产气荚膜梭菌ε毒素的细胞毒机制及致病机理的研究进展

产气荚膜梭菌ε毒素（Epsilon toxin ，ETX）由B、D型产气荚膜梭菌产生并分泌至宿主动物体内，在临床上主要症状为肠毒血症．ETX属于以七聚体形式存在的β‐样成孔毒素，它能够形成由14个β折叠片组成的“β‐桶状”结构，这个“β‐桶状”结构可以插入真核细胞的质膜形成穿孔．在细胞水平，ETX能够迅速使细胞膜肿胀、多种细胞器破坏，最终导致靶细胞的坏死．在哺乳动物体内，ETX能够使哺乳动物血管产生水肿，从而穿透血脑屏障而聚积在动物肾和脑中，导致机体随着谷氨酸盐的释放而产生过度兴奋，这一系列反应的发生可以引起机体出现脑水肿和肾衰竭，最终导致动物的死亡．目前， ETX备受关注的主要原因不仅仅因为它是一种β‐样成孔毒素，而是可以作为潜在的一种工具类药物，经改造后可以携带治疗药物在短时间内靶向性地到达哺乳动物脑和中枢神经系统，继而为脑和中枢神经系统疾病的治疗提供新的方向．结合国内外相关研究，对ETX细胞毒机制及致病机理进行了综和评述．     

关于子宫内膜异位症的再认识及其意义

子宫内膜异位症是严重影响育龄妇女健康及生育的常见病、多发病。课题组在该病的基础与临床研究过程中，形成了独到的病因学观点。即认为，内异症是由异常的子宫在位内膜组织随经血逆流至盆腹腔，在异地完成粘附、侵袭、血管形成之病理过程，而形成病灶。致病的关键系子宫在位内膜本身，而在位内膜干/祖细胞或其微环境的改变可能是根本原因。此外，内异症还表现出类肿瘤特质。上述病因学研究结果推进了临床诊疗技术和水平。近年来在位内膜标志物的检测和局部治疗更反映了“源头”诊疗的新观念。对内异症发病机制的再认识和新观念，直接影响了临床问题解决的新方向。     

<Emphasis Type="Italic">Legionella pneumophila</Emphasis> — a human pathogen that co-evolved with fresh water protozoa

The bacterial pathogen Legionella pneumophila is found ubiquitously in fresh water environments where it replicates within protozoan hosts. When inhaled by humans it can replicate within alveolar macrophages and cause a severe pneumonia, Legionnaires disease. Yet much needs to be learned regarding the mechanisms that allow Legionella to modulate host functions to its advantage and the regulatory network governing its intracellular life cycle. The establishment and publication of the complete genome sequences of three clinical L. pneumophila isolates paved the way for major breakthroughs in understanding the biology of L. pneumophila. Based on sequence analysis many new putative virulence factors have been identified foremost among them eukaryotic-like proteins that may be implicated in many different steps of the Legionella life cycle. This review summarizes what is currently known about regulation of the Legionella life cycle and gives insight in the Legionella-specific features as deduced from genome analysis. Received 1 September 2006; received after revision 10 October 2006; accepted 22 November 2006     

Triplet repeat disorders: discussion of molecular mechanisms

Comparison of the growing number of disorders known to be associated with triplet repeat expansions reveals both common features and a diversity of molecular pathways. Despite significant progress towards the characterization of proteins coded by the mutant genes, the complex nature of these disorders requires identification of all molecular components of the triplet repeat pathways. In this brief review we will discuss recent progress in determining the molecular mechanisms of disorders with unstable trinucleotide mutations. Received 13 January 1999; received after revision 8 March 1999; accepted 9 March 1999     

Pathogenesis of Plasmodium falciparum malaria: the roles of parasite adhesion and antigenic variation

