Rickettsiae and rickettsial infections: The current state of knowledge

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Abstract

New human rickettsial pathogens have been discovered, and long-known rickettsiae of undetermined pathogenicity have been demonstrated to cause illness. Disease associated with Rickettsia slovaca has unique clinical manifestations, including prominent lymphadenopathy without fever and rash. Rickettsial genomes are highly conserved, with reductive evolution leading to a small genome that relies on the host cell for many biosynthetic functions. Advances in the evaluation of the pathogenesis of rickettsial disease include identification of rickettsial adhesins, a host cell receptor, signaling elements associated with entry of rickettsiae by induced phagocytosis, rickettsial enzymes mediating phagosomal escape, and host actin-based rickettsial cell-to-cell spread. Disruption of adherens junctions of infected endothelial cells likely plays a role in the critical pathophysiologic mechanism: increased microvascular permeability. Production of reactive oxygen species by infected endothelium injures these cells. However, disseminated intravascular coagulation rarely occurs. Immunity is mediated by reactive cytokine-activated rickettsicidal nitrogen and oxygen species and by clearance of rickettsiae by cytotoxic CD8 T cells.

Original languageEnglish (US)
JournalClinical Infectious Diseases
Volume45
Issue numberSUPPL. 1
DOIs
StatePublished - Jul 15 2007

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Rickettsia Infections
Rickettsia
Genome
Adherens Junctions
Disseminated Intravascular Coagulation
Capillary Permeability
Exanthema
Phagocytosis
Endothelium
Virulence
Actins
Immunity
Reactive Oxygen Species
Fever
Nitrogen
Endothelial Cells
Cytokines
Oxygen
T-Lymphocytes
Enzymes

ASJC Scopus subject areas

  • Immunology

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Rickettsiae and rickettsial infections : The current state of knowledge. / Walker, David.

In: Clinical Infectious Diseases, Vol. 45, No. SUPPL. 1, 15.07.2007.

Research output: Contribution to journalArticle

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