Immunological defense mechanisms in tuberculosis and MAC-infection.

Protective immunity to mycobacterial infections develops in immunocompetent hosts after activation of alpha beta- and gamma delta-T cells in association with the generation of a protection-specific cytokine profile that stimulates the bactericidal potential of the macrophages. The maintenance of a delicate balance between Th1 and Th2 response is decisive for infection control and prevention of exacerbation of disease. Mycobacterial infection in the immunocompromised host is mainly due to the diminished cellular immune function. In addition, nontuberculous mycobacteria isolated from AIDS patients have special virulence factors that promote development of disease by further compromising the function of an already damaged cytokine network.