The key mechanisms of multi-system responses triggered by central nervous system damage in hand,foot,and mouth disease severity  

作　　者：Wangquan Ji Peiyu Zhu Yuexia Wang Yu Zhang Zijie Li Haiyan Yang Shuaiyin Chen Yuefei Jin Guangcai Duan 

机构地区：[1]Department of Epidemiology,College of Public Health,Zhengzhou University,Zhengzhou 450001,Henan province,China

出　　处：《Infectious Medicine》2024年第3期41-53,共13页感染医学（英文）

基　　金：National Natural Science Foundation of China(YJ.,No.82002147 and No.82372229,GD.,No.82273695,and SC.,No.82073618);China Postdoctoral Science Foundation(YJ.,No.2024T170246 and No.2024M750815);Open Research Fund of National Health Commission Key Laboratory of Birth Defects Prevention&Henan Key Laboratory of Population Defects Prevention(YJ.,No.ZD202301);Open Grant from the Pingyuan Laboratory(YJ.,No.2023PY-OP-0202);Open Project of Henan Province Engineering Research Center of Diagnosis and Treatment of Pediatric Infection and Critical Care(YJ.,No.ERC202302)。

摘　　要：Hand,foot,and mouth disease(HFMD)is a prevalent infectious affliction primarily affecting children,with a small portion of cases progressing to neurological complications.Notably,in a subset of severe HFMD cases,neurological manifestations may result in significant sequelae and pose a risk of mortality.We systematically conducted literature retrieval from the databases PubMed(1957–2023),Embase(1957–2023),and Web of Science(1957–2023),in addition to consulting authoritative guidelines.Subsequently,we rigorously selected the most relevant articles within the scope of this review for comprehensive analysis.It is widely recognized that the severity of HFMD is attributed to a multifaceted array of pathophysiological mechanisms.The implication of multi-system dysfunction appears to be perturbances of the human defense system;therefore,it contributes to the severity of HFMD.In this review,we provide an overview and analysis of recent insights into the molecular mechanisms contributing to the severity of HFMD,with a particular focus on cytokine release syndrome,the involvement of the renin-angiotensin system,regional immunity,endothelial dysfunction,catecholamine storm,viral invasion,and the molecular mechanisms of neurological damage.We speculate that the domino effect of diverse physiological systems,initiated by damage to the central nervous system,serve as the primary mechanisms governing the severity of HFMD.Simultaneously,we emphasize the knowledge gaps and research urgently required to delineate a quick roadmap for ongoing and essential studies on HFMD.

关 键 词：Hand foot and mouth disease Pathogenic mechanisms Central nervous system Catecholamine storm Multi-system response 

分 类 号：R745[医药卫生—神经病学与精神病学]