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Causes and costs of global COVID-19 vaccine inequity. 全球新冠肺炎疫苗不公平的原因和代价。
IF 9 2区 医学 Q1 Medicine Pub Date : 2024-01-01 Epub Date: 2023-10-23 DOI: 10.1007/s00281-023-00998-0
Maddalena Ferranna

Despite the rapid development of safe and effective COVID-19 vaccines and the widely recognized health and economic benefits of vaccination, there exist stark differences in vaccination rates across country income groups. While more than 70% of the population is fully vaccinated in high-income countries, vaccination rates in low-income countries are only around 30%. The paper reviews the factors behind global COVID-19 vaccine inequity and the health, social, and economic costs triggered by this inequity. The main contributors to vaccine inequity include vaccine nationalism, intellectual property rights, constraints in manufacturing capacity, poor resilience of healthcare systems, and vaccine hesitancy. Vaccine inequity has high costs, including preventable deaths and cases of illnesses in low-income countries, slow economic recovery, and large learning losses among children. Increasing vaccination rates in low-income countries is in the self-interest of higher-income countries as it may prevent the emergence of new variants and continuous disruptions to global supply chains.

尽管安全有效的新冠肺炎疫苗迅速发展,疫苗接种的健康和经济效益也得到广泛认可,但各国收入群体的疫苗接种率存在明显差异。虽然高收入国家70%以上的人口完全接种了疫苗,但低收入国家的疫苗接种率仅为30%左右。本文回顾了全球新冠肺炎疫苗不公平背后的因素,以及这种不公平引发的健康、社会和经济成本。疫苗不平等的主要原因包括疫苗民族主义、知识产权、制造能力限制、医疗系统的应变能力差以及疫苗犹豫。疫苗不公平的代价很高,包括低收入国家可预防的死亡和疾病、缓慢的经济复苏以及儿童的大量学习损失。提高低收入国家的疫苗接种率符合高收入国家的自身利益,因为这可能会防止新变种的出现和全球供应链的持续中断。
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引用次数: 0
Physiological and immunological barriers in the lung. 肺部的生理和免疫屏障。
IF 9 2区 医学 Q1 Medicine Pub Date : 2024-01-01 Epub Date: 2024-03-07 DOI: 10.1007/s00281-024-01003-y
Takahiro Kageyama, Takashi Ito, Shigeru Tanaka, Hiroshi Nakajima

The lungs serve as the primary organ for respiration, facilitating the vital exchange of gases with the bloodstream. Given their perpetual exposure to external particulates and pathogens, they possess intricate protective barriers. Cellular adhesion in the lungs is robustly maintained through tight junctions, adherens junctions, and desmosomes. Furthermore, the pulmonary system features a mucociliary clearance mechanism that synthesizes mucus and transports it to the outside. This mucus is enriched with chemical barriers like antimicrobial proteins and immunoglobulin A (IgA). Additionally, a complex immunological network comprising epithelial cells, neural cells, and immune cells plays a pivotal role in pulmonary defense. A comprehensive understanding of these protective systems offers valuable insights into potential pathologies and their therapeutic interventions.

肺是呼吸的主要器官,促进气体与血液的重要交换。由于肺部长期暴露于外界微粒和病原体,它们拥有复杂的保护屏障。肺部的细胞粘附通过紧密连接、粘附连接和脱膜小体得以牢固维持。此外,肺系统还具有粘液纤毛清除机制,可合成粘液并将其向外输送。这种粘液富含化学屏障,如抗菌蛋白和免疫球蛋白 A(IgA)。此外,由上皮细胞、神经细胞和免疫细胞组成的复杂免疫网络在肺部防御中发挥着关键作用。全面了解这些保护系统有助于深入了解潜在的病症及其治疗干预措施。
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引用次数: 0
Epithelial recognition and elimination against aberrant cells. 上皮细胞识别和消除异常细胞。
IF 9 2区 医学 Q1 Medicine Pub Date : 2024-01-01 Epub Date: 2024-02-27 DOI: 10.1007/s00281-024-01001-0
Shiyu Ayukawa, Nagisa Kamoshita, Takeshi Maruyama

