Division of Anatomy and Histology, Department of Biomedical Sciences, Faculty of Health Sciences, Tygerberg, Stellenbosch University, South Africa.
Tuberculosis (Edinb). 2011 Nov;91(6):510-23. doi: 10.1016/j.tube.2011.07.005. Epub 2011 Aug 10.
The diverse clinico- and histopathological features, frequency of transmission and treatment outcome of Mycobacterium tuberculosis have been associated with several environmental, host and bacterial factors. Many Mycobacterium tuberculosis genotypes have been studied in an attempt to understand the genetic variations among the different genotypes and to clarify their contribution to phenotypic differences. Strains of the Beijing genotype have been extensively investigated due to their increased ability to spread and cause disease. Here we review the evidence of hypervirulence of the Beijing genotype as well as other Beijing-associated phenotypic characteristics such as alternate host immune modulation, clinical and pathological features, drug resistance, resistance to BCG vaccination and other epidemiological features to enhance our understanding of the contribution of pathogenic factors. From the data collected it is clear that the genetic background of Mycobacterium tuberculosis may influence the differential induction of the immune response, drug resistance patterns and clinical, epidemiological and pathogenic features which define disease progression following infection. This highlights the importance of ongoing research into the genetic mechanisms underlying the phenotypic and genotypic characteristics of different Mycobacterium tuberculosis genotype strains. Furthermore, these findings could help to direct future drug, vaccine and diagnostic test development towards targeting critical virulence factors and to identify persons at risk for developing active disease thereby limiting transmission and the perpetuation of the tuberculosis epidemic.
分枝杆菌的临床和组织病理学特征多种多样，其传播频率和治疗结果与多种环境、宿主和细菌因素有关。已经研究了许多结核分枝杆菌基因型，以试图了解不同基因型之间的遗传变异，并阐明它们对表型差异的贡献。由于北京基因型分枝杆菌具有更强的传播和致病能力，因此对其进行了广泛研究。本文综述了北京基因型分枝杆菌的高致病性以及其他与北京基因型相关的表型特征，如替代宿主免疫调节、临床和病理特征、耐药性、卡介苗接种耐药性和其他流行病学特征，以增强我们对致病因素贡献的理解。从收集的数据来看，很明显，分枝杆菌的遗传背景可能会影响免疫反应、耐药模式以及临床、流行病学和发病特征的差异诱导，这些特征定义了感染后的疾病进展。这凸显了对不同结核分枝杆菌基因型菌株的表型和基因型特征的遗传机制进行持续研究的重要性。此外，这些发现有助于指导针对关键毒力因子的未来药物、疫苗和诊断测试的开发，并确定发生活动性疾病的风险人群，从而限制传播和结核病流行的持续。
