Wallis R S, Ellner J J, Shiratsuchi H
Department of Medicine, Case Western Reserve University, Cleveland, OH.
Res Microbiol. 1992 May;143(4):398-405. doi: 10.1016/0923-2508(92)90053-q.
The marriage of two scourges, one old (mycobacterial disease) and one new (HIV), has presented an enormous challenge to the medical and public health communities, and has stirred renewed interest in mechanisms for immune control of mycobacterial infection. Virulence of both M. avium and M. tuberculosis appears to be inversely related to the capacity of the microorganisms to induce production of protective cytokines in infected hosts. TNF alpha and IFN gamma are central to this process, and mycobacterial polysaccharides may be their main determinant. Despite these similarities, M. tuberculosis and M. avium cause illnesses at the polar extremes of HIV disease. Tuberculosis, occurring early in the course of HIV disease, may promote HIV replication in otherwise latently infected cells via induction of cytokines. As such, the potential exists for accelerated progression to AIDS due to the mutual synergy of these pathogens.
两种祸害的结合，一种是古老的（分枝杆菌病），一种是新出现的（HIV），给医学和公共卫生界带来了巨大挑战，并重新激发了人们对分枝杆菌感染免疫控制机制的兴趣。鸟分枝杆菌和结核分枝杆菌的毒力似乎都与微生物在受感染宿主中诱导产生保护性细胞因子的能力呈负相关。肿瘤坏死因子α和干扰素γ是这一过程的核心，而分枝杆菌多糖可能是其主要决定因素。尽管有这些相似之处，但结核分枝杆菌和鸟分枝杆菌在HIV疾病的两极引发疾病。结核病发生在HIV疾病进程的早期，可能通过诱导细胞因子促进HIV在原本潜伏感染细胞中的复制。因此，由于这些病原体的相互协同作用，存在加速发展为艾滋病的可能性。