Epithelial cells, which are non-immune cells, not only function as a physical defence barrier but also continuously monitor and eliminate aberrant epithelial cells in their vicinity. In other words, it has become evident that epithelial cells possess immune cell-like functions. In fact, recent research has revealed that epithelial cells recognise the Major Histocompatibility Complex I (MHC-I) of aberrant cells as a mechanism for surveillance. This cellular defence mechanism of epithelial cells probably detects aberrant cells more promptly than the conventional immune response, making it a novel and primary biological defence. Furthermore, there is the potential for this new immune-like biological defence mechanism to establish innovative treatment for disease prevention, leading to increasing anticipation for its future medical applications. In this review, we aim to summarise the recognition and attack mechanisms of aberrant cells by epithelial cells in mammals, with a particular focus on the field of cancer. Additionally, we discuss the potential therapeutic applications of epithelial cell-based defence against cancer, including novel prophylactic treatment methods based on molecular mechanisms.

上皮细胞是一种非免疫细胞,不仅具有物理防御屏障的功能,还能持续监测和消除其周围的异常上皮细胞。换句话说,上皮细胞显然具有类似免疫细胞的功能。事实上,最近的研究发现,上皮细胞能识别异常细胞的主要组织相容性复合物 I(MHC-I),这是一种监视机制。上皮细胞的这种细胞防御机制可能比传统的免疫反应更快地检测到异常细胞,从而使其成为一种新型的主要生物防御机制。此外,这种类似免疫的新型生物防御机制还有可能建立起预防疾病的创新疗法,因此人们对其未来的医学应用越来越期待。在这篇综述中,我们旨在总结哺乳动物上皮细胞对异常细胞的识别和攻击机制,尤其关注癌症领域。此外,我们还讨论了基于上皮细胞的癌症防御的潜在治疗应用,包括基于分子机制的新型预防性治疗方法。
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引用次数: 0
The overlooked bacterial pandemic. 被忽视的细菌大流行
IF 9 2区 医学 Q1 Medicine Pub Date : 2024-01-01 Epub Date: 2023-12-11 DOI: 10.1007/s00281-023-00997-1
Danilo Gomes Moriel, Diego Piccioli, Maria Michelina Raso, Mariagrazia Pizza

The COVID-19 pandemic had a significant economic and health impact worldwide. It also reinforced the misperception that only viruses can pose a threat to human existence, overlooking that bacteria (e.g., plague and cholera) have severely haunted and shaped the course of human civilization. While the world is preparing for the next viral pandemic, it is again overlooking a silent one: antimicrobial resistance (AMR). This review proposes to show the impact of bacterial infections on civilization to remind the pandemic potential. The work will also discuss a few examples of how bacteria can mutate risking global spread and devastating outcomes, the effect on the global burden, and the prophylactic and therapeutic measures. Indeed, AMR is dramatically increasing and if the trend is not reversed, it has the potential to quickly turn into the most important health problem worldwide.

COVID-19 大流行对全世界的经济和健康产生了重大影响。它还加深了人们的错误认识,即只有病毒才会对人类生存构成威胁,而忽视了细菌(如鼠疫和霍乱)也严重困扰和塑造了人类文明的进程。当全世界都在为下一次病毒大流行做准备时,却再次忽略了一个无声的流行病:抗菌药耐药性(AMR)。本综述旨在展示细菌感染对人类文明的影响,提醒人们注意大流行病的潜在可能。这项工作还将讨论几个例子,说明细菌如何发生变异,导致全球传播和破坏性后果的风险、对全球负担的影响以及预防和治疗措施。事实上,AMR 正在急剧增加,如果不扭转这一趋势,它有可能迅速成为全球最重要的健康问题。
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引用次数: 0
The role of vaccines in the COVID-19 pandemic: what have we learned? 疫苗在 COVID-19 大流行中的作用:我们学到了什么?
IF 9 2区 医学 Q1 Medicine Pub Date : 2024-01-01 Epub Date: 2023-07-12 DOI: 10.1007/s00281-023-00996-2
Florian Krammer

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged late in 2019 and caused the coronavirus disease 2019 (COVID-19) pandemic that has so far claimed approximately 20 million lives. Vaccines were developed quickly, became available in the end of 2020, and had a tremendous impact on protection from SARS-CoV-2 mortality but with emerging variants the impact on morbidity was diminished. Here I review what we learned from COVID-19 from a vaccinologist's perspective.

