Department of Pathology, Stanford School of Medicine, Stanford University, Stanford, CA, USA.
Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland.
Semin Immunopathol. 2020 Jun;42(3):333-353. doi: 10.1007/s00281-020-00790-4. Epub 2020 Feb 25.
Mycobacterial pathogens can be categorized into three broad groups: Mycobacterium tuberculosis complex causing tuberculosis, M. leprae and M. lepromatosis causing leprosy, and atypical mycobacteria, or non-tuberculous mycobacteria (NTM), responsible for a wide range of diseases. Among the NTMs, M. ulcerans is responsible for the neglected tropical skin disease Buruli ulcer (BU). Most pathogenic mycobacteria, including M. leprae, evade effector mechanisms of the humoral immune system by hiding and replicating inside host cells and are furthermore excellent modulators of host immune responses. In contrast, M. ulcerans replicates predominantly extracellularly, sheltered from host immune responses through the cytotoxic and immunosuppressive effects of mycolactone, a macrolide produced by the bacteria. In the year 2018, 208,613 new cases of leprosy and 2713 new cases of BU were reported to WHO, figures which are notoriously skewed by vast underreporting of these diseases.
结核分枝杆菌复合体引起结核病，麻风分枝杆菌和麻风分枝杆菌引起麻风病，以及非结核分枝杆菌（NTM），负责多种疾病。在 NTM 中，溃疡分枝杆菌是导致被忽视的热带皮肤疾病——布鲁里溃疡（BU）的罪魁祸首。大多数致病性分枝杆菌，包括麻风分枝杆菌，通过隐藏在宿主细胞内并复制来逃避体液免疫系统的效应机制，并且还是宿主免疫反应的出色调节剂。相比之下，溃疡分枝杆菌主要在细胞外复制，通过细菌产生的大环内酯类物质—— 类脂化合物的细胞毒性和免疫抑制作用，躲避宿主免疫反应的影响。在 2018 年，世界卫生组织报告了 208613 例新的麻风病例和 2713 例新的 BU 病例，这些数字因这些疾病的大量漏报而严重扭曲。
