Hemorrhagic Fever with Renal Syndrome in the New, and Hantavirus Pulmonary Syndrome in the old world: Paradi(se)gm lost or regained?
Hemorrhagic Fever with Renal Syndrome in the New, and Hantavirus Pulmonary Syndrome in the old world: Paradi(se)gm lost or regained?
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DOI：
10.1016/j.virusres.2013.12.036
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发表时间：
2014-07-17
期刊：
影响因子：
5
通讯作者：
Van Ranst, Marc
中科院分区：
文献类型：
--
作者：
Clement, Jan;Maes, Piet;Van Ranst, Marc
自1994年首次临床描述所谓的“汉坦病毒肺综合征”（HPS）为“新认识的疾病”以来，汉坦病毒感染一直被表征为呈现两种不同的综合征，即旧世界的所谓“肾综合征出血热”（HFRS），其以肾脏为主要靶器官，与新世界的HPS形成对比，以肺为主要靶器官。然而，自1934年以来，欧洲文献已经提到了一种大多较温和的局部HERS形式，恰当地命名为“肾病性肾炎”（NE），由原型欧洲汉坦病毒物种普马拉病毒（PUUV）引起。20世纪80年代和90年代早期的几份NE报告描述了在任何肾脏受累之前已经存在非心源性HPS样肺受累，并且越来越多的证据表明HPS和HFRS之间存在相当大的临床重叠。此外，越来越多的免疫学见解指向共同的病理机制，导致毛细血管通透性过高，所有汉他病毒感染的主要特征，无论是新的和旧的世界。现在也许是时候重新考虑由同一布尼亚病毒科中同一汉坦病毒属的病毒引起的两种“不同”综合征的范例，并就一种共同的、更合乎逻辑的疾病命名达成一致，例如简单而简短的“汉坦病毒热”。(C)2014爱思唯尔有限公司版权所有。
Since the first clinical description in 1994 of the so-called "Hantavirus Pulmonary Syndrome" (HPS) as a "newly recognized disease", hantavirus infections have always been characterized as presenting in two distinct syndromes, the so-called "Hemorrhagic Fever with Renal Syndrome" (HFRS) in the Old World, with the kidney as main target organ, in contrast to HPS in the New World, with the lung as main target organ. However, European literature mentions already since 1934 a mostly milder local HERS form, aptly named "nephropathia epidemica" (NE), and caused by the prototype European hantavirus species Puumala virus (PUUV). Several NE reports dating from the 1980s and early 1990s described already non-cardiogenic HPS-like lung involvement, prior to any kidney involvement, and increasing evidence is now mounting that a considerable clinical overlap exists between HPS and HFRS. Moreover, growing immunologic insights point to common pathologic mechanisms, leading to capillary hyperpermeability, the cardinal feature of all hantavirus infections, both of the New and Old World. It is now perhaps time to reconsider the paradigm of two "different" syndromes caused by viruses of the same Hantavirus genus in the same Bunyaviridae family, and to agree on a common, more logical disease denomination, such as simply and briefly "Hantavirus fever". (C) 2014 Elsevier B.V. All rights reserved.