de Martino Maurizio, Lodi Lorenzo, Galli Luisa, Chiappini Elena
Department of Health Sciences, University of Florence, Florence, Italy.
Front Pediatr. 2019 Aug 27;7:350. doi: 10.3389/fped.2019.00350. eCollection 2019.
The encounter between (Mtb) and the host leads to a complex and multifaceted immune response possibly resulting in latent infection, tubercular disease or to the complete clearance of the pathogen. Macrophages and CD4 T lymphocytes, together with granuloma formation, are traditionally considered the pillars of immune defense against Mtb and their role stands out clearly. However, there is no component of the immune system that does not take part in the response to this pathogen. On the other side, Mtb displays a complex artillery of immune-escaping mechanisms capable of responding in an equally varied manner. In addition, the role of each cellular line has become discussed and uncertain further than ever before. Each defense mechanism is based on a subtle balance that, if altered, can lean to one side to favor Mtb proliferation, resulting in disease progression and on the other to the host tissue damage by the immune system itself. Through a brief and complete overview of the role of each cell type involved in the Mtb response, we aimed to highlight the main literature reviews and the most relevant studies in order to facilitate the approach to such a complex and changeable topic. In conclusion, this narrative mini-review summarizes the various immunologic mechanisms which modulate the individual ability to fight Mtb infection taking in account the major host and pathogen determinants in the susceptibility to tuberculosis.
结核分枝杆菌(Mtb)与宿主的相遇会引发复杂且多方面的免疫反应,可能导致潜伏感染、结核病,或者使病原体被完全清除。传统上,巨噬细胞和CD4 T淋巴细胞以及肉芽肿形成被认为是抗结核免疫防御的支柱,它们的作用十分突出。然而,免疫系统中没有哪个组成部分不参与对这种病原体的反应。另一方面,Mtb展现出一系列复杂的免疫逃逸机制,能够以同样多样的方式做出反应。此外,每种细胞系的作用比以往任何时候都更具争议性和不确定性。每种防御机制都基于一种微妙的平衡,如果这种平衡被打破,可能会偏向一边,有利于Mtb增殖,导致疾病进展,或者偏向另一边,导致免疫系统对宿主组织造成损害。通过简要而全面地概述参与Mtb反应的每种细胞类型的作用,我们旨在突出主要的文献综述和最相关的研究,以便于探讨这样一个复杂多变的主题。总之,这篇叙述性的小型综述总结了各种免疫机制,这些机制调节个体抵抗Mtb感染的能力,同时考虑了宿主和病原体在结核病易感性方面的主要决定因素。