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肠道中的诺如病毒遭遇:多方面的相互作用和疾病结局。

Norovirus encounters in the gut: multifaceted interactions and disease outcomes.

机构信息

Department of Medicine, Division of Infectious Diseases, Edison Family Center for Genome Sciences and Systems Biology, Washington University School of Medicine, St. Louis, MO, USA.

出版信息

Mucosal Immunol. 2019 Nov;12(6):1259-1267. doi: 10.1038/s41385-019-0199-4. Epub 2019 Sep 9.

Abstract

Noroviruses are major causes of gastroenteritis, with epidemic outbreaks occurring frequently. They are an important global health concern, especially for pediatric and immunocompromised populations, and are challenging pathogens to target immunologically due to their rapid rates of genetic and antigenic evolution and failure to stimulate durable protective immunity. In this Review, we summarize our current understanding of norovirus pathogenesis, noting the prominent role of murine norovirus as a small animal model for norovirus research. We highlight intriguing data supporting the possible involvement of norovirus in sequelae including irritable bowel syndrome and inflammatory bowel diseases, and describe the innate and adaptive immune mechanisms involved in control of both human and murine norovirus infection. Furthermore, we discuss the potential implications of recent discoveries regarding norovirus interactions with the gut microbiota, and briefly detail current understanding of noroviral evolution and its influence on viral pathogenesis. Our mechanistic understanding of norovirus pathogenesis continues to improve with increasing availability of powerful model systems, which will ultimately facilitate development of effective preventive and therapeutic approaches for this pathogen.

摘要

诺如病毒是导致肠胃炎的主要病原体,其流行疫情时常发生。由于诺如病毒具有快速的遗传和抗原进化以及无法刺激持久的保护性免疫等特点,因此针对其进行免疫靶向治疗极具挑战性,该病毒已成为全球范围内的重要健康关注点,尤其是对儿科和免疫功能低下人群而言。在这篇综述中,我们总结了目前对诺如病毒发病机制的认识,指出了鼠诺如病毒作为诺如病毒研究的小动物模型的重要作用。我们强调了一些有趣的数据,这些数据支持诺如病毒可能与包括肠易激综合征和炎症性肠病在内的后遗症有关,并描述了控制人和鼠诺如病毒感染所涉及的固有和适应性免疫机制。此外,我们还讨论了最近关于诺如病毒与肠道微生物群相互作用的发现的潜在意义,并简要详细介绍了目前对诺病毒进化及其对病毒发病机制影响的认识。随着功能强大的模型系统的不断普及,我们对诺如病毒发病机制的机制理解也在不断提高,这将最终有助于为该病原体开发有效的预防和治疗方法。

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