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Vet Pathol. 2009 Sep;46(5):792-9. doi: 10.1354/vp.08-VP-0265-N-REV. Epub 2009 May 9.

Review paper: Host-pathogen interactions in the kidney during chronic leptospirosis.

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  • 1Veterinary Sciences Centre, UCD School of Agriculture Food Science and Veterinary Medicine, UCD Conway Institute of Biomolecular and Biomedical Research, College of Life Sciences, University College Dublin, Belfield, Dublin 4, Ireland.

Abstract

Pathogenic species of Leptospira cause leptospirosis, a global zoonotic disease. Leptospira colonize renal tubules of chronically infected maintenance hosts, from where they are shed in urine to the environment and survive in suitable moist conditions. Transmission of disease to new hosts is facilitated by contact with contaminated urine or water sources, because Leptospira can penetrate broken skin or mucosal surfaces of new hosts. Infection of new hosts may be asymptomatic, as with chronically infected maintenance hosts, or may result in an acute disease process in which clinical signs can include fever, jaundice, renal failure, and pulmonary hemorrhage. Those factors that determine if an animal will suffer an acute or a chronic infection are not fully understood but include host animal species, infecting serovar, and infecting dose. During chronic infection, renal colonization and leptospiruria persist despite cellular and humoral responses by the host. Tubulointerstitial nephritis is the most common lesion associated with chronic infection, and this may progress to fibrosis and subsequent renal failure. This review aims to address how Leptospira cause tubulointerstitial nephritis during chronic leptospirosis and to summarize the mechanisms by which Leptospira might evade host immune responses during chronic colonization of the renal tubule.

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