Pathogenesis of human cytomegalovirus in the immunocompromised host.
Pathogenesis of human cytomegalovirus in the immunocompromised host.
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DOI：
10.1038/s41579-021-00582-z
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发表时间：
2021-12
期刊：
影响因子：
--
通讯作者：
Reeves M
中科院分区：
文献类型：
--
作者：
Griffiths P;Reeves M
人类巨细胞病毒 (HCMV) 是一种疱疹病毒，在发达国家感染约 60% 的成年人，在发展中国家感染超过 90% 的成年人。通常，它受到强烈的免疫反应的控制，因此感染无症状或症状轻微。然而，如果免疫系统受到损害，HCMV 就会复制到高水平并导致严重的终末器官疾病。在了解免疫功能低下宿主中 HCMV 感染和疾病的自然史和发病机制方面正在取得实质性进展。病毒载量的系列测量定义了 HCMV 复制的动态，现在已常规用于对个体患者进行抗病毒药物干预。它们还用作药效学读数，以评估可防止 HCMV 复制的原型疫苗，并确定这种保护的免疫相关性。这一新信息为目前正在评估的新型抗病毒药物和疫苗的随机对照试验的设计提供了信息。在这篇综述中，我们讨论了对 HCMV 的免疫反应和病毒采取的对策、潜伏期的建立和重新激活、其他菌株的外源性再感染、发病机制、终末器官疾病的发展、感染的间接影响、复制控制的免疫相关性、当前的治疗策略和新型候选疫苗的评估。人类巨细胞病毒 (HCMV) 感染通常由强烈的免疫反应控制；然而，当免疫系统受到损害时，HCMV 可以复制到高水平并导致终末器官疾病。在这篇综述中，Griffiths 和 Reeves 讨论了免疫功能低下个体的 HCMV 发病机制以及治疗和预防感染和疾病的新兴策略。
Human cytomegalovirus (HCMV) is a herpesvirus that infects ~60% of adults in developed countries and more than 90% in developing countries. Usually, it is controlled by a vigorous immune response so that infections are asymptomatic or symptoms are mild. However, if the immune system is compromised, HCMV can replicate to high levels and cause serious end organ disease. Substantial progress is being made in understanding the natural history and pathogenesis of HCMV infection and disease in the immunocompromised host. Serial measures of viral load defined the dynamics of HCMV replication and are now used routinely to allow intervention with antiviral drugs in individual patients. They are also used as pharmacodynamic read-outs to evaluate prototype vaccines that may protect against HCMV replication and to define immune correlates of this protection. This novel information is informing the design of randomized controlled trials of new antiviral drugs and vaccines currently under evaluation. In this Review, we discuss immune responses to HCMV and countermeasures deployed by the virus, the establishment of latency and reactivation from it, exogenous reinfection with additional strains, pathogenesis, development of end organ disease, indirect effects of infection, immune correlates of control of replication, current treatment strategies and the evaluation of novel vaccine candidates. Human cytomegalovirus (HCMV) infection is ordinarily controlled by a vigorous immune response; however, HCMV can replicate to high levels and cause end organ disease when the immune system is compromised. In this Review, Griffiths and Reeves discuss HCMV pathogenesis in immunocompromised individuals and emerging strategies to treat and prevent infection and disease.
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影响因子：
6.4
作者：
CHOU, SW;DENNISON, KM
通讯作者：
DENNISON, KM
DOI：
10.1093/infdis/jiy102
发表时间：
2018-05-25
期刊：
The Journal of infectious diseases
影响因子：
--
作者：
Baraniak I;Kropff B;McLean GR;Pichon S;Piras-Douce F;Milne RSB;Smith C;Mach M;Griffiths PD;Reeves MB
通讯作者：
Reeves MB
影响因子：
7.7
作者：
Fielding, Ceri A.;Weekes, Michael P.;Wilkinson, Gavin W. G.
通讯作者：
Wilkinson, Gavin W. G.
影响因子：
6.4
作者：
Cope, AV;Sabin, C;Emery, VC
通讯作者：
Emery, VC
影响因子：
4.5
作者：
Cannon MJ;Davis KF
通讯作者：
Davis KF