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Mutation-based mechanisms of antibiotic resistance. 基于突变的抗生素耐药性机制。
IF 7.8 1区 生物学 Q1 MICROBIOLOGY Pub Date : 2026-02-03 DOI: 10.1128/mmbr.00101-25
Rajeev Misra

SUMMARYAntibiotic resistance is a major global health threat, with an estimated 1.14 million deaths in 2021 linked to antibiotic resistance. Mutations naturally arise as bacteria evolve to defend against and survive various environmental challenges, including those exerted by antibiotics. Both overuse and misuse of antibiotics can accelerate selection for resistant bacteria. Misuse can happen when antibiotic treatment ends prematurely, resulting in sub-lethal antibiotic levels. This provides an ideal environment for the proliferation of resistance-causing mutations, which, in some cases, are enhanced further by triggering the synthesis of error-prone DNA polymerases. Low levels of antibiotics are also found in the environment, creating breeding grounds for the evolution of antibiotic resistance. Mutations diminish the impact of antibiotics by three principal mechanisms: (i) reducing antibiotic influx, (ii) elevating antibiotic efflux, and (iii) altering cellular targets of antibiotics. The first two mechanisms confer modest resistance against a broad range of antibiotics; however, in combination with the third target-specific mechanism, they become the foundation of high-level antibiotic resistance. Ultimately, while the manifestation of mutations cannot be prevented, steps can be taken to lower their frequency by carefully considering the need for antibiotic prescription, exploring combination therapies, integrating adjuvants such as efflux pump inhibitors, and minimizing environmental contamination of antibiotics.

抗生素耐药性是一项重大的全球健康威胁,估计2021年有114万人死亡与抗生素耐药性有关。随着细菌进化以抵御和生存各种环境挑战,包括抗生素带来的挑战,突变自然产生。抗生素的过度使用和误用都会加速耐药细菌的选择。当抗生素治疗过早结束时,可能会发生滥用,导致抗生素水平低于致死水平。这为耐药突变的增殖提供了理想的环境,在某些情况下,通过触发容易出错的DNA聚合酶的合成,这种增殖会进一步增强。环境中也发现了低水平的抗生素,为抗生素耐药性的进化创造了温床。突变通过三种主要机制减少抗生素的影响:(i)减少抗生素流入,(ii)增加抗生素外流,(iii)改变抗生素的细胞靶点。前两种机制赋予了对多种抗生素的适度耐药性;然而,与第三种靶向机制结合,它们成为高水平抗生素耐药的基础。最终,虽然突变的表现是无法预防的,但可以通过仔细考虑抗生素处方的需要、探索联合疗法、整合外排泵抑制剂等佐剂以及最大限度地减少抗生素对环境的污染来采取措施降低其频率。
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引用次数: 0
Discovery and biosynthesis of antifungal microbial secondary metabolites. 抗真菌微生物次生代谢物的发现和生物合成。
IF 7.8 1区 生物学 Q1 MICROBIOLOGY Pub Date : 2026-01-13 DOI: 10.1128/mmbr.00075-25
Blondelle Matio Kemkuignou, Magnus Haahr, Matiss Maleckis, Ling Ding

SUMMARYThe high mortality associated with invasive fungal infections, coupled with limited therapeutic options, underscores the urgent need for antifungal agents with novel mechanisms of action. Natural products represent a particularly valuable resource, providing structurally diverse and evolutionary refined scaffolds that often outperform those found in synthetic libraries. Historically, microorganisms have proven to be a rich source of antibiotics and other therapeutic agents. Access to diverse phylogenetic lineages and biosynthetic pathways has been essential for antifungal drug development. In this review, we highlight the chemical and biosynthetic diversity of antifungal natural products derived from both fungi and bacteria. We emphasize that microbial natural products continue to play a crucial role in antifungal development, particularly through the integration of natural product chemistry, microbiology, genetics, and advanced omics technologies.

