Hookworm infection
Hookworm infection
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DOI：
10.1038/nrdp.2016.88
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发表时间：
2016-12-08
影响因子：
81.5
通讯作者：
Bethony, Jeffrey M.
中科院分区：
文献类型：
--
作者：
Loukas, Alex;Hotez, Peter J.;Bethony, Jeffrey M.
钩虫是一种土壤传播的线虫寄生虫，可以在人类宿主的小肠中存活多年；美洲Necator americanus是主要的感染种。成虫以宿主的血液为食，可引起缺铁性贫血，特别是在高危人群（儿童和育龄妇女）中。发展中热带国家有近5亿人受到感染，模拟模型估计，钩虫感染导致每年损失1.04亿残疾调整生命年。人类对钩虫会产生免疫反应，但在将成虫从肠道中清除方面大多是不成功的。因此，宿主切换到免疫耐受状态，使钩虫能够在肠道中居住多年。虽然驱虫药是可用的和广泛使用的，但它们的疗效不一，药物不能防止再感染。因此，需要其他旨在改善水质、环境卫生和个人卫生的控制战略。此外，正在努力通过公私伙伴关系开发人类钩虫疫苗。然而，钩虫也可能是一种资源；由于钩虫具有调节宿主炎症的能力，研究人员正在通过实验感染患者来治疗一些炎症性疾病，以此作为发现新的抗炎分子的方法。这一领域的努力很可能产生新的生物治疗自身免疫性疾病和过敏性疾病。
Hookworms are soil-transmitted nematode parasites that can reside for many years in the small intestine of their human hosts; Necator americanus is the predominant infecting species. Adult worms feed on the blood of a host and can cause iron deficiency anaemia, especially in high-risk populations (children and women of childbearing age). Almost 500 million people in developing tropical countries are infected, and simulation models estimate that hookworm infection is responsible for > 4 million disability-adjusted life years lost annually. Humans mount an immune response to hookworms, but it is mostly unsuccessful at removing adult worms from the bowel. Accordingly, the host switches to an immune-tolerant state that enables hookworms to reside in the gut for many years. Although anthelmintic drugs are available and widely used, their efficacy varies and the drugs do not prevent reinfection. Thus, other control strategies aimed at improving water quality, sanitation and hygiene are needed. In addition, efforts are underway to develop a human hookworm vaccine through public-private partnerships. However, hookworms could also be a resource; as hookworms have the capability to regulate the host's inflammation, researchers are experimentally infecting patients to treat some inflammatory diseases as an approach to discover new anti-inflammatory molecules. This area of endeavour might well yield new biotherapeutics for autoimmune and allergic diseases.