Department of Microbial Infection and Immunity, Center for Microbial Interface Biology, The Ohio State University, Biomedical Research Tower, 460 W 12th ave, Rm 798, Columbus, OH, 43210, USA.
Semin Immunopathol. 2013 Sep;35(5):563-83. doi: 10.1007/s00281-013-0388-2. Epub 2013 Jul 18.
Tuberculosis (TB) remains one of the greatest threats to human health. The causative bacterium, Mycobacterium tuberculosis (Mtb), is acquired by the respiratory route. It is exquisitely human adapted and a prototypic intracellular pathogen of macrophages, with alveolar macrophages (AMs) being the primary conduit of infection and disease. The outcome of primary infection is most often a latently infected healthy human host, in whom the bacteria are held in check by the host immune response. Such individuals can develop active TB later in life with impairment in the immune system. In contrast, in a minority of infected individuals, the host immune response fails to control the growth of bacilli, and progressive granulomatous disease develops, facilitating spread of the bacilli via infectious aerosols coughed out into the environment and inhaled by new hosts. The molecular details of the Mtb-macrophage interaction continue to be elucidated. However, it is clear that a number of complex processes are involved at the different stages of infection that may benefit either the bacterium or the host. Macrophages demonstrate tremendous phenotypic heterogeneity and functional plasticity which, depending on the site and stage of infection, facilitate the diverse outcomes. Moreover, host responses vary depending on the specific characteristics of the infecting Mtb strain. In this chapter, we describe a contemporary view of the behavior of AMs and their interaction with various Mtb strains in generating unique immunologic lung-specific responses.
结核病（TB）仍然是对人类健康的最大威胁之一。致病细菌结核分枝杆菌（Mtb）通过呼吸道获得。它是高度适应人类的典型细胞内病原体，肺泡巨噬细胞（AMs）是感染和疾病的主要途径。初次感染的结果通常是潜伏感染的健康人类宿主，在宿主免疫反应的控制下，细菌被抑制。这些个体在免疫系统受损后可能在以后的生活中患上活动性结核病。相比之下，在少数感染个体中，宿主免疫反应无法控制细菌的生长，进展为进行性肉芽肿性疾病，促进细菌通过传染性飞沫传播到环境中，并被新宿主吸入。Mtb-巨噬细胞相互作用的分子细节仍在阐明中。然而，很明显，在感染的不同阶段涉及到许多复杂的过程，这些过程可能有利于细菌或宿主。巨噬细胞表现出巨大的表型异质性和功能可塑性，根据感染的部位和阶段，促进了不同的结果。此外，宿主的反应取决于感染的特定 Mtb 菌株的特征。在本章中，我们描述了 AMs 的行为及其与各种 Mtb 菌株相互作用的现代观点，以产生独特的免疫肺部特异性反应。
