Proceedings of the National Academy of Sciences | 2021
Natural resistance to worms exacerbates bovine tuberculosis severity independently of worm coinfection
Abstract
Significance Interactions between pathogens can have substantial negative effects on host health. Therefore, identifying the causes of these interactions is integral for effective disease management and control. Interactions between two pathogens that simultaneously or sequentially infect the same host are common. We show that interactions also arise when genetically based defenses against one pathogen affect responses to another, even when the first pathogen is concurrently absent. This mode of pathogen interaction provides insight for understanding patterns of variation in disease severity in natural populations. It also implies that, under some conditions, control strategies that rely on selecting for resistance to one pathogen, in livestock for example, might jeopardize control of another. Pathogen interactions arising during coinfection can exacerbate disease severity, for example when the immune response mounted against one pathogen negatively affects defense of another. It is also possible that host immune responses to a pathogen, shaped by historical evolutionary interactions between host and pathogen, may modify host immune defenses in ways that have repercussions for other pathogens. In this case, negative interactions between two pathogens could emerge even in the absence of concurrent infection. Parasitic worms and tuberculosis (TB) are involved in one of the most geographically extensive of pathogen interactions, and during coinfection worms can exacerbate TB disease outcomes. Here, we show that in a wild mammal natural resistance to worms affects bovine tuberculosis (BTB) severity independently of active worm infection. We found that worm-resistant individuals were more likely to die of BTB than were nonresistant individuals, and their disease progressed more quickly. Anthelmintic treatment moderated, but did not eliminate, the resistance effect, and the effects of resistance and treatment were opposite and additive, with untreated, resistant individuals experiencing the highest mortality. Furthermore, resistance and anthelmintic treatment had nonoverlapping effects on BTB pathology. The effects of resistance manifested in the lungs (the primary site of BTB infection), while the effects of treatment manifested almost entirely in the lymph nodes (the site of disseminated disease), suggesting that resistance and active worm infection affect BTB progression via distinct mechanisms. Our findings reveal that interactions between pathogens can occur as a consequence of processes arising on very different timescales.