The evolutionary logic of sepsis

L. Rózsa, Péter Apari, Mihály Sulyok, Dennis Tappe, Imre Bodó, Richárd Hardi, V. Müller

Research output: Contribution to journalComment/debate

1 Citation (Scopus)

Abstract

The recently proposed Microbiome Mutiny Hypothesis posits that members of the human microbiome obtain information about the host individuals' health status and, when host survival is compromised, switch to an intensive exploitation strategy to maximize residual transmission. In animals and humans, sepsis is an acute systemic reaction to microbes invading the normally sterile body compartments. When induced by formerly mutualistic or neutral microbes, possibly in response to declining host health, sepsis appears to fit the ‘microbiome mutiny’ scenario except for its apparent failure to enhance transmission of the causative organisms. We propose that the ability of certain species of the microbiome to induce sepsis is not a fortuitous side effect of within-host replication, but rather it might, in some cases, be the result of their adaptive evolution. Whenever host health declines, inducing sepsis can be adaptive for those members of the healthy human microbiome that are capable of colonizing the future cadaver and spread by cadaver-borne transmission. We hypothesize that such microbes might exhibit switches along the ‘mutualist – lethal pathogen – decomposer – mutualist again’ scenario, implicating a previously unsuspected, surprising level of phenotypic plasticity. This hypothesis predicts that those species of the healthy microbiome that are recurring causative agents of sepsis can participate in the decomposition of cadavers, and can be transmitted as soil-borne or water-borne infections. Furthermore, in individual sepsis cases, the same microbial clones that dominate the systemic infection that precipitates sepsis, should also be present in high concentration during decomposition following death: this prediction is testable by molecular fingerprinting in experimentally induced animal models. Sepsis is a leading cause of human death worldwide. If further research confirms that some cases of sepsis indeed involve the ‘mutiny’ (facultative phenotypic switching) of normal members of the microbiome, then new strategies could be devised to prevent or treat sepsis by interfering with this process.

Original languageEnglish
Pages (from-to)135-141
Number of pages7
JournalInfection, Genetics and Evolution
Volume55
DOIs
Publication statusPublished - Nov 1 2017

Fingerprint

sepsis (infection)
Sepsis
Microbiota
Cadaver
decomposition
animal
microorganisms
phenotypic plasticity
health status
clone
pathogen
death
degradation
microbiome
Health
infection
prediction
Infection
Health Status
Cause of Death

Keywords

  • Cadaver-borne transmission
  • Evolutionary medicine
  • Facultative virulence
  • Microbiome Mutiny Hypothesis
  • Sepsis

ASJC Scopus subject areas

  • Microbiology
  • Ecology, Evolution, Behavior and Systematics
  • Molecular Biology
  • Genetics
  • Microbiology (medical)
  • Infectious Diseases

Cite this

The evolutionary logic of sepsis. / Rózsa, L.; Apari, Péter; Sulyok, Mihály; Tappe, Dennis; Bodó, Imre; Hardi, Richárd; Müller, V.

In: Infection, Genetics and Evolution, Vol. 55, 01.11.2017, p. 135-141.

Research output: Contribution to journalComment/debate

Rózsa L, Apari P, Sulyok M, Tappe D, Bodó I, Hardi R et al. The evolutionary logic of sepsis. Infection, Genetics and Evolution. 2017 Nov 1;55:135-141. https://doi.org/10.1016/j.meegid.2017.09.006
Rózsa, L. ; Apari, Péter ; Sulyok, Mihály ; Tappe, Dennis ; Bodó, Imre ; Hardi, Richárd ; Müller, V. / The evolutionary logic of sepsis. In: Infection, Genetics and Evolution. 2017 ; Vol. 55. pp. 135-141.
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