Pathogenesis of central nervous system tuberculosis.
Pathogenesis of central nervous system tuberculosis.
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DOI：
10.2174/156652409787581655
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发表时间：
2009-03
影响因子：
2.5
通讯作者：
Jain SK
中科院分区：
文献类型：
--
作者：
Be NA;Kim KS;Bishai WR;Jain SK
中枢神经系统（CNS）结核病是一种严重的，往往是致命的结核病，主要影响幼儿。HIV合并感染和结核分枝杆菌耐药菌株使CNS结核病的诊断和治疗更加复杂。目前关于中枢神经系统结核病发病机制的概念是基于1933年进行的尸检研究，该研究表明结核性脑膜炎是在M周围形成的结核瘤破裂进入脑脊液后发生的。在最初的血行播散过程中，结核沉积在脑实质和脑膜中。外源抗原包括沉积在脑实质中的病原体不能被CNS中的免疫系统有效检测。这些实验数据可以解释临床观察到的延迟“反常”的扩大或发展的颅内结核瘤，观察数周到数月的患者接受抗结核治疗。由于严重的后遗症，即使中枢神经系统结核病得到有效治疗，这是重要的是要制定预防策略，这种疾病。最近利用动物模型的数据表明，除了宿主因素，M。结核病基因及其编码的蛋白质可能特异性地促进细菌在CNS中的侵入和存活。了解这些微生物因素如何影响中枢神经系统疾病将是至关重要的发展这样的预防策略。
Central Nervous System (CNS) tuberculosis is a serious, often fatal form of tuberculosis, predominantly affecting young children. HIV co-infection and drug resistant strains of Mycobacterium tuberculosis are making the diagnosis and treatment of CNS tuberculosis more complicated. Current concepts about the pathogenesis of CNS tuberculosis are based on necropsy studies done in 1933, which suggest that tuberculous meningitis develops subsequent to the rupture into the cerebrospinal fluid of tuberculomas that form around M. tuberculosis deposited in the brain parenchyma and meninges during the initial hematogenous dissemination. Foreign antigens including pathogens deposited in the brain parenchyma are not detected efficiently by the immune system in the CNS. These experimental data may explain the clinical observation of delayed “paradoxical” enlargement or development of intracranial tuberculomas, observed several weeks to months in patients receiving anti-tuberculous therapy. Since severe sequelae are observed even when CNS tuberculosis is treated effectively, it is important to develop preventive strategies for this disease. Recent data utilizing animal models suggests that, in addition to host factors, M. tuberculosis genes and their encoded proteins may contribute specifically to bacterial invasion and survival in the CNS. Understanding how these microbial factors affect CNS disease would be essential to developing such preventive strategies.
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影响因子：
82.9
作者：
Liu, Yawei;Teige, Ingrid;Issazadeh-Navikas, Shohreh
通讯作者：
Issazadeh-Navikas, Shohreh
影响因子：
3.6
作者：
Padayatchi, NI;Bamber, S;Bobat, R
通讯作者：
Bobat, R
影响因子：
64.8
作者：
Pethe, K;Alonso, S;Menozzi, FD
通讯作者：
Menozzi, FD
影响因子：
3.1
作者：
Birkness, KA;Deslauriers, M;Quinn, FD
通讯作者：
Quinn, FD
影响因子：
3.1
作者：
Bermudez, LE;Sangari, FJ;Goodman, J
通讯作者：
Goodman, J