tetano
Editor, Senior Moderator
Enferm Infecc Microbiol Clin. 2012 Oct;30 Suppl 4:18-24. doi: 10.1016/S0213-005X(12)70100-3.
Immunopathogenesis of 2009 pandemic influenza.
Almansa R, Bermejo-Mart?n JF, de Lejarazu Leonardo RO.
Source
Unidad de Investigaci?n M?dica en Infecci?n e Inmunidad (IMI), Investigaci?n Biom?dica del Cl?nico (ibC), Hospital Cl?nico Universitario, Valladolid, Spain; Instituto de Estudios de Ciencias de la Salud de Castilla y Le?n (IECSCYL), Soria, Spain; Centro Nacional de Gripe de Valladolid, Facultad de Medicina, Universidad de Valladolid, Valladolid, Spain.
Abstract
Three years after the pandemic, major advances have been made in our understanding of the innate and adaptive immune responses to the influenza A(H1N1)pdm09 virus and those responses' contribution to the immunopathology associated with this infection. Severe disease is characterized by early secretion of proinflammatory and immunomodulatory cytokines. This cytokine secretion persisted in patients with severe viral pneumonia and was directly associated with the degree of viral replication in the respiratory tract. Cytokines play important roles in the antiviral defense, but persistent hypercytokinemia may cause inflammatory tissue damage and participate in the genesis of the respiratory failure observed in these patients. An absence of pre-existing protective antibodies was the rule for both mild and severe cases. A role for pathogenic immunocomplexes has been proposed for this disease. Defective T cell responses characterize severe cases of infection caused by the influenza A(H1N1)pdm09 virus. Immune alterations associated with accompanying conditions such as obesity, pregnancy or chronic obstructive pulmonary disease may interfere with the normal development of the specific response to the virus. The role of host immunogenetic factors associated with disease severity is also discussed in this review. In conclusion, currently available information suggests a complex immunological dysfunction/alteration that characterizes the severe cases of 2009 pandemic influenza. The potential benefits of prophylactic/therapeutic interventions aimed at preventing/correcting such dysfunction warrant investigation.
Copyright ? 2012 Elsevier Espa?a, S.L. All rights reserved.
PMID:
23116788
[PubMed - in process]
http://www.ncbi.nlm.nih.gov/pubmed/23116788
Immunopathogenesis of 2009 pandemic influenza.
Almansa R, Bermejo-Mart?n JF, de Lejarazu Leonardo RO.
Source
Unidad de Investigaci?n M?dica en Infecci?n e Inmunidad (IMI), Investigaci?n Biom?dica del Cl?nico (ibC), Hospital Cl?nico Universitario, Valladolid, Spain; Instituto de Estudios de Ciencias de la Salud de Castilla y Le?n (IECSCYL), Soria, Spain; Centro Nacional de Gripe de Valladolid, Facultad de Medicina, Universidad de Valladolid, Valladolid, Spain.
Abstract
Three years after the pandemic, major advances have been made in our understanding of the innate and adaptive immune responses to the influenza A(H1N1)pdm09 virus and those responses' contribution to the immunopathology associated with this infection. Severe disease is characterized by early secretion of proinflammatory and immunomodulatory cytokines. This cytokine secretion persisted in patients with severe viral pneumonia and was directly associated with the degree of viral replication in the respiratory tract. Cytokines play important roles in the antiviral defense, but persistent hypercytokinemia may cause inflammatory tissue damage and participate in the genesis of the respiratory failure observed in these patients. An absence of pre-existing protective antibodies was the rule for both mild and severe cases. A role for pathogenic immunocomplexes has been proposed for this disease. Defective T cell responses characterize severe cases of infection caused by the influenza A(H1N1)pdm09 virus. Immune alterations associated with accompanying conditions such as obesity, pregnancy or chronic obstructive pulmonary disease may interfere with the normal development of the specific response to the virus. The role of host immunogenetic factors associated with disease severity is also discussed in this review. In conclusion, currently available information suggests a complex immunological dysfunction/alteration that characterizes the severe cases of 2009 pandemic influenza. The potential benefits of prophylactic/therapeutic interventions aimed at preventing/correcting such dysfunction warrant investigation.
Copyright ? 2012 Elsevier Espa?a, S.L. All rights reserved.
PMID:
23116788
[PubMed - in process]
http://www.ncbi.nlm.nih.gov/pubmed/23116788