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Die Bedeutung der Virulenzfaktoren von Pseudomonas aeruginosa für akute und chronische Pseudomonas aeruginosa-Infektionen

The importance of pseudomonas aeruginosa virulence factors for acute and chronic pseudomonas aeruginosa infections

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Zusammenfassung

Die Virulenz vonPseudomonas aeruginosa ist multifaktoriell und wird durch eine Reihe extrazellulärer Enzyme und anderer Substanzen bewirkt. Ihre Bedeutung für die Pathogenese menschlicherP. aeruginosa-Infektionen ist vom jeweiligen Infektionstyp abhängig. In akuten, generalisierenden Infektionen bei Patienten mit eingeschränktem Immunsystem sind Exotoxin A, alkalische Protease und Elastase wesentliche Pathogenitätsfaktoren. Ihre Bedeutung in chronischen, lokalisierten Infektionen bei immunkompetenten Patienten (z. B: zystische Fibrose) scheint geringer zu sein: sie werden durch Antikörper in Immunkomplexen neutralisiert, und Exotoxin A wird zusätzlich durch lysosomale Proteinasen aus polymorphkernigen Leukozyten inaktiviert. Das Rhamnolipid vonP. aeruginosa, das in Sputen von Patienten mit zystischer Fibrose nachgewiesen werden konnte, entgeht der Immunantwort des Wirts und ist daher neben den Phenazin-Pigmenten auch bei chronischenP. aeruginosa-Infektionen als potentieller Virulenzfaktor anzusehen.

Summary

The virulence ofPseudomonas aeruginosa is multifactorial and caused by several extracellular enzymes and other substances. The importance of these virulence factors for the pathogenesis of humanP. aeruginosa infections is dependent on the type of infection. For acute, systemic infections in immunocompromised patients, exotoxin A, alkaline protease and elastase are essential virulence factors. In localized infections (e. g., cystic fibrosis) they seem to be of minor importance, since they are neutralized by specific antibodies in immune complexes, and in the case of exotoxin A cleavage by proteinases from polymorphonuclear leukocytes occurs. The rhamnolipid ofP. aeruginosa which has been detected in sputa of patients with cystic fibrosis evades the host's immune response and has to be regarded as a potential virulence factor together with the phenazine pigments, also in chronicP. aeruginosa infections.

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  1. Hygiene Institut, Abteilung Allgemeine Hygiene und Umwelthygiene, Universität Tübingen, Silcherstraße 7, D-7400, Tübingen, Germany

    G. Döring

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Döring, G. Die Bedeutung der Virulenzfaktoren von Pseudomonas aeruginosa für akute und chronische Pseudomonas aeruginosa-Infektionen. Infection 15, 47–50 (1987). https://doi.org/10.1007/BF01646122

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