Colonization of Mucosal Surfaces
http://www.100md.com
《新英格兰医药杂志》
In the past few years, interest in the bacteria that inhabit normal mucosal surfaces and skin has truly ignited. These colonized sites are conveniently referred to as "external," in that they have direct contact with the environment and are continually bathed by food, water, and air. Aside from costly and wrong-headed attempts to cleanse the bowel of noxious microbes (it is remarkable how many rational patients still go in for this practice), there has always been a group of enthusiastic academics — microbiologists, dentists, physicians, cell biologists, nutritionists and, more recently, geneticists and population epidemiologists — who look on the microflora with wonder. Some are attracted by the extraordinary number of organisms and species in and on the human body, others need to know what causes a harmlessly colonizing microbe to become an infectious agent, and still others wonder what this microbial garden actually contributes to health. Then there are those with commercial interests, whose need is to understand how to make cosmetics and other toiletries increasingly effective or long-lasting in the face of established microflora, or how to isolate and modify bacterial strains that can live and divide in the gut (rather than being immediately expelled) as probiotic agents. Joining in more recently are researchers who question what these seemingly harmless microbes have to do with inflammatory bowel disease, rheumatoid arthritis, and many other unexplained chronic inflammatory diseases. Ready access to the sites of inflammation and the surrounding microbial population is a great ally of studies of this kind, as has been made clear in the early contributions by dental microbiologists and immunologists to the understanding of chronic inflammatory illnesses in the oral cavity.
Scanning Electron Micrograph Showing Bacteria on Fungiform Papillae of the Tongue.
David Gregory and Debbie Marshall/Wellcome Photo Library.
As the science linking the normal microflora to disease unfolds, terms such as host mimicry, adhesin, M cell, defensin, quorum sensing, biofilm, nucleotide-binding-oligomerization – domain 2 protein, integrin, and intimin appear increasingly in the medical literature — terms that in the past were confined to the writings of microbiologists and immunologists. This terminology is a challenge even for the informed physician, and reference works to which they can turn are essential. The two books reviewed here deal comprehensively with the colonizing microflora. They are complementary yet very different in style and scope.
Microbial Inhabitants of Humans was written solely by Michael Wilson of University College London, and single authorship brings the great benefit of coherence. This book is an aerial view of exactly what the title describes and will instruct well those who want to grasp the scope of the vast and varied topic of the normal microflora. Each site in the body receives its own chapter, and the organization of the chapters is uniform. Thus, in my own field of gastroenterology, a discussion of the anatomy and physiology of the gut precedes a broad treatment of the environmental features of each organ along its length, which bacteria colonize each site and their numbers (microbial taxonomy is richly detailed throughout the book), how microbes interact on each epithelium, the defense mechanisms that control them, and some of the local and systemic diseases that they cause. The skin, urogenital tract, respiratory tract, oral cavity, and other sites are discussed in turn.
As one approaches this book, the first stop should be the table of contents, where the design of the book becomes obvious. One disadvantage of the organization according to organs is that common systems such as mucosal immunity are described separately for each organ, when they might well have been dealt with once instead and then cross-referenced, as required. This book may not satisfy a need to obtain deep scientific details, but for the reader broadly interested in this complex subject, its handling of the material is very well done indeed. Chapters on topics with which I am particularly familiar had no errors of fact and touched on everything relevant. And — much to my satisfaction — the book even has a section on what an epithelium is, which will be valuable to basic scientists, who sometimes look so closely at microbial physiology and genetics that they need an occasional reminder of the ground on which this remarkable microbial–human game is played.
Colonization of Mucosal Surfaces is a very different book, delving deeply into each of many topics in contributions by 60 authors, many of them leading workers in the field. It is packed with specific information and is surprisingly free of redundancy. If you do not yet have a clear notion of what pathogen-associated molecular patterns are or what toll-like–receptor signaling is all about, this book is for you. It apparently was written for workers in the fields of microbial pathogenesis, mucosal immunity, and microbial physiology and genetics, but that does not mean that the practicing physician will not find value here, since mucins, probiotic agents, and biofilm formation all get full treatment and the ways specific bacteria colonize specific mucosal and cutaneous sites are also well described.
There are many fine chapters, and those on quorum sensing, signal transduction, IgA proteases, and the special role of certain carbohydrates such as sialic acids are done exceptionally well. However, I thought that the oral cavity and its complex and often pathogenic microbiology were inappropriately left out. It may surprise Journal readers to learn that a microorganism known as Bacteroides thetaiotaomicron has revealed that bacteria induce the formation of glycoproteins on host (mouse) epithelial-cell surfaces, which means that colonizing bacteria actually can influence the metabolism in host cells and patterns of protein expression. So much for the passive role usually ascribed to the enormous bacterial mass carried around in the lower bowel.
