Immunotherapy for Tuberculosis: what's the better choice?
Immunotherapy for Tuberculosis: what's the better choice?
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DOI：
10.2741/4079
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发表时间：
2012-06-01
影响因子：
3.1
通讯作者：
Zhao, Jinqiu
中科院分区：
文献类型：
--
作者：
Guo, Shuliang;Zhao, Jinqiu
结核病（TB）患者中Th1反应降低和Th2反应增加引起的Th1/Th2失衡是结核病发病和发展的重要因素。针对结核病的保护性免疫反应包括抑菌反应和杀菌反应。然而不幸的是，免疫保护和免疫病理学在结核病患者中同时存在。结核病免疫治疗的主要目的是通过增强Th1反应并抑制过度的Th2反应来恢复Th1/Th2平衡。结核病的免疫治疗可分为三类：利用细胞因子的免疫增强治疗、免疫抑制治疗和免疫调节治疗。免疫调节疗法针对 Th1/Th2 失衡，包括细胞因子调节疗法、抗体调节疗法、多剂量热灭活母牛分枝杆菌疫苗、胸腺肽激素和 DNA 疫苗。补充结核病免疫治疗的一种新方法是同时上调 Th1 反应并下调 Th2 反应。虽然免疫疗法有助于结核病治疗，但也可能导致免疫病理损伤。因此，免疫疗法需要改进和进一步研究，以最大限度地发挥其潜力。
A Th1/Th2 imbalance in tuberculosis (TB) patients caused by a decreased Th1 response and an increased Th2 response is a significant factor in the pathogenesis and development of TB. Protective immune responses to TB include bacteriostatic and bactericidal responses. Unfortunately, however, immunoprotection and immune pathology co-exist in TB patients. Immunotherapy for TB principally aims to restore the Th1/Th2 balance by enhancing the Th1 response and suppressing the excessive Th2 response. Immunotherapy for TB can be classified into three categories: immune-enhancing therapy using cytokines, immunosuppressive therapy, and immunomodulatory therapy. Immunomodulatory therapy targets the Th1/Th2 imbalance and includes cytokine regulation therapy, antibody regulation therapy, a multi-dose heat-inactivated Mycobacterium vaccae vaccine, thymosin hormones and a DNA vaccine. A new approach in supplementary TB immunotherapy is to simultaneously up-regulate the Th1 response and down-regulate the Th2 response. While immunotherapy can contribute to TB treatment, it may also cause immunopathological injury. Therefore, immunotherapy needs to be improved and further studied to maximize its potential.