Department of Infectious, Parasitic, and Immune-Mediated Diseases, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161, Rome, Italy,
Arch Immunol Ther Exp (Warsz). 2013 Dec;61(6):445-57. doi: 10.1007/s00005-013-0242-1. Epub 2013 Aug 18.
Approximately 40 million whooping cough cases and between 200,000 and 400,000 pertussis-linked deaths are recorded each year. Although several types of vaccines are licensed and widely used, Bordetella pertussis continues to circulate in populations with high vaccine coverage of infants and children due to the waning of protection induced by the vaccination. B. pertussis typically expresses a wide array of virulence factors which promote bacterial adhesion and invasion by altering the local environment, including pertussis toxin, tracheal cytotoxin, adenylate cyclase toxin, filamentous hemagglutinin, and the lipooligosaccharide. The virulence factors of B. pertussis also possess immunomodulatory properties, exerted through their enzymatic and receptor-binding activities. Both pro- and anti-inflammatory effects are mediated, that can subvert host innate and adaptive immunity and favor the onset of a long-term infection. This review describes the capacities of B. pertussis virulence factors to modulate host immune responses and the mechanisms employed, which have been the subject of extensive research in the recent years, both in murine and human experimental systems. Knowledge of these mechanisms is gaining increasing importance, since it could provide in the near future the basis for the identification of therapeutic agents for modulating the immune system as well as novel molecular targets to treat pertussis.
每年约有 4000 万例百日咳病例和 20 万至 40 万例与百日咳相关的死亡病例。尽管有几种类型的疫苗获得许可并广泛使用，但由于婴儿和儿童接种疫苗的保护作用逐渐减弱，Bordetella pertussis 仍在高疫苗接种率的人群中传播。B. pertussis 通常表达多种毒力因子，通过改变局部环境促进细菌粘附和入侵，包括百日咳毒素、气管细胞毒素、腺苷酸环化酶毒素、丝状血凝素和脂寡糖。B. pertussis 的毒力因子还具有免疫调节特性，通过其酶和受体结合活性发挥作用。这两种促炎和抗炎作用都被介导，这可能颠覆宿主固有和适应性免疫，并有利于长期感染的发生。本文综述了 B. pertussis 毒力因子调节宿主免疫反应的能力及其所采用的机制，近年来在小鼠和人类实验系统中对这些机制进行了广泛的研究。了解这些机制的重要性日益增加，因为它可能为识别调节免疫系统的治疗剂以及治疗百日咳的新型分子靶点提供依据。
