Heterogeneity in tuberculosis.

Heterogeneity in tuberculosis.
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DOI:
10.1038/nri.2017.69
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发表时间:
2017-11
期刊:
Nature reviews. Immunology
影响因子:
--
通讯作者:
Flynn JL
Flynn JL
中科院分区:
其他
文献类型:
--
作者:
Cadena AM;Fortune SM;Flynn JL

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结核分枝杆菌是结核病(TB)的病原体,感染会导致人类出现一系列临床症状。大多数感染表现为一种临床上无症状的受控状态,称为潜伏性结核病感染(LTBI);一小部分感染者出现有症状的活动性结核病。在这两种看似二元的状态中,宿主的结果有一系列不同的症状、微生物学、免疫反应和病理。最近,很明显,即使在一个人的体内,感染也是多样化的。很好地理解结核病内在的异质性--无论是在人群层面还是在个人层面--对于制定干预战略至关重要,这些干预战略解释并瞄准在这种感染中发生的当地宿主-病原体相互作用的独特、复杂和独立的性质。在这篇综述中,我们利用模型系统和人类数据来讨论结核病生物学的多个方面,以及它们与在人类疾病中观察到的总体异质性的关系。
Infection with Mycobacterium tuberculosis, the causative agent of tuberculosis (TB), results in a range of clinical presentations in humans. Most infections manifest as a clinically asymptomatic, contained state that is termed latent TB infection (LTBI); a smaller subset of infected individuals present with symptomatic, active TB. Within these two seemingly binary states, there is a spectrum of host outcomes that have varying symptoms, microbiologies, immune responses and pathologies. Recently, it has become apparent that there is diversity of infection even within a single individual. A good understanding of the heterogeneity that is intrinsic to TB — at both the population level and the individual level — is crucial to inform the development of intervention strategies that account for and target the unique, complex and independent nature of the local host–pathogen interactions that occur in this infection. In this Review, we draw on model systems and human data to discuss multiple facets of TB biology and their relationship to the overall heterogeneity observed in the human disease.
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