Novel aspects on the pathogenesis of Mycoplasma pneumoniae pneumonia and therapeutic implications.
Novel aspects on the pathogenesis of Mycoplasma pneumoniae pneumonia and therapeutic implications.
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DOI：
10.3389/fmicb.2014.00410
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发表时间：
2014
影响因子：
5.2
通讯作者：
Goto H
中科院分区：
文献类型：
--
作者：
Saraya T;Kurai D;Nakagaki K;Sasaki Y;Niwa S;Tsukagoshi H;Nunokawa H;Ohkuma K;Tsujimoto N;Hirao S;Wada H;Ishii H;Nakata K;Kimura H;Kozawa K;Takizawa H;Goto H
肺炎支原体 (Mp) 是社区获得性肺炎的主要原因。许多不同的报告都讨论了从动物模型或人类受试者获得的有关 Mp 肺炎的知识。关于这一关键问题所积累的专业知识很难应用于临床，并且潜在的问题可能仍未被发现。因此，我们的多学科团队广泛查阅了有关 Mp 肺炎的文献，并将动物模型的研究结果与人类受试者的研究结果进行了比较。在人类中，MP肺炎的典型病理学特征据报道为肺泡内中性粒细胞和淋巴细胞浸润，以及支气管血管周围区域淋巴细胞/浆细胞浸润。在此，我们证明了 Mp 肺炎的新特点，即 Mp 肺炎的严重程度似乎取决于宿主对 Mp 的先天免疫，而先前的 Mp 暴露（再次暴露或潜伏性呼吸道感染）可能通过上调支气管上皮细胞和肺泡巨噬细胞上 Toll 样受体 2 的表达来加速这种免疫。大环内酯类药物治疗可能对大环内酯类耐药 Mp 肺炎患者有益，不是通过细菌学作用而是通过免疫调节作用。这篇详尽的综述重点关注发病机制，并扩展到克拉霉素等一些治疗意义，并讨论了 Mp 肺炎的各个方面。我们希望这可能会给这种常见的呼吸道疾病带来新的见解。
Mycoplasma pneumoniae (Mp) is a leading cause of community acquired pneumonia. Knowledge regarding Mp pneumonia obtained from animal models or human subjects has been discussed in many different reports. Accumulated expertise concerning this critical issue has been hard to apply clinically, and potential problems may remain undiscovered. Therefore, our multidisciplinary team extensively reviewed the literature regarding Mp pneumonia, and compared findings from animal models with those from human subjects. In human beings, the characteristic pathological features of Mp pneumonia have been reported as alveolar infiltration with neutrophils and lymphocytes and lymphocyte/plasma cell infiltrates in the peri-bronchovascular area. Herein, we demonstrated the novel aspects of Mp pneumonia that the severity of the Mp pneumonia seemed to depend on the host innate immunity to the Mp, which might be accelerated by antecedent Mp exposure (re-exposure or latent respiratory infection) through up-regulation of Toll-like receptor 2 expression on bronchial epithelial cells and alveolar macrophages. The macrolides therapy might be beneficial for the patients with macrolide-resistant Mp pneumonia via not bacteriological but immunomodulative effects. This exhaustive review focuses on pathogenesis and extends to some therapeutic implications such as clarithromycin, and discusses the various diverse aspects of Mp pneumonia. It is our hope that this might lead to new insights into this common respiratory disease.
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影响因子：
3.6
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通讯作者：
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