The necessity to revise Koch's postulates and its application to infectious and non-infectious diseases: a mini-review.

Advances in the science have promoted all aspects of human's life; these, in turn, have changed many principles and scientific postulates. Koch's postulates, since the beginning of their implementation, have been one of the important subjects involving complications and misinterpretations regarding the causal relationship of microbe-hosts. These postulates have been shown not to be correct in some cases including the inability of some microbes to grow in the culture medium, viruses, or anaerobic bacteria. Today, due to some new scientific facts like the social behaviors of bacteria, such as quorum sensing, there are serious problems regarding the definition of whole microbial effects; these include microbiomes and viromes, as well as their interaction with the existing eukaryotics, the complicated relations between bacteria, L-forms, and cell wall-deficient bacteria, and the important role of microbes in the development of non-infectious diseases. So, the application of Koch's postulates to explain the causal relationships between host-microbes could be difficult. Therefore, nowadays, even the molecular Koch's postulates are not accountable. Also, according to the new scientific discoveries, various criteria such as changes in the immune system, pathology, and clinical findings, along with the results of daily laboratory tests, should be used to apply Koch's postulates in the etiologic studies. Otherwise, the possible etiologic relationships between the host-microbes cannot be verified due to numerous complications; certainly, the relationship between the doctor and the lab is ultimately weakened. Therefore, public health, prevention, and much of the antimicrobial treatments will also remain in a state of ambiguity.