侵袭性真菌感染的高死亡率,加上有限的治疗选择,强调了迫切需要具有新型作用机制的抗真菌药物。天然产物是一种特别有价值的资源,它提供了结构多样化和进化精致的支架,通常比合成文库中的支架性能更好。从历史上看,微生物已被证明是抗生素和其他治疗剂的丰富来源。获得不同的系统发育谱系和生物合成途径对于抗真菌药物的开发至关重要。在这篇综述中,我们重点介绍了来自真菌和细菌的抗真菌天然产物的化学和生物合成多样性。我们强调,微生物天然产物继续在抗真菌开发中发挥关键作用,特别是通过天然产物化学,微生物学,遗传学和先进的组学技术的整合。
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引用次数: 0
The many journeys of botulinum neurotoxins and the bacteria that produce them-evolutionary, geographic, and research-related movements that have contributed to our understanding of a diverse pathogen. 肉毒杆菌神经毒素和产生它们的细菌的许多旅程-进化,地理和研究相关的运动,有助于我们了解多样化的病原体。
IF 7.8 1区 生物学 Q1 MICROBIOLOGY Pub Date : 2026-01-07 DOI: 10.1128/mmbr.00230-25
Theresa J Smith

SUMMARYBotulism is a neuroparalytic intoxication caused by a collection of large proteins, known as botulinum neurotoxins (BoNTs), that are related in amino acid sequence and structure. The extreme potency of BoNTs can be traced to their ability to access and enter cholinergic nerve terminals, their enzymatic nature, and their persistence within these cells. The extreme diversity seen among the BoNTs (7 serotypes and 44 subtypes) and the bacteria that produce them (7 species) stands in stark contrast to its close relative, tetanus toxin, which exists as a single protein entity produced by a single bacterial strain. Botulism may take many forms. It can be due to direct ingestion with BoNT (foodborne), or it may be the consequence of germination and toxin production within the body (infant and adult toxicoinfections, wound botulism). As BoNT-producing organisms are soil inhabitants, the cycle that results in botulism begins when the spores of these bacteria are moved to a location that is favorable for its growth and toxin production, be that in foods, humans, or animals. Multiple researchers in the United States did pioneering work concerning the etiology of botulism, including the identification of different types, the recognition of various host sensitivities, and the necessary conditions for germination and toxin production of these bacteria. As part of their work, several large collections of BoNT-producing bacteria were amassed. This review is a culmination of historical events relating to botulism in the United States and provides listings containing source information on strains from various collections that have provided valuable reference bacteria for basic research studies on botulism and the development of diagnostic tests, quality control testing, and botulism treatments and countermeasures, such as antisera and vaccines.

肉毒中毒是一种神经麻痹性中毒,由一种被称为肉毒神经毒素(BoNTs)的大蛋白引起,它们的氨基酸序列和结构相关。bont的极端效力可以追溯到它们进入胆碱能神经末梢的能力,它们的酶性质以及它们在这些细胞内的持久性。bont(7种血清型和44种亚型)和产生它们的细菌(7种)之间的极端多样性与它的近亲破伤风毒素形成鲜明对比,后者是由单一菌株产生的单一蛋白质实体。肉毒杆菌中毒有多种形式。它可能是由于直接摄入BoNT(食源性),也可能是体内萌发和毒素产生的结果(婴儿和成人毒性感染,伤口肉毒杆菌中毒)。由于产生肉毒杆菌的生物是土壤居民,当这些细菌的孢子被转移到有利于其生长和产生毒素的地方时,无论是在食物、人类还是动物中,导致肉毒杆菌中毒的循环就开始了。美国的多名研究人员在肉毒杆菌中毒的病因学方面做了开创性的工作,包括鉴定不同类型的肉毒杆菌,识别不同的宿主敏感性,以及这些细菌萌发和产生毒素的必要条件。作为工作的一部分,他们收集了大量产生bont的细菌。本综述总结了美国与肉毒杆菌中毒有关的历史事件,并提供了来自各种收集的菌株的来源信息清单,这些菌株为肉毒杆菌中毒的基础研究和诊断测试、质量控制测试以及肉毒杆菌中毒治疗和对策(如抗血清和疫苗)的发展提供了有价值的参考细菌。
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引用次数: 0
New tools for exploring parasite biology and elucidating host-pathogen interactions in cryptosporidiosis. 探索寄生虫生物学和阐明隐孢子虫病宿主-病原体相互作用的新工具。
IF 7.8 1区 生物学 Q1 MICROBIOLOGY Pub Date : 2026-01-07 DOI: 10.1128/mmbr.00148-22
Abigail Kimball, Wanyi Huang, Iti Saraav, Lisa Funkhouser-Jones, Valentin Greigert, Fuxian Yang, Rui Xu, Yaoyu Feng, Lihua Xiao, L David Sibley

