Pathology of postprimary tuberculosis in humans and mice: Contradiction of long-held beliefs
Pathology of postprimary tuberculosis in humans and mice: Contradiction of long-held beliefs
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DOI：
10.1016/j.tube.2006.11.003
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发表时间：
2007-07-01
期刊：
影响因子：
3.2
通讯作者：
Actor, Jeffrey K.
中科院分区：
文献类型：
--
作者：
Hunter, Robert L.;Jagannath, Chinnaswamy;Actor, Jeffrey K.
结核病仍然是世界上主要的传染性死亡原因之一。大约80%的疾病是由于原发后（继发）肺结核。不幸的是，发展中的病变组织很少，也没有公认的模型原发后结核病。在前抗生素时代，当组织更丰富时，一些研究者将早期原发后结核描述为脂质性肺炎，与今天通常描述的干酪化肉芽肿完全不同。我们使用组织病理学，免疫组织化学和抗酸染色检查组织从几个人未经治疗的原发性和原发后结核病和比较的结果与小鼠的再活化结核病。结果证实，发展中的原发后结核病开始于伴有支气管阻塞的脂质性肺炎，其中感染仅限于泡沫状肺泡巨噬细胞。空洞是由结核性肺炎的干酪样变和迟发型超敏反应（DTH）的微血管闭塞共同作用的结果。在小鼠中，结核病的再活化开始于类似的结核性脂质性肺炎，伴有支气管阻塞和DTH参与的证据。两个种属中发生坏死与脂滴内微生物的定位有关。这些结果表明，在小鼠中的再活化结核病是一个有价值的发展人类原发后结核病的模型。(c)2006爱思唯尔有限公司保留所有权利。
Tuberculosis remains one of the world's leading infectious causes of death. Approximately 80% of all disease is due to postprimary (secondary) tuberculosis in the lung. Unfortunately, tissues of developing lesions are seldom available and there are no recognized models of postprimary tuberculosis. In the preantibiotic era when tissues were more abundant, several investigators described early postprimary tuberculosis as a lipid pneumonia quite different from the caseating granulomas commonly described today. We used histopathologic, immunohistochemical and acid fast stains to examine tissues from several people with untreated primary and postprimary tuberculosis and compared the findings with those of mice with reactivation tuberculosis. The results confirmed that developing postprimary tuberculosis begins as a lipid pneumonia accompanied by bronchial obstruction in which infection is restricted to foamy alveolar macrophages. Cavities result from a combination of caseation of tuberculous pneumonia and microvascular occlusion characteristic of delayed type hypersensitivity (DTH). Reactivation tuberculosis in the mouse begins as a similar tuberculous lipid pneumonia with bronchial obstruction and evidence for participation of DTH. Developing necrosis in both species is associated with localization of organisms within lipid droplets. These results suggest that reactivation tuberculosis in mice is a valuable model of developing human postprimary tuberculosis. (c) 2006 Elsevier Ltd. All rights reserved.