Persons and pathogens: consequences of co-existence.

There is considerable evidence that infectious agents may be a cofactor, or even the cause, of a panoply of chronic inflammatory diseases, as well as of some cancers and neurologic diseases. Examples are presented of the evidence for the thesis that infectious antecedents may underlie many inflammatory conditions and some of the diseases in which infections are postulated to be the precipitating factor.Given that infectious agents may give rise to an impressive array of chronic diseases, should we, therefore, consider alternative modes of treatment for such diseases which focus on the infectious antecedent rather than the consequent disease?With regard to therapy, are new classes of antibiotic/anti-inflammatory drugs needed? Or would preventive measures, such as better food handling and water treatment, along with a widespread campaign of prophylactic and therapeutic vaccines against the likely infectious agents, be a more cost effective approach to ameliorate or ablate the onset of a wide range of inflammatory diseases, cancers and neurologic diseases? Since this conference was primarily designed to discuss the safety and efficacy of NSAIDs, it is appropriate to ponder whether chronic/lifelong NSAID/aspirin intake may have value in preventing or treating chronic inflammatory and neurologic diseases as well as some cancers. There are studies that indicate that long term use of some NSAIDs including aspirin may reduce the likelihood of occurrence of some of these chronic diseases. We thus should ponder the potential risks and benefits of lifelong NSAID/aspirin intake. To that end we should ask what kind of a database should be established so that a valid estimate of the benefits versus the risks of extended, perhaps lifelong, use of a present or future NSAID(s) may be considered for the prevention of any given disease?