两种并发呼吸道病原体的致命协同感染。

IF 4.7 3区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Archives of Medical Research Pub Date : 2024-10-24 DOI:10.1016/j.arcmed.2024.103101
Kevin Roe
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引用次数: 0

摘要

人类曾发生过同时感染病原体的致命协同感染,包括人类免疫缺陷病毒和结核分枝杆菌感染,或在流感病毒或细菌(如肺炎链球菌)与严重急性呼吸系统综合征冠状病毒 2(SARS-CoV-2)同时感染的动物或人类模型中。然而,两种呼吸道病毒病原体之间或病毒与真菌病原体之间的细胞内协同作用可能性值得进一步研究。病原体同时协同感染的条件是a) 两种病原体之间的有害干扰相对较小;b) 一种病原体有能力通过直接免疫操纵或间接提供感染机会和/或代谢协助,直接或间接协助第二种病原体;c) 在人类或环境中大量流行,可能包括在任何类型的医疗保健设施或其他有可能受感染的人类或动物载体聚集的地方流行;d) 病原体的大量传播,这将使它们同时发生病原体感染的可能性大大增加。提出了病原体协同作用的新定义:"病原体协同作用是指两种或两种以上病原体在同时感染过程中相互作用,导致感染严重程度高于单种病原体的单一感染。除肺部外,非呼吸道病原体也可同时感染其他器官。然而,可通过空气传播的呼吸道病原体,尤其是 RNA 病毒,可造成高度广泛和协同的并发感染。例如,冠状病毒、流感病毒和类似呼吸道病毒的某些毒株具有高度传播性和/或广泛流行于各种载体,可传播给人类,并具有改变肺部免疫防御系统的多种能力。
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Lethal synergistic infections by two concurrent respiratory pathogens
Lethal synergistic infections by concurrent pathogens have occurred in humans, including human immunodeficiency virus and Mycobacterium tuberculosis infections, or in animal or human models of influenza virus, or bacteria, e.g., Streptococcus pneumoniae, concurrent with severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2). However, the intracellular synergistic interaction possibilities between two respiratory viral pathogens, or between viral and fungal pathogens, merits additional examination. The requirements for synergistic concurrent pathogen infections are: a) relatively little detrimental interference between two pathogens, b) one pathogen having the capability of directly or indirectly assisting the second pathogen by direct immuno–manipulation or indirect provision of infection opportunities and/or metabolic assistance, c) substantial human or environmental prevalence, possibly including a prevalence in any type of health–care facilities or other locations having congregations of potentially infected human or animal vectors and d) substantial transmissibility of the pathogens, which would make their concurrent pathogen infections much more probable. A new definition of pathogen synergy is proposed: “pathogen synergy is an interaction of two or more pathogens during concurrent infections causing an increased infection severity compared to mono–infections by the individual pathogens.” Non–respiratory pathogens can also concurrently infect organs besides the lungs. However, the air–transmissible respiratory pathogens, particularly the RNA viruses, can enable highly widespread and synergistic concurrent infections. For instance, certain strains of coronaviruses, influenza viruses and similar respiratory viruses, are highly transmissible and/or widely prevalent in various vectors for transmission to humans and have numerous capabilities for altering lung immune defenses.
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来源期刊
Archives of Medical Research
Archives of Medical Research 医学-医学:研究与实验
CiteScore
12.50
自引率
0.00%
发文量
84
审稿时长
28 days
期刊介绍: Archives of Medical Research serves as a platform for publishing original peer-reviewed medical research, aiming to bridge gaps created by medical specialization. The journal covers three main categories - biomedical, clinical, and epidemiological contributions, along with review articles and preliminary communications. With an international scope, it presents the study of diseases from diverse perspectives, offering the medical community original investigations ranging from molecular biology to clinical epidemiology in a single publication.
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