Journal
PATHOGENS
Volume 9, Issue 10, Pages -Publisher
MDPI
DOI: 10.3390/pathogens9100813
Keywords
Tuberculosis; human; lung; pathogenesis; post-primary; animal model; pathology; X-ray; granuloma; Koch; hypersensitivity; caseation
Categories
Funding
- NIH [HL55969, HL68527, AI055449, HL068537, AI117990]
Ask authors/readers for more resources
Research on the pathogenesis of tuberculosis (TB) has been hamstrung for half a century by the paradigm that granulomas are the hallmark of active disease. Human TB, in fact, produces two types of granulomas, neither of which is involved in the development of adult type or post-primary TB. This disease begins as the early lesion; a prolonged subclinical stockpiling of secreted mycobacterial antigens in foamy alveolar macrophages and nearby highly sensitized T cells in preparation for a massive necrotizing hypersensitivity reaction, the Koch Phenomenon, that produces caseous pneumonia that is either coughed out to form cavities or retained to become the focus of post-primary granulomas and fibrocaseous disease. Post-primary TB progresses if the antigens are continuously released and regresses when they are depleted. This revised paradigm is supported by nearly 200 years of research and suggests new approaches and animal models to investigate long standing mysteries of human TB and vaccines that inhibit the early lesion to finally end its transmission.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available