Boelaert Johan R, Vandecasteele Stefaan J, Appelberg Rui, Gordeuk Victor R
Internal Medicine, Unit of Renal and Infectious Diseases, Algemeen Ziekenhuis St-Jan, Brugge, B-8000, Belgium.
J Infect Dis. 2007 Jun 15;195(12):1745-53. doi: 10.1086/518040. Epub 2007 May 4.
Several lines of evidence have suggested that iron is critical for Mycobacterium tuberculosis growth in macrophages. Macrophage iron loading in patients with African iron overload increases the risk of tuberculosis (TB) and may worsen TB outcome. Likewise, macrophage iron loading may contribute to an increased predisposition toward TB in HIV infection. Human genetic disorders or variations may increase the risk of TB or worsen its outcome through macrophage iron loading, including the haptoglobin 2-2 phenotype, NRAMP1 polymorphisms (at least in Africans and Asians), and possibly ferroportin 1 mutations, but not HFE hemochromatosis. Thus, the host's iron status may be an important yet underevaluated factor in TB prevention and therapy and in TB vaccine design.
多项证据表明，铁对于巨噬细胞中结核分枝杆菌的生长至关重要。非洲铁过载患者巨噬细胞铁负荷增加会增加患结核病（TB）的风险，并可能使结核病结局恶化。同样，巨噬细胞铁负荷可能导致HIV感染中患结核病的易感性增加。人类遗传疾病或变异可能通过巨噬细胞铁负荷增加患结核病的风险或使结核病结局恶化，包括触珠蛋白2-2表型、NRAMP1多态性（至少在非洲人和亚洲人中），以及可能的铁转运蛋白1突变，但不包括HFE血色素沉着症。因此，宿主的铁状态可能是结核病预防、治疗及结核病疫苗设计中一个重要但未得到充分评估的因素。
