Clark D P, Sears C L
The Johns Hopkins University School of Medicine in the Divisions of Medical Microbiology and Cytopathology, Department of Pathology Room 406 Pahology, 600 North Wolfe Street, Baltimore, MD 21287-6940, USA.
Parasitol Today. 1996 Jun;12(6):221-5. doi: 10.1016/0169-4758(96)10018-1.
Human infection with the protozoan parasite Cryptosporidium parvum has recently emerged as a global public health problem. Although infection is unrelenting in patients classically regarded as immunocompromised, a tantalizing observation is that infection with this parasite results in both acute self-limited as well as chronic diarrhea in young children. Recent data have begun to elucidate multiple potential mechanisms by which parasitism of the intestinal epithelium may yield an intestinal secretory response. However, a central issue for future studies is to understand how Cryptosporidium infection in young children results in such a broad spectrum of clinical presentation. An answer to this question is likely to result through a dual understanding of how systemic or enteric immunity impacts on intestinal secretory responses and how intra-cellular parasitism alters intestinal epithelial cell function and signals the submucosal intestinal compartment. The virulence factors of Cryptosporidium mediating these events need to be identified. Douglas Clark and Cynthia Sears here review the current understanding of the pathogenesis of intestinal secretion in response to Cryptosporidium infection, and discuss key questions requiring additional study.
人类感染原生动物寄生虫微小隐孢子虫最近已成为一个全球公共卫生问题。虽然在传统上被视为免疫功能低下的患者中感染持续存在，但一个引人关注的观察结果是，这种寄生虫感染在幼儿中会导致急性自限性腹泻以及慢性腹泻。最近的数据已开始阐明肠道上皮寄生可能产生肠道分泌反应的多种潜在机制。然而，未来研究的一个核心问题是了解幼儿隐孢子虫感染如何导致如此广泛的临床表现。要回答这个问题，可能需要从两方面来理解，即全身或肠道免疫如何影响肠道分泌反应，以及细胞内寄生如何改变肠道上皮细胞功能并向肠黏膜下腔发出信号。介导这些事件的隐孢子虫毒力因子有待确定。道格拉斯·克拉克和辛西娅·西尔斯在此回顾了目前对隐孢子虫感染后肠道分泌发病机制的理解，并讨论了需要进一步研究的关键问题。
