肾综合征出血热患者的固有免疫反应

Innate immune responses of hemorrhagic fever with renal syndrome

肾综合征出血热（hemorrhagic fever with re-nal syndrome,HFRS）为一种广泛存在、持续感染的急性自然疫源性传染病。我国是世界上HFRS疫情最严重的国家之一,20世纪50年代至今,已累计报告发病总数约150万人,死亡近5万人。20世纪80年代以来,通过以疫苗接种和灭鼠、防鼠为主的综合性防控措施,在降低高发病率、控制疫情暴发等方面取得了积极的成果。

Hemorrhagic fever with renal syndrome（HFRS） is a group of diseases characterized by fever,hemorrhage and renal injury.Its pathogen is Hantaviruses,which belong to Bunyaviridae.This disease is epidemic in several regions across the Eurasian landmass,particularly in China,where it has been an important public health concern because of the high incidence and mortality rate,and limited treatment and vaccination.So far the pathogenesis of HFRS has not been fully elucidated.Although Hantaviruses are infectious for endothelial cells and may cause direct injury,a large body of evidence suggests that immune mechanisms rather than direct viral cytopathology are responsible for the principal abnormality,vascular dysfunction resulting in plasma leakage in HFRS.Virus infection elicits a cascade of rapid innate immune responses in the host that are aimed at blocking viral replication through the activation of an early defense mechanism.Dendritic cells and nature killer cells,two main kinds of innate immune cells,are activated in the phases of HFRS.Vascular endothelial cells,as the main infected cells of Hantavirus,also play antiviral function.Recently,Toll-like receptors（TLRs）,an important molecule in innate immunity,become a major focus in Hantavirus research.Activation of the innate immune responses generally leads to the induction of type-I interferon and cytokines/chemokines as the first lines of defense against viral infection.Therefore,innate immune responses may play pivotal roles in the pathogenesis of HFRS.