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进行性多灶性白质脑病——流行病学、免疫反应、临床差异、治疗

Progressive multifocal leukoencephalopathy - epidemiology, immune response, clinical differences, treatment.

作者信息

Snopková S, Štourač P, Fašaneková L, Mihalčin M, Havlíčková K, Svačinka R, Volfová P, Snopek P, Husa P

出版信息

Epidemiol Mikrobiol Imunol. 2019 Winter;68(1):24-31.

Abstract

Progressive multifocal leukoencephalopathy (PML) is a severe disease of the central nervous system with very high mortality. It is caused by the JC virus with high seroprevalence, at up to 80%. Development of PML is typically opportunistic, particularly in acquired immunodeficiency syndrome, and usually affects patients with profound immunodeficiency. Furthermore, as a result of highly efficient immunosuppressive and immunomodulatory treatments in recent years, the number of PML cases has increased in the general population. In this article, the authors mention virological and epidemiological relationships and characteristic manifestations of PML. Possible relationships of humoral and cellular immunity are discussed and limited treatment options including prophylaxis are mentioned.

摘要

进行性多灶性白质脑病(PML)是一种中枢神经系统的严重疾病,死亡率极高。它由血清阳性率高达80%的JC病毒引起。PML的发病通常具有机会性,尤其在获得性免疫缺陷综合征中,且通常影响免疫功能严重低下的患者。此外,由于近年来高效免疫抑制和免疫调节治疗的应用,普通人群中PML病例的数量有所增加。在本文中,作者提及了PML的病毒学和流行病学关系以及特征性表现。讨论了体液免疫和细胞免疫的可能关系,并提及了包括预防措施在内的有限治疗选择。

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