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首页> 外文期刊>Pulmonary Circulation >Schistosomiasis and the Pulmonary Vasculature (2013 Grover Conference Series):
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Schistosomiasis and the Pulmonary Vasculature (2013 Grover Conference Series):

机译：血吸虫病和肺血管（2013年格罗弗会议系列）：

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Inflammation is associated with multiple forms of pulmonary arterial hypertension (PAH), including autoimmune (scleroderma) and infectious (HIV, schistosomiasis) etiologies. More than 200 million people worldwide are infected with Schistosoma, predominantly in Brazil, Africa, the Middle East, and South Asia. Schistosomiasis causes PAH in about 6.1% of those chronically infected and is particularly associated with the species Schistosoma mansoni. Treatment for schistosomiasis-associated PAH includes antihelminthic treatment, if active infection is present (although associated with little immediate benefit to the pulmonary hypertension), and then pharmacologic treatment with targeted pulmonary vascular therapies, including phosphodiesterase type 5 inhibitors and endothelin receptor antagonists. The pathophysiological mechanism by which this parasitic infection causes pulmonary hypertension is unknown but is unlikely to be simple mechanical obstruction of the pulmonary vasculature by parasite eggs. Preexisting hepatosplenic disease due to Schistosoma infection is likely important because of portopulmonary hypertension and/or because it allows egg embolization to the lung by portocaval shunts. Potential immune signaling originating in the periegg granulomas causing the pulmonary vascular disease includes the cytokines interleukin (IL)-4, IL-6, IL-13, and transforming growth factor β. Modulating these pathways may be possible targets for future therapy of schistosomiasis-associated PAH specifically, and study of this disease may provide novel insights into other inflammatory causes of PAH.
机译：炎症与多种形式的肺动脉高压（PAH）相关，包括自身免疫性（硬皮病）和传染性（HIV，血吸虫病）病因。全世界有超过2亿人感染了血吸虫，主要分布在巴西，非洲，中东和南亚。血吸虫病在慢性感染者中引起PAH的比例约为6.1％，尤其与曼氏血吸虫病有关。血吸虫病相关PAH的治疗包括抗蠕虫药治疗（如果存在主动感染的话）（尽管与肺动脉高压几乎没有直接好处），然后进行靶向肺血管治疗的药物治疗，包括5型磷酸二酯酶抑制剂和内皮素受体拮抗剂。这种寄生虫感染引起肺动脉高压的病理生理机制尚不清楚，但不太可能是寄生虫卵对肺血管的简单机械阻塞。由于门静脉高压症和/或因为它允许门腔分流术将卵栓塞到肺部，因此由于血吸虫感染而导致的先前存在的肝脾病很重要。起源于引起肺血管疾病的皮氏肉芽肿的潜在免疫信号包括细胞因子白介素（IL）-4，IL-6，IL-13和转化生长因子β。调节这些途径可能是未来血吸虫病相关PAH治疗的可能目标，对该病的研究可能为PAH的其他炎性原因提供新的见解。

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