The End of the Binary Era: Revisiting the Spectrum of Tuberculosis.

The End of the Binary Era: Revisiting the Spectrum of Tuberculosis.
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DOI:
10.4049/jimmunol.1800993
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发表时间:
2018-11-01
期刊:
Journal of immunology (Baltimore, Md. : 1950)
影响因子:
--
通讯作者:
Flynn JL
Flynn JL
中科院分区:
其他
文献类型:
--
作者:
Lin PL;Flynn JL

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人类结核分枝杆菌感染被认为会导致活动性症状结核(TB)或潜伏性无症状感染(LTBI)。现在很清楚,这种二元分类不足以描述无数的感染结果。在活动性结核病中,有症状的疾病可轻至重,伴有一系列肺部和胸部淋巴结受累,或肺外表现。大多数人控制了感染并发展为LTBI,具有重新激活为活动性结核病的不同风险。然而,一些经常接触的人似乎对感染有抵抗力,而另一些人可能最初受到感染,但随后消除了所有杆菌。影响这些不同结果的免疫因素尚不清楚,但可能涉及一系列不同的反应。在这里,我们回顾了支持人类结核分枝杆菌感染谱的数据,以及非人类灵长类动物的数据,这些数据允许解剖导致不同感染结果的免疫反应。
Human Mycobacterium tuberculosis infection was thought to result in either active symptomatic tuberculosis (TB) or latent asymptomatic infection (LTBI). It is now clear that this binary classification is insufficient to describe the myriad infection outcomes. In active TB, symptomatic disease can be mild to severe, with a range of lung and thoracic lymph node involvement, or extrapulmonary manifestations. Most humans control the infection and develop LTBI, with differential risks of reactivation to active TB. However, some frequently exposed persons appear to be resistant to infection, while others may initially become infected yet subsequently eliminate all bacilli. The immunologic factors influencing these varied outcomes are still not clear, but likely involve a range of different responses. Here we review the data supporting the spectrum of M. tuberculosis infection in humans, as well as data in non-human primates that allow dissection of the immune responses leading to the varied outcomes of infection.
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