PATHOGENESIS OF SHIGELLA-DYSENTERIAE 1 (SHIGA) DYSENTERY
PATHOGENESIS OF SHIGELLA-DYSENTERIAE 1 (SHIGA) DYSENTERY
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DOI：
10.1093/infdis/127.3.261
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发表时间：
1973-01-01
影响因子：
6.4
通讯作者：
LIBONATI, JP
中科院分区：
文献类型：
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作者：
LEVINE, MM;DUPONT, HL;LIBONATI, JP
志贺杆菌在肠道病原体中是特殊的，它具有两种潜在的致病作用模式：侵袭性和肠毒素。对每个人的作用进行了调查。在动物和体外模型中定义了两种完全毒力（侵入性产毒）和两种改良（非侵入性产毒和侵入性非产毒）志贺菌株。这些剧毒菌株在剂量低至 101 个生物体的情况下就能使志愿者患病。疾病的特征是发烧、短暂腹泻以及稀便带血和粘液。患病期间，从16份小肠内容物样本中的1份中分离出病原体，无法证明游离毒素。与此同时，大量志贺菌从粪便中排出。主要病变位于大肠，通过直肠镜检查和活检证实有临床结肠炎。 86 名男性中的 85 名对大量非侵入性产毒菌株（106−1011 个生物体）具有良好的耐受性。一名志愿者在细菌恢复为侵袭性形式后患了痢疾。相比之下，一种侵入性的非产毒菌株会在猴子和志愿者中引起志贺氏菌病。上皮穿透是痢疾志贺氏菌的主要毒力特性1。志贺毒素在人类疾病中的作用仍有待确定。
The Shiga bacillus is exceptional among enteric pathogens in possessing two potential pathogenetic modes of action, invasiveness and enterotoxin. The role of each was investigated. ,Two fully virulent (invasive toxigenic) and two modified (noninvasive toxigenic and invasive nontoxigenic) Shiga strains were defined in animal and in-vitro models. The virulent strains produced disease in volunteers in doses as low as 101organisms. Illness was characterized by fever, short-lived diarrhea, and passage of scanty stools of blood and mucus. During illness, the pathogen was isolated from one of 16 samples of small-intestinal contents, and free toxin could not be demonstrated. Concomitantly, large numbers of Shiga organisms were excreted in stool. The major lesions were in the large bowel where clinical colitis was confirmed by proctoscopy and biopsy. Large numbers of a noninvasive toxigenic strain (106−1011organisms) were well tolerated by 85 of 86 men. One volunteer had dysentery after the organism had reverted to an invasive form. In contrast, an invasive nontoxigenic strain caused shigellosis in monkeys and volunteers. Epithelial penetration is the cardinal virulence property ofShigella dysenteriae1. The role of Shiga toxin in human disease remains to be defined.