A review of the global burden, novel diagnostics, therapeutics, and vaccine targets for cryptosporidium.
A review of the global burden, novel diagnostics, therapeutics, and vaccine targets for cryptosporidium.
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DOI：
10.1016/s1473-3099(14)70772-8
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发表时间：
2015-01
影响因子：
56.3
通讯作者：
Houpt, Eric R.
中科院分区：
文献类型：
--
作者：
Checkley, William;White, A. Clinton, Jr.;Jaganath, Devon;Arrowood, Michael J.;Chalmers, Rachel M.;Chen, Xian-Ming;Fayer, Ronald;Griffiths, Jeffrey K.;Guerrant, Richard L.;Hedstrom, Lizbeth;Huston, Christopher D.;Kotloff, Karen L.;Kang, Gagandeep;Mead, Jan R.;Miller, Mark;Petri, William A., Jr.;Priest, Jeffrey W.;Roos, David S.;Striepen, Boris;Thompson, R. C. Andrew;Ward, Honorine D.;Van Voorhis, Wesley A.;Xiao, Lihua;Zhu, Guan;Houpt, Eric R.
隐孢子虫属是公认的水源性流行病和免疫功能低下宿主中肠道疾病的原因。研究还提请注意被低估的全球负担，并表明在最佳诊断，治疗和免疫方面存在重大差距。隐孢子虫病越来越被认为是世界范围内发病率和死亡率的重要原因。在低资源环境和高收入国家的研究证实了隐孢子虫作为腹泻和儿童营养不良原因的重要性。隐孢子虫感染的诊断测试是次优的，需要经常不敏感的专门测试。抗原检测和PCR提高了灵敏度，而多重抗原检测和分子测定未得到充分利用。治疗对健康宿主有一定效果，但对艾滋病患者没有证明有效。隐孢子虫基因组的使用有助于确定有希望的治疗靶点，药物正在开发中，但评估体外和动物疗效的方法还没有很好的标准化。暴露后的部分免疫表明成功疫苗的潜力，有几种正在开发中;然而，保护的替代品还没有很好的定义。改进生物体的繁殖和遗传操作方法将是重大进展。
Cryptosporidium spp are well recognised as causes of diarrhoeal disease during waterborne epidemics and in immunocompromised hosts. Studies have also drawn attention to an underestimated global burden and suggest major gaps in optimum diagnosis, treatment, and immunisation. Cryptosporidiosis is increasingly identified as an important cause of morbidity and mortality worldwide. Studies in low-resource settings and high-income countries have confirmed the importance of cryptosporidium as a cause of diarrhoea and childhood malnutrition. Diagnostic tests for cryptosporidium infection are suboptimum, necessitating specialised tests that are often insensitive. Antigen-detection and PCR improve sensitivity, and multiplexed antigen detection and molecular assays are underused. Therapy has some effect in healthy hosts and no proven efficacy in patients with AIDS. Use of cryptosporidium genomes has helped to identify promising therapeutic targets, and drugs are in development, but methods to assess the efficacy in vitro and in animals are not well standardised. Partial immunity after exposure suggests the potential for successful vaccines, and several are in development; however, surrogates of protection are not well defined. Improved methods for propagation and genetic manipulation of the organism would be significant advances.