Rom W N, Schluger N, Law K, Condos R, Zhang Y, Weiden M, Harkin T, Tchou-Wong K M
New York University Medical Center, Dept. of Medicine, Bellevue Hospital Chest Service, New York 10016, USA.
Schweiz Med Wochenschr. 1995 Nov 11;125(45):2178-85.
Despite the importance of tuberculosis as the leading cause of death due to infectious disease in the world, it has only been recently that an understanding of the human host response in this infection has begun to emerge. The key components of this response are cytokines and components of cellular immunity, predominantly T-lymphocytes and macrophages. Though the relationships among the components of the immune response are complex, it seems likely that in response to mycobacterial infection associated with active disease, cytokines such as TNF-alpha and IL-1 beta are produced; these cytokines serve to recruit more lymphocytes, generally of the T(H) (T helper) phenotype, which then produces substances such as the macrophage activating factor interferon-gamma. Macrophages activated by IFN-gamma ar thus stimulating to enhance intracellular killing of mycobacteria. The role of other cytokines, such as IL-6 and IL-8, both of which are induced by M. tuberculosis or its cell was components, is less clear. Further elucidation of the human host response to tuberculosis should help in the development of new vaccines and treatment strategies.
尽管结核病作为全球传染病致死的首要原因具有重要性,但直到最近,对这种感染中人类宿主反应的认识才开始出现。这种反应的关键组成部分是细胞因子和细胞免疫成分,主要是T淋巴细胞和巨噬细胞。虽然免疫反应各成分之间的关系很复杂,但在对与活动性疾病相关的分枝杆菌感染作出反应时,似乎会产生诸如肿瘤坏死因子-α和白细胞介素-1β等细胞因子;这些细胞因子有助于招募更多通常为T(H)(辅助性T)表型的淋巴细胞,这些淋巴细胞随后会产生诸如巨噬细胞激活因子干扰素-γ等物质。因此,被干扰素-γ激活的巨噬细胞受到刺激,从而增强对分枝杆菌的细胞内杀伤作用。其他细胞因子的作用,如白细胞介素-6和白细胞介素-8,两者均由结核分枝杆菌或其细胞壁成分诱导产生,其作用尚不清楚。进一步阐明人类宿主对结核病的反应应有助于开发新的疫苗和治疗策略。