严重急性呼吸系统综合征冠状病毒 2(SARS-CoV-2)于 2019 年晚些时候出现,并引发了 2019 年冠状病毒病(COVID-19)大流行,迄今已夺走了约 2000 万人的生命。疫苗研发迅速,于 2020 年底上市,对防止 SARS-CoV-2 死亡产生了巨大影响,但随着新变种的出现,对发病率的影响有所减弱。在此,我从疫苗学家的角度回顾一下我们从 COVID-19 中了解到的情况。
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引用次数: 0
Sex differences in the inflammatory response to stroke. 中风炎症反应的性别差异。
IF 9 2区 医学 Q1 Medicine Pub Date : 2023-05-01 Epub Date: 2022-11-10 DOI: 10.1007/s00281-022-00969-x
Muhammad Bilal Tariq, Juneyoung Lee, Louise D McCullough

Ischemic stroke is a leading cause of morbidity and mortality and disproportionally affects women, in part due to their higher longevity. Older women have poorer outcomes after stroke with high rates of cognitive deficits, depression, and reduced quality of life. Post-stroke inflammatory responses are also sexually dimorphic and drive differences in infarct size and recovery. Factors that influence sex-specific immune responses can be both intrinsic and extrinsic. Differences in gonadal hormone exposure, sex chromosome compliment, and environmental/social factors can drive changes in transcriptional and metabolic profiles. In addition, how these variables interact, changes across the lifespan. After the onset of ischemic injury, necrosis and apoptosis occur, which activate microglia and other glial cells within the central nervous system, promoting the release of cytokines and chemokines and neuroinflammation. Cells involved in innate and adaptive immune responses also have dual functions after stroke as they can enhance inflammation acutely, but also contribute to suppression of the inflammatory cascade and later repair. In this review, we provide an overview of the current literature on sex-specific inflammatory responses to ischemic stroke. Understanding these differences is critical to identifying therapeutic options for both men and women.

缺血性中风是发病和死亡的主要原因,对女性的影响尤为严重,部分原因是女性寿命较长。老年女性中风后的预后较差,认知障碍、抑郁和生活质量下降的比例较高。中风后的炎症反应也存在性别差异,并导致梗塞大小和恢复情况的不同。影响性别特异性免疫反应的因素既有内在因素,也有外在因素。性腺激素暴露的差异、性染色体缺陷以及环境/社会因素都会导致转录和代谢特征发生变化。此外,这些变量的相互作用方式也会在人的一生中发生变化。缺血性损伤发生后,细胞会发生坏死和凋亡,从而激活中枢神经系统内的小胶质细胞和其他胶质细胞,促进细胞因子和趋化因子的释放以及神经炎症。参与先天性免疫反应和适应性免疫反应的细胞在中风后也具有双重功能,因为它们既能增强急性炎症反应,也能促进炎症级联反应的抑制和后期修复。在本综述中,我们概述了目前有关缺血性中风的性别特异性炎症反应的文献。了解这些差异对于确定男性和女性的治疗方案至关重要。
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引用次数: 0
Unveiling the immunopathology of stroke: a comprehensive view on brain-immune interaction. 揭示脑卒中的免疫病理:脑免疫相互作用的综合观点。
IF 9 2区 医学 Q1 Medicine Pub Date : 2023-05-01 DOI: 10.1007/s00281-023-00995-3
Tim Magnus, Arthur Liesz
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引用次数: 0
Role of alarmins in poststroke inflammation and neuronal repair. 警报器在脑卒中后炎症和神经元修复中的作用。
IF 9 2区 医学 Q1 Medicine Pub Date : 2023-05-01 DOI: 10.1007/s00281-022-00961-5
Seiichiro Sakai, Takashi Shichita

