Fellag M, Loukil A, Drancourt M
Aix-Marseille-Université, IRD, MEPHI, IHU Méditerranée Infection, Marseille, France.
IHU Méditerranée Infection, Marseille, France.
New Microbes New Infect. 2020 Aug 1;41:100712. doi: 10.1016/j.nmni.2020.100712. eCollection 2021 May.
Several pieces of the puzzle of the natural history of tuberculosis are assembled in this review to illustrate the potential reservoirs and sources of the complex (MTBC) mycobacteria, their transmission to animals and humans, and their fate in populations, in a co-evolutionary perspective. Millennia-old companions of mammalian and human populations, MTBC are detected in the soil, in which they infect and survive within vegetative amoebae and cysts, except for . Never detected in the sphere of plants, they are transmissible by transcutaneous, digestive and respiratory routes and cause an infection of the lymphatic system with secondary dissemination in most tissues, in which they determine a specific and non-pathognomonic granulomatous inflammatory reaction; in which MTBC survives in dormant form irrespective of MTBC species and mammalian species; indicating that the current epidemiology in mammalian populations is essentially governed by the probabilities of contact between mammalian species and MTBC species. Individual variabilities in clinical expression of tuberculosis are related to MTBC species, strain and inoculum; host genetic factors; acquired modulations of the inflammatory response; and probably human microbiota. This review of the literature suggests an evolutionary natural history of telluric environmental mycobacteria, satellites of unicellular eukaryotes, transmissible to mammals via the digestive and then respiratory tracts, in which they determine a fatal contagious infection that is primarily lymphatic and a quiescence-mimicking encysted form. This review opens perspectives for microbiological and translational medical research.
本综述汇集了结核病自然史拼图的几个部分，从共同进化的角度说明复合（MTBC）分枝杆菌的潜在储存库和来源、它们向动物和人类的传播以及它们在人群中的命运。MTBC作为哺乳动物和人类群体数千年来的伴生物，在土壤中被检测到，它们在土壤中可感染营养型变形虫和囊肿并在其中存活，但不包括……从未在植物领域中检测到，它们可通过经皮、消化和呼吸道途径传播，并引起淋巴系统感染，在大多数组织中继发扩散，在这些组织中它们引发一种特定的、非特征性的肉芽肿性炎症反应；无论MTBC的种类和哺乳动物的种类如何，MTBC都以休眠形式存活；这表明哺乳动物群体中当前的流行病学主要由哺乳动物物种与MTBC物种之间的接触概率所决定。结核病临床表现的个体差异与MTBC的种类、菌株和接种量、宿主遗传因素、炎症反应的后天调节以及可能的人类微生物群有关。对文献的这一综述提示了陆生环境分枝杆菌的进化自然史，这些分枝杆菌是单细胞真核生物的卫星菌，可通过消化道然后呼吸道传播给哺乳动物，在哺乳动物中它们引发一种主要为淋巴性的致命性传染性感染以及一种类似静止状态的包囊形式。本综述为微生物学和转化医学研究开辟了前景。
