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Bacterial infections of respiratory and gastrointestinal mucosae
Book Reviews. Bacterial Infections of Respiratory and Gastrointestinal Mucosae Edited by W. Donachie, E. Griffiths and J. Stephen, Society for General Microbiology, Oxford University Press, Oxford, UK, Volume 24, 1989, £25.00, ISBN 185-2211 482
This book is based upon aspects of a Society for General Microbiology symposium held in September 1987 and is restricted primarily to a discussion of a selection of pathogens associated with respiratory and gastrointestinal mucosae. As stated by the editors, the book 'aims t o . . . highlight new discoveries on virulence determinants, clarify extant complex situations, develop a better understanding of pathophysiological'and immunological responses of the host to mucosal infections, and evaluate prospects for vaccine improvement and development'. Of the 12 chapters, four cover the functions of and factors associated with the respiratory and gut mucosal surfaces, the mechanisms of disease and the immune response. The remainder look at the pathogenesis of infections produced by specific organisms at one or the other surface. Chapter 1 by P.S. Richardson is brief but puts the airway mucosa in a good physical perspective and describes the significance of the actual mucus layer, both in terms of trapping foreign particles, whether they be dust, bacteria or viruses, and the mechanisms for the removal of this debris, and as a protective barrier against dehydration. A similar approach to the small intestine is provided by O. Lundgren (chapter 8). This chapter concentrates on absorption and secretion with emphasis on the transport mechanisms themselves but also highlighting the importance of the enteric nervous system in the transport processes. J. Bienenstock (chapter 2) presents a very concise review of immunity at mucosal surfaces with an excellent diagrammatic representation of the interactions of antigens with the immune system and the production and role of IgE and both forms of IgA. This diagram also serves as the cover illustration where IgE somehow managed to be omitted. Although the extent of the conciseness may seem extreme to the immunologist, it avoids all the specific jargon but still gives the desired global view. Chapter 11 by J.P. Stephen and M.P.
$140 Vaccine,Vol. 8, Supplement 1990
Osborne, is an interesting discussion of the ways in which organisms and/or their toxic products could deleteriously affect intestinal function based on their research with routine rotavirus infection but extrapolated to bacterial systems. They present evidence that the primary pathological event is an interference with blood flow and that subsequently villus tips are shed and cell division induced with concomitant fluid secretion. This is a different viewpoint to that usually expressed but it does provide a testable model. The respiratory infections that are examined are Legionella pneumophila, Haemophilus influenzae, Bordetella spp.,
Pasteurella haemolytica and Pseudomonas aeruoinosa. Chapter 3 (A. Baskerville) is descriptive in its treatment of Leoionella but leaves a lot of unanswered questions, however, this is probably a reflection of the state of understanding of Legionella pathogenesis. The description of Pasteurella haemolytica as a respiratory pathogen in domestic ruminants, particularly sheep, in chapter 6 (W. Donachie) suffers in a similar way. But presumably the inclusion, by the editors, of these less well studied organisms was designed to give breadth to the examples and also demonstrate that there are many areas of microbial pathogenesis that have barely been researched. Haemophilus influenzae represents an interesting commensal organism which has the capacity to spread from its normal habitat in the upper respiratory tract to cause disease (R. Wilson and E.R. Moxon, chapter 4). The approach taken by these authors is to discuss the organism and its association with the respiratory tract and to look at possible mechanisms by which the 'contiguous spread' and also pulmonary damage can occur. The discussion of virulence factors of Bordetella (chapter 5, A.C. Wardlaw) is comprehensive and includes details of host specificity, the virulence determinants in the different species, the regulation of virulence via the vir locus and even
