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Jump to: navigation, search Koch's postulates ( / ko k/) are four criteria designed to establish a causal relationship between a causative microbe and a disease. The postulates were formulated by Robert Koch and Friedrich Loeffler in 1884 and refined and published by Koch in 1890. Koch applied the postulates to establish the etiology of anthrax and tuberculosis, but they have been generalized to other diseases.
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1 The postulates 2 History 3 Kochs postulates for the 21st century 4 See also 5 References 6 Further reading
The third postulate specifies "should", not "must", because as Koch himself proved in regard to both tuberculosis and cholera,[2] not all organisms exposed to an infectious agent will acquire the infection. Noninfection may be due to such factors as general health and proper immune functioning; acquired immunity from previous exposure or vaccination; or genetic immunity, as with the resistance to malaria conferred by possessing at least one sickle cell allele. The second postulate may also be suspended for certain microorganisms or entities that cannot (at the present time) be grown in pure culture, such as prions responsible for CreutzfeldtJakob disease.[3] In summary, a body of evidence that satisfies Koch's postulates is sufficient but not necessary to establish causation.
[edit] History
Koch's postulates were developed in the 19th century as general guidelines to identify pathogens that could be isolated with the techniques of the day.[4] Even in Koch's time, it was recognized that some infectious agents were clearly responsible for disease even though they did not fulfill all of the postulates.[2][5] Attempts to rigidly apply Koch's postulates to the diagnosis of viral diseases in the late 19th century, at a time when viruses could not be seen or isolated in culture, may have impeded the early development of the field of virology.[6][7] Currently, a number of infectious agents are accepted as the cause of disease despite their not fulfilling all of Koch's postulates.[8] Therefore, while Koch's postulates retain historical importance and continue to inform the approach to microbiologic diagnosis, fulfillment of all four postulates is not required to demonstrate causality. Koch's postulates have also influenced scientists who examine microbial pathogenesis from a molecular point of view. In the 1980s, a molecular version of Koch's postulates was developed to guide the identification of microbial genes encoding virulence factors.[9]
1. A nucleic acid sequence belonging to a putative pathogen should be present in most cases of an infectious disease. Microbial nucleic acids should be found preferentially in those organs or gross anatomic sites known to be diseased, and not in those organs that lack pathology. 2. Fewer, or no, copy numbers of pathogen-associated nucleic acid sequences should occur in hosts or tissues without disease. 3. With resolution of disease, the copy number of pathogen-associated nucleic acid sequences should decrease or become undetectable. With clinical relapse, the opposite should occur. 4. When sequence detection predates disease, or sequence copy number correlates with severity of disease or pathology, the sequence-disease association is more likely to be a causal relationship. 5. The nature of the microorganism inferred from the available sequence should be consistent with the known biological characteristics of that group of organisms. 6. Tissue-sequence correlates should be sought at the cellular level: efforts should be made to demonstrate specific in situ hybridization of microbial sequence to areas of tissue pathology and to visible microorganisms or to areas where microorganisms are presumed to be located. 7. These sequence-based forms of evidence for microbial causation should be reproducible.
[edit] References
1. ^ Koch Robert (1893). "ber den augenblicklichen Stand der bakteriologischen Choleradiagnose" (in German). Zeitschrift fr Hygiene und Infectionskrankheiten 14: 319333. doi:10.1007/BF02284324. 2. ^ a b Koch Robert (1884). "2 Die Aetiologie der Tuberkulose". Mitt Kaiser Gesundh. pp. 188. 3. ^ Inglis TJ (November 2007). "Principia aetiologica: taking causality beyond Koch's postulates". J. Med. Microbiol. 56 (Pt 11): 141922. doi:10.1099/jmm.0.47179-0. PMID 17965339. http://jmm.sgmjournals.org/cgi/content/full/56/11/1419.