Bruyn G A, Zegers B J, van Furth R
Department of Infectious Diseases, University Hospital, Leiden, The Netherlands.
Clin Infect Dis. 1992 Jan;14(1):251-62. doi: 10.1093/clinids/14.1.251.
Various aspects of the host's response to infection by Streptococcus pneumoniae are reviewed. First, the structure of the bacterium is described, with a focus on those elements that are related to its immunogenicity and pathogenicity. The epidemiology of the pneumococcal serotypes, which are differentiated by the molecular structure of the capsule, is considered briefly, and several key points are emphasized--for example, that some pneumococcal types are more pathogenic than others; that variations in biological behavior are based on differences in the chemical composition of the capsule, although the particular factors determining virulence are not known; and that cell wall peptidoglycan, a structure common to all pneumococci, plays an important role in the inflammatory reaction in the tissues. Next, current views on the pathogenesis of pneumococcal infections are discussed. Finally, the roles of type-specific antibodies to the capsular polysaccharide and of complement in the opsonization of pneumococci and the clearance of these bacteria from the bloodstream by the spleen and liver are reviewed.
本文综述了宿主对肺炎链球菌感染的反应的各个方面。首先，描述了该细菌的结构，重点关注与免疫原性和致病性相关的那些元素。简要考虑了通过荚膜分子结构区分的肺炎球菌血清型的流行病学，并强调了几个关键点——例如，某些肺炎球菌类型比其他类型更具致病性；生物学行为的差异基于荚膜化学成分的差异，尽管决定毒力的具体因素尚不清楚；以及细胞壁肽聚糖，这是所有肺炎球菌共有的结构，在组织炎症反应中起重要作用。接下来，讨论了关于肺炎球菌感染发病机制的当前观点。最后，综述了针对荚膜多糖的型特异性抗体和补体在肺炎球菌调理作用以及脾脏和肝脏从血流中清除这些细菌方面的作用。
