Department of Medicine, University of Washington, Seattle, WA, USA.
Department of Population & Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA.
Nat Rev Immunol. 2018 Sep;18(9):575-589. doi: 10.1038/s41577-018-0025-3.
Mycobacterium tuberculosis is a leading cause of mortality worldwide and establishes a long-lived latent infection in a substantial proportion of the human population. Multiple lines of evidence suggest that some individuals are resistant to latent M. tuberculosis infection despite long-term and intense exposure, and we term these individuals 'resisters'. In this Review, we discuss the epidemiological and genetic data that support the existence of resisters and propose criteria to optimally define and characterize the resister phenotype. We review recent insights into the immune mechanisms of M. tuberculosis clearance, including responses mediated by macrophages, T cells and B cells. Understanding the cellular mechanisms that underlie resistance to M. tuberculosis infection may reveal immune correlates of protection that could be utilized for improved diagnostics, vaccine development and novel host-directed therapeutic strategies.
结核分枝杆菌是全球主要的致死原因之一，在很大一部分人群中引发长期潜伏性感染。多项证据表明，尽管长期且大量接触，仍有部分个体对潜伏性结核分枝杆菌感染具有抵抗力，我们将这些个体称为“抵抗者”。在这篇综述中，我们讨论了支持抵抗者存在的流行病学和遗传学数据，并提出了最佳定义和描述抵抗者表型的标准。我们综述了最近对结核分枝杆菌清除的免疫机制的研究进展，包括巨噬细胞、T 细胞和 B 细胞介导的反应。了解导致结核分枝杆菌感染的抵抗机制可能揭示保护的免疫相关性，这可用于改进诊断、疫苗开发和新的宿主导向治疗策略。
