Contini Carlo, Seraceni Silva, Cultrera Rosario, Castellazzi Massimiliano, Granieri Enrico, Fainardi Enrico
Section of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Ferrara, Via Fossato di Mortara, 23, 44100 Ferrara, Italy.
Interdiscip Perspect Infect Dis. 2010;2010:273573. doi: 10.1155/2010/273573. Epub 2010 Feb 21.
Chlamydophila pneumoniae is an intracellular pathogen responsible for a number of different acute and chronic infections. The recent deepening of knowledge on the biology and the use of increasingly more sensitive and specific molecular techniques has allowed demonstration of C. pneumoniae in a large number of persons suffering from different diseases including cardiovascular (atherosclerosis and stroke) and central nervous system (CNS) disorders. Despite this, many important issues remain unanswered with regard to the role that C. pneumoniae may play in initiating atheroma or in the progression of the disease. A growing body of evidence concerns the involvement of this pathogen in chronic neurological disorders and particularly in Alzheimer's disease (AD) and Multiple Sclerosis (MS). Monocytes may traffic C. pneumoniae across the blood-brain-barrier, shed the organism in the CNS and induce neuroinflammation. The demonstration of C. pneumoniae by histopathological, molecular and culture techniques in the late-onset AD dementia has suggested a relationship between CNS infection with C. pneumoniae and the AD neuropathogenesis. In particular subsets of MS patients, C. pneumoniae could induce a chronic persistent brain infection acting as a cofactor in the development of the disease. The role of Chlamydia in the pathogenesis of mental or neurobehavioral disorders including schizophrenia and autism is uncertain and fragmentary and will require further confirmation.
肺炎衣原体是一种细胞内病原体,可引发多种急慢性感染。近年来,随着对其生物学特性的深入了解以及越来越多敏感且特异的分子技术的应用,已证实在大量患有不同疾病(包括心血管疾病(动脉粥样硬化和中风)和中枢神经系统(CNS)疾病)的人群中存在肺炎衣原体。尽管如此,关于肺炎衣原体在动脉粥样硬化的发生或疾病进展中可能发挥的作用,许多重要问题仍未得到解答。越来越多的证据表明这种病原体与慢性神经疾病有关,尤其是与阿尔茨海默病(AD)和多发性硬化症(MS)有关。单核细胞可能携带肺炎衣原体穿过血脑屏障,在中枢神经系统中释放该病原体并引发神经炎症。通过组织病理学、分子和培养技术在晚发性AD痴呆中证实肺炎衣原体,提示中枢神经系统感染肺炎衣原体与AD神经发病机制之间存在关联。在特定亚组的MS患者中,肺炎衣原体可引发慢性持续性脑部感染,作为疾病发展的辅助因素。衣原体在包括精神分裂症和自闭症在内的精神或神经行为障碍发病机制中的作用尚不确定且不完整,需要进一步证实。