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麻疹:儿童及免疫功能低下患者中一种再度出现的疾病概述

Measles: An Overview of a Re-Emerging Disease in Children and Immunocompromised Patients.

作者信息

Misin Andrea, Antonello Roberta Maria, Di Bella Stefano, Campisciano Giuseppina, Zanotta Nunzia, Giacobbe Daniele Roberto, Comar Manola, Luzzati Roberto

机构信息

Department of Infectious Diseases, Azienda Sanitaria Universitaria Giuliano Isontina (ASU GI), Via G.L. Gatteri 25/1, 34125 Trieste, Italy.

Faculty of Medicine and Surgery, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy.

出版信息

Microorganisms. 2020 Feb 18;8(2):276. doi: 10.3390/microorganisms8020276.

Abstract

Despite the availability of a safe and effective vaccine, in 2018, around 350,000 measles cases were reported worldwide, which resulted in an estimate of 142,300 deaths from measles. Additionally, in 2017, global measles cases spiked, causing the death of 110,000 people, mostly children under the age of 5 years and immunocompromised adults. The increase in measles incidence is caused by the ongoing reduction of vaccination coverage. This event has triggered public and scientific interest. For this reason, we reviewed the pathophysiology of measles infection, focusing on mechanisms by which the virus spreads systemically through the host organism. By reaching the lymphocytes from the airways through a "trojan horse" strategy, measles induces an immunosuppression status. H and F glycoproteins, both expressed in the envelope, ensure attachment of the virus to host cells and spreading from one cell to another by binding to several receptors, as described in detail. The severity of the disease depends both on the age and underlying conditions of patients as well as the social and health context in which epidemics spread, and is often burdened by sequelae and complications that may occur several years after infection. Particular attention was paid to special groups that are more susceptible to severe or atypical measles. An overview of microbiology, symptoms, diagnosis, prevention, and treatment completes and enriches the review.

摘要

尽管有安全有效的疫苗,但在2018年,全球报告了约35万例麻疹病例,估计有14.23万人死于麻疹。此外,2017年全球麻疹病例激增,导致11万人死亡,其中大多数是5岁以下儿童和免疫功能低下的成年人。麻疹发病率上升是由于疫苗接种覆盖率持续下降所致。这一事件引发了公众和科学界的关注。因此,我们回顾了麻疹感染的病理生理学,重点关注病毒通过宿主机体进行全身传播的机制。麻疹通过“特洛伊木马”策略从呼吸道到达淋巴细胞,从而诱导免疫抑制状态。包膜中表达的H和F糖蛋白通过与多种受体结合,确保病毒附着于宿主细胞并从一个细胞传播到另一个细胞,详情如下所述。疾病的严重程度既取决于患者的年龄和基础状况,也取决于流行病传播的社会和健康背景,并且常常受到感染后数年可能出现的后遗症和并发症的影响。特别关注了更容易患严重或非典型麻疹的特殊群体。对微生物学、症状、诊断、预防和治疗的概述完善并丰富了本综述。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/171b/7074809/f5bb7975cbba/microorganisms-08-00276-g001.jpg

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