Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA.
Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA; Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO 63110, USA; Department of Molecular Microbiology, Washington University School of Medicine, St. Louis, MO 63110, USA; The Andrew M. and Jane M. Bursky Center for Human Immunology and Immunotherapy Programs, Washington University School of Medicine, St. Louis, MO 63110, USA.
Neuron. 2019 Sep 4;103(5):771-783. doi: 10.1016/j.neuron.2019.07.015.
CNS infections continue to rise in incidence in conjunction with increases in immunocompromised populations or conditions that contribute to the emergence of pathogens, such as global travel, climate change, and human encroachment on animal territories. The severity and complexity of these diseases is impacted by the diversity of etiologic agents and their routes of neuroinvasion. In this review, we present historical, clinical, and molecular concepts regarding the mechanisms of pathogen invasion of the CNS. We also discuss the structural components of CNS compartments that influence pathogen entry and recent discoveries of the pathways exploited by pathogens to facilitate CNS infections. Advances in our understanding of the CNS invasion mechanisms of different neurotropic pathogens may enable the development of strategies to control their entry and deliver drugs to mitigate established infections.
中枢神经系统感染的发病率持续上升,这与免疫功能低下人群或导致病原体出现的情况有关,如全球旅行、气候变化和人类对动物领地的侵占。这些疾病的严重程度和复杂性受到病原体的多样性及其神经入侵途径的影响。在这篇综述中,我们介绍了关于病原体入侵中枢神经系统机制的历史、临床和分子概念。我们还讨论了影响病原体进入的中枢神经系统隔室的结构成分,以及病原体利用这些途径促进中枢神经系统感染的最新发现。对不同嗜神经病原体进入中枢神经系统机制的理解的进展,可能使开发控制其进入和运送药物以减轻已建立的感染的策略成为可能。