Polotskiĭ Iu E
Arkh Patol. 1980;42(3):82-9.
All enteropathogens first attach to the glycocalyx on the enterocyte surface. Then noninvasive cholera vibrios and enterotoxicogenic E. coli multiply on the enterocyte microvilli producing enterotoxins which cause pronounced enterocyte hypersecretion. Invasive enteropathogens differ in the model of penetration into enterocytes, multiplication site, the effect on the fate of invaded enterocytes, the ability of the infectious process for generalization. Recent studies have confirmed the decisive role of Shigella intraepithelial multiplication in the development of ulcerative dysenteric mucosal inflammation, Salmonella penetration through the enterocytes, multiplication in macrophages and development of not only enterocolitis but generalized infection as well. In case of enteropathogenic E. coli causing infantile enteritis, multiplication of the attached germs with the resulting damage to the enterocyte surface plays the main role whereas bacterial invasion through the enterocytes is limited and of secondary importance. All the invasive enterobacteria produce peculiar cytotoxic enterotoxins which stimulate but also damage the enterocytes.
所有肠道病原体首先附着于肠上皮细胞表面的糖萼。然后,非侵袭性霍乱弧菌和产肠毒素性大肠杆菌在肠上皮细胞微绒毛上繁殖,产生肠毒素,导致明显的肠上皮细胞过度分泌。侵袭性肠道病原体在侵入肠上皮细胞的模式、繁殖部位、对被侵入肠上皮细胞命运的影响以及感染过程的播散能力等方面存在差异。最近的研究证实,志贺菌在上皮内繁殖在溃疡性痢疾性黏膜炎症的发展中起决定性作用,沙门菌穿透肠上皮细胞,在巨噬细胞中繁殖,不仅会引发小肠结肠炎,还会导致全身性感染。在引起婴儿肠炎的致病性大肠杆菌病例中,附着细菌的繁殖以及由此对肠上皮细胞表面造成的损伤起主要作用,而细菌通过肠上皮细胞的侵袭则有限且次要。所有侵袭性肠道细菌都会产生特殊的细胞毒性肠毒素,这些毒素既能刺激肠上皮细胞,也会对其造成损伤。