细菌性脑膜炎的免疫学研究进展

Update on immunology associated with bacterial meningitis

细菌性脑膜炎是小儿时期最常见的中枢神经系统感染性疾病之一，尽管给予积极治疗，其病死率及致残率仍居高不下。研究表明，病原感染后导致宿主免疫失调是该病高致残率的主要因素。补体3沉积细菌表面并活化是补体介导的细菌清除的关键步骤。脑脊液中3或5水平明显变化提示预后不良。致病菌穿过血脑屏障后，细菌细胞组分被模式识别受体识别，刺激机体产生过量细胞因子，介导白细胞募集及氧化应激反应，最终导致神经元不可逆损伤。该文以肺炎链球菌感染为例，综述细菌性脑膜炎的免疫学研究进展。

Bacterial meningitis is one of the most common infectious diseases of the central nervous sys tem in childhood, with high mortality and disability rate despite available treatment. Studies have shown that the host immunity dysfunction after the infection plays a central role in neurological sequelae. The deposition and activation of complement component C3 on the bacterial surface is a key step in the complement cascade leading to elimination of the microbe, and the level of complement component C3 or C5 in cerebrospinal fluid may pre dict outcome of bacterial meningitis. After the microorganisms cross the bloodbrain barrier, bacterial compounds are recognized by pattern recognition receptors, triggering the production of excessive cytokines, attracting leuko cytes and generating oxidative stress, which contributes to neuron injury irreversibly. This review focuses on cur rent research progress on immunology associated with Pneumococcal meningitis.