Permutations of time and place in tuberculosis

The Lancet Infectious Diseases
Paul T Elkington, Jon S Friedland

Abstract

Tuberculosis remains a global health pandemic. The current depiction of the Mycobacterium tuberculosis life cycle proposes that airborne bacilli are inhaled and phagocytosed by alveolar macrophages, resulting in the formation of a granuloma that ruptures into the airways to reinitiate the infectious cycle. However, this widely proposed model overlooks the fact, established 100 years ago, that the initial site of M tuberculosis implantation is in the lower zones of the lungs, whereas infectious cavitary pulmonary disease develops at the lung apices. The immunological events at these two pulmonary locations are different--cavitation only occurs in the apices and not in the bases. Yet the current conceptual model of tuberculosis renders the immunology of these two temporally and spatially separated events identical. One key consequence is that prevention of primary childhood tuberculosis at the lung bases is regarded as adequate immunological protection, but extensive evidence shows that greater immunity could predispose to immunopathology and transmission at the lung apex. A much greater understanding of time and place in the immunopathological mechanisms underlying human tuberculosis is needed before further pre-exposure vaccina...Continue Reading

References

Oct 1, 1996·The European Respiratory Journal·S AktoğuS M Dereli
Mar 26, 2003·Infection and Immunity·Jennifer L TaylorIan M Orme
Sep 19, 2003·Lancet·Thomas R FriedenChristopher Dye
Aug 13, 2009·European Journal of Immunology·Douglas Young
May 15, 2010·Science·David G RussellJoAnne L Flynn
May 22, 2010·Lancet·Stefan H E KaufmannPaul-Henri Lambert
Feb 18, 2011·Nature Reviews. Microbiology·Ruth McNerney, Peter Daley
Feb 25, 2011·Science Translational Medicine·Paul T ElkingtonJon S Friedland
Apr 13, 2011·Clinical Microbiology Reviews·Candice K Kwan, Joel D Ernst
Apr 27, 2011·The Journal of Clinical Investigation·Paul ElkingtonJon S Friedland
Feb 22, 2012·American Journal of Respiratory and Critical Care Medicine·Naomi F WalkerPaul T Elkington
Feb 19, 2013·The Journal of Infection·Paul T Elkington
Feb 23, 2013·The Journal of Biological Chemistry·Gregg B Fields
Mar 23, 2013·Annual Review of Immunology·Anne O'GarraMatthew P R Berry
Mar 27, 2013·Current Opinion in Pulmonary Medicine·Stephen D Lawn
Mar 28, 2013·The Lancet Infectious Diseases·Robert S WallisAlimuddin Zumla
May 22, 2013·Proceedings of the National Academy of Sciences of the United States of America·Reza Yaesoubi, Ted Cohen
Dec 4, 2013·Microbiology and Molecular Biology Reviews : MMBR·Thomas R HawnOmar Vandal
Dec 19, 2014·Nature Immunology·Ian M OrmeAndrea M Cooper
Dec 20, 2014·Cell·C J CambierLalita Ramakrishnan
Feb 14, 2015·The Journal of Infectious Diseases·Basim Al ShammariPaul T Elkington

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Citations

Oct 30, 2016·Tuberculosis and Respiratory Diseases·Seung Heon Lee
Mar 18, 2016·PLoS Pathogens·Lucy C K BellMahdad Noursadeghi
Dec 22, 2017·Thorax·Marc Tebruegge, Paul T Elkington
Oct 29, 2019·American Journal of Respiratory and Critical Care Medicine·Liku B TezeraPaul Elkington
Feb 27, 2016·Critical Care Nursing Quarterly·Parth RaliNitin Bhanot
May 6, 2017·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Naomi F WalkerPaul T Elkington
Mar 7, 2020·Microbiology and Molecular Biology Reviews : MMBR·Elise A LamontAnthony D Baughn
May 1, 2017·Archives of Pharmacal Research·Shahzaib AhamadMd Imtaiyaz Hassan
Aug 25, 2018·American Journal of Respiratory and Critical Care Medicine·Paul T ElkingtonChristian H Ottensmeier
Mar 19, 2021·Pediatric Research·Huanbin XuXiaolei Wang
Jun 16, 2021·The Journal of Clinical Investigation·Qing Hao MiowCatherine Wm Ong

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