Local Immune Responses in Human Tuberculosis: Learning From the Site of Infection
Local Immune Responses in Human Tuberculosis: Learning From the Site of Infection
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DOI：
10.1093/infdis/jis043
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发表时间：
2012-05-15
影响因子：
6.4
通讯作者：
Andersson, Jan
中科院分区：
文献类型：
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作者：
Brighenti, Susanna;Andersson, Jan
结核病中的宿主 - 病原体相互作用应在疾病部位进行研究，因为结核分枝杆菌主要存在于局部组织病变中。尽管结核分枝杆菌感染涉及不同的结核病临床类型，如肺结核、结核性胸膜炎和淋巴结结核，但大多数人类结核病研究是使用外周血中的细胞进行的，这可能无法恰当地反映在感染局部部位所诱导的结核分枝杆菌特异性免疫反应。与感染组织相比，在血液中发现的结核分枝杆菌特异性效应T细胞比例非常低，因此在这些不同的部位所诱导的细胞免疫反应和调节机制可能存在相当大的差异。在这篇综述中，我们讨论了感染局部部位与外周循环中免疫反应的差异。还描述了参与肉芽肿形成和维持的细胞类型和免疫反应，以及用于评估局部结核病发病机制的原位技术。我们需要加强和改进用于剖析人类结核病免疫发病机制的探索策略，目的是加速相关研究成果在临床实践中的应用。
Host-pathogen interactions in tuberculosis should be studied at the disease site because Mycobacterium tuberculosis is predominately contained in local tissue lesions. Although M. tuberculosis infection involves different clinical forms of tuberculosis, such as pulmonary tuberculosis, pleural tuberculosis, and lymph node tuberculosis, most studies of human tuberculosis are performed using cells from the peripheral blood, which may not provide a proper reflection of the M. tuberculosis-specific immune responses induced at the local site of infection. A very low proportion of M. tuberculosis-specific effector T cells are found in the blood compared with the infected tissue, and thus there may be considerable differences in the cellular immune response and regulatory mechanisms induced in these diverse compartments. In this review, we discuss differences in the immune response at the local site of infection compared with the peripheral circulation. The cell types and immune reactions involved in granuloma formation and maintenance as well as the in situ technologies used to assess local tuberculosis pathogenesis are also described. We need to strengthen and improve the exploratory strategies used to dissect immunopathogenesis in human tuberculosis with the aim to accelerate the implementation of relevant research findings in clinical practice.