SUMMARYCryptosporidiosis is a major public health concern, the extent of which has only truly been appreciated within the last decade. Cryptosporidium research has undergone a renaissance, with new insights into population structure, species diversity, and evolution of the parasite driven by the advent of genetic transformation techniques and novel models for culture in vitro and in vivo. Here, we summarize the impact of these advances on our understanding of this important parasite. In the initial section, we focus on what we have learned about host range and infectivity from comparative genomics, briefly review the public health impact of human infection, and summarize recent findings on immune control and interactions with other gut microbes that influence infection. The second half of the review is devoted to new technical advances that have uncovered novel biological findings. As research on Cryptosporidium is still in its infancy, we finish by summarizing some of the challenges and opportunities for future research.

隐孢子虫病是一个主要的公共卫生问题,其严重程度在过去十年才得到真正的认识。隐孢子虫研究经历了一次复兴,在遗传转化技术和体外和体内培养新模型的推动下,人们对隐孢子虫的种群结构、物种多样性和进化有了新的认识。在这里,我们总结了这些进展对我们了解这种重要寄生虫的影响。在第一部分中,我们重点介绍了我们从比较基因组学中了解到的宿主范围和传染性,简要回顾了人类感染对公共卫生的影响,并总结了最近在免疫控制和与其他影响感染的肠道微生物相互作用方面的发现。该评论的后半部分致力于揭示新的生物学发现的新技术进步。由于隐孢子虫的研究仍处于起步阶段,我们总结了未来研究的一些挑战和机遇。
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引用次数: 0
Cell wall hydrolases of Escherichia coli. 大肠杆菌细胞壁水解酶。
IF 7.8 1区 生物学 Q1 MICROBIOLOGY Pub Date : 2026-01-07 DOI: 10.1128/mmbr.00226-24
Shambhavi Garde, Debnita Mongal, Manjula Reddy

SUMMARYBacterial cell walls are made up of peptidoglycan (PG), a primary load-bearing layer that forms a protective exoskeleton around the cytoplasmic membrane. PG is a heteropolymer composed of glycan chains attached to short peptides that are crosslinked to each other, forming a mesh-like macromolecule that prevents osmotic lysis of the cell. Far from being a static exoskeleton, PG is a dynamic living polymer that undergoes continuous synthesis, expansion, remodeling, and turnover throughout the bacterial cell cycle. Central to the dynamic nature of PG is a finely tuned balance between two seemingly opposite processes-synthesis and hydrolysis. The PG synthases, which are essential for bacterial viability, have long been recognized as excellent drug targets and have therefore been studied extensively for decades. On the other hand, the significance of PG hydrolysis in diverse fundamental PG processes has become increasingly evident in recent years. Bacteria encode several highly conserved PG hydrolases with distinct substrate specificities that contribute to critical cellular processes, including cell wall expansion during growth, cell division, remodeling, and recycling, as well as predation and pathogenesis. Consequently, PG hydrolases represent promising targets for the development of novel antibacterial therapeutics. This review provides a comprehensive overview of the classification, physiological functions, and regulatory mechanisms governing the PG hydrolases in the model organism Escherichia coli and highlights parallels among related taxa across the bacterial kingdom.

