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过去十年肺部感染性疾病的基础研究:临床医生需要了解什么?

The past decade in bench research into pulmonary infectious diseases: What do clinicians need to know?

作者信息

Finch Simon, Keir Holly R, Dicker Alison J, Chalmers James D

机构信息

Scottish Centre for Respiratory Research, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK.

出版信息

Respirology. 2017 Aug;22(6):1062-1072. doi: 10.1111/resp.13106. Epub 2017 Jun 28.

Abstract

Respiratory infections are primarily treated with antibiotics, drugs that are mostly inexpensive and have been widely available since the 1940s and 1950s. Nevertheless, despite antibiotics, the burden of disease in pneumonia, bronchiectasis, cystic fibrosis, COPD and rare respiratory infections remains exceptionally high. There is an urgent need for translational studies to develop new treatments or new biomarkers to improve outcomes in these conditions. The 'translational gaps' between bench science and clinical practice are particularly challenging in respiratory infections. This is partly due to the poor representativeness of animal models of infection to human disease, and a long-term lack of investment into pulmonary infection research. The revolution in genomics and other omics technologies, however, is beginning to unlock clinically important information about the host response to infection, the behaviour of bacterial communities and the development of new antibiotics. It is not possible to review the extensive progress made in the last decade into the pathophysiology of the different respiratory infections and so here, we focus on major technologies that are now changing respiratory infection research, specifically bacterial whole-genome sequencing, the microbiota, personalized medicine with omics technologies, new antibiotic development and host inflammatory cell biology.

摘要

呼吸道感染主要用抗生素治疗,这些药物大多价格低廉,自20世纪40年代和50年代以来就广泛可得。然而,尽管有抗生素,肺炎、支气管扩张症、囊性纤维化、慢性阻塞性肺疾病和罕见呼吸道感染的疾病负担仍然异常高。迫切需要开展转化研究,以开发新的治疗方法或新的生物标志物,从而改善这些疾病的治疗效果。在呼吸道感染方面,基础科学与临床实践之间的“转化差距”尤其具有挑战性。部分原因在于感染动物模型对人类疾病的代表性较差,以及长期以来对肺部感染研究缺乏投入。然而,基因组学和其他组学技术的革命正开始揭示有关宿主对感染的反应、细菌群落行为以及新抗生素开发的重要临床信息。回顾过去十年在不同呼吸道感染病理生理学方面取得的广泛进展是不可能的,因此在这里,我们重点关注目前正在改变呼吸道感染研究的主要技术,特别是细菌全基因组测序、微生物群、组学技术的个性化医疗、新抗生素开发以及宿主炎症细胞生物学。

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