Revisiting the role of the granuloma in tuberculosis

被引:597
作者
Ramakrishnan, Lalita [1 ,2 ]
机构
[1] Univ Washington, Dept Microbiol, Seattle, WA 98195 USA
[2] Univ Washington, Dept Med & Immunol, Seattle, WA 98195 USA
基金
美国国家卫生研究院;
关键词
TUMOR-NECROSIS-FACTOR; MYCOBACTERIUM-MARINUM INFECTION; INHIBITS MACROPHAGE RESPONSES; ADAPTIVE IMMUNE-RESPONSE; IFN-GAMMA; T-CELLS; INTERFERON-GAMMA; PROTECTIVE IMMUNITY; TRANSCRIPTIONAL RESPONSES; INFLAMMATORY RESPONSE;
D O I
10.1038/nri3211
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
The granuloma, which is a compact aggregate of immune cells, is the hallmark structure of tuberculosis. It is historically regarded as a host-protective structure that 'walls off' the infecting mycobacteria. This Review discusses surprising new discoveries - from imaging studies coupled with genetic manipulations - that implicate the innate immune mechanisms of the tuberculous granuloma in the expansion and dissemination of infection. It also covers why the granuloma can fail to eradicate infection even after adaptive immunity develops. An understanding of the mechanisms and impact of tuberculous granuloma formation can guide the development of therapies to modulate granuloma formation. Such therapies might be effective for tuberculosis as well as for other granulomatous diseases.
引用
收藏
页码:352 / 366
页数:15
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