细菌细胞壁由肽聚糖(PG)组成,肽聚糖是一种主要的承重层,在细胞质膜周围形成保护性外骨骼。PG是一种杂聚物,由连接在短肽上的聚糖链组成,这些短肽相互交联,形成网状大分子,防止细胞的渗透裂解。PG远非一个静态的外骨骼,而是一个动态的活聚合物,在整个细菌细胞周期中经历不断的合成、膨胀、重塑和周转。PG动态特性的核心是两个看似相反的过程-合成和水解之间的精细调节平衡。PG合成酶是细菌生存所必需的,长期以来被认为是很好的药物靶点,因此几十年来被广泛研究。另一方面,近年来,PG水解在各种基本PG过程中的意义越来越明显。细菌编码几种高度保守的PG水解酶,这些酶具有不同的底物特异性,有助于关键的细胞过程,包括生长过程中的细胞壁扩张、细胞分裂、重塑和再循环,以及捕食和发病机制。因此,PG水解酶是开发新型抗菌药物的有希望的靶点。本文综述了模式生物大肠杆菌中PG水解酶的分类、生理功能和调控机制,并强调了细菌王国中相关分类群之间的相似之处。
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引用次数: 0
Deleterious consequences of Shiga toxin in the CNS. 志贺毒素对中枢神经系统的有害影响。
IF 7.8 1区 生物学 Q1 MICROBIOLOGY Pub Date : 2026-01-05 DOI: 10.1128/mmbr.00301-25
Ana Belén Ramos-Aloi, Luciana Soledad Arias, Alipio Pinto, Jorge Goldstein

SUMMARYThe primary objective of this review is to provide an update on the most recent findings concerning the adverse effects of Shiga toxin-producing Escherichia coli (STEC) on the central nervous system (CNS), from both clinical and experimental perspectives. Considered the main predictor of death, STEC encephalopathy plays a critical role in hemolytic uremic syndrome (HUS), which affects between 11% and 64% of HUS patients and considerably increases the risk of morbidity and mortality. Of note, STEC encephalopathy in the absence of HUS has been observed in approximately 5% of cases. The ability of enterohemorrhagic E. coli to adapt to its microenvironment has been responsible for global outbreaks. Once in circulation, Shiga toxin rapidly induces endothelial damage via the Gb3 receptor. Brain inflammation in STEC encephalopathies has been consistently reported and experimentally confirmed. The entry of Shiga toxin into the brain leads to direct neuronal damage through its interaction with neuronal Gb3, as demonstrated in clinical case studies and experimental models. This review also discusses the adverse effects of STEC on the brain, which may arise from metabolic or circulatory disruptions, secondary damage to the CNS, or a multifactorial combination. Recent studies have highlighted the significance of neuroimaging techniques in diagnosing HUS encephalopathy. Efforts have been made to identify early neural biomarkers and develop corresponding treatments. Although various biomarkers have been reported, additional studies are needed for further development and standardization. Late-stage pharmacological treatments for encephalopathy are also discussed, both in clinical settings and experimental research.

摘要:本综述的主要目的是从临床和实验角度提供有关产志贺毒素大肠杆菌(STEC)对中枢神经系统(CNS)不良反应的最新发现。被认为是死亡的主要预测因素,产志贺毒素大肠杆菌脑病在溶血性尿毒症(HUS)中起着关键作用,影响11%至64%的溶血性尿毒症患者,并大大增加了发病率和死亡率的风险。值得注意的是,在没有溶血性尿毒综合征的情况下,约有5%的病例出现产志贺毒素大肠杆菌脑病。肠出血性大肠杆菌适应其微环境的能力是造成全球疫情的原因。志贺毒素一旦进入循环,通过Gb3受体迅速诱导内皮细胞损伤。产志贺毒素大肠杆菌脑病的脑部炎症一直被报道和实验证实。正如临床病例研究和实验模型所证明的那样,志贺毒素通过与神经元Gb3的相互作用进入大脑导致直接的神经元损伤。本综述还讨论了产大肠杆菌对大脑的不良影响,可能由代谢或循环中断、中枢神经系统继发性损伤或多因素组合引起。最近的研究强调了神经影像学技术在诊断溶血性尿毒综合征脑病中的重要性。人们已经努力识别早期神经生物标志物并开发相应的治疗方法。虽然已经报道了各种生物标志物,但需要进一步的研究来进一步开发和标准化。在临床设置和实验研究中也讨论了脑病的晚期药物治疗。
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引用次数: 0
Reconsidering the blood-brain barrier: histopathology and microanatomy of cryptococcal CNS infection. 重新考虑血脑屏障:隐球菌性中枢神经系统感染的组织病理学和显微解剖学。
IF 7.8 1区 生物学 Q1 MICROBIOLOGY Pub Date : 2025-12-18 Epub Date: 2025-10-21 DOI: 10.1128/mmbr.00078-25
Tania C Sorrell, J Muse Davis

