Factors that deregulate the protective immune response in tuberculosis.
Tuberculosis (TB) is a chronic infectious disease which essentially affects the lungs and produces profound abnormalities on the immune system. Although most people infected by the tubercle bacillus (90%) do not develop the disease during their lifetime, when there are alterations in the immune system, such as co-infection with HIV, malnutrition, or diabetes, the risk of developing active disease increases considerably. Interestingly, during the course of active disease, even in the absence of immunosuppressive conditions, there is a profound and prolonged suppression of Mycobacterium tuberculosis-specific protective immune responses. Several immune factors can contribute to downregulate the protective immunity, permitting disease progression. In general, many of these factors are potent anti-inflammatory molecules that are probably overproduced with the intention to protect against tissue damage, but the consequence of this response is a decline in protective immunity facilitating bacilli growth and disease progression. Here the most significant participants in protective immunity are reviewed, in particular the factors that deregulate protective immunity in TB. Their manipulation as novel forms of immunotherapy are also briefly commented.
Hernandez-Pando
Rogelio
R
Experimental Pathology Section, Department of Pathology, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Tlalpan, Mexico City, CP-14000, México. rhpando@quetzal.innsz.mx
Orozco
Hector
H
Aguilar
Diana
D
D000818:Animals; D017209:Apoptosis / Q000276:immunology; D003713:Dendritic Cells / Q000276:immunology; D018450:Disease Progression; D006023:Glycoproteins / Q000378:metabolism; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000502:physiology; D055633:Immune System Phenomena / Q000276:immunology*; D008264:Macrophages / Q000276:immunology; D009169:Mycobacterium tuberculosis / Q000276:immunology* / Q000378:metabolism; D010913:Pituitary-Adrenal System / Q000502:physiology; D011458:Prostaglandins E / Q000378:metabolism; D016176:T-Lymphocyte Subsets / Q000276:immunology; D018417:Th1 Cells / Q000276:immunology; D018418:Th2 Cells / Q000276:immunology; D016212:Transforming Growth Factor beta / Q000276:immunology; D014376:Tuberculosis / Q000276:immunology* / Q000382:microbiology / Q000503:physiopathology; D023083:beta-Defensins / Q000276:immunology
D006023:Glycoproteins; D011458:Prostaglandins E; D016212:Transforming Growth Factor beta; D023083:beta-Defensins