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艰难梭菌是医院感染性腹泻中最常见的病原菌之一,在过去10年中,由于ribotyping 027型等高毒菌株的出现,全球艰难梭菌感染相关性疾病发病率显著上升,已经成为欧美许多国家法定传染病必报的监测病原。致病艰难梭菌的毒力因子主要包括A毒素和B毒素,刺激机体发生免疫应答。除外A、B毒素,少数艰难梭菌还产生二元毒素。本文对近年来艰难梭菌引起机体抗感染免疫的相关致病因子及其基因功能的最新研究进展进行了回顾和总结,并重点探讨了主要致病因子A毒素和B毒素结构功能及基因表达调控特征,包括构建A、B毒素分子模型,致病基因编码区多态性特征,以及负向调控因子tcdC的变异及影响,对未来疫苗靶位点的筛选以及艰难梭菌致病机制中信号转导研究具有指导意义。
Clostridium difficile is one of the most common pathogenic bacteria in nosocomial diarrhea and the global incidence of C. difficile infection-related diseases has risen dramatically in the past 10 years due to the emergence of isolates of type such as ribotyping 027, National legal infectious diseases must be reported to monitor the pathogen. Pathogenic C. difficile virulence factors include A toxin and B toxin, stimulate the body to produce an immune response. Except for A, B toxins, a small number of C. difficile also produce binary toxins. In this review, we reviewed and summarized the recent research progress on the pathogenesis of C. difficile causing anti-infective immunity and its gene function in recent years, and focused on the structural functions and gene expression regulation of the major virulence factors A toxins and B toxins Including the construction of molecular models of A and B toxins, the polymorphism of coding region of pathogenic genes and the variation and influence of negative regulatory factor tcdC, the screening of future vaccine target sites and the signal transduction in pathogenesis of C. difficile Guidance research is instructive.