The influence of innate and adaptative immune responses on the differential clinical outcomes of leprosy.
The influence of innate and adaptative immune responses on the differential clinical outcomes of leprosy.
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DOI：
10.1186/s40249-016-0229-3
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发表时间：
2017-02-06
影响因子：
8.1
通讯作者：
de Jesus AR
中科院分区：
文献类型：
--
作者：
Fonseca AB;Simon MD;Cazzaniga RA;de Moura TR;de Almeida RP;Duthie MS;Reed SG;de Jesus AR
麻风病是由麻风分枝杆菌引起的一种慢性传染病。根据世卫组织五个区域121个国家的官方报告，2014年有213899例新诊断病例。虽然麻风病影响皮肤和周围神经，但它可以表现出一系列的临床和组织病理学形式，这些形式受到感染个体免疫反应的强烈影响。这些形式包括结核样麻风（TT）的极端，M。麻风特异性Th 1，但也有Th 17，限制M的反应。麻风增殖，直至瘤型麻风（LL），M.不控制M的麻风病特异性Th 2和T调节反应。而是允许细菌传播。极间边界临床形式呈现类似但不那么极端的免疫偏倚。急性炎症发作，称为麻风反应，是可能在治疗之前、期间或之后发生的并发症，并造成进一步的神经损伤，可能导致不可逆转的慢性残疾。本文综述了先天性和适应性免疫反应，以及它们之间的相互作用，这是已知的影响发病机制和影响麻风的临床结果。本文的在线版本（doi：10.1186/s40249-016-0229-3）包含补充材料，可供授权用户使用。
Leprosy is a chronic infectious disease caused by Mycobacterium leprae. According to official reports from 121 countries across five WHO regions, there were 213 899 newly diagnosed cases in 2014. Although leprosy affects the skin and peripheral nerves, it can present across a spectrum of clinical and histopathological forms that are strongly influenced by the immune response of the infected individuals. These forms comprise the extremes of tuberculoid leprosy (TT), with a M. leprae-specific Th1, but also a Th17, response that limits M. leprae multiplication, through to lepromatous leprosy (LL), with M. leprae-specific Th2 and T regulatory responses that do not control M. leprae replication but rather allow bacterial dissemination. The interpolar borderline clinical forms present with similar, but less extreme, immune biases. Acute inflammatory episodes, known as leprosy reactions, are complications that may occur before, during or after treatment, and cause further neurological damages that can cause irreversible chronic disabilities. This review discusses the innate and adaptive immune responses, and their interactions, that are known to affect pathogenesis and influence the clinical outcome of leprosy. The online version of this article (doi:10.1186/s40249-016-0229-3) contains supplementary material, which is available to authorized users.