Colonization of Mucosal Surfaces maintains the high quality of the publication series of the American Society for Microbiology. One minor criticism is that in some chapters, reference is made to other books on infectious diseases and microbiology, rather than to original sources — a shortcut that can rarely be justified.
Looked at together, the book by Wilson and the book edited by Nataro and colleagues are both well worth having. Neither distinguishes itself by its illustrations, and once again, indexing seems to be an insurmountable obstacle for even the most devoted editors and authors. Microbial Inhabitants of Humans will open the door and fully orient those who are not in this field, whereas Colonization of Mucosal Surfaces should become a standard for those who are in it. The latter book will need a revision soon, because its editors chose to capture the details of a science that is growing very rapidly.
Andrew G. Plaut, M.D.
Tufts–New England Medical Center
Boston, MA 02111(Edited by James P. Nataro)
Scanning Electron Micrograph Showing Bacteria on Fungiform Papillae of the Tongue.
David Gregory and Debbie Marshall/Wellcome Photo Library.
As the science linking the normal microflora to disease unfolds, terms such as host mimicry, adhesin, M cell, defensin, quorum sensing, biofilm, nucleotide-binding-oligomerization – domain 2 protein, integrin, and intimin appear increasingly in the medical literature — terms that in the past were confined to the writings of microbiologists and immunologists. This terminology is a challenge even for the informed physician, and reference works to which they can turn are essential. The two books reviewed here deal comprehensively with the colonizing microflora. They are complementary yet very different in style and scope.
Microbial Inhabitants of Humans was written solely by Michael Wilson of University College London, and single authorship brings the great benefit of coherence. This book is an aerial view of exactly what the title describes and will instruct well those who want to grasp the scope of the vast and varied topic of the normal microflora. Each site in the body receives its own chapter, and the organization of the chapters is uniform. Thus, in my own field of gastroenterology, a discussion of the anatomy and physiology of the gut precedes a broad treatment of the environmental features of each organ along its length, which bacteria colonize each site and their numbers (microbial taxonomy is richly detailed throughout the book), how microbes interact on each epithelium, the defense mechanisms that control them, and some of the local and systemic diseases that they cause. The skin, urogenital tract, respiratory tract, oral cavity, and other sites are discussed in turn.
As one approaches this book, the first stop should be the table of contents, where the design of the book becomes obvious. One disadvantage of the organization according to organs is that common systems such as mucosal immunity are described separately for each organ, when they might well have been dealt with once instead and then cross-referenced, as required. This book may not satisfy a need to obtain deep scientific details, but for the reader broadly interested in this complex subject, its handling of the material is very well done indeed. Chapters on topics with which I am particularly familiar had no errors of fact and touched on everything relevant. And — much to my satisfaction — the book even has a section on what an epithelium is, which will be valuable to basic scientists, who sometimes look so closely at microbial physiology and genetics that they need an occasional reminder of the ground on which this remarkable microbial–human game is played.
Colonization of Mucosal Surfaces is a very different book, delving deeply into each of many topics in contributions by 60 authors, many of them leading workers in the field. It is packed with specific information and is surprisingly free of redundancy. If you do not yet have a clear notion of what pathogen-associated molecular patterns are or what toll-like–receptor signaling is all about, this book is for you. It apparently was written for workers in the fields of microbial pathogenesis, mucosal immunity, and microbial physiology and genetics, but that does not mean that the practicing physician will not find value here, since mucins, probiotic agents, and biofilm formation all get full treatment and the ways specific bacteria colonize specific mucosal and cutaneous sites are also well described.
There are many fine chapters, and those on quorum sensing, signal transduction, IgA proteases, and the special role of certain carbohydrates such as sialic acids are done exceptionally well. However, I thought that the oral cavity and its complex and often pathogenic microbiology were inappropriately left out. It may surprise Journal readers to learn that a microorganism known as Bacteroides thetaiotaomicron has revealed that bacteria induce the formation of glycoproteins on host (mouse) epithelial-cell surfaces, which means that colonizing bacteria actually can influence the metabolism in host cells and patterns of protein expression. So much for the passive role usually ascribed to the enormous bacterial mass carried around in the lower bowel.
Colonization of Mucosal Surfaces maintains the high quality of the publication series of the American Society for Microbiology. One minor criticism is that in some chapters, reference is made to other books on infectious diseases and microbiology, rather than to original sources — a shortcut that can rarely be justified.
Looked at together, the book by Wilson and the book edited by Nataro and colleagues are both well worth having. Neither distinguishes itself by its illustrations, and once again, indexing seems to be an insurmountable obstacle for even the most devoted editors and authors. Microbial Inhabitants of Humans will open the door and fully orient those who are not in this field, whereas Colonization of Mucosal Surfaces should become a standard for those who are in it. The latter book will need a revision soon, because its editors chose to capture the details of a science that is growing very rapidly.
Andrew G. Plaut, M.D.
Tufts–New England Medical Center
Boston, MA 02111(Edited by James P. Nataro)