Pathogenesis of microbial keratitis
Pathogenesis of microbial keratitis
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DOI：
10.1016/j.micpath.2016.12.013
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发表时间：
2017-03-01
影响因子：
3.8
通讯作者：
Khan, Naveed Ahmed
中科院分区：
文献类型：
--
作者：
Lakhundi, Sahreena;Siddiqui, Ruqaiyyah;Khan, Naveed Ahmed
微生物性角膜炎是由细菌、真菌和原生生物病原体引起的威胁视力的眼部感染。上皮缺损和损伤是使眼睛易受角膜病原体感染的关键诱发因素。在细菌病原体中，最常见的导致角膜炎的病原体包括金黄色葡萄球菌、铜绿假单胞菌、肺炎链球菌和沙雷氏菌属。角膜感染的真菌因子包括丝状菌和酵母菌，包括镰刀菌属、曲霉属、褐丝孢菌属、弯孢菌属、拟青霉属、Scedosporium和念珠菌属，而在原生生物中，阿米巴属。会导致眼部疾病临床特征包括发红、疼痛、流泪、视力模糊和炎症，但症状因病原体而异。与微生物发病机制相关的潜在分子机制包括毒力因子以及有助于角膜炎进展的宿主因子，导致眼组织损伤。因此，治疗的重点不仅应该是消除罪魁祸首，而且应该是中和毒力因子，以尽量减少损害，以及修复受损的组织。全面了解微生物性角膜炎的发病机制将有助于合理制定治疗措施。这是对我们目前对这一领域所取得进展的理解的及时审查。再加上最近可用的基因组序列信息和高通量基因组学技术，以及创新方法的可用性，这将激发人们对这一领域的兴趣。(C)2017爱思唯尔有限公司版权所有
Microbial keratitis is a sight-threatening ocular infection caused by bacteria, fungi, and protist pathogens. Epithelial defects and injuries are key predisposing factors making the eye susceptible to corneal pathogens. Among bacterial pathogens, the most common agents responsible for keratitis include Staphylococcus aureus, Pseudomonas aeruginosa, Streptococcus pneumonia and Serratia species. Fungal agents of corneal infections include both filamentous as well as yeast, including Fusarium, Aspergillus, Phaeohyphomycetes, Curvularia, Paecilomyces, Scedosporium and Candida species, while in protists, Acanthamoeba spp. are responsible for causing ocular disease. Clinical features include redness, pain, tearing, blur vision and inflammation but symptoms vary depending on the causative agent. The underlying molecular mechanisms associated with microbial pathogenesis include virulence factors as well as the host factors that aid in the progression of keratitis, resulting in damage to the ocular tissue. The treatment therefore should focus not only on the elimination of the culprit but also on the neutralization of virulence factors to minimize the damage, in addition to repairing the damaged tissue. A complete understanding of the pathogenesis of microbial keratitis will lead to the rational development of therapeutic interventions. This is a timely review of our current understanding of the advances made in this field in a comprehensible manner. Coupled with the recently available genome sequence information and high throughput genomics technology, and the availability of innovative approaches, this will stimulate interest in this field. (C) 2017 Elsevier Ltd. All rights reserved.