Immunotherapy for tuberculosis: what's the better choice?
A Th1/Th2 imbalance in tuberculosis (TB) patients caused by a decreased Th1 response and an increased Th2 response is a significant factor in the pathogenesis and development of TB. Protective immune responses to TB include bacteriostatic and bactericidal responses. Unfortunately, however, immunoprotection and immune pathology co-exist in TB patients. Immunotherapy for TB principally aims to restore the Th1/Th2 balance by enhancing the Th1 response and suppressing the excessive Th2 response. Immunotherapy for TB can be classified into three categories: immune-enhancing therapy using cytokines, immunosuppressive therapy, and immunomodulatory therapy. Immunomodulatory therapy targets the Th1/Th2 imbalance and includes cytokine regulation therapy, antibody regulation therapy, a multi-dose heat-inactivated Mycobacterium vaccae vaccine, thymosin hormones and a DNA vaccine. A new approach in supplementary TB immunotherapy is to simultaneously up-regulate the Th1 response and down-regulate the Th2 response. While immunotherapy can contribute to TB treatment, it may also cause immunopathological injury. Therefore, immunotherapy needs to be improved and further studied to maximize its potential.
Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital, Chongqing Medical University, China. guosl999@yeah.net
Shuliang
S
Guo
Jinqiu
J
Zhao
D016207:Cytokines / Q000276:immunology; D000068800:Etanercept; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007155:Immunologic Factors / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007167:Immunotherapy / Q000379:methods*; D007371:Interferon-gamma / Q000627:therapeutic use; D007376:Interleukin-2 / Q000627:therapeutic use; D009169:Mycobacterium tuberculosis / Q000276:immunology; D011239:Prednisolone / Q000008:administration & dosage; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use; D018417:Th1 Cells / Q000276:immunology; D018418:Th2 Cells / Q000276:immunology; D013792:Thalidomide / Q000031:analogs & derivatives / Q000627:therapeutic use; D032581:Tuberculosis Vaccines / Q000627:therapeutic use; D014397:Tuberculosis, Pulmonary / Q000276:immunology / Q000382:microbiology / Q000628:therapy*
D016207:Cytokines; C508594:IL2 protein, human; D007074:Immunoglobulin G; D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors; D007166:Immunosuppressive Agents; D007376:Interleukin-2; D018124:Receptors, Tumor Necrosis Factor; D032581:Tuberculosis Vaccines; D013792:Thalidomide; D007371:Interferon-gamma; D011239:Prednisolone; D000068800:Etanercept