@article{5fee9f197581409ba45b8fbf9007002e,
title = "Parasite resource manipulation drives bimodal variation in infection duration",
abstract = "Over a billion people on earth are infected with helminth parasites and show remarkable variation in parasite burden and chronicity. These parasite distributions are captured well by classic statistics, such as the negative binomial distribution. But the within-host processes underlying this variation are not well understood. In this study, we explain variation in macroparasite infection outcomes on the basis of resource flows within hosts. Resource flows realize the interactions between parasites and host immunity and metabolism. When host metabolism is modulated by parasites, we find a positive feedback of parasites on their own resources. While this positive feedback results in parasites improving their resource availability at high burdens, giving rise to chronic infections, it also results in a threshold biomass required for parasites to establish in the host, giving rise to acute infections when biomass fails to clear the threshold. Our finding of chronic and acute outcomes in bistability contrasts with classic theory, yet is congruent with the variation in helminth burdens observed in human and wildlife populations.",
keywords = "Acute, Chronic, Immunity, Parasite, Resource manipulation, Within-host",
author = "{Van Leeuwen}, Anieke and Budischak, {Sarah A.} and Graham, {Andrea Linn} and Cressler, {Clayton E.}",
note = "Funding Information: We acknowledge the National Science Foundation Research Coordination Network on Infectious Disease Evolution Across Scales (RCN-IDEAS) for research exchanges that led to the development of this theory and these models; Princeton University and the program on Research and Policy in Infectious Disease Dynamics (RAPIDD) of the Fogarty International Center for funding the empirical work; A.v.L. was supported by the National Science Foundation grant no. GEO-1211972. Our work to connect insights from empirical and theoretical research was supported through the NSF RCN-IDEAS research exchange programme, based at Princeton University. We want to acknowledge this funding and thank the programme for bridging approaches by bringing diverse researchers together in the same room. We want to thank William Craigens and Ross Prin-gle for help with the empirical work. Funding Information: We acknowledge the National Science Foundation Research Coordination Network on Infectious Disease Evolution Across Scales (RCN-IDEAS) for research exchanges that led to the development of this theory and these models; Princeton University and the program on Research and Policy in Infectious Disease Dynamics (RAPIDD) of the Fogarty International Center for funding the empirical work; A.v.L. was supported by the National Science Foundation grant no. GEO-1211972. Acknowledgements Funding Information: Our work to connect insights from empirical and theoretical research was supported through the NSF RCN-IDEAS research exchange programme, based at Princeton University. We want to acknowledge this funding and thank the programme for bridging approaches by bringing diverse researchers together in the same room. We want to thank William Craigens and Ross Pringle for help with the empirical work. Publisher Copyright: {\textcopyright} 2019 The Author(s) Published by the Royal Society. All rights reserved.",
year = "2019",
month = may,
day = "15",
doi = "10.1098/rspb.2019.0456",
language = "English (US)",
volume = "286",
journal = "Proceedings of the Royal Society B: Biological Sciences",
issn = "0962-8452",
publisher = "Royal Society of London",
number = "1902",
}