免疫反应对内性莱什曼病:一个全面的审查
Lorenzo Lodi1,2, Marta Voarino1, Silvia Stocco1
1Department of Health Sciences, University of Florence, Florence, Italy.
Frontiers in immunology
|October 3, 2024
概括
由于宿主-寄生虫免疫相互作用,莱什曼尼亚感染呈现出不同的临床形式. 了解这些免疫机制是治疗内脏莱什曼病 (VL) 和类似于HLH的相关疾病的关键.
科学领域:
- 免疫学 免疫学 免疫学
- 传染性疾病 传染性疾病
- 寄生虫学的寄生虫学
背景情况:
- 莱什马尼亚donovani和莱什马尼亚婴儿导致各种疾病,从无症状感染到致命的内脏莱什马尼亚症 (VL).
- 临床多样性包括卡拉阿扎尔后皮肤雷什曼病 (PKDL) 和与VL相关的血细胞淋巴细胞模仿 (VL-HLH模仿).
- 这些变异源于宿主免疫反应和寄生虫免疫逃避策略.
研究的目的:
- 审查莱什曼尼亚感染的各种临床表现的基础上的免疫机制.
- 专注于免疫功能低下个体的内性莱什马尼亚感染 (免疫的先天性错误,获得的免疫缺陷).
- 澄清VL和HLH之间的关系 - - 模仿,强调诊断和治疗方面的影响.
主要方法:
- 对过去5年的出版文献进行叙述性回顾.
- 在莱什曼病的各种临床表现中分析宿主-寄生虫免疫相互作用.
- 检查Leishmania寄生虫使用的免疫逃避策略.
主要成果:
- 莱什曼尼亚寄生虫使用免疫检查点来创建有利于生存的抗炎环境.
- 大约70%的个体会产生一种保护性炎症反应,形成颗粒瘤.
- 免疫抑制可以导致疾病的重新激活;艾滋病毒或原发性免疫缺陷的个体有更严重的感染和更高的复发率.
- VL-HLH模仿可能代表症状性VL的严重形式,需要在HLH患者中排除VL.
结论:
- 对宿主寄生虫免疫学的深入理解对于有效的莱什曼病治疗和预防至关重要.
- 在患有复发性疾病或VL-HLH模仿的患者中,识别免疫缺陷至关重要.
- 区分VL和HLH至关重要,因为治疗VL可以解决免疫失调.
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