SUMMARYMeningoencephalitis is the most severe form of cryptococcal infection. Pathogenic cryptococcal species enter the body primarily via the respiratory system. The central nervous system (CNS) is by far the most common site of cryptococcal dissemination, despite its reputation as a privileged anatomical space. Results from both in vitro and in vivo experiments have suggested multiple cellular and molecular mechanisms for entering the CNS, but no single one has been proven responsible for this remarkable neurotropism. While experimental approaches to the problem have centered around a uniform conception of the blood-brain barrier, a review of the histopathological forms of CNS disease shows marked variety in the locations and forms of lesions and their relevant anatomical barriers. Based on the microanatomy, it is likely that the pathway from blood into the CNS differs from lesion type to lesion type. In considering the genesis of cryptococcal CNS infection, we will first summarize cryptococcal virulence determinants of relevance to CNS infection and the conceptualization of the blood-brain barrier, its history, and functions. Next, we will summarize modes of cryptococcal entry through the blood-brain barrier and the interplay between fungal virulence determinants and host factors. We will outline the common histological findings of cryptococcal meningoencephalitis and examine the relevant vascular structures, discussing their implications for mechanisms of dissemination in the context of the vasculature, the host cellular and metabolic environment, and cryptococcal virulence factors in different parts of the CNS. Finally, we will discuss the value of different animal and in vitro models of cryptococcal infection and the endothelial glycocalyx, a ubiquitous feature of endothelial surfaces seldom considered in microbial pathogenesis.

脑膜脑炎是隐球菌感染最严重的形式。致病性隐球菌主要通过呼吸系统进入人体。中枢神经系统(CNS)是隐球菌传播最常见的部位,尽管它被认为是一个特殊的解剖空间。体外和体内实验的结果表明,进入中枢神经系统的多种细胞和分子机制,但没有一个单一的机制被证明对这种显著的嗜神经性负责。虽然这个问题的实验方法一直围绕着血脑屏障的统一概念,但对中枢神经系统疾病的组织病理学形式的回顾显示,病变的位置和形式及其相关的解剖屏障有明显的变化。根据显微解剖,从血液进入中枢神经系统的途径可能因病变类型而异。在考虑隐球菌性中枢神经系统感染的起源时,我们将首先总结与中枢神经系统感染相关的隐球菌毒力决定因素以及血脑屏障的概念、历史和功能。接下来,我们将总结隐球菌通过血脑屏障进入的模式以及真菌毒力决定因素与宿主因素之间的相互作用。我们将概述隐球菌性脑膜脑炎的常见组织学发现,并检查相关的血管结构,讨论它们在脉管系统、宿主细胞和代谢环境以及中枢神经系统不同部位隐球菌毒力因子的背景下传播机制的意义。最后,我们将讨论不同动物和体外隐球菌感染模型和内皮糖萼的价值,内皮糖萼是内皮表面普遍存在的特征,在微生物发病机制中很少被考虑。
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引用次数: 0
Effects of cooling on E. coli's DNA organization, structure, and gene expression. 冷却对大肠杆菌DNA组织、结构和基因表达的影响。
IF 7.8 1区 生物学 Q1 MICROBIOLOGY Pub Date : 2025-12-18 Epub Date: 2025-11-06 DOI: 10.1128/mmbr.00153-25
Amir M Arsh, Miguel M Azevedo, Andre S Ribeiro

