preview

Tuberculosis ( Tb ) Is The Disease Of The Lung Caused By A Slow Growing Intracellular Pathogen

Good Essays

2.1 TB burden and epidemiology
Tuberculosis (TB) is the disease of the lung caused by a slow-growing intracellular pathogen called Mycobacterium tuberculosis (M.tb) (1). In 2014, there were 9.6 million cases of active TB disease worldwide, and 1.2 million TB-related deaths according to World Health Organization (WHO) (2). The burden of the disease can be appreciated with the knowledge that one third of the world population is latently infected with M.tb, and 5-10% of exposed individuals develop active disease and are able to spread the infection to more people every year (3,1). To reduce this burden, effective strategies are required in both preventative and therapeutic areas of research.
2.2 Primary infection and host defense in TB
2.2.1 …show more content…

We have shown that the recruitment of antigen-presenting cells (APCs) is delayed for up to day 7 post-infection which can be attributed to the lack of pro-inflammatory cytokines, in particular, TNF-α which is critical for the control of mycobacterial infection (5). Delayed influx of APCs to the airway lumen impairs the ability of the host immune system to control the bacterial infection in a timely manner. Once there is a high influx of APCs at the site of pathogen entry, antigens or mycobacteria are transported from the lung to the draining lymph node (DLN). The migration of APCs to DLN is mediated by the upregulation of expression of chemokine receptor CCR7 that allows APCs to respond to CCL19 and CCL21 chemokine gradients which are constitutively expressed in the LN (3,5,8). Normally migration of DCs occurs within few hours after infection; for example in case of influenza, the required time is 20 hours, whereas in the case of TB infection it takes between 8-10 days, implying that this delayed migration is the limiting step towards the initiation of adaptive immune responses.

2.2.2 Initiation of adaptive immunity
Cellular immunity plays a critical role in the control of M.tb infection. It has been shown that CD4+T-helper 1 (Th1) cells play a central role in protection against TB disease, primarily through the production of macrophage-activating cytokines such as IFN-γ and TNF-α (9–11). In the process of primary infection,

Get Access