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埃博拉出血热病毒:发病机制、免疫反应及潜在预防措施

Ebola haemorrhagic fever virus: pathogenesis, immune responses, potential prevention.

作者信息

Marcinkiewicz Janusz, Bryniarski Krzysztof, Nazimek Katarzyna

机构信息

Department Of Immunology, Jagiellonian University Medical College, Krakow, Poland.

出版信息

Folia Med Cracov. 2014;54(3):39-48.

Abstract

Ebola zoonotic RNA filovirus represents human most virulent and lethal pathogens, which induces acute hemorrhagic fever and death within few days in a range of 60-90% of symptomatic individuals. Last outbreak in 2014 in West Africa caused panic that Ebola epidemic can be spread to other continents. Number of deaths in late December reached almost 8,000 individuals out of more than 20,000 symptomatic patients. It seems that only a coordinated international response could counteract the further spread of Ebola. Major innate immunity mechanisms against Ebola are associated with the production of interferons, that are inhibited by viral proteins. Activation of host NK cells was recognized as a leading immune function responsible for recovery of infected people. Uncontrolled cell infection by Ebola leads to an impairment of immunity with cytokine storm, coagulopathy, systemic bleeding, multi-organ failure and death. Tested prevention strategies to induce antiviral immunity include: i. recombinant virus formulations (vaccines); ii. cocktail of monoclonal antibodies (serotherapy); iii. alternative RNA-interference-based antiviral methods. Maintaining the highest standards of aseptic and antiseptic precautions is equally important. Present brief review summarizes a current knowledge concerning pathogenesis of Ebola hemorrhagic disease and the virus interaction with the immune system and discusses recent advances in prevention of Ebola infection by vaccination and serotherapy.

摘要

埃博拉人畜共患RNA丝状病毒是人类最具毒性和致命性的病原体,它可导致急性出血热,并在数天内导致60%至90%的有症状个体死亡。2014年在西非的最后一次疫情爆发引发了恐慌,担心埃博拉疫情会蔓延到其他大陆。12月底,在2万多名有症状的患者中,死亡人数几乎达到8000人。似乎只有协调一致的国际应对措施才能遏制埃博拉的进一步传播。针对埃博拉的主要先天免疫机制与干扰素的产生有关,而干扰素会被病毒蛋白抑制。宿主自然杀伤细胞的激活被认为是负责感染人群康复的主要免疫功能。埃博拉不受控制的细胞感染会导致免疫功能受损,引发细胞因子风暴、凝血病、全身出血、多器官衰竭和死亡。经测试的诱导抗病毒免疫的预防策略包括:i. 重组病毒制剂(疫苗);ii. 单克隆抗体鸡尾酒(血清疗法);iii. 基于RNA干扰的替代抗病毒方法。保持最高标准的无菌和防腐预防措施同样重要。本简要综述总结了关于埃博拉出血热疾病发病机制以及病毒与免疫系统相互作用的当前知识,并讨论了通过疫苗接种和血清疗法预防埃博拉感染的最新进展。

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