School of Biosciences, Faculty of Health and Medical Sciences, Taylor's University, No 1, Jalan Taylor's, 47500, Subang Jaya, Selangor, Malaysia.
I Department of Medical Microbiology & Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, UPM Serdang, Selangor, Malaysia.
Int Microbiol. 2020 May;23(2):127-136. doi: 10.1007/s10123-019-00067-3. Epub 2019 Mar 14.
Human leptospirosis is considered as one of the most widespread and potentially fatal zoonotic diseases that causes high mortality and morbidity in the endemic regions of tropical and subtropical countries. The infection can arise from direct or indirect exposure of human through contaminated environment that contains leptospires or animal reservoirs that carry leptospires. The clinical manifestations during human leptospirosis ranges from asymptomatic, mild infections to severe and life-threatening complications involving multi-organ failures with kidneys, lungs and liver severely affected. Despite much efforts have been put in to unravel the pathogenesis during human leptospirosis, it remains obscure to which extent the host factors or the pathogen itself contribute towards the pathogenesis. Host innate immunity, especially, polymorphonuclear neutrophils and complement system are involved in the first line of defense during human leptospirosis. However, pathogenic Leptospira has acquired diverse evasion strategies to evade from host immunity and establish infection in infected hosts. Hence, in this review, we focus on organs pathology during human leptospiral infection and host evasion strategies employed by Leptospira. A profound understanding on leptospiral immunity and how Leptospira subvert the immune system may provide new insights on the development of therapeutic regimens against this species in future.
人类钩端螺旋体病被认为是最广泛和潜在致命的人畜共患病之一，在热带和亚热带国家的流行地区导致高死亡率和发病率。感染可通过直接或间接暴露于含有钩端螺旋体或携带钩端螺旋体的动物宿主的受污染环境中发生。人类钩端螺旋体病的临床表现从无症状、轻度感染到严重和危及生命的并发症不等，涉及多器官衰竭，肾脏、肺部和肝脏严重受损。尽管人们已经做出了很多努力来阐明人类钩端螺旋体病的发病机制，但宿主因素或病原体本身在多大程度上导致发病机制仍不清楚。宿主先天免疫，特别是多形核白细胞和补体系统，参与人类钩端螺旋体病的第一道防线。然而，致病性钩端螺旋体已经获得了多种逃避宿主免疫和在感染宿主中建立感染的逃避策略。因此，在这篇综述中，我们重点关注人类钩端螺旋体感染期间的器官病理学和钩端螺旋体采用的宿主逃避策略。深入了解钩端螺旋体的免疫机制以及钩端螺旋体如何颠覆免疫系统，可能为未来针对该物种开发治疗方案提供新的见解。
