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首页> 外文期刊>Vaccine >Realities and enigmas of human viral influenza: pathogenesis, epidemiology and control [Review]
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Realities and enigmas of human viral influenza: pathogenesis, epidemiology and control [Review]

机译：人类病毒性流感的现实和谜：发病机制，流行病学和控制[综述]

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Influenza A is a viral disease of global dimension, presenting with high morbidity and mortality in annual epidemics, and in pandemics which are of infrequent occurrence but which have very high attack rates. Influenza probes reveal a continuing battle for survival between host and parasite in which the host population updates the specificity of its pool of humoral immunity by contact with and response to infection with the most recent viruses which possess altered antigenic specificity in their hemagglutinin (HA) ligand. HA ligand binds the virus to the cell to bring about infection. Viral survival relies on escape from host immunity through antigenic alterations in nature which arise through genetic drift by point mutation principally of the HA gene, or through genetic shift by reassortment exchange of the HA ligand with that of viruses retained in avian species. Partial control of influenza is by use of killed whole, subunit, or possible live virus vaccines, all of which rely on worldwide surveillance to provide early detection of the altered immunologic specificity of the next virus to come. Future global surveillance may be aided by studies of sampled viral isolates in laboratories having capabilities for accelerated genetic sequencing and for automated rapid throughput analyses as well. Influenza vaccines of the future must be directed toward use of conserved group-specific viral antigens, such as are present in transitional proteins which are exposed during the fusion of virus to the host cell. Chemotherapy, though still primordial, must eventually provide the ultimate solution to vaccine failures. Probing the enigma of the severe influenza pandemic of 1918-1919 is an exciting contemporary venture in which genetic reconstruction of the viral genome from surviving archival RNA is being conducted with great success. Present evidence reveals successive recycling in pandemics, of only 3 of the 15 possible avian viral HAs. Pandemics are believed, conventionally, to be derived solely by rare events in which wild viruses of man acquire a new HA ligand of avian origin. There might be an alternative possibility involving a periodicity in selective control by the host population itself, in its receptivity or rejection at a particular time of particular reassortant viruses which might be created more frequently in nature than we are presently aware. This hypothesis, though remote, provides a different way to view and to probe the enigma of pandemic influenza.
机译：甲型流感是一种全球性的病毒性疾病，在每年的流行病和罕见的流行病中都有很高的发病率和死亡率，但发作率却很高。流行性感冒探针揭示了宿主与寄生虫之间持续生存的斗争，其中宿主群体通过接触和应答感染其血凝素（HA）配体抗原特异性已改变的最新病毒来更新其体液免疫库的特异性。 HA配体将病毒结合到细胞上以引起感染。病毒的存活依赖于宿主自身免疫力的逃逸，而抗原逃逸是自然界中的抗原改变，这种改变主要是由于HA基因的点突变引起的遗传漂移，或者是由于HA配体与禽类中保留的病毒的重配交换引起的遗传迁移。流感的部分控制是通过使用灭活的完整，亚基或可能的活病毒疫苗，所有这些疫苗都依赖于全球监视，以提供对下一种病毒改变后的免疫学特异性的早期检测。在实验室中，通过对样品中分离出的病毒分离株进行研究，可以加快基因测序和自动快速通量分析的能力。未来的流感疫苗必须针对保守的组特异性病毒抗原的使用，例如存在于病毒与宿主细胞融合过程中暴露的过渡蛋白中。化学疗法尽管仍然是原始的，但最终必须为疫苗失败提供最终的解决方案。探索1918-1919年严重流感大流行的谜团是一项激动人心的当代事业，其中，从存活的档案RNA中进行病毒基因组的遗传重建正在取得巨大成功。目前的证据表明，在15种可能的禽病毒HA中，只有3种在大流行中连续回收。通常认为，大流行仅由罕见事件引起，其中人的野生病毒获得了禽源的新HA配体。可能存在另一种可能性，涉及宿主种群自身选择性控制的周期性，即在特定时间对特定重配病毒的接受性或排斥性，这在自然界可能比我们目前所知的频率更高。这个假设尽管遥远，却提供了一种不同的方式来查看和探究大流行性流感的谜团。

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