a possible evolutionary tree for the Bordetellae. Pseudomonas aeruginosa in cystic fibrosis (chapter 7, J.R.W. Govan) receives the lengthiest treatment within the book and although comprehensive could have been condensed. Much of the chapter is devoted to alginate synthesis and its significance in the production of the mucoid colony phenotype. The diarrhoeal or intestinal pathogens described are enterotoxigenic (ETEC), enterohaemorrhagic (EHEC) and enteropathogenic (EPEC) Escherichia coli and the enteroinvasive organisms Shigella, Salmonella and Yersinia. The various diarrhoeagenic E. coli are described in chapter 9 (J.B. Kaper and C.O. Tacket). The different classes are treated in turn looking at toxins, adhesins and colonization factors and the molecular genetics of these virulence determinants and their significance in pathogenesis. It provides a reasonably comprehensive compilation of the determinants, however, with all the different 'LT's, ST's, CFA's, PCF's, CS's' etc. it could be a bit confusing for all but the ETEC aficionado. P.J. Sansonetti and co-authors (chapter 10) compare the strategies of infection by the enteroinvasive organisms Shigella, Salmonella and Yersiniawith emphasis on their speciality, Shigella flexneri. It is one of the most readable chapters in the book and demonstrates how all the various experimental approaches from using animal models, tissue culture cells, pathology and molecular genetics, can come together to provide insights into the various aspects of the pathogenesis of an infection. Finally, chapter 12 (J. Holmgren and A.-M. Svennerholm)concentrate on their studies on the development of vaccines against cholera and ETEC. They summarize the testing in humans, both in volunteers and in a field trial in Bangladesh, of a cholera vaccine based on killed whole cells with or without the addition of cholera toxin (CT) B-subunit. The same strategy is being used for development of an ETEC vaccine since the two infections are very similar, and in fact CT and LT are highly homologous. There is considerable discussion on the virulence factors of ETEC which is a repetition of chapter 9, but virtually none concerning the important components of the whole cells used in the cholera vaccine. A comparison with live vaccine alternatives would have been beneficial in this context. Very few textbooks are available which are suitable as reading material for
Book review
microbiology courses concentrating on the ever increasing field of the molecular basis of bacterial pathogenicity. This book helps fill this gap in that it provides a reasonable approach to defining the problem areas for gut and lung infections, discusses the immune mechanisms which are available and looks at how the various bacteria go about producing their infections, physiological and pathological changes, and inducing an immune response. Although limited
to its scope, it does provide a series of good examples. The book provides a good overview of the areas covered and would make suitable reading for the more advanced undergraduate or postgraduate student or researcher seeking to become more familiar with the field of microbial pathogenesis and immunity in general. For the specialist, the book brings little new information, but the articles do serve as useful summaries/reviews of their
respective areas written in a style that could be readily followed by biological scientists from a broad range of disciplines. It will certainly find a ready home on many bookshelves and at the SGM members' price certainly represents good value.
Paul Manning University of Adelaide, South Australia
Vaccine, Vol. 8, Supplement 1990 $141
This book is based upon aspects of a Society for General Microbiology symposium held in September 1987 and is restricted primarily to a discussion of a selection of pathogens associated with respiratory and gastrointestinal mucosae. As stated by the editors, the book 'aims t o . . . highlight new discoveries on virulence determinants, clarify extant complex situations, develop a better understanding of pathophysiological'and immunological responses of the host to mucosal infections, and evaluate prospects for vaccine improvement and development'. Of the 12 chapters, four cover the functions of and factors associated with the respiratory and gut mucosal surfaces, the mechanisms of disease and the immune response. The remainder look at the pathogenesis of infections produced by specific organisms at one or the other surface. Chapter 1 by P.S. Richardson is brief but puts the airway mucosa in a good physical perspective and describes the significance of the actual mucus layer, both in terms of trapping foreign particles, whether they be dust, bacteria or viruses, and the mechanisms for the removal of this debris, and as a protective barrier against dehydration. A similar approach to the small intestine is provided by O. Lundgren (chapter 8). This chapter concentrates on absorption and secretion with emphasis on the transport mechanisms themselves but also highlighting the importance of the enteric nervous system in the transport processes. J. Bienenstock (chapter 2) presents a very concise review of immunity at mucosal surfaces with an excellent diagrammatic representation of the interactions of antigens with the immune system and the production and role of IgE and both forms of IgA. This diagram also serves as the cover illustration where IgE somehow managed to be omitted. Although the extent of the conciseness may seem extreme to the immunologist, it avoids all the specific jargon but still gives the desired global view. Chapter 11 by J.P. Stephen and M.P.
