Casanova Jean-Laurent, Abel Laurent
Laboratory of Human Genetics of Infectious Diseases, Institut National de la Santé et de la Recherche Médicale, U550, Paris, France.
Science. 2007 Aug 3;317(5838):617-9. doi: 10.1126/science.1142963.
A paradigm shift is occurring in the field of primary immunodeficiencies, with revision of the definition of these conditions and a considerable expansion of their limits. Inborn errors of immunity were initially thought to be confined to a few rare, familial, monogenic, recessive traits impairing the development or function of one or several leukocyte subsets and resulting in multiple, recurrent, opportunistic, and fatal infections in infancy. A growing number of exceptions to each of these conventional qualifications have gradually accumulated. It now appears that most individuals suffer from at least one of a multitude of primary immunodeficiencies, the dissection of which is helping to improve human medicine while describing immunity in natura.
原发性免疫缺陷领域正在发生范式转变,这些病症的定义得到修订,其范畴也有了相当大的扩展。免疫缺陷最初被认为仅限于一些罕见的、家族性的、单基因隐性性状,这些性状会损害一个或几个白细胞亚群的发育或功能,并导致婴儿期出现多次反复的机会性致命感染。这些传统定义中的每一条都逐渐积累了越来越多的例外情况。现在看来,大多数人至少患有多种原发性免疫缺陷中的一种,对这些病症的剖析有助于改善人类医学,同时也能揭示自然状态下的免疫情况。