Luna-Pineda Víctor Manuel, Ochoa Sara, Cruz-Córdova Ariadnna, Cázares-Domínguez Vicenta, Vélez-González Fernanda, Hernández-Castro Rigoberto, Xicohtencatl-Cortes Juan
Laboratorio de Investigación en Bacteriología Intestinal, Hospital Infantil de México Federico Gómez. Ciudad de México, México.
Instituto de Fisiología Celular, Universidad Nacional Autónoma de México. Ciudad de México, México.
Bol Med Hosp Infant Mex. 2018;75(2):67-78. doi: 10.24875/BMHIM.M18000011.
Urinary tract infections (UTI) are considered one of the main causes of morbidity worldwide, and uropathogenic Escherichia coli (UPEC) is the etiological agent associated with these infections. The high morbidity produced by the UTI and the limitation of antibiotic treatments promotes the search for new alternatives against these infections. The knowledge that has been generated regarding the immune response in the urinary tract is important for the development of effective strategies in the UTI prevention, treatment, and control. Molecular biology and bioinformatic tools have allowed the construction of fusion proteins as biomolecules for the development of a viable vaccine against UTI. The fimbrial adhesins (FimH, CsgA, and PapG) of UPEC are virulence factors that contribute to the adhesion, invasion, and formation of intracellular bacterial communities. The generation of recombinant proteins from fimbrial adhesins as a single molecule is obtained by fusion technology. A few in vivo and in vitro studies have shown that fusion proteins provide an efficient immune response and protection against UTI produced by UPEC. Intranasal immunization of immunogenic molecules has generated a response in the urinary tract mucosa compared with other routes of immunization. The objective of this review was to propose a vaccine designed against UTI caused by UPEC, describing the general scenario of the infection, the mechanism of pathogenicity of bacteria, and the immune response of the host.
尿路感染（UTI）被认为是全球发病的主要原因之一，而尿路致病性大肠杆菌（UPEC）是与这些感染相关的病原体。UTI产生的高发病率以及抗生素治疗的局限性促使人们寻找针对这些感染的新替代方法。关于尿路免疫反应所产生的知识对于制定有效的UTI预防、治疗和控制策略非常重要。分子生物学和生物信息学工具已使融合蛋白作为生物分子得以构建，用于开发一种可行的抗UTI疫苗。UPEC的菌毛粘附素（FimH、CsgA和PapG）是毒力因子，有助于细胞内细菌群落的粘附、侵袭和形成。通过融合技术可获得作为单一分子的来自菌毛粘附素的重组蛋白。一些体内和体外研究表明，融合蛋白可提供有效的免疫反应，并抵御由UPEC引起的UTI。与其他免疫途径相比，免疫原性分子的鼻内免疫已在尿路黏膜产生反应。本综述的目的是提出一种针对由UPEC引起的UTI设计的疫苗，描述感染的总体情况、细菌的致病机制以及宿主的免疫反应。
