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at the Department of Medical Biometry, University of Tübingen

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Facilitation

Facilitation


Facilitation is based on positive feedback which is rarely observed in nature. In filariases, it occurs, for example, if vectors possess a cibarial armature, a tooth-like chitin structure which lacerates ingested Mf. At low microfilariae densities, this cibarial armature substantially reduces the proportion of surviving microfilariae. At high Mf densities, however, the cibarial armature might be inefficient because it is masked by a few Mf promoting the survival of the others

As a result, we obtain a profile as shown above: the proportion of surviving microfilaria in the fly increases with increasing microfilarial density in the human skin. Another example of facilitation in filariasis is parasite-induced immunosuppression.

Figure above: Fitting a facilitated and a non-regulated relationship to the same data leads to an intersection between both curves. This intersection is an unstable equilibrium, called breakpoint, i.e. a parasite density below which infection cannot persist. The trivial equilibrium (the infection-free state) is in this case stable. Without external influences, the system tends towards the infection-free state state (gray arrow). Facilitation processes 'facilitate' the eradicability of an infection, because they destabilize the endemic state and stabilize the infection-free state.

The endemic equilibrium must be provided by an associated limitation process leading to a second intersection between both curves (see figure below). Starting from the infection-free state, this leads to equilibriae in the following order:

Elimination (stable) - Breakpoint (unstable) - Endemic state (stable).

Facilitation + Limitation

This figure has important implications for the control of an infection: will the intervention be cancelled while the parasite density still exceeds the value of the breakpoint, then, the system will tend back to the stable equilibrium of the endemic state (gray arrow pointing upwards). If, on the other hand, the intervention will be continued until the parasite density underruns the value of a breakpoint, then, the infection will go extinct without further efforts, because the systems tends by itself towards the stable infection-free state (gray arrow pointing downwards). See also Persistence graphs.

Further reading: Duerr HP, Dietz K, Eichner M, 2005. Determinants of the eradicability of filarial infections: a conceptual approach. Trends in Parasitology 21: 88-96. Abstract at PubMed

Related pages: Limitation, Eradicability of onchocerciasis, Limitation & Control.

Responsible for this page: Dr. H.-P. Duerr
Webmaster: Prof. Dr. M. Eichner (last change of this page on 13 July 2009)
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