The immunopathobiology of syphilis: the manifestations and course of syphilis are determined by the level of delayed-type hypersensitivity.
The immunopathobiology of syphilis: the manifestations and course of syphilis are determined by the level of delayed-type hypersensitivity.
复制标题
梅毒的免疫病理学：梅毒的表现和过程取决于延迟型超敏反应的水平。
DOI：
10.1097/dad.0b013e3181e8b587
复制
发表时间：
2011-07
期刊：
影响因子：
--
通讯作者：
Sell S
中科院分区：
文献类型：
--
作者：
Carlson JA;Dabiri G;Cribier B;Sell S
几个世纪以来，梅毒一直困扰着人类，目前在西半球死灰复燃。虽然第三级疾病的发病率显著降低，并认识到与艾滋病毒感染的促进相互作用，但梅毒的自然历史基本保持不变；因此，需要新的策略来更有效地对抗这种病原体。兔实验性梅毒的免疫病理特征人类梅毒的病程、分期和病理；人类梅毒与麻风病的比较表明，梅毒的临床病程及其组织表现是由延迟型超敏反应（DTH）和对病原体梅毒螺旋体的体液免疫之间的平衡决定的。强烈的DTH反应与发育良好的下疳中感染生物体的清除有关，而细胞毒性t细胞反应或强烈的体液抗体反应与长期感染和发展为三级疾病有关。继发性和三期人梅毒的许多变异性症状/表现是免疫反应无法清除机体的表现，这是由于缺乏募集，更重要的是，被致敏的CD4 t细胞激活的巨噬细胞。卡介苗（BCG）疫苗接种可增强DTH，并已被证明在预防麻风病方面产生低但可测量的有益效果，麻风病显示出与梅毒具有共同特征的疾病谱系。在预防梅毒方面，应该设计一种潜在的预防梅毒的疫苗，以增强DTH的反应。
Syphilis has plagued mankind for centuries and is currently resurgent in the Western hemisphere. While there has been a significant reduction of tertiary disease, and recognition of facilitative interactions with HIV infection, the natural history of syphilis has remained largely unchanged; thus, new strategies are required to more effectively combat this pathogen. The immunopathologic features of experimental syphilis in the rabbit; the course, stages, and pathology of human syphilis; and a comparison of human syphilis with leprosy suggest that the clinical course of syphilis and its tissue manifestations are determined by the balance between delayed type hypersensitivity (DTH) and humoral immunity to the causative agent, Treponema pallidum. A strong DTH response is associated with clearance of the infecting organisms in a well-developed chancre, whereas a cytotoxic T-cell response or strong humoral antibody response is associated with prolonged infection and progression to tertiary disease. Many of the protean symptoms/appearances of secondary and tertiary human syphilis are manifestations of immune reactions that fail to clear the organism, due to a lack of recruitment and more importantly, activation of macrophages by sensitized CD4 T-cells. The Bacillus Calmette Guerin (BCG) vaccination can enhance DTH and has been shown to produce a low, but measurable beneficial effect in the prevention of leprosy, a disease that shows a disease spectrum with characteristics in common with syphilis. In the prevention of syphilis, a potential vaccine protective against syphilis should be designed to augment the DTH response.