{"id":44,"date":"2020-05-04T16:07:17","date_gmt":"2020-05-04T15:07:17","guid":{"rendered":"https:\/\/blogs.ncl.ac.uk\/markbooth\/?p=44"},"modified":"2020-05-04T16:07:19","modified_gmt":"2020-05-04T15:07:19","slug":"ten-reasons-we-need-parasitology","status":"publish","type":"post","link":"https:\/\/blogs.ncl.ac.uk\/markbooth\/2020\/05\/04\/ten-reasons-we-need-parasitology\/","title":{"rendered":"Ten reasons we need Parasitology"},"content":{"rendered":"\n<p>NOTE: This post started off as 2 lists in another blog I wrote which is no longer maintained. The text has been modified from the originals, which can be read <a href=\"https:\/\/tropicalepidemiology.wordpress.com\/\">here<\/a> <\/p>\n\n\n\n<figure class=\"wp-block-image\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"768\" src=\"https:\/\/blogs.ncl.ac.uk\/markbooth\/files\/2020\/05\/IMG_1238-1024x768.jpg\" alt=\"\" class=\"wp-image-45\" srcset=\"https:\/\/blogs.ncl.ac.uk\/markbooth\/files\/2020\/05\/IMG_1238-1024x768.jpg 1024w, https:\/\/blogs.ncl.ac.uk\/markbooth\/files\/2020\/05\/IMG_1238-300x225.jpg 300w, https:\/\/blogs.ncl.ac.uk\/markbooth\/files\/2020\/05\/IMG_1238-768x576.jpg 768w, https:\/\/blogs.ncl.ac.uk\/markbooth\/files\/2020\/05\/IMG_1238-400x300.jpg 400w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n\n\n<p>If you read this and raise your eyebrows at the notion that there is a long-standing society dedicated to the subject of Parasitology then I am not  entirely surprised. The <a href=\"http:\/\/www.bsp.uk.net\">British Society for Parasitology<\/a> has been in existence for over 50 years. It continues to supports young career scientists in particular. Despite the persistence of the BSP, my own observations suggest that the discipline of  parasitology is becoming increasingly rarified, at least in the UK  higher-education context.<\/p>\n\n\n\n<p><em>So what?<\/em>, you might say.\u00a0 The language of research changes  over time; we cannot remain fixed on one term indefinitely by default.  There has to be a reason to maintain the notion of parasitology as a  standalone discipline. If developments in global health mean that  parasites other than <a href=\"https:\/\/tropicalepidemiology.wordpress.com\/2016\/02\/08\/goodbye-guinea-worm-you-were-just-too-visible\/\">Guinea worm<\/a> are somehow <a href=\"https:\/\/www.biomedcentral.com\/collections\/elimination-para-inf\">eliminated <\/a>from  the world, then it is likely that parasitology will be eventually subsumed into other domains, and at least some parasitologists will move  away from the discipline all together as research funds become diverted and the students of tomorrow focus on other health issues.<\/p>\n\n\n\n<p>I agree up to a point with this view, providing that we can be certain about plans to deliver on <a href=\"https:\/\/unitingtocombatntds.org\/reports\/5th-report\/\">parasite control targets<\/a>, ensure <a href=\"https:\/\/en.wikipedia.org\/wiki\/Universal_health_care\">universal health care<\/a>\u00a0 <em>etc<\/em>.\u00a0  But wait, hang on a second. What\u2019s that coming over the hill? Can you  see it, just there, just a few years ahead? No of course you can\u2019t. No  one can draw data down from the future. It is inherently uncertain.<\/p>\n\n\n\n<p>It is this uncertainty that means we need to keep up basic, applied,  operational and implementation research in the field of parasitology.  Here are just 10  areas of research (from a potentially much longer list) that are  linked to future uncertainties and which, if addressed,\u00a0 could\u00a0 help us  reach our shared goal of sustainable health (each point links to an  exemplar publication). <\/p>\n\n\n\n<p><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">1) Widely used broad-spectrum drugs have different levels of <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4128617\/\">effectiveness<\/a> depending on the species of parasite against which they are targeted.<\/h2>\n\n\n\n<p><strong><em>So what?<\/em><\/strong> \u00a0 Parasite ecology is shaped by the  selective removal of certain species, leading potentially to new  demographic and spatio-temporal\u00a0 patterns of infection and morbidity  attributable to infection. Not all treated individuals will receive the  same benefit from treatment, depending on their mix of infections.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">2) Individuals mount different&nbsp;<a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3021922\/pdf\/S0031182010001216a.pdf\"> immune response<\/a> to infection depending on genetic background, presence of co-infections, previous exposure, age etc<\/h2>\n\n\n\n<p><strong><em>So what?<\/em><\/strong> Not everyone will benefit in the same way from treatment, or respond in an identical way to any putative vaccine.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">3) Signs and symptoms associated with worm infections are also caused <a href=\"http:\/\/journals.cambridge.org\/action\/displayAbstract?fromPage=online&amp;aid=1920832&amp;fileId=S0031182008000346\">by other types of pathogen<\/a> including some viruses and bacterial pathogens<\/h2>\n\n\n\n<p><strong><em>So wha<\/em>t<em>?<\/em> <\/strong>The benefits of chemotherapy on reducing  morbidity may not be easily estimated due to imprecise or biased  estimates of attributable\u00a0 morbidity.