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评估患有蜱传疾病患者的多微生物免疫反应。

Evaluating polymicrobial immune responses in patients suffering from tick-borne diseases.

机构信息

Department of Biological and Environmental Sciences, NanoScience Center, University of Jyväskylä, Jyväskylä, Finland.

Te?ted Ltd, Mattilaniemi 6-8, Jyväskylä, Finland.

出版信息

Sci Rep. 2018 Oct 29;8(1):15932. doi: 10.1038/s41598-018-34393-9.

Abstract

There is insufficient evidence to support screening of various tick-borne diseases (TBD) related microbes alongside Borrelia in patients suffering from TBD. To evaluate the involvement of multiple microbial immune responses in patients experiencing TBD we utilized enzyme-linked immunosorbent assay. Four hundred and thirty-two human serum samples organized into seven categories followed Centers for Disease Control and Prevention two-tier Lyme disease (LD) diagnosis guidelines and Infectious Disease Society of America guidelines for post-treatment Lyme disease syndrome. All patient categories were tested for their immunoglobulin M (IgM) and G (IgG) responses against 20 microbes associated with TBD. Our findings recognize that microbial infections in patients suffering from TBDs do not follow the one microbe, one disease Germ Theory as 65% of the TBD patients produce immune responses to various microbes. We have established a causal association between TBD patients and TBD associated co-infections and essential opportunistic microbes following Bradford Hill's criteria. This study indicated an 85% probability that a randomly selected TBD patient will respond to Borrelia and other related TBD microbes rather than to Borrelia alone. A paradigm shift is required in current healthcare policies to diagnose TBD so that patients can get tested and treated even for opportunistic infections.

摘要

目前尚无足够的证据支持在患有 TBD 的患者中同时筛查与伯氏疏螺旋体相关的各种蜱传疾病(TBD)相关微生物。为了评估多种微生物免疫反应在 TBD 患者中的参与情况,我们利用酶联免疫吸附试验(ELISA)进行了研究。我们将 432 个人类血清样本分为七类,这些样本遵循了疾病控制与预防中心(CDC)的两阶段莱姆病(LD)诊断指南和美国传染病学会(IDSA)的治疗后莱姆病综合征指南。所有患者类别均接受了针对与 TBD 相关的 20 种微生物的免疫球蛋白 M(IgM)和 G(IgG)反应检测。我们的研究结果表明,TBD 患者中的微生物感染不符合一种微生物、一种疾病的“ Germ Theory”理论,因为 65%的 TBD 患者对各种微生物产生免疫反应。我们已经根据布拉德福德·希尔(Bradford Hill)的标准,在 TBD 患者与 TBD 相关的合并感染和必要的机会性微生物之间建立了因果关联。本研究表明,随机选择的 TBD 患者对伯氏疏螺旋体和其他相关 TBD 微生物产生反应的概率为 85%,而不是仅对伯氏疏螺旋体产生反应。目前需要对医疗保健政策进行范式转变,以便对 TBD 进行诊断,从而使患者能够接受检测和治疗,甚至是针对机会性感染的治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b008/6206025/29a90900037f/41598_2018_34393_Fig1_HTML.jpg

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