PDF(Pubmed)
Abstract：
Human infections with the protozoan Lophomonas have been increasingly reported in the medical literature over the past three decades. Initial reports were based on microscopic identification of the purported pathogen in respiratory specimens. Later, a polymerase chain reaction (PCR) was developed to detect Lophomonas blattarum, following which there has been a significant increase in reports. In this minireview, we thoroughly examine the published reports of Lophomonas infection to evaluate its potential role as a human pathogen. We examined the published images and videos of purported Lophomonas, compared its morphology and motility characteristics with host bronchial ciliated epithelial cells and true L. blattarum derived from cockroaches, analyzed the published PCR that is being used for its diagnosis, and reviewed the clinical data of patients reported in the English and Chinese literature. From our analysis, we conclude that the images and videos from human specimens do not represent true Lophomonas and are predominantly misidentified ciliated epithelial cells. Additionally, we note that there is insufficient clinical evidence to attribute the cases to Lophomonas infection, as the clinical manifestations are non-specific, possibly caused by other infections and comorbidities, and there is no associated tissue pathology attributable to Lophomonas. Finally, our analysis reveals that the published PCR is not specific to Lophomonas and can amplify DNA from commensal trichomonads. Based on this thorough review, we emphasize the need for rigorous scientific scrutiny before a microorganism is acknowledged as a novel human pathogen and discuss the potential harms of misdiagnoses for patient care and scientific literature.
摘要：
在过去的三十年中，医学文献中越来越多地报道了人类感染原生动物Lophomonas。最初的报告是基于呼吸道标本中所谓病原体的显微镜鉴定。稍后，聚合酶链反应（PCR）被开发来检测白斑，随后，报告大幅增加。在这篇小型评论中，我们彻底检查了已发表的有关Lophomonas感染的报告，以评估其作为人类病原体的潜在作用。我们检查了所谓的Lophomonas的已发布图像和视频，将其形态和运动特性与宿主支气管纤毛上皮细胞和源自蟑螂的真钝毛，分析了用于诊断的已发表的PCR，并回顾了中英文文献报道的患者临床资料。根据我们的分析,我们得出的结论是，来自人类标本的图像和视频并不代表真正的Lophomonas，并且主要是错误识别的纤毛上皮细胞。此外,我们注意到，没有足够的临床证据来将这些病例归因于Lophomonas感染，由于临床表现是非特异性的，可能是由其他感染和合并症引起的，并且没有可归因于Lophomonas的相关组织病理学。最后,我们的分析表明，已发表的PCR不是针对Lophomonas的，并且可以从共生滴虫中扩增DNA。根据这次彻底的审查，我们强调在微生物被公认为新型人类病原体之前，需要进行严格的科学审查，并讨论了误诊对患者护理和科学文献的潜在危害。
