DST/NRF Centre of Excellence for Biomedical Tuberculosis Research, South African Medical Research Council Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
J Clin Microbiol. 2021 Feb 18;59(3). doi: 10.1128/JCM.01771-20.
Tuberculous meningitis (TBM) is the most devastating form of tuberculosis (TB), causing high mortality or disability. Clinical management of the disease is challenging due to limitations of the existing diagnostic approaches. Our knowledge on the immunology and pathogenesis of the disease is currently limited. More research is urgently needed to enhance our understanding of the immunopathogenesis of the disease and guide us toward the identification of targets that may be useful for vaccines or host-directed therapeutics. In this review, we summarize the current knowledge about the immunology and pathogenesis of TBM and summarize the literature on existing and new, especially biomarker-based, approaches that may be useful in the management of TBM. We identify research gaps and provide directions for research which may lead to the development of new tools for the control of the disease in the near future.
结核性脑膜炎（TBM）是最具破坏性的结核病（TB）形式，可导致高死亡率或残疾。由于现有诊断方法的局限性，该病的临床管理极具挑战。我们目前对该病的免疫学和发病机制的了解有限。迫切需要更多的研究来增强我们对疾病免疫发病机制的理解，并指导我们确定可能对疫苗或宿主定向治疗有用的目标。在这篇综述中，我们总结了目前关于 TBM 的免疫学和发病机制的知识，并总结了关于现有和新的、特别是基于生物标志物的方法的文献，这些方法可能有助于 TBM 的管理。我们确定了研究空白，并为研究提供了方向，这可能导致在不久的将来开发出控制该疾病的新工具。
