Pawlowski Sean W, Warren Cirle Alcantara, Guerrant Richard
Division of Infectious Disease and International Health, Center for Global Health, University of Virginia School of Medicine, Charlottesville, Virginia 22908, USA.
Gastroenterology. 2009 May;136(6):1874-86. doi: 10.1053/j.gastro.2009.02.072. Epub 2009 May 7.
Studies of microbial pathogens and the toxins they produce are important for determining the mechanisms by which they cause disease and spread throughout a population. Some bacteria produce secretory enterotoxins (such as cholera toxin or the heat-labile or stable enterotoxins produced by Escherichia coli) that invade cells directly. Others invade cells or produce cytotoxins (such as those produced by Shigella, enteroinvasive E coli, or Clostridium difficile) that damage cells or trigger host responses that cause small or large bowel diseases (such as enteroaggregative or enteropathogenic E coli or Salmonella). Viruses (such as noroviruses and rotaviruses) and protozoa (such as Cryptosporidium, Giardia, or Entamoeba histolytica) disrupt cell functions and cause short- or long-term disease. Much epidemiologic data about these pathogens have been collected from community- and hospital-acquired settings, as well as from patients with traveler's or persistent diarrhea. These studies have led to practical approaches for prevention, diagnosis, and treatment.
对微生物病原体及其产生的毒素进行研究，对于确定它们引发疾病并在人群中传播的机制至关重要。一些细菌会产生分泌性肠毒素（如霍乱毒素或大肠杆菌产生的不耐热或耐热肠毒素），这些毒素会直接侵入细胞。其他细菌则侵入细胞或产生细胞毒素（如志贺氏菌、侵袭性大肠杆菌或艰难梭菌产生的细胞毒素），这些毒素会损害细胞或引发宿主反应，从而导致小肠或大肠疾病（如聚集性或致病性大肠杆菌或沙门氏菌引起的疾病）。病毒（如诺如病毒和轮状病毒）和原生动物（如隐孢子虫、贾第虫或溶组织内阿米巴）会破坏细胞功能并导致短期或长期疾病。关于这些病原体的许多流行病学数据已从社区获得性和医院获得性环境中收集，以及从患有旅行者腹泻或持续性腹泻的患者中收集。这些研究已产生了预防、诊断和治疗的实用方法。
