ПСЕВДОТУБЕРКУЛЕЗ КАК ПЕРСИСТЕНТНАЯ ИНФЕКЦИЯ: ЭТИОПАТОГЕНЕТИЧЕСКИЕ ПРЕДПОСЫЛКИ

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).