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首页> 外文期刊>Archivum Immunologiae et Therapiae Experimentalis >Revisiting the Natural History of Tuberculosis The Inclusion of Constant Reinfection, Host Tolerance, and Damage-Response Frameworks Leads to a Better Understanding of Latent Infection and its Evolution towards Active Disease
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Revisiting the Natural History of Tuberculosis The Inclusion of Constant Reinfection, Host Tolerance, and Damage-Response Frameworks Leads to a Better Understanding of Latent Infection and its Evolution towards Active Disease

机译：回顾结核病的自然史持续不断的感染，宿主耐受性和损伤反应框架的纳入可以使人们更好地了解潜伏感染及其向活动性疾病的演变

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摘要

Once Mycobacterium tuberculosis infects a person it can persist for a long time in a process called latent tuberculosis infection (LTBI). LTBI has traditionally been considered to involve the bacilli remaining in a non-replicating state (dormant) in old lesions but still retaining their ability to induce reactivation and cause active tuberculosis (TB) once a disruption of the immune response takes place. The present review aims to challenge these concepts by including recent experimental data supporting LTBI as a constant endogenous reinfection process as well as the recently introduced concepts of damage-response and tolerance frameworks to explain TB induction. These frameworks highlight the key role of an exaggerated and intolerant host response against M. tuberculosis bacilli which induces the classical TB cavity in immunocompetent adults once the constant endogenous reinfection process has resulted in the presence of bacilli in the upper lobes, where they can grow faster and the immune response is delayed. This essay intends to provide new clues to understanding the induction of TB in non-immunosuppressed patients. Keywords Mycobacterium tuberculosis - Foamy macrophages - Dynamic hypothesis - Damage-framework response - Tolerance theory
机译：结核分枝杆菌一旦感染人，就可以在称为潜伏性结核感染（LTBI）的过程中持续很长时间。传统上，LTBI被认为是在旧病灶中残留有非复制状态（休眠）的细菌，但是一旦免疫反应中断，细菌仍会保留其诱导再激活并引起活动性结核病（TB）的能力。本综述旨在通过包括支持LTBI作为恒定的内源性再感染过程的最新实验数据以及最近引入的解释结核病诱导的损伤反应和耐受性框架的概念来挑战这些概念。这些框架凸显了针对结核分枝杆菌的夸张且不耐受的宿主反应的关键作用，一旦持续的内源性再感染过程导致上叶中存在细菌，细菌就会在免疫能力强的成年人中诱发经典的TB腔，从而使它们可以更快地生长并且免疫反应被延迟。本文旨在为理解非免疫抑制患者的结核病诱导提供新的线索。关键词结核分枝杆菌-泡沫巨噬细胞-动态假设-损伤框架反应-耐受理论

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