Severe loss of cerebral blood flow causes hypoxia and glucose deprivation in the brain tissue, resulting in necrotic cell death in the ischemic brain. Several endogenous molecules, called alarmins or damage-associated molecular patterns (DAMPs), are extracellularly released from the dead cells to activate pattern recognition receptors (PRRs) in immune cells that infiltrate into ischemic brain tissue following the disruption of the blood-brain barrier (BBB) after stroke onset. The activated immune cells produce various inflammatory cytokines and chemokines, triggering sterile cerebral inflammation in the ischemic brain that causes further neuronal cell death. Poststroke inflammation is resolved within several days after stroke onset, and neurological functions are restored to some extent as neural repair occurs around peri-infarct neurons. Clearance of DAMPs from the injured brain is necessary for the resolution of poststroke inflammation. Neurons and glial cells also express PRRs and receive DAMP signaling. Although the role of PRRs in neural cells in the ischemic brain has not yet been clarified, the signaling pathway is likely to be contribute to stroke pathology and neural repair after ischemic stroke. This review describes the molecular dynamics, signaling pathways, and functions of DAMPs in poststroke inflammation and its resolution.

严重的脑血流损失导致脑组织缺氧和葡萄糖剥夺,导致缺血脑的坏死细胞死亡。几种内源性分子,称为警报器或损伤相关分子模式(DAMPs),从死细胞外释放,激活免疫细胞中的模式识别受体(PRRs),这些细胞在中风发作后血脑屏障(BBB)破坏后渗入缺血脑组织。被激活的免疫细胞产生各种炎症细胞因子和趋化因子,在缺血脑中引发无菌性脑炎症,导致进一步的神经元细胞死亡。卒中后炎症在卒中发作后数天内得到解决,由于梗死周围神经元周围的神经修复,神经功能得到一定程度的恢复。从受伤的大脑中清除DAMPs是解决中风后炎症的必要条件。神经元和神经胶质细胞也表达PRRs并接受DAMP信号。虽然PRRs在缺血性脑神经细胞中的作用尚未明确,但其信号通路可能参与脑卒中病理和缺血性脑卒中后的神经修复。本文综述了DAMPs在脑卒中后炎症中的分子动力学、信号通路和功能及其解决方法。
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引用次数: 4
Differences in the post-stroke innate immune response between young and old. 年轻人和老年人中风后先天免疫反应的差异。
IF 9 2区 医学 Q1 Medicine Pub Date : 2023-05-01 DOI: 10.1007/s00281-023-00990-8
Mattia Gallizioli, Maria Arbaizar-Rovirosa, David Brea, Anna M Planas

Aging is associated to progressive changes impairing fundamental cellular and tissue functions, and the relationships amongst them through the vascular and immune systems. Aging factors are key to understanding the pathophysiology of stroke since they increase its risk and worsen its functional outcome. Most currently recognised hallmarks of aging are also involved in the cerebral responses to stroke. Notably, age-associated chronic low-grade inflammation is related to innate immune responses highlighted by induction of type-I interferon. The interferon program is prominent in microglia where it interrelates cell damage, danger signals, and phagocytosis with immunometabolic disturbances and inflammation. Microglia engulfment of damaged myelin and cell debris may overwhelm the cellular capacity for waste removal inducing intracellular lipid accumulation. Acute inflammation and interferon-stimulated gene expression are also typical features of acute stroke, where danger signal recognition by microglia trigger immunometabolic alterations underscored by lipid droplet biogenesis. Aging reduces the capacity to control these responses causing increased and persistent inflammation, metabolic dysregulation, and impaired cellular waste disposal. In turn, chronic peripheral inflammation during aging induces immunosenescence further worsening stroke-induced immunodepression, thus increasing the risk of post-stroke infection. Aging also alters gut microbiota composition inducing dysbiosis. These changes are enhanced by age-related diseases, such as atherosclerosis and type-II diabetes, that further promote vascular aging, predispose to stroke, and exacerbate brain inflammation after stroke. Current advances in aging research suggest that some age-associated alterations may be reversed. Future work will unravel whether such evolving anti-aging research may enable designing strategies to improve stroke outcome in the elderly.

