The immunology of tuberculosis: From bench to bedside

Abstract

Tuberculosis (TB) is an international public health priority and kills almost two million people annually. TB is out of control in Africa due to increasing poverty and HIV coinfection, and drug-resistant TB threatens to destabilize TB control efforts in several regions of the world. Existing diagnostic tools and therapeutic interventions for TB are suboptimal. Thus, new vaccines, immunotherapeutic interventions and diagnostic tools are urgently required to facilitate TB control efforts. An improved understanding of the immunopathogenesis of TB can facilitate the identification of correlates of immune protection, the design of effective vaccines, the rational selection of immunotherapeutic agents, the evaluation of new drug candidates, and drive the development of new immunodiagnostic tools. Here we review the immunology of TB with a focus on aspects that are clinically and therapeutically relevant. An immunologically orientated approach to tackling TB can only succeed with concurrent efforts to alleviate poverty and reduce the global burden of HIV.

Underweight increases the risk of pulmonary tuberculosis in adult

“…(7) This is in agreement with a study conducted in Africa, showing that the majority of pulmonary tuberculosis patients have chronic energy-protein deficiency. (17) Vitamin A deficiency as seen from its adequacy levels was also found in the group of cases in comparison with the group of controls. This was because there were more subjects (79.4%) with optimal adequacy levels for vitamin A in the group of controls than in the group of cases.…”

What Factors May Influence Epidemiological Situation of Tuberculosis in Poland and in the World?

“…It increases the phagocytic activity of macrophages and enhances the killing of intracellular bacteria [15,19,56,57]. Thus treating with anti-TNF monoclonal antibodies (infliximab, adalimumamb, certolizumab) or antibodies for its receptors (etanercept) can provoke activation of LTBI.…”

“…On the other hand, TNF together with IFN gamma plays a great role in the immunology of tuberculosis [15,19,57]. It increases the phagocytic activity of macrophages and enhances the killing of intracellular bacteria [15,19,56,57].…”

Serum levels of interleukin-6 in contacts of active pulmonary tuberculosis

“…This reaction depends on the integrated action of several cytokines such as interleukin-12 (IL-12), IFN-λ, tumor necrosis factor alpha (TNF-α) as well as reactive nitrogen and oxygen intermediates. The combined actions of these substances promote the destruction of bacilli previously phagocytosed by infected macrophages (3,7,9,13) .…”

“…Among individuals exposed to M. tb and those who developed an adaptive immune response to it, hence considered affected by LTBI, only a small proportion (about 5 %) will evolve into the active form of the disease within 2-5 years. 95% will remain free of the active disease unless they become immunocompromised, namely in the case of co-infection with human immunodeficiency virus (HIV) or undergoing immunosuppressive treatment (3) .…”