Carbonetti Nicholas H
Department of Microbiology and Immunology, University of Maryland School of Medicine, 685 W. Baltimore St., HSF-I 380, Baltimore, MD 21201, USA
Pathog Dis. 2016 Oct;74(7). doi: 10.1093/femspd/ftw087. Epub 2016 Sep 7.
The significant and sometimes dramatic rise in the number of circulating white blood cells (leukocytosis) in infants suffering from pertussis (whooping cough) has been recognized for over a century. Although pertussis is a disease that afflicts people of all ages, it can be particularly severe in young infants, and these are the individuals in whom leukocytosis is most pronounced. Very high levels of leukocytosis are associated with poor outcome in infants hospitalized with pertussis and modern treatments are often aimed at reducing the number of leukocytes. Pertussis leukocytosis is caused by pertussis toxin, a soluble protein toxin released by Bordetella pertussis during infection, but the exact mechanisms by which this occurs are still unclear. In this minireview, I discuss the history of clinical and experimental findings on pertussis leukocytosis, possible contributing mechanisms causing this condition and treatments aimed at reducing leukocytosis in hospitalized infants. Since recent studies have detailed significant associations between specific levels of pertussis leukocytosis and fatal outcome, this is a timely review that may stimulate new thinking on how to understand and combat this problem.
患有百日咳（小儿咳嗽）的婴儿体内循环白细胞数量显著且有时急剧增加（白细胞增多症），这一现象已被认识超过一个世纪。尽管百日咳是一种困扰各年龄段人群的疾病，但在幼儿中可能尤为严重，而白细胞增多症在这些幼儿中最为明显。白细胞增多症水平极高与住院百日咳婴儿的不良预后相关，现代治疗通常旨在减少白细胞数量。百日咳白细胞增多症由百日咳毒素引起，百日咳博德特氏菌在感染期间释放的一种可溶性蛋白质毒素，但具体发生机制仍不清楚。在这篇小型综述中，我讨论了关于百日咳白细胞增多症的临床和实验研究结果的历史、导致这种情况的可能机制以及旨在减少住院婴儿白细胞增多症的治疗方法。由于最近的研究详细阐述了百日咳白细胞增多症的特定水平与致命结局之间的重要关联，这是一篇及时的综述，可能会激发关于如何理解和应对这一问题的新思考。
