Immunopathogenesis of polymicrobial otitis media.
Immunopathogenesis of polymicrobial otitis media.
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DOI：
10.1189/jlb.0709518
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发表时间：
2010-02
影响因子：
5.5
通讯作者：
Bakaletz LO
中科院分区：
文献类型：
--
作者：
Bakaletz LO
URT病毒和细菌在OM发病机制中的协同关系尚未完全了解，但总体上是基于病毒对气道防御的损害。OM，或中耳炎，是世界范围内儿童的高度流行感染。OM是一种多因素疾病，具有多种风险因素，包括先前或并发的病毒URT感染。因此，OM也是一种多微生物疾病。病毒易患细菌性OM的机制很多;然而，所有这些机制都是基于宿主主要气道防御受损的一般原则。因此，尽管对病毒感染呼吸道的细菌重复感染所涉及的分子机制尚未完全了解，但已知URT病毒可诱导气道粘膜上皮的组织病理学，上调用于细菌粘附的真核受体的表达，改变气道粘液的生化和流变学性质，并影响先天性和获得性宿主免疫功能等。尽管本文在OM的背景下进行了讨论，但在人类呼吸道的先前或并发病毒感染期间，已知病毒对气道防御的损害以及导致的随后细菌合并感染的易感性也在中气道和下气道中起作用。
The synergistic relationship between URT viruses and bacteria in OM pathogenesis is not fully understood, but overall is predicated on viral impairment of airway defenses. OM, or inflammation of the middle ear, is a highly prevalent infection in children worldwide. OM is a multifactorial disease with multiple risk factors, including preceding or concurrent viral URT infection. Hence, OM is also a polymicrobial disease. The mechanisms by which viruses predispose to bacterial OM are replete; however, all are predicated on the general principle of compromise of primary host airway defenses. Thus, despite an as‐yet incomplete understanding of the molecular mechanisms involved in bacterial superinfection of a virus‐compromised respiratory tract, the URT viruses are known to induce histopathology of airway mucosal epithelium, up‐regulate expression of eukaryotic receptors used for bacterial adherence, alter the biochemical and rheological properties of airway mucus, and affect innate and acquired host immune functions, among others. Although discussed here in the context of OM, during preceding or concurrent viral infection of the human respiratory tract, viral impairment of airway defenses and the resulting predisposition to subsequent bacterial coinfection are also known to be operational in the mid and lower airway as well.
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