Institute of Pathogenic Biology, Basic Medical School, Hengyang Medical School, University of South China, Hengyang Central Hospital, Hengyang, 421001, Hunan, China.
Hunan Provincial Key Laboratory for Special Pathogens Prevention and Control, University of South China, Hengyang, 421001, Hunan, China.
Curr Microbiol. 2022 Dec 2;80(1):14. doi: 10.1007/s00284-022-03103-0.
Mycoplasma pneumoniae, an obligate parasitic pathogen without cell wall, can cause severe upper and lower respiratory tract symptoms. It is the pathogen of human bronchitis and walking pneumonia, and named community-acquired pneumonia. In addition to severe respiratory symptoms, there are clinical extrapulmonary manifestations in the skin, brain, kidney, musculoskeletal, digestive system, and even blood system after M. pneumoniae infection. Hereby, we comprehensively summarized and reviewed the intrapulmonary and extrapulmonary pathogenesis of M. pneumoniae infection. The pathogenesis of related respiratory symptoms caused by M. pneumoniae is mainly adhesion damage, direct damage including nutrient predation, invasion and toxin, cytokine induced inflammation damage and immune evasion effect. The pathogenesis of extrapulmonary manifestations includes direct damage mediated by invasion and inflammatory factors, indirect damage caused by host immune response, and vascular occlusion. The intrapulmonary and extrapulmonary pathogenic mechanisms of M. pneumoniae infection are independent and interrelated, and have certain commonalities. In fact, the pathogenic mechanisms of M. pneumoniae are complicated, and the specific content is still not completely clear, further researches are necessary for determining the detailed pathogenesis of M. pneumoniae. This review can provide certain guidance for the effective prevention and treatment of M. pneumoniae infection.
肺炎支原体，一种无细胞壁的专性寄生病原体，可引起严重的上、下呼吸道症状。它是人类支气管炎和游走性肺炎的病原体，被命名为社区获得性肺炎。除了严重的呼吸道症状外，肺炎支原体感染后还会在皮肤、大脑、肾脏、肌肉骨骼、消化系统，甚至血液系统中出现临床肺外表现。因此，我们全面总结和回顾了肺炎支原体感染的肺内和肺外发病机制。肺炎支原体引起相关呼吸道症状的发病机制主要是黏附损伤、直接损伤包括营养掠夺、侵袭和毒素、细胞因子诱导的炎症损伤和免疫逃逸作用。肺外表现的发病机制包括侵袭和炎症因子介导的直接损伤、宿主免疫反应引起的间接损伤以及血管阻塞。肺炎支原体感染的肺内和肺外发病机制是独立和相互关联的，具有一定的共性。事实上，肺炎支原体的发病机制很复杂，具体内容尚不完全清楚，需要进一步研究以确定肺炎支原体的详细发病机制。本综述可为肺炎支原体感染的有效防治提供一定的指导。
