Nontuberculous mycobacteria
Nontuberculous mycobacteria
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DOI：
10.1097/00000441-200101000-00008
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发表时间：
2001-01-01
影响因子：
3.1
通讯作者：
Holland, SM
中科院分区：
文献类型：
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作者：
Holland, SM
非结核分枝杆菌在很大程度上是无处不在的环境有机体，很少会引起人类疾病。因此，正常的宿主对这些微生物的防御必须相当强大，因为暴露是普遍的，疾病很少见。临床上最常见的微生物有鸟型分枝杆菌、胞内分枝杆菌、堪萨斯分枝杆菌、偶发分枝杆菌、脓肿分枝杆菌和龟分枝杆菌。(1)这些微生物在结构和生化上与其致病性较强的近亲结核分枝杆菌(MTB)有显著的相似性。由于它们的致病性明显低于结核分枝杆菌，因此对这些感染具有异常易感性的患者应该包括那些具有可能被识别的缺陷的患者。对这些患者的研究将导致确定对这些微生物的潜在耐药机制，这反过来可能对宿主对这些感染的防御以及它们更具毒性的相对结核分枝杆菌具有很高的信息量。此外，识别允许在其他正常宿主中感染非结核分枝杆菌的宿主因素将确定可以作为治疗干预目标的途径。因此，寻找非结核分枝杆菌的遗传和获得性易感性也是寻找结核分枝杆菌的易感因素，也是认识可用于治疗的内源性途径的机会。
The nontuberculous mycobacteria are for the most part ubiquitous environmental organisms that only rarely cause disease in humans. Therefore, the normal host defense against these organisms must be quite robust, as exposure is universal and disease is rare. The organisms that are most commonly encountered in clinical practice, Mycobacterium avium, M intracellulare, M kansasii, M fortuitum, M abscessus, and M chelonae, are frequently found in water sources and soil.(1) These organisms share significant structural and biochemical similarities with their more pathogenic relative, M tuberculosis (MTB). Because they are of significantly lower pathogenicity than MTB, patients with abnormal susceptibility to these infections should include those with defects that may be identifiable. Study of these patients should lead to determination of the mechanisms underlying resistance to these organisms, which in turn are likely to be highly informative regarding host defense against these infections and their more virulent relative MTB. Furthermore, recognition of host factors that permit infection with nontuberculous mycobacteria in otherwise normal hosts will identify pathways that can be targeted for therapeutic intervention. Thus, the search for genetic and acquired susceptibility to nontuberculous mycobacteria is also a search for susceptibility factors for MTB as well as an opportunity to recognize endogenous pathways that can be exploited therapeutically.