Department of Respiratory Medicine, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi Children's Hospital, Wuxi, 214000, China.
Department of Respiratory Medicine & Clinical Allergy Center, Affiliated Children's Hospital of Jiangnan University (Wuxi Children's Hospital), Wuxi, 214000, China.
Microb Pathog. 2024 Oct;195:106865. doi: 10.1016/j.micpath.2024.106865. Epub 2024 Aug 15.
Community-Acquired Respiratory Distress Syndrome Toxin (CARDS TX) is a unique exotoxin produced by Mycoplasma pneumoniae (MP) and has been confirmed to possess ADP-ribosyltransferase (ART) and vacuolating activities. CARDS TX binds to receptors on the surfaces of mammalian cells followed by entry into the cells through clathrin-mediated endocytosis, and exerts cytotoxic effects by undergoing retrograde transport and finally cleavage on endosomes and cellular organelles. In addition, CARDS TX can trigger severe inflammatory reactions resulting in airway dysfunction, producing allergic inflammation and asthma-like conditions. As a newly discovered virulence factor of MP, CARDS TX has been extensively studied in recent years. As resistance to macrolide drugs has increased significantly in recent years and there is no vaccine against MP, the development of a vaccine targeting CARDS TX is considered a potential preventive measure. This review focuses on recent studies and insights into this toxin, providing directions for a better understanding of MP pathogenesis and treatment. IMPORTANCE: A serious hazard to worldwide public health in recent years, Mycoplasma pneumoniae (MP) is a prominent bacterium that causes community-acquired pneumonia (CAP) in hospitalized children. Due to their high prevalence and fatality rates, MP infections often cause both respiratory illnesses and extensive extrapulmonary symptoms. It has recently been shown that MP produces a distinct exotoxin known as Community-Acquired Respiratory Distress Syndrome Toxin (CARDS TX). Mycoplasma pneumoniae pneumonia (MPP)-like tissue injury is caused by this toxin because it has both ADP-ribosyltransferase and vacuolating properties. A better knowledge of MP etiology and therapy is provided by this review, which focuses on latest research and insights into this toxin.
社区获得性呼吸窘迫综合征毒素 (CARDS TX) 是由肺炎支原体 (MP) 产生的一种独特的外毒素，已被证实具有 ADP-核糖基转移酶 (ART) 和空泡形成活性。CARDS TX 与哺乳动物细胞表面的受体结合，然后通过网格蛋白介导的内吞作用进入细胞，并通过逆行运输最终在内涵体和细胞细胞器上裂解，发挥细胞毒性作用。此外，CARDS TX 可引发严重的炎症反应，导致气道功能障碍，产生过敏炎症和哮喘样病症。作为 MP 的一种新发现的毒力因子，CARDS TX 近年来得到了广泛研究。由于近年来大环内酯类药物的耐药性显著增加，而且没有针对 MP 的疫苗，因此针对 CARDS TX 的疫苗开发被认为是一种潜在的预防措施。本综述重点介绍了该毒素的最新研究进展和见解，为更好地理解 MP 的发病机制和治疗提供了方向。重要性：近年来，对全球公共卫生构成严重威胁的肺炎支原体 (MP) 是一种引起住院儿童社区获得性肺炎 (CAP) 的重要细菌。由于其高发病率和死亡率，MP 感染常导致呼吸道疾病和广泛的肺外症状。最近表明，MP 产生了一种独特的外毒素，称为社区获得性呼吸窘迫综合征毒素 (CARDS TX)。这种毒素会导致类似于肺炎支原体肺炎 (MPP) 的组织损伤，因为它具有 ADP-核糖基转移酶和空泡形成特性。本综述重点介绍了该毒素的最新研究进展和见解，为更好地理解 MP 的病因学和治疗提供了方向。
