Leitch Gordon J, He Qing
Department of Physiology, Morehouse School of Medicine, Atlanta, GA 30310-1495, USA.
J Biomed Res. 2012 Jan;25(1):1-16. doi: 10.1016/S1674-8301(11)60001-8. Epub 2012 Feb 21.
Apicomplexan protozoan parasites of the genus Cryptosporidium infect the gastrointestinal tract and lungs of a wide variety of animals, including humans. The majority of human infections are due to either Cryptosporidium hominis (C. hominis) and/or Cryptosporidium parvum (C. parvum). The parasite has a complex life cycle that includes both asexual and sexual stages. While there are invasive free living stages, proliferation and differentiation take place within a unique parasitrophorous vacuole under the host cell brush border but outside the host cell cytoplasm. Infection is spread by environmentally resistant spores that primarily contaminate drinking water and occasionally food sources, which may cause significant outbreaks of diarrhea that generally lasts less than 2 w in immunocompetent individuals. In immunodeficient or immunosuppressed individuals, diarrhea may be copious and can result in significant morbidity and mortality, particularly in AIDS patients. Although diagnosis is relatively simple, effective drug treatment, particulary for infections in immunodeficient patients, has not been uniformly successful. This overview summarizes the species known to infect humans, aspects of the parasite life cycle, sources of infection, the pathophysiology of cryptosporidiosis, the immune response to infection, diagnosis, treatment and some aspects of cryptosporidiosis in China.
隐孢子虫属的顶复门原生动物寄生虫可感染包括人类在内的多种动物的胃肠道和肺部。大多数人类感染是由人隐孢子虫(C. hominis)和/或微小隐孢子虫(C. parvum)引起的。该寄生虫具有复杂的生命周期,包括无性和有性阶段。虽然存在可自由生活的侵袭性阶段,但增殖和分化发生在宿主细胞刷状缘下方但在宿主细胞胞质外的独特寄生泡内。感染通过具有环境抗性的孢子传播,这些孢子主要污染饮用水,偶尔也污染食物来源,这可能导致腹泻的大规模爆发,在免疫功能正常的个体中腹泻通常持续不到2周。在免疫缺陷或免疫抑制个体中,腹泻可能很严重,并可能导致显著的发病率和死亡率,尤其是在艾滋病患者中。虽然诊断相对简单,但有效的药物治疗,特别是针对免疫缺陷患者的感染,并非一直成功。本综述总结了已知感染人类的物种、寄生虫生命周期的各个方面、感染源、隐孢子虫病的病理生理学、对感染的免疫反应、诊断、治疗以及中国隐孢子虫病的一些方面。