Looking back at smallpox
Looking back at smallpox
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DOI：
10.1086/381976
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发表时间：
2004-03-15
影响因子：
11.8
通讯作者：
Buller, M
中科院分区：
文献类型：
--
作者：
Bray, M;Buller, M
天花显然是通过天花病毒从另一种动物物种转移到人类身上而产生的。通过造成短暂的感染，需要密切接触才能传播，并产生牢固的免疫力，这种病原体总是容易受到简单隔离措施的影响。病毒DNA聚合酶的高度复制保真度限制了天花适应人类的能力，并保留了正痘病毒的抗原交叉反应性，因此牛痘疫苗可以预防天花。宿主衍生的编码免疫调节蛋白的基因有助于保护病毒复制免受先天免疫反应的影响。临床变异的检查表明，疾病的严重程度通常由潜伏期内的宿主反应决定。病毒复制的控制有助于早期接种疫苗，并可能加强额外的免疫干预。大量的炎症反应是疾病的主要特征。一些循环病毒水平高的患者发展为类似感染性休克的出血性疾病。需要继续研究病毒与宿主的相互作用，以抵御转基因制剂。
Smallpox apparently arose through transfer of variola virus to humans from another animal species. By causing a brief infection that required close contact for transmission and engendered solid immunity, the agent was always vulnerable to simple isolation measures. The high replicative fidelity of the viral DNA polymerase limited variola's ability to adapt to humans and preserved orthopoxviral antigenic cross-reactivity, so that vaccinia vaccination protected against smallpox. Host-derived genes encoding immunomodulatory proteins helped shelter viral replication from innate immune responses. Examination of clinical variants suggests that severity of illness was usually determined by host responses during the incubation period. Control of viral replication was aided by early postexposure vaccination and might be strengthened by additional immunological interventions. Massive inflammatory responses were responsible for major features of illness. Some patients with high levels of circulating virus developed hemorrhagic disease resembling septic shock. Continued study of virus-host interactions is needed to defend against genetically modified agents.