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   Abstract         Curriculum          Bibliografia  ......Gaetano D'Onofrio
 
 
Infectious diseases were a past problem few years ago, but recent appearance of Aids, the increase of tuberculosis, the expansion of unusual and multiresistant bacterial pathogens and new viral agents represent a serious danger for the public health even in developed countries such as Italy. 
Recently, during an important meeting in Washington, Lederberg affirmed that “the viruses are the real competitors of mankind because acts both as parasites and as genetic substances conditioning the human host”.  
This co-evolution (man-virus) is a complex mechanism and has been reinforcing the importance of immune response as a key system in the balance between human host and viruses during the natural history of the diseases.  
Infectious diseases are many and may interest different tissues determining many diseases such as pulmonary infections, hepatitis, gastroenteritis, encephalitis, tuberculosis and other. Particularly, tubercolosis is an important disease and according  to the data of World Health Organization (WHO) it represents a serious problem for the public health.  
This dramatic increase seems related to Hiv epidemic (in 1994, the coinfections of tubercolosis and Hiv interested around 5 millions people). 
Not only tubercolosis and Hiv infections are a serious therapeutic problem but also many bacterial diseases because an increasing number of organism are resistant to antibiotics and there are more immunosuppressed patients in the hospital population. 
This background underlines the role of different in the strategy against these infections: 

A. Vaccination and correct information on disease epidemiology 

In this context, it is much important the collaboration between the specialists in infectious diseases and the general practitioners and, in particular, in the treatment of those diseases in which the prevention is the single available method. 

B.  Correct and rapid diagnosis of the infectious diseases 

It is important to use new sensitive methods of pathogen detection such as the polymerase chain reaction (PCR) and branched DNA techniques (bDNA) because the diagnosis of infections using the classical parameters has many false-negative and false-positive interpretations.  
Moreover, microbiological diagnosis is also difficult because of the peculiar histopathological pattern of infections and, finally, it require quantitative microbiological cultures to distinguish colonization from infection. 

C. Evaluation of the mechanisms of the immune response against the infectious pathogens. 

Our understanding of immune response has increased considerably in recent years and these knowledges have contributed to a global view of immune response during the infections.  
Today, it is possible evaluate CD4 and CD8 lymphocyte dynamics and cytokine patterns during different infectious diseases such as Hiv infection, tuberculosis, viral hepatitis, leishmaniosis, and also many bacterial infections.  
A significant feature of the natural history of many infections is the occurrence of an imbalance in the immuoregulatory cytokine network and the expansion of particular lymphocyte populations such as T cell naive, memory and activated CD38+.  
This new global pathophysiological view of the immune response has important practical implications for therapy.  
It is likely that the study of immune response in next years will represent a better system for monitoring all the infectious diseases. 
 
 

 
 
 
 
 
 
 
 
 
 
 
 
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