Cytokine immunopathogenesis of enterovirus 71 brain stem encephalitis.

Cytokine immunopathogenesis of enterovirus 71 brain stem encephalitis.
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DOI:
10.1155/2012/876241
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发表时间:
2012
影响因子:
--
通讯作者:
Liu CC
Liu CC
中科院分区:
其他
文献类型:
--
作者:
Wang SM;Lei HY;Liu CC

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肠道病毒71型(EV71)是疱疹性咽峡炎和手足口病的重要病因之一。它还可能导致中枢神经系统(CNS)的严重并发症。脑干脑炎合并肺水肿是严重的并发症,可导致死亡。EV71在白细胞、内皮细胞和树突细胞中复制,导致产生免疫和炎症介质,这些介质形成先天性和获得性免疫应答以及疾病的并发症。细胞因子作为先天免疫的一部分,有利于抗病毒和Th1免疫应答的发展。细胞因子和趋化因子在EV71脑干脑炎的发病机制中起重要作用。中枢神经系统和全身炎症反应感染发挥重要作用,但明显不同,在发病机制中的EV71肺水肿。静脉注射免疫球蛋白和米力农(一种磷酸二酯酶抑制剂)的给药已显示可调节炎症,减少交感神经过度活跃,并改善EV 71自主神经系统失调和肺水肿患者的存活率。
Enterovirus 71 (EV71) is one of the most important causes of herpangina and hand, foot, and mouth disease. It can also cause severe complications of the central nervous system (CNS). Brain stem encephalitis with pulmonary edema is the severe complication that can lead to death. EV71 replicates in leukocytes, endothelial cells, and dendritic cells resulting in the production of immune and inflammatory mediators that shape innate and acquired immune responses and the complications of disease. Cytokines, as a part of innate immunity, favor the development of antiviral and Th1 immune responses. Cytokines and chemokines play an important role in the pathogenesis EV71 brain stem encephalitis. Both the CNS and the systemic inflammatory responses to infection play important, but distinctly different, roles in the pathogenesis of EV71 pulmonary edema. Administration of intravenous immunoglobulin and milrinone, a phosphodiesterase inhibitor, has been shown to modulate inflammation, to reduce sympathetic overactivity, and to improve survival in patients with EV71 autonomic nervous system dysregulation and pulmonary edema.
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