Department of Dermatology, Taizhou Central Hospital (Taizhou University Hospital), Taizhou University, Taizhou, 318000, China.
Department of Laboratory Medicine, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Shenyang, 110042, China.
Curr Med Chem. 2023;30(39):4450-4465. doi: 10.2174/0929867330666230207115157.
Although the burden of malaria has been successfully controlled globally, this disease remains a major public health issue. To date, neither existing drugs nor vaccines against malaria are sufficient in eliminating malaria worldwide. To achieve the eradication of malaria by 2040, effective interventions targeting all species are urgently needed. As the cornerstone of vaccine design, immune memory serves a significant role in the host's defense against infections. It has long been considered that innate immunity is non-specific and lacks immunologic memory. However, emerging evidence has suggested that innate immunity can be trained following exposure of the body to infectious agents, such as or its products, which, in turn, promotes the onset of a type of memory in innate immune cells. The above "trained" innate immune cells, whose phenotype is modified in response to epigenetic modifications, metabolic recombination, or cytokine secretion, exhibit differential pathophysiology after the exposure of the body to a pathogen. In addition, -infected red blood cells and other host cells can secrete exosomes that contain conserved parasite-specific information, such as proteins, RNA, non-coding RNA molecules, and nucleic acids. These molecules can act as stimuli for promoting the establishment of "trained" innate immunity against malaria, thereby altering the onset and progression of the parasitic disease. A deeper understanding of the role of exosomes in the development of "trained" innate immunity during infection could provide novel therapeutic and prevention strategies against malaria infections.
尽管疟疾的负担在全球范围内得到了成功控制，但这种疾病仍然是一个主要的公共卫生问题。迄今为止，现有的抗疟疾药物和疫苗都不足以在全球范围内消除疟疾。为了在 2040 年实现消除疟疾的目标，迫切需要针对所有疟原虫种的有效干预措施。作为疫苗设计的基石，免疫记忆在宿主抵御感染方面发挥着重要作用。长期以来，人们一直认为先天免疫是非特异性的，缺乏免疫记忆。然而，新出现的证据表明，先天免疫可以在机体暴露于传染性病原体（如疟原虫或其产物）后得到训练，这反过来又促进了先天免疫细胞中一种记忆的产生。上述“训练有素”的先天免疫细胞，其表型会因表观遗传修饰、代谢重组或细胞因子分泌而发生改变，在机体暴露于病原体后会表现出不同的病理生理学特征。此外，感染疟原虫的红细胞和其他宿主细胞可以分泌含有保守的寄生虫特异性信息的外泌体，如蛋白质、RNA、非编码 RNA 分子和核酸。这些分子可以作为刺激物，促进针对疟疾的“训练有素”先天免疫的建立，从而改变寄生虫病的发病和进展。深入了解外泌体在疟原虫感染过程中“训练有素”先天免疫发展中的作用，可能为抗疟疾感染提供新的治疗和预防策略。