衰老与损害基本细胞和组织功能的进行性变化以及它们之间通过血管和免疫系统的关系有关。衰老因素是了解中风病理生理的关键,因为它们增加了中风的风险并使其功能结果恶化。目前公认的大多数衰老特征也与大脑对中风的反应有关。值得注意的是,年龄相关的慢性低度炎症与先天免疫反应有关,先天免疫反应是由i型干扰素诱导的。干扰素程序在小胶质细胞中发挥着重要作用,它将细胞损伤、危险信号和吞噬与免疫代谢紊乱和炎症联系起来。小胶质细胞吞噬受损的髓磷脂和细胞碎片可能压倒细胞清除废物的能力,诱导细胞内脂质积累。急性炎症和干扰素刺激的基因表达也是急性中风的典型特征,其中小胶质细胞对危险信号的识别引发了脂滴生物发生所强调的免疫代谢改变。衰老降低了控制这些反应的能力,导致炎症增加和持续,代谢失调,细胞废物处理受损。反过来,衰老过程中的慢性外周炎症导致免疫衰老,进一步加重脑卒中引起的免疫抑制,从而增加脑卒中后感染的风险。衰老也会改变肠道菌群组成,导致生态失调。与年龄相关的疾病,如动脉粥样硬化和ii型糖尿病,会进一步促进血管老化,易患中风,并加剧中风后的脑部炎症,从而增强这些变化。衰老研究的最新进展表明,一些与年龄相关的改变可能被逆转。未来的工作将揭示这种不断发展的抗衰老研究是否可以设计出改善老年人中风结果的策略。
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引用次数: 4
Thromboinflammatory challenges in stroke pathophysiology. 卒中病理生理学中的血栓炎性挑战。
IF 9 2区 医学 Q1 Medicine Pub Date : 2023-05-01 DOI: 10.1007/s00281-023-00994-4
R D Szepanowski, S Haupeltshofer, S E Vonhof, B Frank, C Kleinschnitz, A I Casas

Despite years of encouraging translational research, ischemic stroke still remains as one of the highest unmet medical needs nowadays, causing a tremendous burden to health care systems worldwide. Following an ischemic insult, a complex signaling pathway emerges leading to highly interconnected thrombotic as well as neuroinflammatory signatures, the so-called thromboinflammatory cascade. Here, we thoroughly review the cell-specific and time-dependent role of different immune cell types, i.e., neutrophils, macrophages, T and B cells, as key thromboinflammatory mediators modulating the neuroinflammatory response upon stroke. Similarly, the relevance of platelets and their tight crosstalk with a variety of immune cells highlights the relevance of this cell-cell interaction during microvascular dysfunction, neovascularization, and cellular adhesion. Ultimately, we provide an up-to-date overview of therapeutic approaches mechanistically targeting thromboinflammation currently under clinical translation, especially focusing on phase I to III clinical trials.

尽管多年来鼓励转化研究,缺血性中风仍然是当今最高的未满足医疗需求之一,给世界各地的卫生保健系统造成了巨大的负担。缺血损伤后,一个复杂的信号通路出现,导致高度相互关联的血栓和神经炎症信号,即所谓的血栓炎症级联。在这里,我们全面回顾了不同免疫细胞类型的细胞特异性和时间依赖性作用,即中性粒细胞、巨噬细胞、T细胞和B细胞,作为中风后调节神经炎症反应的关键血栓炎症介质。同样,血小板及其紧密串扰与多种免疫细胞的相关性突出了微血管功能障碍、新生血管形成和细胞粘附过程中细胞-细胞相互作用的相关性。最后,我们提供了最新的治疗方法的概述机械靶向血栓炎症目前正在临床翻译,特别是侧重于I期至III期临床试验。
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引用次数: 3
期刊
Seminars in Immunopathology
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