The pathogenesis of nephropathia epidemica: New knowledge and unanswered questions

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• 作者：Jukka Mustonen ; Satu M盲kel盲 ; Tuula Outinen ; Outi Laine ; Juulia Jylh盲v盲 ; Petteri T. Arstila ; Mikko Hurme ; Antti Vaheri
• 关键词：Hantavirus ; Hemorrhagic fever with renal syndrome ; Nephropathia epidemica ; Puumala virus
• 刊名：Antiviral Research
• 出版年：December, 2013
• 年：2013
• 卷：100
• 期：3
• 页码：589-604
• 全文大小：2010 K

文摘

Puumala virus (PUUV) causes an acute hemorrhagic fever with renal syndrome (HFRS), a zoonosis also called nephropathia epidemica (NE). The reservoir host of PUUV is the bank vole (Myodes glareolus). Herein we review the main clinical manifestations of NE, acute kidney injury, increased vascular permeability, coagulation abnormalities as well as pulmonary, cardiac, central nervous system and ocular manifestations of the disease. Several biomarkers of disease severity have recently been discovered: interleukin-6, pentraxin-3, C-reactive protein, indoleamine 2,3-dioxygenase, cell-free DNA, soluble urokinase-type plasminogen activator, GATA-3 and Mac-2 binding protein. The role of cytokines, vascular endothelial growth hormone, complement, bradykinin, cellular immune response and other mechanisms in the pathogenesis of NE as well as host genetic factors will be discussed. Finally therapeutic aspects and directions for further research will be handled.