Leishmaniasis
Leishmaniasis
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DOI：
10.1016/s0140-6736(98)10178-2
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发表时间：
1999-10-02
期刊：
影响因子：
168.9
通讯作者：
Herwaldt, BL
中科院分区：
文献类型：
--
作者：
Herwaldt, BL
1903年，利什曼和多诺万分别描述了患有危及生命的疾病（现在称为内脏利什曼病）的印度患者脾组织中的原生动物，现在称为杜氏利什曼原虫。近一个世纪后，利什曼病及其主要综合征（即内脏、皮肤和粘膜）的许多特征仍然保持不变。但也发生了很大变化。和以前一样，这种白蛉传播的疾病在印度和其他地方定期流行。但利什曼病也在新的地区和环境中出现，例如作为一种与艾滋病相关的机会性感染。诊断通常仍然依赖于经典的微生物学方法，但基于分子的方法正在接受测试。半个世纪以来，五价锑化合物一直是抗利什曼病治疗的支柱，但两性霉素 B 的脂质制剂（尽管价格昂贵且肠胃外给药）代表了治疗内脏利什曼病的重大进步。迫切需要将了解利什曼原虫免疫反应和利什曼病发病机制方面的技术进步转化为现场适用且负担得起的诊断、治疗和预防该疾病的方法。
In 1903, Leishman and Donovan separately described the protozoan now called Leishmania donovani in splenic tissue from patients in India with the life-threatening disease now called visceral leishmaniasis. Almost a century later, many features of leishmaniasis and its major syndromes (ie, visceral, cutaneous, and mucosal) have remained the same; but also much has changed. As before, epidemics of this sandfly-borne disease occur periodically in India and elsewhere; but leishmaniasis has also emerged in new regions and settings, for example, as an AIDS-associated opportunistic infection. Diagnosis still typically relies on classic microbiological methods, but molecular-based approaches are being tested. Pentavalent antimony compounds have been the mainstay of antileishmanial therapy for half a century, but lipid formulations of amphotericin B (though expensive and administered parenterally) represent a major advance for treating visceral leishmaniasis. A pressing need is for the technological advances in the understanding of the immune response to leishmania and the pathogenesis of leishmaniasis to be translated into field-applicable and affordable methods for diagnosis, treatment, and prevention of this disease.