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细胞因子和趋化因子在脑疟疾发病机制中的作用。

Cytokines and Chemokines in Cerebral Malaria Pathogenesis.

机构信息

Parasitology Unit, Max Planck Institute for Infection BiologyBerlin, Germany.

Institute of Chemistry and Biochemistry, Free UniversityBerlin, Germany.

出版信息

Front Cell Infect Microbiol. 2017 Jul 20;7:324. doi: 10.3389/fcimb.2017.00324. eCollection 2017.

Abstract

Cerebral malaria is among the major causes of malaria-associated mortality and effective adjunctive therapeutic strategies are currently lacking. Central pathophysiological processes involved in the development of cerebral malaria include an imbalance of pro- and anti-inflammatory responses to infection, endothelial cell activation, and loss of blood-brain barrier integrity. However, the sequence of events, which initiates these pathophysiological processes as well as the contribution of their complex interplay to the development of cerebral malaria remain incompletely understood. Several cytokines and chemokines have repeatedly been associated with cerebral malaria severity. Increased levels of these inflammatory mediators could account for the sequestration of leukocytes in the cerebral microvasculature present during cerebral malaria, thereby contributing to an amplification of local inflammation and promoting cerebral malaria pathogenesis. Herein, we highlight the current knowledge on the contribution of cytokines and chemokines to the pathogenesis of cerebral malaria with particular emphasis on their roles in endothelial activation and leukocyte recruitment, as well as their implication in the progression to blood-brain barrier permeability and neuroinflammation, in both human cerebral malaria and in the murine experimental cerebral malaria model. A better molecular understanding of these processes could provide the basis for evidence-based development of adjunct therapies and the definition of diagnostic markers of disease progression.

摘要

脑型疟疾是疟疾相关死亡的主要原因之一,目前缺乏有效的辅助治疗策略。脑型疟疾发展过程中的中枢病理生理过程包括感染时促炎和抗炎反应失衡、内皮细胞激活以及血脑屏障完整性丧失。然而,引发这些病理生理过程的事件顺序以及它们复杂相互作用对脑型疟疾发展的贡献仍不完全清楚。几种细胞因子和趋化因子已反复与脑型疟疾严重程度相关。这些炎症介质水平的升高可能是脑型疟疾期间白细胞在脑微血管中聚集的原因,从而导致局部炎症的放大,并促进脑型疟疾的发病机制。在此,我们重点介绍细胞因子和趋化因子对脑型疟疾发病机制的贡献,特别强调它们在内皮细胞激活和白细胞募集中的作用,以及它们在血脑屏障通透性和神经炎症进展中的作用,包括在人类脑型疟疾和实验性脑型疟疾模型中。对这些过程的更好分子理解可以为基于证据的辅助治疗开发和疾病进展的诊断标志物的定义提供基础。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/299a/5517394/695344ad5743/fcimb-07-00324-g0001.jpg

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