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重新审视隐孢子虫病的全球问题及建议。

Revisiting the global problem of cryptosporidiosis and recommendations.

作者信息

Shrivastava Arpit Kumar, Kumar Subrat, Smith Woutrina A, Sahu Priyadarshi Soumyaranjan

机构信息

Infection Biology and Immunology Laboratory, School of Biotechnology, KIIT University, Bhubaneswar, Odisha, India.

Department of Veterinary Medicine and Epidemiology, School of Veterinary Medicine, One Health Institute, University of California, Davis, California, USA.

出版信息

Trop Parasitol. 2017 Jan-Jun;7(1):8-17. doi: 10.4103/2229-5070.202290.

Abstract

Cryptosporidiosis is a gastrointestinal illness caused by the protozoan parasite species, which is a leading cause of diarrhea in a variety of vertebrate hosts. The primary mode of transmission is through oral routes; infections spread with the ingestion of oocysts by susceptible animals or humans. In humans, infections are commonly found in children and immunocompromised individuals. The small intestine is the most common primary site of infection in humans while extraintestinal cryptosporidiosis occurs in immunocompromised individuals affecting the biliary tract, lungs, or pancreas. Both innate and adaptive immune responses play a critical role in parasite clearance as evident from studies with experimental infection in mice. However, the cellular immune responses induced during human infections are poorly understood. In this article, we review the currently available information with regard to epidemiology, diagnosis, therapeutic interventions, and strategies being used to control cryptosporidiosis infection. Since cryptosporidiosis may spread through zoonotic mode, we emphasis on more epidemiological surveillance-based studies in developing countries with poor sanitation and hygiene. These epidemiological surveys must incorporate fecal source tracking measures to identify animal and human populations contributing significantly to the fecal burden in the community, as mitigation measures differ by host type.

摘要

隐孢子虫病是一种由原生动物寄生虫引起的胃肠道疾病,是多种脊椎动物宿主腹泻的主要原因。主要传播途径是经口传播;感染通过易感动物或人类摄入卵囊而传播。在人类中,感染常见于儿童和免疫功能低下的个体。小肠是人类最常见的主要感染部位,而免疫功能低下个体的肠道外隐孢子虫病则发生在影响胆道、肺部或胰腺的部位。先天性和适应性免疫反应在清除寄生虫方面都起着关键作用,这在小鼠实验感染研究中很明显。然而,人类感染期间诱导的细胞免疫反应了解甚少。在本文中,我们回顾了目前关于隐孢子虫病感染的流行病学、诊断、治疗干预措施以及控制策略的可用信息。由于隐孢子虫病可能通过人畜共患病模式传播,我们强调在卫生和环境卫生较差的发展中国家开展更多基于流行病学监测的研究。这些流行病学调查必须纳入粪便来源追踪措施,以识别对社区粪便负担有重大贡献的动物和人群,因为缓解措施因宿主类型而异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5bb4/5369280/77a5895961e0/TP-7-8-g001.jpg

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