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Morphologic evaluation of the pathogenesis of bacterial enteric infections
Y u Polotsky1, E Dragunsky, T h Khavkin
1Division of Pathology, Walter Reed Army Institute of Research, Washington, D.C.
Abstract:
Current advances in the understanding of the pathogenicity of the agents of diarrheal infections, Vibrio cholerae, diarrheagenic E. coli, Shigella, Salmonella, and enteropathogenic Yersinia, have, to a great extent, become possible due to morphological studies of host-pathogen interactions in natural and experimental infections. Despite a multigenic nature and a diversity of pathogenic features in the bacterial species and even in serogroups of the same species, it is now possible to delineate four major patterns of interaction of enteric pathogens with their cellular targets, the enterocytes, and with the immune apparatus of the gut. These patterns, epicellular cytotonic, epicellular restructuring cytotonic, invasive intraepithelial cytotonic and cytotoxic, and invasive transcellular cytotonic and cytotoxic bacteremic, underlie early pathogenesis and clinical manifestations in the respective diarrheal diseases. In this review, the results of the morphological analyses of these patterns over the last 3 decades as well as some methodological problems encountered in the interpretation of morphological observations are discussed.
Insights
Morphological studies reveal four key interaction patterns between enteric pathogens like Vibrio cholerae and E. coli, and the gut. These patterns explain early pathogenesis and clinical symptoms of diarrheal diseases.
Area of Science:
- Microbiology
- Pathogenesis
- Gastroenterology
Background:
- Understanding diarrheal disease pathogenesis relies on host-pathogen interaction studies.
- Key enteric pathogens include Vibrio cholerae, diarrheagenic E. coli, Shigella, Salmonella, and Yersinia.
Purpose of the Study:
- To review morphological analyses of host-pathogen interactions in diarrheal diseases over three decades.
- To delineate major interaction patterns of enteric pathogens with gut enterocytes and the immune system.
Main Methods:
- Morphological analysis of host-pathogen interactions in natural and experimental infections.
- Review of studies on Vibrio cholerae, diarrheagenic E. coli, Shigella, Salmonella, and Yersinia.
Main Results:
- Four major interaction patterns identified: epicellular cytotonic, epicellular restructuring cytotonic, invasive intraepithelial cytotonic/cytotoxic, and invasive transcellular cytotonic/cytotoxic bacteremic.
- These patterns correlate with early pathogenesis and clinical manifestations of diarrheal diseases.
Conclusions:
- Morphological studies are crucial for understanding enteric pathogen pathogenicity.
- The four identified interaction patterns provide a framework for studying diarrheal disease mechanisms.