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宿主-病原体分子因素促成糖尿病中 spp. 的发病机制。

Host-Pathogen Molecular Factors Contribute to the Pathogenesis of spp. in Diabetes Mellitus.

作者信息

Morales-Franco Berenice, Nava-Villalba Mario, Medina-Guerrero Edgar Octavio, Sánchez-Nuño Yaír Adonaí, Davila-Villa Perla, Anaya-Ambriz Elsa Janneth, Charles-Niño Claudia Lisette

机构信息

Departamento de Microbiología y Patología. Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Sierra Mojada 950, Edificio O, CP 44340 Guadalajara, Jalisco Mexico.

Laboratorio de Investigación en Patología. Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Sierra Mojada 950, Edificio C, CP 44340 Guadalajara, Jalisco Mexico.

出版信息

Curr Trop Med Rep. 2021;8(1):6-17. doi: 10.1007/s40475-020-00222-1. Epub 2021 Jan 22.

Abstract

PURPOSE OF REVIEW

Infectious diseases represent up to 12% of all deaths in people with diabetes mellitus (DM). The development and progression of DM generate a chronic inflammatory state with unique characteristics that have been exploited by some pathogens; one of them is spp., a fungus considered the causative agent of mucormycosis. This disease has a poor prognosis with high mortality rates, and the apparition of resistant isolates each year has become a worrying concern. DM is an actual and continuing health problem, and for that reason, it is of foremost importance to study the pathogenesis of mucormycosis to generate new prevention and treatment strategies.

RECENT FINDINGS

The worldwide incidence of mucormycosis has increased in recent years. The pathogenic mechanisms and factors identified in spp. are the cell wall, spore germination, proteins, and enzymes related to iron sequestration, CotH fungal protein, positive regulation of the GRP78 cell receptor, and immune evasion due to survival within phagocytes, among others. The physiopathology of DM offers favorable conditions for the successful replication of spp.

SUMMARY

The main reason for increase of incidence of mucormycosis caused by spp. has been associated with the rise of worldwide prevalence of DM. Knowing the fungal pathogenic mechanisms as well as the relationships between with the microenvironment found in the human body will undoubtedly help generate better antifungals to enhance treatment outcomes. Nowadays, some strategies to combat the fungus are based on the knowledge of its proteins, cellular interactions, and iron metabolism.

摘要

综述目的

传染病在糖尿病患者的所有死亡原因中占比高达12%。糖尿病的发生和发展会引发一种具有独特特征的慢性炎症状态,一些病原体利用了这些特征;其中之一是 属真菌,它被认为是毛霉菌病的病原体。这种疾病预后较差,死亡率很高,而且每年出现的耐药菌株已成为一个令人担忧的问题。糖尿病是一个现实且持续存在的健康问题,因此,研究毛霉菌病的发病机制以制定新的预防和治疗策略至关重要。

最新发现

近年来,毛霉菌病在全球的发病率有所上升。在 属真菌中确定的致病机制和因素包括细胞壁、孢子萌发、与铁螯合相关的蛋白质和酶、CotH真菌蛋白、GRP78细胞受体的正向调节以及在吞噬细胞内存活导致的免疫逃避等。糖尿病的生理病理学为 属真菌的成功复制提供了有利条件。

总结

由 属真菌引起的毛霉菌病发病率上升的主要原因与全球糖尿病患病率的上升有关。了解真菌的致病机制以及 与人体微环境之间的关系无疑将有助于研发出更好的抗真菌药物以提高治疗效果。如今,一些对抗这种真菌的策略基于对其蛋白质、细胞相互作用和铁代谢的了解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ccd9/7819772/444f573957c8/40475_2020_222_Fig1_HTML.jpg

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