Department of Pediatrics, Children's Hospital of Pittsburgh of the University of Pittsburgh Medical Center, University of Pittsburgh School of Medicine, Pittsburgh, PA 15224; and.
Department of Microbiology and Molecular Genetics, University of Pittsburgh School of Medicine, Pittsburgh, PA 15261
J Immunol. 2018 Nov 1;201(9):2541-2548. doi: 10.4049/jimmunol.1800993.
Human infection was thought to result in either active symptomatic tuberculosis (TB) or latent asymptomatic infection. It is now clear that this binary classification is insufficient to describe the myriad of infection outcomes. In active TB, symptomatic disease can be mild to severe, with a range of lung and thoracic lymph node involvement or extrapulmonary manifestations. Most humans control the infection and develop latent TB infection, with differential risks of reactivation to active TB. However, some frequently exposed persons appear to be resistant to infection, whereas others may initially become infected yet subsequently eliminate all bacilli. The immunologic factors influencing these varied outcomes are still not clear, but likely involve a range of different responses. In this article, we review the data supporting the spectrum of infection in humans as well as data in nonhuman primates that allow dissection of the immune responses leading to the varied outcomes of infection.
人们曾认为人类感染会导致活动性有症状结核病（TB）或潜伏性无症状感染。但现在很清楚，这种二分法不足以描述感染的众多结果。在活动性 TB 中，有症状的疾病可能从轻到重，涉及肺部和胸内淋巴结的一系列受累或肺外表现。大多数人控制感染并发展为潜伏性 TB 感染，但复发为活动性 TB 的风险存在差异。然而，一些经常暴露的人似乎对感染有抵抗力，而另一些人可能最初感染，但随后消除了所有细菌。影响这些不同结果的免疫因素尚不清楚，但可能涉及一系列不同的反应。在本文中，我们回顾了支持人类感染谱的数据，以及在非人类灵长类动物中可以剖析导致感染结果多样化的免疫反应的数据。