SUMMARYBacteria are frequently subject to potentially lethal temperature shifts in their natural environments. We review the changes in the structure and dynamics of the gene regulatory network of the bacterium Escherichia coli during cold shocks. First, we describe the effects of cold shocks on higher-order cellular structures (cytoplasm and membrane) and functions (growth, division, and biofilm formation). Next, we focus on the nucleoid, DNA supercoiling, topoisomerases, ATP, and nucleoid-associated proteins. Afterward, we describe the mutual effects of changes in transcription dynamics and DNA supercoiling during cold shocks, followed by the consequent genome-wide, time-lapse changes in the transcriptome. Finally, we briefly describe the post-transcriptional effects of cold shocks and the cellular processes of acclimatization. In the end, we discuss how studying this topic can assist in developing temperature-sensitive synthetic genetic circuits, efficient bioindustrial processes, and new means to cope with bacterial antibiotic tolerance.

细菌在自然环境中经常受到可能致命的温度变化的影响。我们回顾了大肠杆菌基因调控网络在冷休克过程中的结构和动态变化。首先,我们描述了冷冲击对高阶细胞结构(细胞质和膜)和功能(生长、分裂和生物膜形成)的影响。接下来,我们将重点关注类核、DNA超缠绕、拓扑异构酶、ATP和核相关蛋白。随后,我们描述了转录动力学变化和DNA超卷曲在冷休克期间的相互影响,随后是转录组的全基因组、延时变化。最后,我们简要地描述了冷冲击的转录后效应和适应的细胞过程。最后,我们讨论了研究这一主题如何有助于开发温度敏感的合成遗传电路,高效的生物工业工艺以及应对细菌抗生素耐药性的新手段。
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引用次数: 0
Vesicle-driven endomembrane systems in fungi. 真菌中囊泡驱动的膜系统。
IF 7.8 1区 生物学 Q1 MICROBIOLOGY Pub Date : 2025-12-18 DOI: 10.1128/mmbr.00297-24
Rebekkah E Pope, Rolf A Prade

SUMMARYIn fungi, the endomembrane system is a pleiomorphic, dynamic network of organelles, driven by vesicle trafficking pathways, which maintain cellular homeostasis, hyphal polar growth, and the secretion of proteins and metabolites. In syncytial hyphae, spatial specialization of organelles and other cellular components of the endomembrane system is evident to support growth and adaptation. Young, apical regions of hyphae contain a Golgi-Spitzenkörper-exocyst triad for rapid polar expansion, whereas distal, older hyphal regions employ unconventional secretion via multivesicular bodies (MVBs), septal vesicle fusion, and extracellular vesicles (EVs) to enhance nutrient acquisition for the entirety of the mycelium. Vesicular trafficking integrates distinct endomembrane compartments into specialized pathways that involve vesicle biogenesis, transport, and fusion to sustain polarized growth and secretion. Actin and microtubules provide tracks for vesicle motility, while Rab GTPases regulate vesicle localization and fusion events. The ESCRT machinery governs MVB formation and scission, COPI/II regulate bidirectional endoplasmic reticulum-Golgi transport, SNARE proteins allow for vesicle and target membrane fusion, and the exocyst complex tethers vesicles to exocytic regions of the plasma membrane. Together, these components form dynamic endomembrane assembly lines that coordinate many cellular processes. The "distance hypothesis" predicts that extracellular vesicle-mediated secretion predominates in subapical regions as tip growth slows. This mechanism extends the secretory capabilities of hyphae and promotes broader distribution of secreted enzymes along hyphae. Having a better understanding of spatially regulated secretion pathways will advance our understanding of fungal cell biology and provide strategies to optimize fungi for industrial protein production.

