Is susceptibility to tuberculosis acquired or inherited?
Is susceptibility to tuberculosis acquired or inherited?
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DOI：
10.1111/j.1365-2796.2006.01741.x
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发表时间：
2007-02-01
影响因子：
11.1
通讯作者：
Schurr, E.
中科院分区：
文献类型：
--
作者：
Schurr, E.
结核病是全球范围内持续存在的重大公共卫生问题。该疾病的显着特征之一是，估计只有 10% 的免疫功能正常的人在感染致病病原体结核分枝杆菌后会出现疾病的临床症状。这一完善的流行病学观察促使人们深入研究引发少数易感个体感染进展为疾病的因素。这项研究的核心是结核病患者是否天生易感该疾病，或者特定的环境因素是否会促进疾病的发展。已知细菌和宿主的遗传和非遗传因素都会影响宿主对结核分枝杆菌的反应。然而，人们对这些不同因素的相互作用及其对疾病发展的影响知之甚少。最近的研究表明，除了常见的宿主易感基因之外，还存在第二组易感基因座，其作用很大程度上取决于个体的临床和暴露史。仅在特定的流行病学环境中，后一种基因可能对促进从感染到疾病的进展具有非常强的作用。这些发现表明，有必要更详细地了解结核病基因与环境相互作用，以了解为什么一小部分人容易感染该疾病，而大多数人对结核病具有天然抵抗力。
Tuberculosis is an ongoing major public health problem on a global scale. One of the striking features of the disease is that only an estimated 10% of immunocompetent persons infected by the causative pathogen Mycobacterium tuberculosis will develop clinical signs of disease. This well-established epidemiological observation has prompted an intense search for the factors that trigger advancement of infection to disease in the small proportion of susceptible individuals. Central to this search is the questions if tuberculosis patients are inherently susceptible to the disease or if disease development is promoted by specific environmental factors. It is known that genetic and non-genetic factors of both the bacterium and the host have impact on the host response to M. tuberculosis. Yet, little is known about the interaction of these different factors and the resulting impact on disease development. Recent work suggests that in addition to common host susceptibility genes a second group of susceptibility loci exists the action of which strongly depends on the individual's clinical and exposure history. The latter genes may have a very strong effect on promoting advancement from infection to disease only in specific epidemiological settings. These findings suggest that a more detailed knowledge of gene-environment interactions in tuberculosis is necessary to understand why a small proportion of individuals are susceptible to the disease whilst the majority of humans are naturally resistant to tuberculosis.