events. In a mouse model of Salmonella infection, a subset of infected hosts becomes superspreaders, shedding high levels of bacteria (>10(8) cfu per g of feces) but remain asymptomatic with a dampened systemic immune state. Here we show that superspreader hosts remain asymptomatic when they are treated with oral antibiotics. In contrast, nonsuperspreader Salmonella-infected hosts that are treated with oral antibiotics rapidly shed superspreader levels of the pathogen but display signs of morbidity. This morbidity is linked to an increase in inflammatory myeloid cells in the spleen followed by increased production of acute-phase proteins and proinflammatory cytokines. The degree of colonic inflammation is similar in antibiotic-treated superspreader and nonsuperspreader hosts, indicating that the superspreader hosts are tolerant of antibiotic-mediated perturbations in the intestinal tract. Importantly, neutralization of acute-phase proinflammatory cytokines in antibiotic-induced superspreaders suppresses the expansion of inflammatory myeloid cells and reduces morbidity. We describe a unique disease-associated tolerance to oral antibiotics in superspreaders that facilitates continued transmission of the pathogen.

KEYWORDS:

acute phase response; carriers; host-to-host transmission; pathogenesis

PMID:
25331868
PMCID:
PMC4226084
DOI:
10.1073/pnas.1409968111
[Indexed for MEDLINE]
Free PMC Article

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