Failures in the Management of Elderly Women with Breast Cancer 英文参考文献.docVIP

Synopses of Research Articles How Group A Streptococci Hide in Macrophages DOI: 10.1371/journal.pmed.0030095 In the past 10 years, evidence has suggested that group A streptococci (GAS) adhere to epithelial cells and invade them. In 1994, LaPenta and colleagues found that GAS could invade human epithelial cells, in some cases better than classical intracellular bacterial pathogens such as Listeria and Salmonella spp. can. Several studies quickly con?rmed this landmark ?nding and produced further evidence to support this mechanism. One study showed that high-frequency invasion needed expression of M protein (a surface protein, variation in which provides the basis of Lance?eld’s method of serotyping GAS) and/or ?bronectin- binding proteins such as SfbI. Another study found that the M1 serotype of GAS was particularly adept at intracellular invasion of epithelial cells. as reservoirs for intracellular bacteria during the acute tissue infection. The data suggest that this could be a mechanism to avoid antibiotic eradication, which might explain why a high bacterial load was present even in tissues collected after prolonged intravenous antibiotic therapy. The authors also note that the localization of GAS varied and depended on the severity of tissue infection; intracellular localization was most frequent in nonin?amed tissue, which also had a low bacterial load. Osterlund’s study had already shown that intracellular GAS was present in pharyngeal epithelial and macrophage-like cells of patients with tonsillitis. However, the current study by Thulin and colleagues shows for the ?rst time that this occurred in vivo during severe invasive GAS soft-tissue infections in humans, even while patients are on antibiotic therapy. The theoretical implication of this study is that if intracellular bacteria are most commonly found in newly involved tissue with low in?ammation and low bacterial load, it might be the case that internalization could promote the spread of bacteria with