真菌的膜系统是一个多形性的、动态的细胞器网络,由囊泡运输途径驱动,维持细胞内稳态、菌丝极性生长以及蛋白质和代谢物的分泌。在合胞菌丝中,细胞器和内膜系统的其他细胞成分的空间特化是支持生长和适应的明显因素。年轻的顶端菌丝区域含有Golgi-Spitzenkörper-exocyst三联体,用于快速极性扩张,而远端较老的菌丝区域则通过多泡体(MVBs)、间隔囊泡融合和细胞外囊泡(EVs)进行非常规分泌,以增强整个菌丝的营养获取。囊泡运输将不同的膜室整合到特殊的途径中,包括囊泡的生物发生、运输和融合,以维持极化的生长和分泌。肌动蛋白和微管提供囊泡运动的轨迹,而Rab GTPases调节囊泡定位和融合事件。ESCRT机制控制MVB的形成和分裂,COPI/II调节双向内质网-高尔基转运,SNARE蛋白允许囊泡和靶膜融合,囊泡复合物将囊泡连接到质膜的胞外区域。这些成分共同构成了动态的膜装配线,协调许多细胞过程。“距离假说”预测细胞外囊泡介导的分泌在根尖下区域占主导地位,因为尖端生长缓慢。这一机制扩大了菌丝的分泌能力,促进了分泌酶沿菌丝的更广泛分布。更好地了解空间调节的分泌途径将促进我们对真菌细胞生物学的理解,并为优化真菌用于工业蛋白质生产提供策略。
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引用次数: 0
HIV reservoirs in lymphomagenesis: hidden driver in the era of viral suppression? 淋巴瘤发生中的HIV蓄水池:病毒抑制时代的隐藏驱动力?
IF 7.8 1区 生物学 Q1 MICROBIOLOGY Pub Date : 2025-12-18 Epub Date: 2025-10-07 DOI: 10.1128/mmbr.00104-25
Yaoguang Li, Qing Xiao, Fengting Yu, Fujie Zhang

SUMMARYDespite advancements in antiretroviral therapy, people living with HIV (PLWH) remain at high risk of lymphoma. The persistence of HIV reservoirs and their spatial association with lymphoma highlights the need to clarify their role in lymphomagenesis. HIV reservoirs, which are established early during infection and maintained through clonal expansion, epigenetic silencing, and immune evasion, may contribute to lymphomagenesis through four interconnected mechanisms: provirus integration effects, viral protein-mediated disturbances, microenvironment dysregulation, and reservoir reactivation. Current therapeutic approaches that simultaneously target HIV reservoirs and lymphoma-including allogeneic hematopoietic stem cell transplantation, chimeric antigen receptor T-cell therapy, and immune checkpoint inhibitors-show promise but face substantial challenges. There is an urgent need to develop accessible strategies that can both eradicate HIV reservoirs and mitigate lymphoma risk. Such efforts may ultimately enable a "double cure" for PLWH with lymphoma, offering new hope against this life-threatening comorbidity. This review summarizes the potential links between HIV reservoirs and HIV-associated lymphoma and outlines emerging therapeutic avenues toward achieving a double cure.

尽管抗逆转录病毒治疗取得了进展,但艾滋病毒感染者(PLWH)仍然处于淋巴瘤的高风险中。HIV储存库的持续存在及其与淋巴瘤的空间关联突出了阐明其在淋巴瘤发生中的作用的必要性。HIV病毒库在感染早期建立,并通过克隆扩增、表观遗传沉默和免疫逃避来维持,可能通过四种相互关联的机制促进淋巴瘤的发生:前病毒整合效应、病毒蛋白介导的干扰、微环境失调和库再激活。目前同时针对HIV储存库和淋巴瘤的治疗方法-包括异体造血干细胞移植,嵌合抗原受体t细胞治疗和免疫检查点抑制剂-显示出希望,但面临重大挑战。迫切需要制定既能根除艾滋病毒库又能减轻淋巴瘤风险的可获得战略。这些努力可能最终使PLWH合并淋巴瘤的“双重治愈”成为可能,为对抗这种危及生命的合并症提供了新的希望。这篇综述总结了HIV储存器和HIV相关淋巴瘤之间的潜在联系,并概述了实现双重治愈的新兴治疗途径。
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引用次数: 0
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Microbiology and Molecular Biology Reviews
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