Differential Organization of the Local Immune Response in Patients with Active Cavitary Tuberculosis or with Nonprogressive Tuberculoma

BackgroundIn 90% of all cases, Mycobacterium tuberculosis infection results in latency rather than active disease, with the pathogen being contained within granulomatous lesions at the site of primary infection. Failure of this containment leads to reactivation of postprimary tuberculosis (TB). The...

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Bibliographic Details
Published in:The Journal of infectious diseases 2005-07, Vol.192 (1), p.89-97
Main Authors: Ulrichs, Timo, Kosmiadi, George A., Jörg, Sabine, Pradl, Lydia, Titukhina, Marina, Mishenko, Vladimir, Gushina, Nadya, Kaufmann, Stefan H. E.
Format: Article
Language:English
Subjects:
Adult
Antigens
Antigens, Bacterial
Bacteria
Drug Resistance, Multiple, Bacterial
Female
Gene Expression
Humans
Infections
Interferon-gamma - biosynthesis
Latent tuberculosis
Lesions
Lung - immunology
Lung - metabolism
Lung - pathology
Lungs
Lymphocytes
Male
Middle Aged
Mycobacterium tuberculosis
Mycobacterium tuberculosis - immunology
Pulmonary tuberculosis
T lymphocytes
Tuberculoma
Tuberculoma - immunology
Tuberculosis, Pulmonary - immunology
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Summary:BackgroundIn 90% of all cases, Mycobacterium tuberculosis infection results in latency rather than active disease, with the pathogen being contained within granulomatous lesions at the site of primary infection. Failure of this containment leads to reactivation of postprimary tuberculosis (TB). The regional immune processes that sustain the delicate balance with persistent M. tuberculosis however, remain unclear MethodsWe compared activation statuses, biological functions, and interactions of host immune cells in human nonprogressive tuberculoma and active cavitary tuberculous lung tissue ResultsDissection of early granuloma formations revealed differential cellular distribution and activation statuses of distinct cell types in different regions relative to the central caseotic caverna or the tuberculoma in tuberculous lung tissue. In patients with tuberculoma with latent infection, distant parts of lung tissue exhibited strong vascularization and profound proliferative activity, indicating that continuous immune defense is required for mycobacterial containment, which is absent in cavitary tuberculous lung lesions ConclusionsWe conclude that differential regulation of the local immune response is crucial for the containment of M. tuberculosis and that a continuous antigen-specific cross talk between the host immune system and M. tuberculosis is ensured during latency. This activation requires sufficient supply of nutrients and well-coordinated structural organization, both of which are lost during reactivation of TB
ISSN:0022-1899
1537-6613
DOI:10.1086/430621