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Assessing optimal treatments for intracellular infection: host immunity, heterogeneity, and the antibiotic resistance challenge

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Resumo:Mathematical models have been used as tools to study the dynamics of infectious diseases for a long time and to design successful control interventions, both at within-host and at the epidemiological level. Models can provide estimates of biological parameters which are difficult or expensive to obtain through experiments. Currently, in infection diseases, the growing antimicrobial resistance of pathogens poses great challenges. Recently, aggressive and moderate approaches are being debated as therapeutic strategies to deal with antibiotic resistance. The discussion is still open, as the field is becoming aware of the risks, due to higher and longer antibiotic prescriptions, not only considering the infection pathogen but also non-target resistance in resident microbiota. In this work, we study intracellular infection dynamics combining effects of antibiotic treatment and adaptive immune responses. The ODE models are based on infection processes for acute and chronic bacterial infections. We find the critical parameter combination in macrophage-bacteria-immunity interaction, dividing regimes of clearance and persistence of infection. Moreover, we study the consequences of antimicrobial treatment on many infection measures, including duration, bacterial burden, pathology and resistance. We notice that different combination of treatment duration and antibiotic doses can lead to the same infection outcomes and that the same treatment can have different effects if applied early or later during the infection course. Moreover, treatment is not always beneficial, as longer durations often select more resistant bacteria. We compare short (3 days) versus long (7 days) treatment duration in-depth. Long treatment duration is overall more efficient, with higher infection resolution. However, there are regimes where short treatment is non-inferior or even superior. Our results highlight the potential of new targeted treatments of intracellular infection, with lower antibiotic doses and duration, combined with sufficient immune action. From this, we extract optimization principles for infection over a range of scenarios and we discuss future directions for the improvement of this area, namely the importance of infection and immunity biomarkers at treatment onset.
Autores principais:Paupério, Francisco Ferreira da Silva
Assunto:Infecção Imunidade Modelos matemáticos Tratamento antibiótico Interacção bactéria-macrófagos Teses de mestrado - 2019
Ano:2019
País:Portugal
Tipo de documento:dissertação de mestrado
Tipo de acesso:acesso aberto
Instituição associada:Universidade de Lisboa
Idioma:inglês
Origem:Repositório da Universidade de Lisboa
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author Paupério, Francisco Ferreira da Silva
author_facet Paupério, Francisco Ferreira da Silva
author_role author
contributor_name_str_mv Dionísio, Francisco,1971-
Gjini, Erida
Repositório Científico de Acesso Aberto da ULisboa
country_str PT
creators_json_txt [{\"Person.name\":\"Paupério, Francisco Ferreira da Silva\"}]
datacite.contributors.contributor.contributorName.fl_str_mv Dionísio, Francisco,1971-
Gjini, Erida
Repositório Científico de Acesso Aberto da ULisboa
datacite.creators.creator.creatorName.fl_str_mv Paupério, Francisco Ferreira da Silva
datacite.date.Accepted.fl_str_mv 2019-01-01T00:00:00Z
datacite.date.available.fl_str_mv 2019-02-22T19:07:37Z
datacite.date.embargoed.fl_str_mv 2019-02-22T19:07:37Z
datacite.rights.fl_str_mv http://purl.org/coar/access_right/c_abf2
datacite.subjects.subject.fl_str_mv Infecção
Imunidade
Modelos matemáticos
Tratamento antibiótico
Interacção bactéria-macrófagos
Teses de mestrado - 2019
datacite.titles.title.fl_str_mv Assessing optimal treatments for intracellular infection: host immunity, heterogeneity, and the antibiotic resistance challenge
dc.contributor.none.fl_str_mv Dionísio, Francisco,1971-
Gjini, Erida
Repositório Científico de Acesso Aberto da ULisboa
dc.creator.none.fl_str_mv Paupério, Francisco Ferreira da Silva
dc.date.Accepted.fl_str_mv 2019-01-01T00:00:00Z
dc.date.available.fl_str_mv 2019-02-22T19:07:37Z
dc.date.embargoed.fl_str_mv 2019-02-22T19:07:37Z
dc.format.none.fl_str_mv application/pdf
dc.identifier.none.fl_str_mv http://hdl.handle.net/10451/37152
dc.language.none.fl_str_mv eng
dc.rights.none.fl_str_mv http://purl.org/coar/access_right/c_abf2
dc.subject.none.fl_str_mv Infecção
Imunidade
Modelos matemáticos
Tratamento antibiótico
Interacção bactéria-macrófagos
Teses de mestrado - 2019
dc.title.fl_str_mv Assessing optimal treatments for intracellular infection: host immunity, heterogeneity, and the antibiotic resistance challenge
dc.type.none.fl_str_mv http://purl.org/coar/resource_type/c_bdcc
description Mathematical models have been used as tools to study the dynamics of infectious diseases for a long time and to design successful control interventions, both at within-host and at the epidemiological level. Models can provide estimates of biological parameters which are difficult or expensive to obtain through experiments. Currently, in infection diseases, the growing antimicrobial resistance of pathogens poses great challenges. Recently, aggressive and moderate approaches are being debated as therapeutic strategies to deal with antibiotic resistance. The discussion is still open, as the field is becoming aware of the risks, due to higher and longer antibiotic prescriptions, not only considering the infection pathogen but also non-target resistance in resident microbiota. In this work, we study intracellular infection dynamics combining effects of antibiotic treatment and adaptive immune responses. The ODE models are based on infection processes for acute and chronic bacterial infections. We find the critical parameter combination in macrophage-bacteria-immunity interaction, dividing regimes of clearance and persistence of infection. Moreover, we study the consequences of antimicrobial treatment on many infection measures, including duration, bacterial burden, pathology and resistance. We notice that different combination of treatment duration and antibiotic doses can lead to the same infection outcomes and that the same treatment can have different effects if applied early or later during the infection course. Moreover, treatment is not always beneficial, as longer durations often select more resistant bacteria. We compare short (3 days) versus long (7 days) treatment duration in-depth. Long treatment duration is overall more efficient, with higher infection resolution. However, there are regimes where short treatment is non-inferior or even superior. Our results highlight the potential of new targeted treatments of intracellular infection, with lower antibiotic doses and duration, combined with sufficient immune action. From this, we extract optimization principles for infection over a range of scenarios and we discuss future directions for the improvement of this area, namely the importance of infection and immunity biomarkers at treatment onset.
