Pneumococcal Pneumonia Mechanisms of Infection and Resolution
Pneumococcal Pneumonia Mechanisms of Infection and Resolution
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DOI：
10.1378/chest.12-0210
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发表时间：
2012-08-01
期刊：
影响因子：
9.6
通讯作者：
Mitchell, Timothy J.
中科院分区：
文献类型：
--
作者：
Dockrell, David H.;Whyte, Moira K. B.;Mitchell, Timothy J.
疫苗接种和抗菌治疗仍然是肺炎球菌性肺炎管理的基石。尽管取得了显著的成功，但肺炎球菌在抗荚膜免疫的选择性压力下进化的能力对免疫规划提出了挑战。治疗的重点是抗生素治疗，但忽视了肺炎期间炎症反应失调的核心作用。未来的治疗方法需要建立在我们对肺炎球菌性肺炎发病机制的理解上的最新进展，包括那些来自肺炎模型的进展。增强宿主反应的基本组成部分，防止大多数定植个体发生肺炎，以及限制对下呼吸道感染的不适当炎症反应的策略是可以用来改善疾病结局的方法。这篇综述强调了最近发现的微生物和宿主的微生物清除和炎症反应的调节，这提供了线索，如何在未来实现这一点的决定因素。胸部2012; 142（2）：482-491
Vaccination and antimicrobial therapy remain the cornerstones of the management of pneumococcal pneumonia. Despite significant successes, the capacity of the pneumococcus to evolve in the face of the selective pressure of anticapsular immunity challenges immunization programs. Treatment focuses on antimicrobial therapy but ignores the central role of the dysregulated inflammatory response during pneumonia. Future therapeutic approaches need to build on the considerable recent advances in our understanding of the pathogenesis of pneumococcal pneumonia, including those from models of pneumonia. Enhancement of the essential components of the host response that prevents most colonized individuals from developing pneumonia and strategies to limit inappropriate inflammatory responses to lower respiratory tract infection are approaches that could be exploited to improve disease outcome. This review highlights recent discoveries relating to the microbial and host determinants of microbial clearance and regulation of the inflammatory response, which provide clues as to how this could be achieved in the future. CHEST 2012; 142(2):482-491