Toxoplasmosis: new challenges for an old disease
Toxoplasmosis: new challenges for an old disease
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DOI：
10.1038/eye.2011.331
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发表时间：
2012-02-01
期刊：
影响因子：
3.9
通讯作者：
LeHoang, P.
中科院分区：
文献类型：
--
作者：
Bodaghi, B.;Touitou, V.;LeHoang, P.
在弓形虫被发现一个多世纪后，眼部疾病的最佳管理需要解决的主要问题。弓形虫性视网膜脉络膜炎是一些地区后葡萄膜炎的主要原因。这种寄生虫与眼睛建立起一种爱恨交加的关系，操纵免疫反应，引发不同的初始病变和进一步复发。现在公认的是，大多数病例是在出生后获得的，而不是先天性的。该病的严重程度主要与寄生虫的基因型和宿主的免疫状态有关。诊断基于临床特征，但可以通过应用于眼液的生物工具进行确认。结合几种技术可以提高对可疑病例的诊断率。治疗管理是最重要的挑战。尽管关于抗寄生虫药物疗效的循证数据仍然缺乏，但已经有了具有良好安全性的新策略，并可能在疾病过程中更早提出，但也可以在选定的病例中提出，以减少危及视力的复发。重新考虑治疗方案和适应症可能是长期维持视功能和避免重大并发症的重要一步。Eye(2012)26,2441-244；doi：10.1038/ye.2011.331；2012年1月6日在线发布
More than a century after the identification of Toxoplasma gondii, major issues need to be addressed for the optimal management of ocular disease. Toxoplasmic retinochoroiditis is the main cause of posterior uveitis in several geographical areas. The parasite establishes a love-hate relationship with the eye, manipulating the immune response and inducing variable initial lesions and further relapses. It is now well established that most cases are acquired after birth and not congenital. The severity of the disease is mainly due to the parasite genotype and the host immune status. Diagnosis is based on clinical features, but may be confirmed by biological tools applied to ocular fluids. Combining several techniques improves the diagnostic yield in equivocal cases. Therapeutic management is the most important challenge. Even though evidence-based data on the efficacy of anti-parasitic drugs are still missing, new strategies with a good safety profile are available and may be proposed earlier during the course of the disease, but also in selected cases, to reduce sight-threatening relapses. Revisiting the therapeutic options and indications may be an important step towards long-term maintenance of the visual function and avoidance of major complications. Eye (2012) 26, 241-244; doi:10.1038/eye.2011.331; published online 6 January 2012