Immune response to streptococcus pneumonia infection
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摘要: 肺炎链球菌(SP)是儿童急性中耳炎、社区获得性肺炎(CAP)、菌血症和化脓性脑膜炎的常见病原体,是人口腔和鼻咽部的正常定植菌,当机体免疫力下降时可导致SP侵袭性疾病(IPD),严重的SP感染可导致感染性休克、坏死性肺炎、呼吸窘迫综合征以及急性心血管事件等严重并发症,是儿童和老年人重症肺炎和死亡的主要原因。疾病的预后及炎症反应的强度由微生物、宿主和治疗3个主要因素决定,其中最重要的是SP的血清型,规避其危险因素是有效预防和控制感染发生的关键。即使常规在儿童和成人接种疫苗的时代,IPD仍然是发病率和死亡率高的重要原因。因此,理解SP对人免疫系统的影响对SP的防治及新型疫苗的研制至关重要。固有免疫系统在SP感染的发生发展中起重要作用,其基本机制已较为清楚。抗体依赖性控制SP定植的免疫学机制已被充分描述,荚膜特异性抗体IgG通过抗体介导的细菌凝集,调理吞噬作用阻止细菌定植。最近研究发现,SP可在局部黏膜诱导较强的初始和记忆性辅助性T细胞17(Th17)抗SP免疫反应,但目前由Th17细胞介导的黏膜免疫机制仍不清楚。进一步研究SP感染后的免疫机制,有助于SP感染的预防和诊治。Abstract: Streptococcus pneumonia (SP) is a common pathogen in children with acute otitis media, community-acquired pneumonia (CAP), bacteremia, and purulent meningitis. It is a normal colonizing bacterium in the human oral and nasopharyngeal tissues. When the body's immune system is weakened, it can cause IPD, and severe SP infection can lead to serious complications such as septic shock, necrotizing pneumonia, respiratory distress syndrome and acute cardiovascular events, which is the leading cause of severe pneumonia and death in children and the elderly. The prognosis of the disease and the intensity of the inflammatory response are determined by three main factors, namely, the microorganism, the host, and the treatment. The most important is the SP serotype. Avoiding its risk factors is the key to effective prevention and control of infection. Even in the era of vaccination for children and adults, IPD remains an important cause of morbidity and mortality. Therefore, understanding the impact of SP on the human immune system is crucial for the prevention and treatment of SP and the development of new vaccines. The innate immune system plays an important role in the development of SP infection, and its basic mechanism has become clear. The immunological mechanisms of antibody-dependent control of SP colonization have been well described. Capsular-specific antibody IgG inhibits bacterial colonization through antibody-mediated bacterial agglutination and opsonophagocytosis. Recent studies have found that SP can induce strong initial and memory helper T cells 17 (Th17) anti-SP immune responses in local mucosa, and the mechanism of mucosal immunity mediated by Th17 cells remains unclear. The further study of the immune mechanism after SP infection contributes to the prevention and diagnosis of SP infection.
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Key words:
- Streptococcus pneumonia /
- Innate immunity /
- Adaptive immunity /
- Th17 cells
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