1. Introduction
1.1. Inflammatory process of tuberculosis
When many infectious units of 1-3 bacilli are inhaled, a phenotypically hardy bacillus is likely to be among them. In addition, the alveolar macrophages apparently vary in their capacity to destroy bacilli [1]. Staining for acid-fast bacilli is very useful for demonstrating
2. Clinical manifestations
As the cellular processes occur, tuberculosis may develop differently in each patient, according to the status of the patient’s immune system. Stages include latency, primary disease, primary progressive disease, and extrapulmonary disease. Each stage has different clinical manifestations [4].
3. T cell activation against Mycobacterium tuberculosis
In human, a TB index case may infect a contact person through cough and expectoration, so the lung is the primary route of infection and often the main tissue exhibiting TB. Infectious droplet nuclei are deposited in the alveolar spaces of the contact person where
4. Animal models of tuberculosis
A wide variety of animal models have been used to test new vaccines and drugs [15]. Mice can harbor high numbers of
5. Alveolar macrophages in tuberculosis
When tubercle bacilli reach alveoli, they are phagocytosed by resident alveolar macrophages. Though tubercle bacilli are killed byalveolar macrophages, tubercle bacilli can also kill macrophages through apoptosis. What is the fate of tubercle bacilli once they enter the phagosomes of macrophages? Alveolar macrophages of aerially infected guinea pigs were collected by bronchoalveolar lavage. At 12 days after infection, one out of 10,000 alveolar macrophages of various sizes contained many tubercle bacilli [31]. This indicates that certain alveolar macrophages permit M. tuberculosis to replicate in the phagosomes, although most of tubercle bacilli are killed by activated alveolar macrophages. It will be of great interest to examine the survival mechanism of
IFN-γ knockout mice were infected with avirulent H37Ra or BCG Pasteur, multinucleated giant cells were recognized in the granulomatous lesions. The lesions also contained tubercle bacilli and consisted of multinucleated cell clusters, being immunopositive with anti-Mac-3 antibody. The alveolar macrophages were transformed into multinucleated ginat cells. We subsequently infected various cytokine-konockout mice with
6. Roles of cytokines, neutrophils, NK cells, NKT cells and γδT cells
IFN-
The role of neutrophils in the development of tuberculosis remained unknown for a long time. We utilized LPS-induced transient neutrophilia in the lungs [31]. LPS (50μg/ml) was administered intratracheally to male Fischer rats, which were then infected with
Natural killer (NK) cells are innate lymphocytes which are a first line of defense against infection. NK cells can kill autologous infected cells without prior sensitization, and are believed to play a pivotal role in innate immunity to microbial pathogens. In mouse model, NK cells are activated and produce IFN-γ during the early response to pulmonary tuberculosis [31] and NK cell-produced IFN-γ regulates the anti-mycobacterial resistance mediated by neutrophils [32]. However animal models do not give a clear answer to whether NK cells is important in
Human NK cells use the NKp46, the natural cytotoxicity receptors (NCRs) and NKG2D receptors to lyse
Certain T subsets, such as NKT cells and
Antigen-specific
7. Conclusion
Tuberculosis is an international public health problem. It is becoming evident that
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