Mortality rates in influenza appear to have been shaped by evolution. During the 1918 pandemic, mortality rates were lower in children compared with adults. This mortality difference occurs in a wide variety of infectious diseases. It has been replicated in mice and might be due to greater tolerance of infection, not greater resistance. Importantly, combination treatment with inexpensive and widely available generic drugs (e.g. statins and angiotensin receptor blockers) might change the damaging host response in adults to a more tolerant response in children. These drugs might work by modifying endothelial dysfunction, mitochondrial biogenesis and immunometabolism. Treating the host response might be the only practical way to reduce global mortality during the next influenza pandemic. It might also help reduce mortality due to seasonal influenza and other forms of acute critical illness. To realize these benefits, we need laboratory and clinical studies of host response treatment before and after puberty.

中文翻译：

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流感，进化和下一次大流行。

流感的死亡率似乎受进化的影响。在1918年大流行期间，儿童的死亡率低于成人。这种死亡率差异发生在多种传染病中。它已在小鼠中复制，可能是由于对感染的耐受性更高，而不是更大的抵抗力。重要的是，与廉价且广泛使用的非专利药物（例如他汀类药物和血管紧张素受体阻滞剂）的联合治疗可能会将成年人的破坏性宿主反应改变为儿童更耐受的反应。这些药物可能通过改变内皮功能障碍，线粒体生物发生和免疫代谢而起作用。在下一次流感大流行中，治疗宿主反应可能是降低全球死亡率的唯一实用方法。它还可能有助于降低因季节性流感和其他形式的严重危疾而导致的死亡率。为了实现这些益处，我们需要在青春期前后对宿主反应治疗进行实验室和临床研究。