Journal
IMMUNOLOGICAL REVIEWS
Volume 264, Issue 1, Pages 276-287Publisher
WILEY-BLACKWELL
DOI: 10.1111/imr.12273
Keywords
bacterial disease; inflammation; in vivo imaging; monocytes; macrophages; tuberculosis
Categories
Funding
- National Science Foundation
- educational ministry of Spain
- American Cancer Society [PF-13-223-01-MPC]
- Mallinckrodt Scholar Award
- Searle Scholar Award
- Vallee Foundation Young Investigator Award
- NIH Director's New Innovator Award [1DP2-OD008614]
- Duke University Center for AIDS Research
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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.
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