耶氏肺孢子菌与宿主免疫防御相互作用

中国真菌学杂志　 2013, Vol. 8 　Issue (1): 51-54.

耶氏肺孢子菌与宿主免疫防御相互作用

任翊¹, 宋营改¹, 李若瑜²

1. 首都医科大学附属北京友谊医院热带医学研究所, 北京 100050;
2. 北京大学第一医院北京大学真菌与真菌病研究中心, 北京 100034

收稿日期:2012-06-08 出版日期:2013-02-28 发布日期:2013-02-28
通讯作者: 李若瑜,E-mail:lry0660@gmail.com E-mail:lry0660@gmail.com
作者简介:任翊,男(汉族),博士,主任医师.E-mail:ren7016@msn.com
基金资助:
首都医科大学基础临床科研合作基金与李桓英医学基金会联合资助项目(11JL-L05);首都医科大学附属北京友谊医院科研启动基金(2010-33)

Interaction between Pneumocystis jirovecii and host immune defense

REN Yi¹, SONG Ying-gai¹, LI Ruo-yu²

1. Beijing Friendship Hospital, Beijing Tropical Medical Research Institute, Capital Medical University, Beijing 100050;
2. Peking University First Hospital, Research Center for Medical Mycology, Peking University, Beijing 100034

Received:2012-06-08 Online:2013-02-28 Published:2013-02-28

摘要/Abstract

摘要： 肺孢子菌肺炎(Pneumocystis pneumonia,PCP)是由酵母样真菌耶氏肺孢子菌(Pneumocystis jirovecii,Pj)引起的肺炎,是免疫缺陷患者重要的致死原因。Pj一般不导致系统性感染,仅在肺部繁殖,引发严重损害肺换气功能的间质性肺炎。Pj通过主要表面糖蛋白(major surface glycoprotein,MSG)的抗原转换,逃避宿主免疫系统清除,而宿主利用dectin-1识别β-(1,3)-D-葡聚糖(beta-1,3-D-glucan,BG)、甘露糖受体识别MSG,启动天然免疫反应,继而CD4⁺T细胞聚集活化,调控细胞免疫和体液免疫。分泌干扰素γ的细胞毒型CD8⁺Tc1细胞有助于控制Pj感染,特异性抗体有助于调理加强吞噬细胞清除Pj,而聚集的中性粒细胞和非Tc1CD8⁺T细胞与肺损伤有关。血浆BG水平可以辅助诊断PCP,而支气管肺泡灌洗液中白介素8的水平与肺损伤及死亡预后有关。

关键词: 肺孢子菌肺炎, 耶氏肺孢子菌, 主要表面糖蛋白

Abstract: Pneumocystis pneumonia (PCP) is a form of pneumonia, caused by the yeast-like fungus Pneumocystis jirovecii (Pj). It is an important lethal factor in immunodeficient patients.Pj generally does not cause systemic infection, only multiply in the lungs. Interstitial pneumonia caused by Pj seriously damages the oxygen exchange function of the lung.Pj uses major surface glycoprotein (MSG) antigen switch to escape host immune elimination. The host initiates innate immune response through the interactions of macrophage mannose receptors with the MSG as well as through interaction of macrophage dectin-1 receptors interacting with the beta-1,3-D-glucan (BG) moiety of the organisms. Pattern recognition induces chemokines and inflammatory cytokine production, which promoting neutrophils and T-lymphocytes recruitment and activation. Cytotoxic 1 CD8⁺T cells which producing interferon-γ are critical in helping control of Pj infections. IgG may facilitate the uptake process by opsonization of the organisms. Neutrophil and non Tc1 CD8⁺T cell recruitment seems to closely correlate with lung injury in humans. The level of BG can help diagnosing PCP. The level of interleukin-8 in the bronchoalveolar lavage fluid could be a predictor of lung impairment and death from PCP.

Key words: Pneumocystis pneumonia, Pneumocystis jirovecii, major surface glycoprotein

中图分类号:

R379.9

任翊, 宋营改, 李若瑜. 耶氏肺孢子菌与宿主免疫防御相互作用[J]. 中国真菌学杂志, 2013, 8(1): 51-54.

REN Yi, SONG Ying-gai, LI Ruo-yu. Interaction between Pneumocystis jirovecii and host immune defense[J]. Chinese Journal of Mycology, 2013, 8(1): 51-54.

参考文献

[1] Cushion MT. Are members of the fungal genus pneumocystis (a) commensals; (b) opportunists; (c) pathogens; or (d) all of the above[J]? PLoS Pathog,2010,6(9):e1001009.
[2] van de Veerdonk FL,Netea MG. T-cell Subsets and Antifungal Host Defenses[J]. Curr Fungal Infect Rep,2010,4(4):238-243.
[3] Ponce CA,Gallo M,Bustamante R,et al. Pneumocystis colonization is highly prevalent in the autopsied lungs of the general population[J]. Clin Infec Dis,2010,50(3):347-353.
[4] de Boer MG,de Fijter JW,Kroon FP. Outbreak and clustering of Pneumocystis pneumonia in kidney transplant recipients: a systemic review[J]. Med Mycol,2011,49(7):673-680.
[5] Catherinot E,Lanternier F,Bougnoux ME,et al. Pneumocystis jirovecii Pneumonia[J]. Infect Dis Clin North Am,2010,24(1):107-138.
[6] Cushion MT,Linke MJ,Ashbaugh A,et al. Echinocandin treatment of pneumocystis pneumonia in rodent models depletes cysts leaving trophic burdens that cannot transmit the infection[J]. PLoS One,2010,5(1):e8524.
[7] Del Bono V,Mularoni A,Furfaro E,et al. Clinical evaluation of a (1,3)-beta-D-glucan assay for presumptive diagnosis of Pneumocystis jiroveci pneumonia in immunocompromised patients[J]. Clin Vaccine Immunol,2009,16(10):1524-1526.
[8] Desmet S,Van Wijngaerden E,Maertens J,et al. Serum (1-3)-beta-D-glucan as a tool for diagnosis of Pneumocystis jirovecii pneumonia in patients with human immunodeficiency virus infection or hematological malignancy[J]. J Clin Microbiol,2009,47(12):3871-3874.
[9] Lasbury ME,Durant PJ,Ray CA,et al. Suppression of alveolar macrophage apoptosis prolongs survival of rats and mice with Pneumocystis pneumonia[J]. J Immunol,2006,176(11):6443-6453.
[10] Huang L,Morris A,Limper AH,et al. An official ATS workshop summary: recent advances and future directions in Pneumocystis pneumonia (PCP)[J]. Proc Am Thorac Soc,2006,3(8):655-664.
[11] McAllister F,Steele C,Zheng M,et al. T cytotoxic-1 CD8+ T cells are effector cells against pneumocystis in mice[J]. J Immunol,2004,172(2):1132-1138.
[12] Keely SP,Stringer JR. Complexity of the MSG gene family of Pneumocystis carinii[J]. BMC Genomics,2009,10(1):367.