Rivas-Santiago Bruno, Vieyra-Reyes Patricia, Araujo Zaida
Departamento de Investigación en Microbiología, Instituto Nacional de Enfermedades Respiratorias, Universidad Nacional Autónoma de México, Ciudad de México, México.
Invest Clin. 2005 Dec;46(4):391-412.
Human pulmonary tuberculosis (TB) is a worldwide public health problem, which is caused by Mycobacterium tuberculosis. It is a fact that one third of the world's population is infected with this mycobacteria, however, only a minority of people infected by M. tuberculosis may develop a clinical disease. In general, about 90% have their bacilli under control in a latent state throughout their lives by means of their immune responses. About 5% will develop primary progressive TB and the remaining 5% will develop the disease in the later stages of their lives, which is known as reactivation or post-primary TB. In resistant individuals, control of the infection mainly requires development of a Th1 cell immunity response. This type of response involves participation of alveolar macrophages and T CD4+, CD8+ and T gammadelta lymphocytes, and production of cytokines such as IL-2, IFN-gamma, IL-12, IL-18 and TNF-alpha, as well as chemokines such as RANTES, MCP-1, MIP-1alpha and IL-8 which play an important role in the migration of different cell subpopulations to the infection site for the formation of granulome. In addition, the role of "natural killer" (NK) cells, along with epitelial cells, is essential as part of the innate immune response.
人类肺结核是一个全球性的公共卫生问题，由结核分枝杆菌引起。事实上，全球三分之一的人口感染了这种分枝杆菌，然而，只有少数感染结核分枝杆菌的人可能会发展为临床疾病。一般来说，约90%的人通过自身免疫反应，在一生中将其杆菌控制在潜伏状态。约5%的人会发展为原发性进行性肺结核，其余5%的人会在生命后期发病，即复发型或原发性后肺结核。在有抵抗力的个体中，控制感染主要需要产生Th1细胞免疫反应。这种反应涉及肺泡巨噬细胞、T CD4+、CD8+和Tγδ淋巴细胞的参与，以及细胞因子如IL-2、IFN-γ、IL-12、IL-18和TNF-α的产生，还有趋化因子如RANTES、MCP-1、MIP-1α和IL-8，它们在不同细胞亚群迁移到感染部位形成肉芽肿的过程中发挥重要作用。此外，“自然杀伤”（NK）细胞以及上皮细胞作为固有免疫反应的一部分，其作用至关重要。
