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[寄生虫病中的反应性嗜酸性粒细胞增多症]

[Reactive hypereosinophilia in parasitic diseases].

作者信息

Ripert C

机构信息

Université de Bordeaux-II, Laboratoire de parasitologie médicale, Bordeaux.

出版信息

Rev Prat. 2000 Mar 15;50(6):602-7.

Abstract

Hypereosinophilia is often linked to the presence of pluricellular parasites in host tissues. Polynuclear eosinophils are sprung from the bone marrow. After multiplying and maturing, they are thrown into the blood flow and from the blood to the tissues where they are found in immediate contact with the parasite. Eosinophils are major components of the parasitic granuloma. Parasitic diseases are a major cause of hypereosinophilia and eosinophilia is mainly due to helminths. Protozoa do not produce hypereosinophilia, except for toxoplasmosis in which a low and discontinuous eosinophilia may be seen. Subsequently, maggots producing myiasis yield to hypereosinophilia too. In helminthiasis, the action of the eosinophil granulocyte is double. In tissues, it destroys the parasite and plays a regulatory role in mastocytes degranulation. Eosinophils which participate in the inflammatory reaction secrete factors which neutralize mediators liberated by mastocytes, histamine mainly, destroyed by histaminase. In a practical point of view, blood hypereosinophilia is a very useful tool for diagnosis. Eosinophilia reach early a high value, this before the parasitic infection becomes detectable by means of resources other than immunological. The eosinophils rates decreases rapidly as an effect of the anthelmintic drug, this confirming the efficacy and specificity of the prescribed treatment.

摘要

嗜酸性粒细胞增多症常与宿主组织中多细胞寄生虫的存在有关。多核嗜酸性粒细胞起源于骨髓。在增殖和成熟后,它们被释放到血流中,然后从血液进入组织,在那里它们与寄生虫直接接触。嗜酸性粒细胞是寄生性肉芽肿的主要成分。寄生虫病是嗜酸性粒细胞增多症的主要原因,嗜酸性粒细胞增多主要归因于蠕虫。原生动物不会引起嗜酸性粒细胞增多症,但弓形虫病除外,在弓形虫病中可能会出现低度且不连续的嗜酸性粒细胞增多。随后,引起蝇蛆病的蛆虫也会导致嗜酸性粒细胞增多。在蠕虫病中,嗜酸性粒细胞的作用是双重的。在组织中,它会破坏寄生虫,并在肥大细胞脱颗粒过程中发挥调节作用。参与炎症反应的嗜酸性粒细胞会分泌一些因子,这些因子可以中和肥大细胞释放的介质,主要是组胺,组胺会被组胺酶破坏。从实际角度来看,血液嗜酸性粒细胞增多症是一种非常有用的诊断工具。嗜酸性粒细胞增多症会在早期达到很高的值,这发生在通过非免疫学方法检测到寄生虫感染之前。随着驱虫药物的作用,嗜酸性粒细胞比率会迅速下降,这证实了所开治疗方法的有效性和特异性。

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