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">4) No currently available medicine prevents re-infection. Re-infection can occur <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3348161\/\">rapidly, slowly or not at all<\/a>\n after treatment depending on behavioural, ecological parasite life \nhistory traits, human genetic traits, demographic and socio-cultural \nfactors<\/h2>\n\n\n\n<p><strong><em>So what<\/em>?<\/strong> Repeated treatments\u00a0 are required to keep  infections at sufficiently low levels until the environment no longer  supports the free-living stages and\/or vectors. Drug resistance, lack of  engagement<em> etc<\/em> are militating factors that increase over time.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">5) Environmental change over space and\/or time affects the natural history of vectors, <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4234839\/\">intermediate hosts<\/a> and&nbsp; free- living parasite stages in different ways depending on species and location.<\/h2>\n\n\n\n<p><strong>\u00a0<em>So what?<\/em><\/strong><em> <\/em>Risk maps drawn up at one particular time point based on underlying hazards may become less informative over time.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">6) Parasites modulate the immune systems of their hosts to potentiate their own survival.<\/h2>\n\n\n\n<p><strong><em>So what<\/em>?<\/strong> \u2013 This can be exploited for our benefit. Some parasite products can be used <a href=\"https:\/\/en.wikipedia.org\/wiki\/Helminthic_therapy\">therapeutically<\/a>,  for example to reduce symptoms associated with inflammatory bowel  diseases, or certain allergies. We need to know how to do this more  effectively.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">7) Parasites can manipulate host behaviour to complete their own life-cycle.<\/h2>\n\n\n\n<p><strong><em>So what?\u00a0<\/em><\/strong> \u2013\u00a0 Parasites are drivers, and part, of the global food chain. They quite often \u2018<a href=\"http:\/\/www.port.ac.uk\/uopnews\/2015\/08\/25\/new-brain-altering-parasite-discovered\/\">want<\/a>\u2018  to be eaten. Their manipulation of host behaviour facilitates  predator-prey relationships and helps maintain stability of wildlife  populations that are connected to human activities. We need to know how  best to exploit this fact to ensure sustainable ecosystems.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">8) There are still no (commercially available) vaccines for any parasitic infection of humans.<\/h2>\n\n\n\n<p><strong><em>So wha<\/em>t?\u00a0<\/strong> \u2013 Given that drugs and other interventions  are only partly effective, we still need to work on vaccinations as a  strategy to remove those parasites that directly impact on the health of  human populations.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">9) Parasites are put under selection pressure from human activities<\/h2>\n\n\n\n<p><strong><em>So what<\/em>?\u00a0<\/strong> If parasites adapt their biology and\/or  ecology as a result of interventions, and\/or <a href=\"https:\/\/doi.org\/10.1098\/rstb.2016.0088\">anthropogenic environmental  pressures<\/a> we need to know in order to plan <a href=\"https:\/\/doi.org\/10.1016\/j.pt.2018.02.001\">mitigation and adaptation strategies<\/a>.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">10) Hundreds of millions of people carry undiagnosed parasitic infections at any one time<\/h2>\n\n\n\n<p><strong>So what?&nbsp;<\/strong> If we are ever to realise <a href=\"http:\/\/www.who.int\/universal_health_coverage\/en\/\">universal health coverage<\/a>\n then we need to find solutions to the lack of diagnostic capacity in \nhealth systems where the populations are affected by parasitic \ninfections.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>NOTE: This post started off as 2 lists in another blog I wrote which is no longer maintained. The text has been modified from the originals, which can be read here If you read this and raise your eyebrows at &hellip; <a href=\"https:\/\/blogs.ncl.ac.uk\/markbooth\/2020\/05\/04\/ten-reasons-we-need-parasitology\/\">Continue reading <span class=\"meta-nav\">&rarr;<\/span><\/a><\/p>\n","protected":false},"author":6957,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[13,2,12],"class_list":["post-44","post","type-post","status-publish","format-standard","hentry","category-uncategorised","tag-list","tag-parasitology","tag-research"],"_links":{"self":[{"href":"https:\/\/blogs.ncl.ac.uk\/markbooth\/wp-json\/wp\/v2\/posts\/44","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.ncl.ac.uk\/markbooth\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.ncl.ac.uk\/markbooth\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.ncl.ac.uk\/markbooth\/wp-json\/wp\/v2\/users\/6957"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.ncl.ac.uk\/markbooth\/wp-json\/wp\/v2\/comments?post=44"}],"version-history":[{"count":1,"href":"https:\/\/blogs.ncl.ac.uk\/markbooth\/wp-json\/wp\/v2\/posts\/44\/revisions"}],"predecessor-version":[{"id":46,"href":"https:\/\/blogs.ncl.ac.uk\/markbooth\/wp-json\/wp\/v2\/posts\/44\/revisions\/46"}],"wp:attachment":[{"href":"https:\/\/blogs.ncl.ac.uk\/markbooth\/wp-json\/wp\/v2\/media?parent=44"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.ncl.ac.uk\/markbooth\/wp-json\/wp\/v2\/categories?post=44"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.ncl.ac.uk\/markbooth\/wp-json\/wp\/v2\/tags?post=44"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}