Lam Adam, Prabhu Rohan, Gross Christine M, Riesenberg Lee Ann, Singh Vinodkumar, Aggarwal Saurabh
Department of Anesthesiology and Perioperative Medicine, University of Alabama at Birmingham, Birmingham, Alabama; and.
Medical College of Georgia, Augusta University, Augusta, Georgia.
Am J Physiol Lung Cell Mol Physiol. 2017 Aug 1;313(2):L218-L229. doi: 10.1152/ajplung.00162.2017. Epub 2017 May 11.
Tuberculosis (TB) is one of the oldest known human diseases and is transmitted by the bacteria (Mtb). TB has a rich history with evidence of TB infections dating back to 5,800 bc TB is unique in its ability to remain latent in an individual for decades, with the possibility of later reactivation, causing widespread systemic symptoms. Currently, it is estimated that more than one-third of the world's population (~2 billion people) are infected with Mtb. Prolonged periods of therapy and complexity of treatment regimens, especially in active infection, have led to poor compliance in patients being treated for TB. Therefore, it is vitally important to have a thorough knowledge of the pathophysiology of Mtb to understand the disease progression, as well as to develop novel diagnostic tests and treatments. Alveolar macrophages represent both the primary host cell and the first line of defense against the Mtb infection. Apoptosis and autophagy of macrophages play a vital role in the pathogenesis and also in the host defense against Mtb. This review will outline the role of these two cellular processes in defense against Mtb with particular emphasis on innate immunity and explore developing therapies aimed at altering host responses to the disease.
结核病(TB)是已知最古老的人类疾病之一,由结核分枝杆菌(Mtb)传播。结核病历史悠久,有证据表明结核病感染可追溯到公元前5800年。结核病的独特之处在于它能够在个体中潜伏数十年,随后有可能重新激活,引发广泛的全身症状。目前,据估计世界上超过三分之一的人口(约20亿人)感染了结核分枝杆菌。长期的治疗和复杂的治疗方案,尤其是在活动性感染中,导致结核病患者的依从性较差。因此,深入了解结核分枝杆菌的病理生理学对于理解疾病进展以及开发新的诊断测试和治疗方法至关重要。肺泡巨噬细胞既是主要的宿主细胞,也是抵御结核分枝杆菌感染的第一道防线。巨噬细胞的凋亡和自噬在发病机制以及宿主对结核分枝杆菌的防御中都起着至关重要的作用。本综述将概述这两种细胞过程在抵御结核分枝杆菌中的作用,特别强调先天免疫,并探索旨在改变宿主对该疾病反应的治疗方法。