Pseudotuberculosis as persistent infection: etiopathogenetic preconditions
The review discusses the pathogenetic features of pseudotuberculosis, which predetermine the possibility of recurrence of the disease and persistent infection. Among them deserve attention the damage of lymphoid organs with the development of secondary immunodeficiency, granulomatous inflammation, efferocytosis, associated with the absorption of apoptotic, phosphatidyl-positive neutrophils. Efferocytosis as one of the antimicrobial strategies of polymorphonuclear leukocytes (PMNLs) reduces the damage to surrounding tissue and increases the production of anti-inflammatory molecules, while the Yersinia infected PMNLs can act as an intermediate host for the subsequent non-inflammatory infection of macrophages. The predisposition of Yersinia, including Y. pseudotuberculosis, to persistence is associated with genetically determined bacterial pathogenicity factors, mainly with their antiphagocytic properties and the ability to produce a cytotoxic necrotic factor (CNFY).