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instname_str Universidade de Lisboa
language eng
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person_str_mv Paupério, Francisco Ferreira da Silva
publishDate 2019
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spelling engpt_PTMathematical models have been used as tools to study the dynamics of infectious diseases for a long time and to design successful control interventions, both at within-host and at the epidemiological level. Models can provide estimates of biological parameters which are difficult or expensive to obtain through experiments. Currently, in infection diseases, the growing antimicrobial resistance of pathogens poses great challenges. Recently, aggressive and moderate approaches are being debated as therapeutic strategies to deal with antibiotic resistance. The discussion is still open, as the field is becoming aware of the risks, due to higher and longer antibiotic prescriptions, not only considering the infection pathogen but also non-target resistance in resident microbiota. In this work, we study intracellular infection dynamics combining effects of antibiotic treatment and adaptive immune responses. The ODE models are based on infection processes for acute and chronic bacterial infections. We find the critical parameter combination in macrophage-bacteria-immunity interaction, dividing regimes of clearance and persistence of infection. Moreover, we study the consequences of antimicrobial treatment on many infection measures, including duration, bacterial burden, pathology and resistance. We notice that different combination of treatment duration and antibiotic doses can lead to the same infection outcomes and that the same treatment can have different effects if applied early or later during the infection course. Moreover, treatment is not always beneficial, as longer durations often select more resistant bacteria. We compare short (3 days) versus long (7 days) treatment duration in-depth. Long treatment duration is overall more efficient, with higher infection resolution. However, there are regimes where short treatment is non-inferior or even superior. Our results highlight the potential of new targeted treatments of intracellular infection, with lower antibiotic doses and duration, combined with sufficient immune action. From this, we extract optimization principles for infection over a range of scenarios and we discuss future directions for the improvement of this area, namely the importance of infection and immunity biomarkers at treatment onset.application/pdfpt_PTAssessing optimal treatments for intracellular infection: host immunity, heterogeneity, and the antibiotic resistance challengePaupério, Francisco Ferreira da SilvaDionísio, Francisco,1971-Gjini, EridaHostingInstitutionOrganizationalRepositório Científico de Acesso Aberto da ULisboae-mailmailto:repositorio@reitoria.ulisboa.ptrepositorio@reitoria.ulisboa.ptURNurn:tid:2021913542019-02-22T19:07:37Z201920182019-01-01T00:00:00ZHandlehttp://hdl.handle.net/10451/37152http://purl.org/coar/access_right/c_abf2open accessInfecçãoImunidadeModelos matemáticosTratamento antibióticoInteracção bactéria-macrófagosTeses de mestrado - 20193822032 bytesliteraturehttp://purl.org/coar/resource_type/c_bdccmaster thesishttp://purl.org/coar/access_right/c_abf2application/pdffulltexthttps://repositorio.ulisboa.pt/bitstreams/4fbf83fb-db9e-4cac-90e9-ef72577f4997/download
spellingShingle Assessing optimal treatments for intracellular infection: host immunity, heterogeneity, and the antibiotic resistance challenge
Paupério, Francisco Ferreira da Silva
Infecção
Imunidade
Modelos matemáticos
Tratamento antibiótico
Interacção bactéria-macrófagos
Teses de mestrado - 2019
status SINGLETON
subject.fl_str_mv Infecção
Imunidade
Modelos matemáticos
Tratamento antibiótico
Interacção bactéria-macrófagos
Teses de mestrado - 2019
title Assessing optimal treatments for intracellular infection: host immunity, heterogeneity, and the antibiotic resistance challenge
title_full Assessing optimal treatments for intracellular infection: host immunity, heterogeneity, and the antibiotic resistance challenge
title_fullStr Assessing optimal treatments for intracellular infection: host immunity, heterogeneity, and the antibiotic resistance challenge
title_full_unstemmed Assessing optimal treatments for intracellular infection: host immunity, heterogeneity, and the antibiotic resistance challenge
title_short Assessing optimal treatments for intracellular infection: host immunity, heterogeneity, and the antibiotic resistance challenge
title_sort Assessing optimal treatments for intracellular infection: host immunity, heterogeneity, and the antibiotic resistance challenge
topic Infecção
Imunidade
Modelos matemáticos
Tratamento antibiótico
Interacção bactéria-macrófagos
Teses de mestrado - 2019
topic_facet Infecção
Imunidade
Modelos matemáticos
Tratamento antibiótico
Interacção bactéria-macrófagos
Teses de mestrado - 2019
url http://hdl.handle.net/10451/37152
visible 1