Whittington Richard J, Begg Douglas J, de Silva Kumudika, Plain Karren M, Purdie Auriol C
The University of Sydney, Faculty of Veterinary Science, Camden, NSW 2570, Australia.
Vet Immunol Immunopathol. 2012 Jul 15;148(1-2):29-47. doi: 10.1016/j.vetimm.2011.03.003. Epub 2011 Mar 29.
Paratuberculosis or Johne's disease of livestock, which is caused by Mycobacterium avium subsp. paratuberculosis (MAP), has increased in prevalence and expanded in geographic and host ranges over about 100 years. The slow and progressive spread of MAP reflects its substantial adaptation to its hosts, the technical limitations of diagnosis, the lack of practical therapeutic approaches, the lack of a vaccine that prevents transmission and the complexity and difficulty of the on-farm control strategies needed to prevent infection. More recently evidence has accumulated for an association of MAP with Crohn's disease in humans, adding to the pressure on animal health authorities to take precautions by controlling paratuberculosis. Mycobacterial infections invoke complex immune responses but the essential determinants of virulence and pathogenesis are far from clear. In this review we compare the features of major diseases in humans and animals that are caused by the pathogenic mycobacteria M. ulcerans, M. avium subsp. avium, M. leprae, M. tuberculosis and MAP. We seek to answer key questions: are the common mycobacterial infections of humans and animals useful "models" for each other, or are the differences between them too great to enable meaningful extrapolation? To simplify this, the immunopathogenesis of mycobacterial infections will be defined at cellular, tissue, animal and population levels and the key events at each level will be discussed. Many pathogenic processes are similar between divergent mycobacterial diseases, and at variance between virulent and avirulent isolates of mycobacteria, suggesting that the research on the pathogenesis of one mycobacterial disease will be informative for the others.
副结核病或家畜的约翰氏病，由副结核分枝杆菌（MAP）引起，在大约100年的时间里，其患病率上升，地理分布范围和宿主范围不断扩大。MAP的缓慢渐进传播反映了其对宿主的高度适应性、诊断的技术局限性、缺乏实用的治疗方法、缺乏预防传播的疫苗以及预防感染所需的农场控制策略的复杂性和难度。最近，越来越多的证据表明MAP与人类克罗恩病有关，这给动物卫生当局带来了更大压力，促使其通过控制副结核病采取预防措施。分枝杆菌感染引发复杂的免疫反应，但其毒力和发病机制的关键决定因素仍远未明确。在本综述中，我们比较了由致病性分枝杆菌溃疡分枝杆菌、鸟分枝杆菌亚种鸟分枝杆菌、麻风分枝杆菌、结核分枝杆菌和MAP引起的人类和动物主要疾病的特征。我们试图回答关键问题：人类和动物常见的分枝杆菌感染对彼此而言是否是有用的“模型”，或者它们之间的差异是否太大而无法进行有意义的推断？为简化这一问题，将在细胞、组织、动物和群体水平上定义分枝杆菌感染的免疫发病机制，并讨论每个水平上的关键事件。许多致病性过程在不同的分枝杆菌疾病之间相似，而在分枝杆菌的有毒和无毒分离株之间则有所不同，这表明对一种分枝杆菌疾病发病机制的研究将为其他疾病提供信息。
