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隐孢子虫病

Cryptosporidiosis.

作者信息

Chappell Cynthia L, Okhuysen Pablo C

机构信息

Center for Infectious Diseases, School of Public Health, The University of Texas Health Science Center at Houston, 77030, USA.

出版信息

Curr Opin Infect Dis. 2002 Oct;15(5):523-7. doi: 10.1097/00001432-200210000-00012.

Abstract

PURPOSE OF REVIEW

Cryptosporidiosis is a self-limited diarrheal disease that occurs in the community setting but can be chronic and potentially serious in immunocompromised patients. Community outbreaks are often associated with water-borne transmission. Cryptosporidium research has increased dramatically since the human disease was first recognized in 1976. The present review summarizes recent work in three of the several areas of active Cryptosporidium investigation.

RECENT FINDINGS

Molecular techniques have revealed that current taxonomic designations need re-evaluation and that humans are host to several Cryptosporidium spp. that were once believed to be limited to the veterinary realm. These findings have important public health implications for water quality standards in the USA and other developed countries. Second, techniques for detecting the parasite in infected individuals (or environmental samples) have progressed from acid-fast staining of fecal smears to the currently used antibody-based systems (enzyme immunoassays and immunofluorescent assays). New molecular methodologies, based on polymerase chain reaction amplification of gene loci, are being developed to improve the sensitivity and specificity for diagnostic and epidemiologic purposes. Third, curative therapy is attained only by an effective immune response or the reconstitution of a failing immune system in the compromised host. However, several drugs are in development, and compounds such as nitazoxanide appear to hold some promise.

SUMMARY

Cryptosporidiosis continues to be a serious problem in immunocompromised patients and on a worldwide scale in undernourished infants and children. The lack of an effective treatment, and the propensity of the parasite to survive in and be transmitted through source waters make this an important public health threat.

摘要

综述目的

隐孢子虫病是一种自限性腹泻疾病,在社区环境中可发生,但在免疫功能低下的患者中可能呈慢性且有潜在严重性。社区暴发通常与水源性传播有关。自1976年首次确认人类感染该疾病以来,隐孢子虫的研究急剧增加。本综述总结了隐孢子虫几个活跃研究领域中三个领域的近期工作。

近期发现

分子技术表明,当前的分类命名需要重新评估,并且人类是几种隐孢子虫的宿主,这些隐孢子虫曾被认为仅限于兽医领域。这些发现对美国和其他发达国家的水质标准具有重要的公共卫生意义。其次,检测感染者(或环境样本)中寄生虫的技术已从粪便涂片的抗酸染色发展到目前使用的基于抗体的系统(酶免疫测定和免疫荧光测定)。基于基因位点聚合酶链反应扩增的新分子方法正在开发中,以提高诊断和流行病学目的的敏感性和特异性。第三,只有通过有效的免疫反应或在受损宿主中重建衰竭的免疫系统才能实现治愈性治疗。然而,有几种药物正在研发中,硝唑尼特等化合物似乎有一定前景。

总结

隐孢子虫病在免疫功能低下的患者中仍然是一个严重问题,在全球范围内,营养不良的婴幼儿中也是如此。缺乏有效的治疗方法,以及该寄生虫在水源中存活并通过水源传播的倾向,使其成为一个重要的公共卫生威胁。

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