The immunology of tuberculosis.
The immunology of tuberculosis.
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结核病的免疫学。
DOI：
10.1164/arrd.1982.125.3p2.42
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发表时间：
1982
期刊：
影响因子：
--
通讯作者：
Collins,FM
中科院分区：
文献类型：
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作者：
Collins,FM
[1]结核病是一种最古老和最广泛的威胁生命的传染病，仍然影响着全世界的人类和动物种群（1,2）。尽管有现成的有效疫苗和各种化疗药物，肺结核仍然是一个主要的健康问题，特别是对许多第三世界国家(3)。即使在美国，1980年也报告了近30,000例新的肺结核病例，其中3,000例死亡直接归因于这种疾病(4)。这种在20年前似乎几乎被根除的疾病的持续存在是非常令人不安的，特别是因为许多新诊断的病例是在特别容易受到耐药结核杆菌菌株感染的人群中发现的(5)。只有将这种疾病目前的发病率与100年前Koch(6)首次发表关于结核病诊断和病因的经典论文时所观察到的发病率进行比较，才能正确地看待近几十年来的巨大进步。科赫的里程碑式的论文，在他同时代的人看来，“当然是有史以来最重要的医学论文之一，也是应用新的实验方法研究疾病的逻辑模型”(7)。然而，科赫的论文远远超出了对另一种人类病原体的简单描述。首先，它建立了一套标准（所谓的科赫假设），在可疑的微生物病原体与给定疾病之间建立因果关系之前，必须满足这些标准(8)。从更狭隘的角度来看，这篇论文也成为了埃尔·特鲁多博士的重要催化剂，引导他进入结核病研究领域。特鲁多一生中大部分时间都患有肺结核，他刚刚在萨拉纳克湖建立了阿迪朗达克小屋疗养院。当科赫的论文首次在德国发表时，非常
FRANK M. COLLINS1 uberculosis is one of the oldest and most widespread of the life-threatening infectious diseases still affecting human and animal populations throughout the world (1, 2). Despite the ready availability of an effective vaccine and the existence of assorted chemotherapeutic agents, pulmonary tuberculosis continues to pose a major health problem, especially for many third world countries (3). Even in the United States, almost 30,000 new cases of pulmonary tuberculosis were reported in 1980, with 3,000 deaths directly ascribable to this disease (4). The continued persistence of a disease that only 20 years ago seemed to be nearly eradicated is highly disturbing, especially because many of the newly diagnosed cases are found in populations especially subject to infection by drug-resistant strains of tubercle bacilli (5). Only when the present incidence of this disease is compared with that observed 100 years ago, when Koch (6) first published his classic paper on the diagnosis and etiology of tuberculosis, can the enormous advances of recent decades be seen in perspective. Koch's landmark paper was, in the view of one of his contemporaries," certainly one of the most important medical papers ever written and a model of logic in the application of the new experimental method to the study of diseases"(7). Koch's paper went far beyond the mere description of yet another human pathogen, however. For one thing, it established a set of criteria (the so-called Koch postulates) that must be satisified before a causal relationship can be established between a suspected microbial pathogen and a given disease (8).From a more parochial viewpoint, this paper also served as an important catalyst for Dr. EL Trudeau, leading him into tuberculosis research. Trudeau, who had tuberculosis for most of his life, had just established the Adirondack Cottage Sanatarium in Saranac Lake. At the time Koch's paper first appeared in Germany, very