Tuberculosis: Immunity

The immune response to infection with Mycobacterium tuberculosis is a highly complex event, involving a coordination of innate and acquired mechanisms. If the infection is left untreated, a chronic phase of infection ensues in most animal models, followed eventually by reactivation disease.

Keywords: tuberculosis; granuloma; mycobacterium; intracellular bacteria; immunity

Figure 1. Macrophages and dendritic cells have a variety of receptor families whereby they can sense the presence of invading bacteria.
Figure 2. Both alveolar macrophages (left) and dendritic macrophages (right) readily ingest mycobacteria. In this photo the DC has a notable cluster of bacilli in its phagosome.
Figure 3. Distribution of CD4 and CD8 cells in the mouse lung granuloma. Whereas CD4 cells are distributed in aggregates across the granuloma, CD8 cells tend to occupy more peripheral sites, often along the rim of the granuloma.
Figure 4. Early (day 30) and late stage (day 100) granulomas in the guinea-pig lung. (a) By day 30 a clear core area of necrosis has already developed. It is surrounded by a layer of macrophages and further out by a large lymphocyte layer, which includes large aggregates or follicle-like structures. A fibrous capsule is beginning to develop. Most obviously on the pleural side of the structure. (b) By day 100 the central core has mineralized. A smaller region to the left may represent a smaller granuloma that has coalesced with the central structure (a common event). Around the core is a pink staining ring of extracellular fibrin which our recent research suggests contains a large number of acid-fast bacilli, some of which persist after chemotherapy; this region is also rich in iron molecules. Outside this is an obvious layer full of foamy macrophages and then a thinner, perhaps compressed layer of dark blue staining lymphocytes. A compressed vessel can be seen at the bottom right of the lesion; we have suggested that bacteria-containing cells are eroded into such vessels by mechanical force (see text).
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 References
    Basaraba RJ, Smith EE, Shanley CA et al. (2006) Pulmonary lymphatics are primary sites of Mycobacterium tuberculosis infection in guinea pigs infected by aerosol. Infection and Immunity 74: 5397–5401.
    Capuano SV 3rd, Croix DA, Pawar S et al. (2003) Experimental Mycobacterium tuberculosis infection of cynomolgus macaques closely resembles the various manifestations of human M. tuberculosis infection. Infection and Immunity 71: 5831–5844.
    Hsu T, Hingley-Wilson SM, Chen B et al. (2003) The primary mechanism of attenuation of bacillus Calmette–Guerin is a loss of secreted lytic function required for invasion of lung interstitial tissue. Proceedings of the National Academy of Sciences of the USA 100: 12420–12425.
    Junqueira-Kipnis AP, Kipnis A, Jamieson A et al. (2003) NK cells respond to pulmonary infection with Mycobacterium tuberculosis, but play a minimal role in protection. Journal of Immunology 171: 6039–6045.
    Khader SA, Pearl JE, Sakamoto K et al. (2005) IL-23 compensates for the absence of IL-12p70 and is essential for the IL-17 response during tuberculosis but is dispensable for protection and antigen-specific IFN-gamma responses if IL-12p70 is available. Journal of Immunology 175: 788–795.
    Orme IM and Cooper AM (1999) Cytokine/chemokine cascades in immunity to tuberculosis. Immunology Today 20: 307–312.
    Pai RK, Pennini ME, Tobian AA et al. (2004) Prolonged toll-like receptor signaling by Mycobacterium tuberculosis and its 19-kilodalton lipoprotein inhibits gamma interferon-induced regulation of selected genes in macrophages. Infection and Immunity 72: 6603–6614.
    Pan H, Yan BS, Rojas M et al. (2005) Ipr1 gene mediates innate immunity to tuberculosis. Nature 434: 767–772.
    Turner J, D'Souza CD, Pearl JE et al. (2001) CD8- and CD95/95L-dependent mechanisms of resistance in mice with chronic pulmonary tuberculosis. American Journal of Respiratory Cellular and Molecular Biology 24: 203–209.
    Voskuil MI, Schnappinger D, Visconti KC et al. (2003) Inhibition of respiration by nitric oxide induces a Mycobacterium tuberculosis dormancy program. Journal of Experimental Medicine 198: 705–713.
 Further Reading
    Baumann S, Eddine AN and Kaufmann SHE (2006) Progress in tuberculosis vaccine development. Current Opinion in Immunology 18: 438–448.
    book Cole ST, Eisenach KD, McMurray DN and Jacobs WR Jr. (eds) (2005) Tuberculosis and the Tubercle Bacillus. Washington DC: ASM Press.
    Flynn JL and Chan J (2001) Immunology of tuberculosis. Annual Reviews of Immunology 19: 93–129.
    book Turner OC, Basaraba RJ, Frank AA and Orme IM (2003) "Granuloma formation in mouse and guinea pig models of experimental tuberculosis". In: Boros DL (ed.) Granulomatous Infections and Inflammation. Washington DC: ASM Press.
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Orme, Ian M(Sep 2007) Tuberculosis: Immunity. In: eLS. John Wiley & Sons Ltd, Chichester. http://www.els.net [doi: 10.1002/9780470015902.a0020184]