title: Adventures within the speckled band: heterogeneity, angiogenesis, and balanced inflammation in the tuberculous granuloma.
abstract: Recent work in a variety of animal models, including mice, zebrafish, and macaques, as well as in humans, has led to a reassessment of several tenets of mycobacterial infection. In this review, we describe new findings about the composition and dynamics of the tuberculous granuloma, the central host structure in mycobacterial infection, as well as inflammatory mediators that drive a successful anti-microbial response on one hand and pathological inflammation on the other. We highlight granuloma heterogeneity that emerges in the context of infection, the functional consequences of angiogenesis in tuberculous granulomas, and data that balanced inflammation in humans, with a central role for tumor necrosis factor, appears to play a key role in optimal defense against mycobacterial infection. These findings have suggested new and specific host-directed therapies that await further clinical exploration.
authors.affiliation: Department of Molecular Genetics and Microbiology, Center for Host-Microbial Interactions, Duke University Medical Center, Durham, NC, USA; University Program in Genetics and Genomics, Duke University, Durham, NC, USA.
authors.forename: Molly A
authors.initials: MA
authors.lastname: Matty
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Roca
authors.forename: Mark R
authors.initials: MR
authors.lastname: Cronan
authors.forename: David M
authors.initials: DM
authors.lastname: Tobin
mesh_terms: D000818:Animals; D000995:Antitubercular Agents / Q000627:therapeutic use; D016207:Cytokines / Q000378:metabolism; D015777:Eicosanoids / Q000378:metabolism; D006099:Granuloma / Q000276:immunology* / Q000378:metabolism / Q000473:pathology*; D006801:Humans; D000860:Hypoxia / Q000378:metabolism; D018836:Inflammation Mediators / Q000378:metabolism; D009169:Mycobacterium tuberculosis / Q000276:immunology*; D009389:Neovascularization, Pathologic / Q000378:metabolism; D014376:Tuberculosis / Q000188:drug therapy / Q000235:genetics / Q000276:immunology* / Q000378:metabolism / Q000473:pathology*
chemical_list: D000995:Antitubercular Agents; D016207:Cytokines; D015777:Eicosanoids; D018836:Inflammation Mediators
keywords: bacterial disease; in vivo imaging; inflammation; monocytes/macrophages; tuberculosis