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麻风分枝杆菌:发病机制、诊断和治疗选择。

Mycobacterium leprae: Pathogenesis, diagnosis, and treatment options.

机构信息

Department of Biology, Chemistry and Environmental Sciences, College of Arts and Sciences, American University of Sharjah, University City, Sharjah, United Arab Emirates.

Department of Biology, Chemistry and Environmental Sciences, College of Arts and Sciences, American University of Sharjah, University City, Sharjah, United Arab Emirates.

出版信息

Microb Pathog. 2020 Dec;149:104475. doi: 10.1016/j.micpath.2020.104475. Epub 2020 Sep 12.

Abstract

Mycobacterium leprae is known to cause leprosy, a neurological and dermatological disease. In the past 20 years, 16 million leprosy cases have been recorded and more than 200,000 new cases were registered each year, indicating that the disease is still progressing without hindrance. M. leprae, an intracellular bacterium, infects the Schwann cells of the peripheral nervous system. Several types of leprosy have been described, including indeterminate, tuberculoid, borderline tuberculoid, mid-borderline, borderline lepromatous and lepromatous, and three different forms of leprosy reactions, namely type 1, 2 and 3, have been designated. Microscopic detection, serological diagnostic test, polymerase chain reaction and flow tests are employed in the diagnosis of leprosy. The recommended treatment for leprosy consists of rifampicin, dapsone, clofazimine, ofloxacin and minocycline and vaccines are also available. However, relapse may occur after treatment has been halted and hence patients must be educated on the signs of relapse to allow proper treatment and reduce severity. In this review, we depict the current understanding of M. leprae pathogenicity, clinical aspects and manifestations. Transmission of leprosy, diagnosis and treatment are also discussed.

摘要

麻风分枝杆菌已知会引起麻风病,这是一种神经和皮肤疾病。在过去的 20 年中,已经记录了 1600 万例麻风病例,并且每年都有超过 20 万例新病例登记,这表明该疾病仍在不受阻碍地发展。麻风分枝杆菌是一种细胞内细菌,感染周围神经系统的施万细胞。已经描述了几种类型的麻风病,包括未定型、结核样型、边缘结核样型、中间型、界限类偏瘤型和瘤型,并且已经指定了三种不同形式的麻风反应,即 1 型、2 型和 3 型。麻风病的诊断采用显微镜检测、血清学诊断试验、聚合酶链反应和流式试验。麻风病的推荐治疗包括利福平、氨苯砜、氯法齐明、氧氟沙星和米诺环素,也有疫苗可用。然而,治疗停止后可能会复发,因此必须对患者进行有关复发迹象的教育,以便进行适当的治疗并减轻严重程度。在这篇综述中,我们描述了对麻风分枝杆菌致病性、临床方面和表现的当前理解。还讨论了麻风病的传播、诊断和治疗。

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