aHIV Pathogenesis Programme, Doris Duke Medical Research Institute bKwaZulu-Natal Research Institute for Tuberculosis and HIV, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa cRagon Institute of Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Boston, Massachusetts, USA dMax Planck Institute for Infection Biology, Berlin, Germany.
Curr Opin Hematol. 2014 Jan;21(1):50-7. doi: 10.1097/MOH.0000000000000007.
The causes of ethnic or benign neutropenia have long been unclear. Here, we discuss the emerging data on the causes and consequences of neutropenia and discuss the relevance of these data for African populations, in which the prevalence of neutropenia is high.
Genetic deletion of the Duffy antigen receptor for chemokines (DARC-null genotype) has been identified as a major determinant for neutropenia. DARC acts as a receptor for Plasmodium vivax malaria and the DARC-null genotype has thus been positively selected among Africans; however, recent studies suggest that Duffy-null-linked neutropenia could increase the risk of HIV infection. Data are emerging that neutrophils are versatile cells that play a critical role not only in direct antimicrobial activity but also in priming and regulating the activity of other innate and adaptive immune cells. Therefore, we discuss here the imperative to better understand the causes, consequences, and the underlying mechanisms of neutropenia among Africans as a prerequisite for rational and optimal biomedical interventions to improve health outcomes.
Neutropenia among Africans, linked to the Duffy-null trait or otherwise, may have significant health consequences that remain largely undetermined and could have a significant impact on the pathogenesis of diseases.
目的综述:导致种族性或良性中性粒细胞减少症的原因长期以来一直不明确。在此,我们讨论了中性粒细胞减少症的原因和后果的最新数据,并讨论了这些数据与中性粒细胞减少症高发的非洲人群的相关性,在这些人群中,中性粒细胞减少症的患病率很高。
最新发现:趋化因子的 Duffy 抗原受体(DARC)缺失基因型已被确定为中性粒细胞减少症的主要决定因素。DARC 作为间日疟原虫疟疾的受体,因此在非洲人群中被积极选择;然而,最近的研究表明,Duffy 缺失相关的中性粒细胞减少症可能会增加 HIV 感染的风险。有数据表明,中性粒细胞是多功能细胞,不仅在直接抗微生物活性中发挥关键作用,而且在启动和调节其他先天和适应性免疫细胞的活性中发挥关键作用。因此,我们在这里讨论了必须更好地了解非洲人中性粒细胞减少症的原因、后果和潜在机制,这是合理和优化生物医学干预以改善健康结果的前提。
总结:与 Duffy 缺失特征有关或无关的非洲人中性粒细胞减少症可能具有重大的健康后果,这些后果在很大程度上尚未确定,并可能对疾病的发病机制产生重大影响。