Monahan A M, Callanan J J, Nally J E
Veterinary Sciences Centre, UCD School of Agriculture Food Science and Veterinary Medicine, UCD Conway Institute of Biomolecular and Biomedical Research, College of Life Sciences, University College Dublin, Belfield, Dublin 4, Ireland.
Vet Pathol. 2009 Sep;46(5):792-9. doi: 10.1354/vp.08-VP-0265-N-REV. Epub 2009 May 9.
Pathogenic species of Leptospira cause leptospirosis, a global zoonotic disease. Leptospira colonize renal tubules of chronically infected maintenance hosts, from where they are shed in urine to the environment and survive in suitable moist conditions. Transmission of disease to new hosts is facilitated by contact with contaminated urine or water sources, because Leptospira can penetrate broken skin or mucosal surfaces of new hosts. Infection of new hosts may be asymptomatic, as with chronically infected maintenance hosts, or may result in an acute disease process in which clinical signs can include fever, jaundice, renal failure, and pulmonary hemorrhage. Those factors that determine if an animal will suffer an acute or a chronic infection are not fully understood but include host animal species, infecting serovar, and infecting dose. During chronic infection, renal colonization and leptospiruria persist despite cellular and humoral responses by the host. Tubulointerstitial nephritis is the most common lesion associated with chronic infection, and this may progress to fibrosis and subsequent renal failure. This review aims to address how Leptospira cause tubulointerstitial nephritis during chronic leptospirosis and to summarize the mechanisms by which Leptospira might evade host immune responses during chronic colonization of the renal tubule.
钩端螺旋体的致病菌种可引发钩端螺旋体病，这是一种全球性的人畜共患病。钩端螺旋体定殖于慢性感染的储存宿主的肾小管中，从那里它们随尿液排到环境中，并在适宜的潮湿条件下存活。与受污染的尿液或水源接触会促进疾病传播给新宿主，因为钩端螺旋体可穿透新宿主的破损皮肤或粘膜表面。新宿主的感染可能无症状，如同慢性感染的储存宿主一样，也可能导致急性疾病过程，其临床症状可包括发热、黄疸、肾衰竭和肺出血。那些决定动物会发生急性还是慢性感染的因素尚未完全明确，但包括宿主动物种类、感染血清型和感染剂量。在慢性感染期间，尽管宿主有细胞和体液反应，肾定殖和钩端螺旋体尿仍会持续存在。肾小管间质性肾炎是与慢性感染相关的最常见病变，这可能会发展为纤维化及随后的肾衰竭。本综述旨在探讨钩端螺旋体在慢性钩端螺旋体病期间如何引起肾小管间质性肾炎，并总结钩端螺旋体在肾小管慢性定殖期间可能逃避宿主免疫反应的机制。
