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弓形虫病

Toxoplasmosis.

作者信息

Halonen Sandra K, Weiss Louis M

机构信息

Department of Microbiology, Montana State University, Bozeman, MT, USA.

出版信息

Handb Clin Neurol. 2013;114:125-45. doi: 10.1016/B978-0-444-53490-3.00008-X.

Abstract

Toxoplasma gondii, an Apicomplexan, is a pathogic protozoan that can infect the central nervous system. Infection during pregnancy can result in a congenial infection with severe neurological sequelae. In immunocompromised individuals reactivation of latent neurological foci can result in encephalitis. Immunocompetent individuals infected with T. gondii are typically asymptomatic and maintain this infection for life. However, recent studies suggest that these asymptomatic infections may have effects on behavior and other physiological processes. Toxoplasma gondii infects approximately one-third of the world population, making it one of the most successful parasitic organisms. Cats and other felidae serve as the definite host producing oocysts, an environmentally resistant life cycle stage found in cat feces, which can transmit the infection when ingested orally. A wide variety of warm-blooded animals, including humans, can serve as the intermediate host in which tissue cysts (containing bradyzoites) develop. Transmission also occurs due to ingestion of the tissue cysts. There are three predominant clonal lineages, termed Types I, II and III, and an association with higher pathogenicity with the Type I strains in humans has emerged. This chapter presents a review of the biology of this infection including the life cycle, transmission, epidemiology, parasite strains, and the host immune response. The major clinical outcomes of congenital infection, chorioretinitis and encephalitis, and the possible association of infection of toxoplasmosis with neuropsychiatric disorders such as schizophrenia, are reviewed.

摘要

弓形虫是一种顶复门原虫,是一种可感染中枢神经系统的致病性原生动物。孕期感染可导致先天性感染并伴有严重的神经后遗症。在免疫功能低下的个体中,潜伏性神经病灶的重新激活可导致脑炎。感染弓形虫的免疫功能正常个体通常无症状,并终生维持这种感染状态。然而,最近的研究表明,这些无症状感染可能会对行为和其他生理过程产生影响。弓形虫感染了世界上约三分之一的人口,使其成为最成功的寄生生物之一。猫和其他猫科动物是产生卵囊的终末宿主,卵囊是在猫粪便中发现的一种具有环境抗性的生命周期阶段,经口摄入时可传播感染。包括人类在内的多种温血动物可作为中间宿主,在其中形成组织囊肿(含有缓殖子)。摄入组织囊肿也会导致传播。有三种主要的克隆谱系,称为I型、II型和III型,并且已发现I型菌株在人类中具有更高的致病性。本章综述了这种感染的生物学特性,包括生命周期、传播、流行病学、寄生虫菌株和宿主免疫反应。还综述了先天性感染的主要临床后果、脉络膜视网膜炎和脑炎,以及弓形虫感染与精神分裂症等神经精神疾病之间可能存在的关联。

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