肺部阿斯伯吉洛症的抗真菌耐药性
Paul E Verweij1,2,3, Yinggai Song1,4,5,6, Jochem B Buil1,2
1Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, the Netherlands.
Seminars in respiratory and critical care medicine
|January 10, 2024
概括
耐药性突变的Aspergillus fumigatus通过遗传变异和选择而出现. 了解像ABPA,CPA和IPA这样的肺部疾病中的这些机制可以改善抗真菌治疗.
科学领域:
- 医学真菌学 医学真菌学
- 抗微生物耐药性 抗微生物耐药性
- 肺部医学 肺部医学
背景情况:
- 阿斯伯吉利会导致人类显著的肺部疾病,包括过敏性支气管肺阿斯伯吉洛症 (ABPA),慢性肺阿斯伯吉洛症 (CPA) 和急性侵入性肺阿斯伯吉洛症 (IPA).
- 烟虫是一种主要的病原体,利用各种形态型 (,,胞) 影响适应性和耐药性.
- 抗真菌药物暴露通过遗传变异和选择驱动了A. fumigatus的耐药性突变.
研究的目的:
- 探索导致肺部疾病的Aspergillus物种抗真菌耐药性的机制.
- 根据它们的起源 (环境与宿主) 来区分抗性突变类型 (TR介导与单点)
- 为了将耐药性基因型与特定的Aspergillus相关的肺部疾病相关联.
主要方法:
- 对已报告的病例和抗药机制的文献综述.
- 在不同Aspergillus疾病背景下分析突变类型 (并列重复介导和单点) .
- 环境中与宿主环境中的抗性出现的比较.
主要成果:
- 环境耐药性通常是TR介导的,而宿主内耐药性通常涉及单点突变.
- 在侵入性阿斯伯吉洛症 (IA) 中很少发现环境耐药性突变,这表明宿主内选择风险较低.
- 阿斯伯瘤表现出主导的单点突变,而ABPA,CPA和CF表现出TR介导和单抗突变.
结论:
- 阿斯伯吉勒斯的抵抗机制因疾病和选择地点 (环境与宿主) 而异.
- 在不同的慢性和侵入性肺部阿斯伯吉洛症形式中观察到不同的突变模式.
- 了解这些耐药性途径对于开发针对阿斯伯吉勒斯菌感染的改进诊断和治疗策略至关重要.
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