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[隐孢子虫病:对其发病机制和耐药性的当前观点]

[Cryptosporidiosis: current views of its pathogenesis and resistance].

作者信息

Goncharov D B, Kobets N B, Nagurskaia E V

出版信息

Med Parazitol (Mosk). 2007 Jan-Mar(1):56-60.

Abstract

Cryptosporidiosis is a socially dangerous opportunistic infection that is intractable and, according to recent data, caused by a diversity of species of the genus Cryptosporidium, which are still recently considered to be nonpathogenic to a human being. The transmission of this infection is by the water route and the technology of water purification cannot be saved from the oocysts of Cryptosporidium. Therefore, the important line of investigations is to study the immunological aspects of the interaction of Cryptosporidia with the cells of a microorganism, the development of a pathological process, and the persistence of the pathogen. The review analyzes the factors providing the mobility of the pathogen, its attachment to and penetration into the cell. The inhibitory effect of a number of substances preventing the binding of sporozoites to the cell is described. It has been established that Cryptosporidia can control the apoptosis of the host's cells and affect different other parameters of cell functional activity. It is shown that infection resistance depends on many factors and it is studied on models with genome or immunity or artificially induced defects. Nitric oxide should be emphasized among the determinants of natural resistance to Cryptosporidia. gamma-IFN has a dominant role in infection control and the good response to infection is associated with the production of a number of cytokines mainly of the Th1 type. There is evidence that there is a relationship of the local immune response to the systemic one in cryptosporidiosis. It is noted that the loss of local immune reactions may cause severe sequels in patients with immunodeficiencies. The importance of nonspecific T-cell defense and antiparasitic antibodies in the control of the infection is demonstrated. It is concluded that the studies that give a better insight into the systemic mechanisms of infection protection should be conducted. In this direction, it is promising to construct models of cryptosporidiosis in the immunocompetent host and those of generalized infection, which will assist in studying the mechanisms that are responsible for the control of cryptosporidial dissemination in immunodeficiencies.

摘要

隐孢子虫病是一种具有社会危害性的机会性感染,难以治疗。根据最近的数据,它由多种隐孢子虫属物种引起,这些物种直到最近还被认为对人类无致病性。这种感染通过水传播途径传播,水净化技术无法去除隐孢子虫的卵囊。因此,重要的研究方向是研究隐孢子虫与微生物细胞相互作用的免疫学方面、病理过程的发展以及病原体的持续存在。该综述分析了病原体移动、附着并侵入细胞的相关因素。描述了一些物质阻止子孢子与细胞结合的抑制作用。已经确定隐孢子虫可以控制宿主细胞的凋亡并影响细胞功能活动的其他不同参数。研究表明,抗感染能力取决于许多因素,并且在具有基因组缺陷、免疫缺陷或人工诱导缺陷的模型上进行了研究。在对隐孢子虫的天然抵抗力的决定因素中,一氧化氮应予以强调。γ-干扰素在感染控制中起主导作用,对感染的良好反应与主要为Th1型的多种细胞因子的产生有关。有证据表明,隐孢子虫病中局部免疫反应与全身免疫反应之间存在关联。值得注意的是,局部免疫反应的丧失可能会在免疫缺陷患者中导致严重后果。证明了非特异性T细胞防御和抗寄生虫抗体在控制感染中的重要性。得出的结论是,应该开展能更好地洞察感染保护系统机制的研究。在这个方向上,构建免疫健全宿主中的隐孢子虫病模型和全身性感染模型很有前景,这将有助于研究负责控制免疫缺陷中隐孢子虫传播的机制。

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