$140 Vaccine,Vol. 8, Supplement 1990
Osborne, is an interesting discussion of the ways in which organisms and/or their toxic products could deleteriously affect intestinal function based on their research with routine rotavirus infection but extrapolated to bacterial systems. They present evidence that the primary pathological event is an interference with blood flow and that subsequently villus tips are shed and cell division induced with concomitant fluid secretion. This is a different viewpoint to that usually expressed but it does provide a testable model. The respiratory infections that are examined are Legionella pneumophila, Haemophilus influenzae, Bordetella spp.,
Pasteurella haemolytica and Pseudomonas aeruoinosa. Chapter 3 (A. Baskerville) is descriptive in its treatment of Leoionella but leaves a lot of unanswered questions, however, this is probably a reflection of the state of understanding of Legionella pathogenesis. The description of Pasteurella haemolytica as a respiratory pathogen in domestic ruminants, particularly sheep, in chapter 6 (W. Donachie) suffers in a similar way. But presumably the inclusion, by the editors, of these less well studied organisms was designed to give breadth to the examples and also demonstrate that there are many areas of microbial pathogenesis that have barely been researched. Haemophilus influenzae represents an interesting commensal organism which has the capacity to spread from its normal habitat in the upper respiratory tract to cause disease (R. Wilson and E.R. Moxon, chapter 4). The approach taken by these authors is to discuss the organism and its association with the respiratory tract and to look at possible mechanisms by which the 'contiguous spread' and also pulmonary damage can occur. The discussion of virulence factors of Bordetella (chapter 5, A.C. Wardlaw) is comprehensive and includes details of host specificity, the virulence determinants in the different species, the regulation of virulence via the vir locus and even
a possible evolutionary tree for the Bordetellae. Pseudomonas aeruginosa in cystic fibrosis (chapter 7, J.R.W. Govan) receives the lengthiest treatment within the book and although comprehensive could have been condensed. Much of the chapter is devoted to alginate synthesis and its significance in the production of the mucoid colony phenotype. The diarrhoeal or intestinal pathogens described are enterotoxigenic (ETEC), enterohaemorrhagic (EHEC) and enteropathogenic (EPEC) Escherichia coli and the enteroinvasive organisms Shigella, Salmonella and Yersinia. The various diarrhoeagenic E. coli are described in chapter 9 (J.B. Kaper and C.O. Tacket). The different classes are treated in turn looking at toxins, adhesins and colonization factors and the molecular genetics of these virulence determinants and their significance in pathogenesis. It provides a reasonably comprehensive compilation of the determinants, however, with all the different 'LT's, ST's, CFA's, PCF's, CS's' etc. it could be a bit confusing for all but the ETEC aficionado. P.J. Sansonetti and co-authors (chapter 10) compare the strategies of infection by the enteroinvasive organisms Shigella, Salmonella and Yersiniawith emphasis on their speciality, Shigella flexneri. It is one of the most readable chapters in the book and demonstrates how all the various experimental approaches from using animal models, tissue culture cells, pathology and molecular genetics, can come together to provide insights into the various aspects of the pathogenesis of an infection. Finally, chapter 12 (J. Holmgren and A.-M. Svennerholm)concentrate on their studies on the development of vaccines against cholera and ETEC. They summarize the testing in humans, both in volunteers and in a field trial in Bangladesh, of a cholera vaccine based on killed whole cells with or without the addition of cholera toxin (CT) B-subunit. The same strategy is being used for development of an ETEC vaccine since the two infections are very similar, and in fact CT and LT are highly homologous. There is considerable discussion on the virulence factors of ETEC which is a repetition of chapter 9, but virtually none concerning the important components of the whole cells used in the cholera vaccine. A comparison with live vaccine alternatives would have been beneficial in this context. Very few textbooks are available which are suitable as reading material for
Book review
microbiology courses concentrating on the ever increasing field of the molecular basis of bacterial pathogenicity. This book helps fill this gap in that it provides a reasonable approach to defining the problem areas for gut and lung infections, discusses the immune mechanisms which are available and looks at how the various bacteria go about producing their infections, physiological and pathological changes, and inducing an immune response. Although limited
to its scope, it does provide a series of good examples. The book provides a good overview of the areas covered and would make suitable reading for the more advanced undergraduate or postgraduate student or researcher seeking to become more familiar with the field of microbial pathogenesis and immunity in general. For the specialist, the book brings little new information, but the articles do serve as useful summaries/reviews of their
respective areas written in a style that could be readily followed by biological scientists from a broad range of disciplines. It will certainly find a ready home on many bookshelves and at the SGM members' price certainly represents good value.
Paul Manning University of Adelaide, South Australia
Vaccine, Vol. 8, Supplement 1990 $141