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精准医学控制. 引起的内脏利什曼病

Precision Medicine in Control of Visceral Leishmaniasis Caused by .

机构信息

Clinical Sciences, Rotterdam Centre for Tropical Medicine, Rotterdam, Netherlands.

出版信息

Front Cell Infect Microbiol. 2021 Nov 9;11:707619. doi: 10.3389/fcimb.2021.707619. eCollection 2021.

Abstract

Precision medicine and precision global health in visceral leishmaniasis (VL) have not yet been described and could take into account how all known determinants improve diagnostics and treatment for the individual patient. Precision public health would lead to the right intervention in each VL endemic population for control, based on relevant population-based data, vector exposures, reservoirs, socio-economic factors and other determinants. In anthroponotic VL caused by , precision may currently be targeted to the regional level in nosogeographic entities that are defined by the interplay of the circulating parasite, the reservoir and the sand fly vector. From this 5 major priorities arise: diagnosis, treatment, PKDL, asymptomatic infection and transmission. These 5 priorities share the immune responses of infection with as an important final common pathway, for which innovative new genomic and non-genomic tools in various disciplines have become available that provide new insights in clinical management and in control. From this, further precision may be defined for groups (e.g. children, women, pregnancy, HIV-VL co-infection), and eventually targeted to the individual level.

摘要

内脏利什曼病(VL)的精准医学和精准全球卫生尚未被描述,可能会考虑到所有已知决定因素如何改善个体患者的诊断和治疗。精准公共卫生将根据相关的基于人群的数据、媒介暴露、储存宿主、社会经济因素和其他决定因素,为控制在每个内脏利什曼病流行地区的正确干预措施提供指导。在由 引起的人源内脏利什曼病中,精准性目前可能针对由循环寄生虫、储存宿主和沙蝇媒介相互作用定义的疾病地理实体的区域水平。由此产生了 5 个主要优先事项:诊断、治疗、皮肤利什曼病、无症状感染和传播。这 5 个优先事项共享感染的免疫反应, 作为一个重要的最终共同途径,为此,不同学科的创新新的基因组和非基因组工具已经可用,为临床管理和控制提供了新的见解。由此,可以为不同群体(例如儿童、妇女、妊娠、HIV-VL 合并感染)进一步定义精准性,并最终针对个体水平。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b1e/8630745/647666d08e22/fcimb-11-707619-g001.jpg

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