Malaria results in up to 2.5 million deaths annually, with young children and pregnant women at greatest risk. The great majority of severe disease is caused by Plasmodium falciparum. A characteristic feature of infection with P. falciparum is the accumulation or sequestration of parasite-infected red blood cells (RBCs) in various organs, such as the brain, lung and placenta, and together with other factors is important in the pathogenesis of severe forms of malaria. Sequestration results from adhesive interactions between parasite-derived proteins expressed on the surface of infected RBCs and a number of host molecules on the surface of endothelial cells, placental cells and uninfected RBCs. Some receptors for parasite adhesion have been implicated in particular malaria syndromes, such as intercellular adhesion molecule 1 in cerebral malaria and chondroitin sulfate A and hyaluronic acid in placental infection. The principal parasite ligand and antigen on the RBC surface, P. falciparum erythrocyte membrane protein 1 encoded by a multigene family termed var, is clonally variant, enabling evasion of specific immune responses. An understanding of these host-parasite interactions in the context of clinical disease and immunity may reveal potential targets to prevent or treat severe forms of malaria. Received 25 June 2001; received after revision 22 August 2001; accepted 24 August 2001     

Pathogenic enterococci: new developments in the 21st century

Enterococci, traditionally viewed as Gram-positive commensal bacteria inhabiting the alimentary canals of humans and animals, are now acknowledged to be organisms capable of causing life-threatening infections in humans, especially in the nosocomial environment. The existence of enterococci in such a dual role is facilitated, at least in part, by its intrinsic and acquired resistance to virtually all antibiotics currently in use. Beginning with the initial identification of a streptococci of fecal origin in the late 19th century, enterococci have been studied for over a century now. A number of comprehensive reviews during this time have addressed various aspects of enterococci, including classification, biology, virulence, antibiotic resistance and so on. This review specifically addresses the important advances in the field of enterococcal research that have occurred since the beginning of the 21st century. Most notable among these developments have been the insights into enterococcal genomes and pathogenicity.Received 10 April 2003; received after revision 31 May 2003; accepted 3 June 2003     

Mechanisms underlying celiac disease and its neurologic manifestations

The extra-intestinal manifestations of celiac disease (CD), including ataxia and peripheral neuropathy, are increasingly being recognized as the presenting symptoms of this autoimmune disease. Although there is a greater understanding of the pathogenesis of the intestinal lesions in CD the mechanisms behind the neurologic manifestations of CD have not been elucidated. In this article, the authors review the cellular and molecular mechanisms behind the histopathologic changes in the intestine, discuss the presentation and characteristics of neurologic manifestations of CD, review the data on the mechanisms behind these manifestations, and discuss the diagnosis and treatment of CD. Molecular mimicry and intermolecular help may play a role in the development of neurologic complications.Received 11 March 2004; received after revision 29 October 2004; accepted 12 November 2004     

从《四部医典》中看藏医对疾病病因和发病机制的认识

藏医学具有悠久的历史。《四部医典》这部巨著是长期的医疗实践的结晶,具有较完整的理论体系、丰富的临床经验和独特的高原文化特色。文章从现代医学的角度探讨和分析了藏医学对疾病的病因和发病机制的认识,“三要素”学说是藏医学的理论基础;藏医用“外緣”和“三要素”的平衡紊乱阐述疾病的发生发展,认为外界的原因如导致“三要素”失衡就会引起机体的病变。“三要素”的辨证关系,也是机体器官功能的辨证关系。研究藏医学的理论基础,对于继承和发扬藏医学遗产、促进藏医药发展具有重要的意义。     

脂肪肝的发病机理和治理研究进展

综述了不同诱因所致脂肪肝的发病机制和治疗,为临床合理选择药物提供了方案。     

Protein N-terminal methionine excision

N-terminal methionine excision (NME) is the major proteolytic pathway responsible for the diversity of N-terminal amino acids in proteins. Dedicated NME components have been identified in all organisms, in all compartments in which protein synthesis occurs: cytoplasm, plastids and mitochondria. Recent studies have revealed that NME is regulated at various levels and plays an important role in controlling protein turnover. NME is essential in Eubacteria and lower eukaryotes and is the target of many natural and synthetic inhibitors. Such inhibitors have considerable potential for use in the treatment of various human diseases, from cancer to bacterial and parasitic infections.Received 19 December 2003; received after revision 21 January 2004; accepted 4 February 2004