Host-dependent patterns of tissue injury in invasive pulmonary aspergillosis
Host-dependent patterns of tissue injury in invasive pulmonary aspergillosis
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DOI：
10.1309/ujrv9dlc11rm3g8r
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发表时间：
2007-03-01
影响因子：
3.5
通讯作者：
Walsh, Thomas J.
中科院分区：
文献类型：
--
作者：
Stergiopoulou, Theodouli;Meletiadis, Joseph;Walsh, Thomas J.
侵袭性肺曲霉病 (IPA) 是中性粒细胞减少症、非中性粒细胞减少症和其他免疫功能低下患者发病和死亡的重要原因。因此，我们比较了 3 组患有严重中性粒细胞减少症、非中性粒细胞减少性免疫抑制和造血干细胞移植的免疫功能低下患者的感染和炎症模式。中性粒细胞减少症患者和造血干细胞移植 (HSCT) 受者的 IPA 病变相似，主要包括血管侵袭和肺泡内出血。中性粒细胞减少症患者和 HSCT 接受者中这些组织学发现的频率与非中性粒细胞减少症患者显着不同 (P < .05)。值得注意的是，即使 HSCT 受者的外周血中性粒细胞计数正常，也可能不会流入感染部位。在非中性粒细胞减少队列中，IPA 病变主要包括中性粒细胞和单核细胞浸润以及炎性坏死。因此，先天宿主防御的状态对 IPA 中观察到的组织学模式有显着影响。
Invasive pulmonary aspergillosis (IPA) is an important cause of morbidity and mortality in neutropenic, nonneutropenic, and other immunocompromised patients. We therefore compared the patterns of infection and inflammation among 3 cohorts of immunocompromised patients with profound neutropenia, nonneutropenic immunosuppression, and hematopoietic stem cell transplantation. Lesions of IPA in neutropenic patients and hematopoietic stem cell transplant (HSCT) recipients were similar and consisted predominantly of angioinvasion and intraalveolar hemorrhage. The frequency of these histologic findings in neutropenic patients and HSCT recipients differed significantly from those of nonneutropenic patients (P < .05). It is noteworthy that even if HSCT recipients have normal peripheral blood neutrophil counts, there may be no influx into sites of infection. In the nonneutropenic cohort, lesions of IPA consisted mainly of neutrophilic and monocytic infiltrates and inflammatory necrosis. Thus, the status of innate host defenses contributes significantly to the histologic patterns observed in IPA.