Immunoregulation in TB: observations and implications.
Regulation of the immune response during active tuberculosis (TB) has been partly deciphered. In pulmonary TB there is transient systemic immunosuppression due to overexpression of transforming growth factor beta and interleukin-10. This is superimposed on a primary T-cell defect. Locally there is intense inflammation (lung, pleural fluid) with overexpression of immunosuppressive factors (bronchoalveolar lavage) and extensive apoptosis. These observations suggest that immune therapies should be aimed at neutralizing the negative regulatory factors rather than accentuating an already intense immune response. Also a partially effective vaccine carries the potential risk of exacerbating disease.
Ellner
Jerrold J
JJ
Boston University and Boston Medical Center, Boston, MA, USA. jerrold.ellner@bumc.org
D017209:Apoptosis; D018893:Bronchoalveolar Lavage; D002986:Clinical Trials as Topic; D016207:Cytokines / Q000378:metabolism; D006801:Humans; D007107:Immune System; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007167:Immunotherapy / Q000379:methods; D007371:Interferon-gamma / Q000378:metabolism; D016753:Interleukin-10 / Q000378:metabolism; D007963:Leukocytes, Mononuclear / Q000166:cytology; D008168:Lung / Q000473:pathology; D009169:Mycobacterium tuberculosis / Q000276:immunology; D016212:Transforming Growth Factor beta / Q000378:metabolism; D014376:Tuberculosis / Q000276:immunology* / Q000503:physiopathology*
D016207:Cytokines; D007166:Immunosuppressive Agents; D016212:Transforming Growth Factor beta; D016753:Interleukin-10; D007371:Interferon-gamma