The most common and lethal bacterial pathogens have co-evolved with the host. Pathogens are the aggressors, and the host immune system is responsible for the defence. However, immune responses can also become destructive, and excessive innate immune activation is a major cause of infection-associated morbidity, exemplified by symptomatic urinary tract infections (UTIs), which are caused, in part, by excessive innate immune activation. Severe kidney infections (acute pyelonephritis) are a major cause of morbidity and mortality, and painful infections of the urinary bladder (acute cystitis) can become debilitating in susceptible patients. Disease severity is controlled at specific innate immune checkpoints, and a detailed understanding of their functions is crucial for strategies to counter microbial aggression with novel treatment and prevention measures. One approach is the use of bacterial molecules that reprogramme the innate immune system, accelerating or inhibiting disease processes. A very different outcome is asymptomatic bacteriuria, defined by low host immune responsiveness to bacteria with attenuated virulence. This observation provides the rationale for immunomodulation as a new therapeutic tool to deliberately modify host susceptibility, control the host response and avoid severe disease. The power of innate immunity as an arbitrator of health and disease is also highly relevant for emerging pathogens, including the current COVID-19 pandemic.

最常见和致命的细菌病原体与宿主共同进化。病原体是侵略者，宿主免疫系统负责防御。然而，免疫反应也可能具有破坏性，过度的先天免疫激活是感染相关发病率的主要原因，例如有症状的尿路感染 (UTI)，其部分是由过度的先天免疫激活引起的。严重的肾脏感染（急性肾盂肾炎）是发病率和死亡率的主要原因，膀胱的疼痛性感染（急性膀胱炎）会使易感患者变得虚弱。疾病的严重程度在特定的先天免疫检查点得到控制，详细了解它们的功能对于通过新的治疗和预防措施对抗微生物侵略的策略至关重要。一种方法是使用细菌分子重新编程先天免疫系统，加速或抑制疾病过程。一个非常不同的结果是无症状菌尿，定义为宿主对毒力减弱的细菌的低免疫反应。这一观察结果为免疫调节作为一种新的治疗工具提供了基本原理，以故意改变宿主易感性、控制宿主反应并避免严重疾病。先天免疫作为健康和疾病仲裁者的力量也与新出现的病原体高度相关，包括当前的 COVID-19 大流行。加速或抑制疾病进程。一个非常不同的结果是无症状菌尿，定义为宿主对毒力减弱的细菌的低免疫反应。这一观察结果为免疫调节作为一种新的治疗工具提供了基本原理，以故意改变宿主易感性、控制宿主反应并避免严重疾病。先天免疫作为健康和疾病仲裁者的力量也与新出现的病原体高度相关，包括当前的 COVID-19 大流行。加速或抑制疾病进程。一个非常不同的结果是无症状菌尿，定义为宿主对毒力减弱的细菌的低免疫反应。这一观察结果为免疫调节作为一种新的治疗工具提供了基本原理，以故意改变宿主易感性、控制宿主反应并避免严重疾病。先天免疫作为健康和疾病仲裁者的力量也与新出现的病原体高度相关，包括当前的 COVID-19 大流行。控制宿主反应，避免严重疾病。先天免疫作为健康和疾病仲裁者的力量也与新出现的病原体高度相关，包括当前的 COVID-19 大流行。控制宿主反应，避免严重疾病。先天免疫作为健康和疾病仲裁者的力量也与新出现的病原体高度相关，包括当前的 COVID-19 大流行。