Bañuls Anne-Laure, Hide Mallorie, Prugnolle Franck
Institut de Recherche pour le Développement, UMR CNRS/IRD 2724, Génétique et Evolution des Maladies Infectieuses, IRD Montpellier, 911 avenue Agropolis, 34394 Montpellier cedex 5, France.
Adv Parasitol. 2007;64:1-109. doi: 10.1016/S0065-308X(06)64001-3.
Leishmaniases remain a major public health problem today despite the vast amount of research conducted on Leishmania pathogens. The biological model is genetically and ecologically complex. This paper explores the advances in Leishmania genetics and reviews population structure, taxonomy, epidemiology and pathogenicity. Current knowledge of Leishmania genetics is placed in the context of natural populations. Various studies have described a clonal structure for Leishmania but recombination, pseudo-recombination and other genetic processes have also been reported. The impact of these different models on epidemiology and the medical aspects of leishmaniases is considered from an evolutionary point of view. The role of these parasites in the expression of pathogenicity in humans is also explored. It is important to ascertain whether genetic variability of the parasites is related to the different clinical expressions of leishmaniasis. The review aims to put current knowledge of Leishmania and the leishmaniases in perspective and to underline priority questions which 'leishmaniacs' must answer in various domains: epidemiology, population genetics, taxonomy and pathogenicity. It concludes by presenting a number of feasible ways of responding to these questions.
尽管对利什曼原虫病原体进行了大量研究，但利什曼病如今仍然是一个重大的公共卫生问题。其生物学模型在遗传和生态方面都很复杂。本文探讨了利什曼原虫遗传学的进展，并综述了种群结构、分类学、流行病学和致病性。利什曼原虫遗传学的现有知识是在自然种群的背景下阐述的。各种研究都描述了利什曼原虫的克隆结构，但也有关于重组、假重组和其他遗传过程的报道。从进化的角度考虑了这些不同模型对利什曼病流行病学和医学方面的影响。还探讨了这些寄生虫在人类致病性表达中的作用。确定寄生虫的遗传变异性是否与利什曼病的不同临床表型相关很重要。这篇综述旨在透视利什曼原虫和利什曼病的现有知识，并强调“利什曼病研究者”在各个领域（流行病学、种群遗传学、分类学和致病性）必须回答的优先问题。文章最后提出了一些回答这些问题的可行方法。
