结核病的发病机制：宿主抗结核免疫与结核分枝杆菌免疫逃避策略之间的相互作用
{"_":"Pathogenesis of Tuberculosis: Interplay Between Host Antituberculosis Immunity and Immune Evasion Strategies of .","i":["Mycobacterium Tuberculosis"]}
摘要(中文译文)
结核病至今仍是全球单一感染性病原体导致死亡的主要原因之一，尽管已有抗结核化疗和卡介苗（Bacillus Calmette-Guérin）疫苗可供使用。结核病的发病机制由宿主保护性免疫与结核分枝杆菌（Mycobacterium tuberculosis）的免疫逃逸策略之间动态而持久的相互作用所驱动。在感染过程中，宿主与病原体之间的双向相互作用，连同免疫代谢和表观遗传重编程，共同塑造肉芽肿的形成与组织结构、纤维性包裹、液化性坏死，并最终决定疾病进展与传播。然而，将宿主保护性免疫、病原体免疫逃逸以及不同感染阶段肉芽肿演变联系起来的系统性框架仍不完整。在本综述中，我们总结了塑造早期固有免疫募集、适应性免疫激活、肉芽肿形成与重塑、持续性感染、肉芽肿破溃以及向活动性结核病进展的宿主-病原体相互作用。我们进一步整合了代谢重编程、表观遗传重编程、训练免疫（trained immunity）、组织驻留免疫以及髓源性免疫抑制网络等新兴概念。最后，我们讨论了这些机制性见解如何为下一代结核病疫苗和辅助治疗的设计提供依据。本综述为理解结核病免疫发病机制建立了全面的概念框架，并为抗结核疫苗和治疗策略的开发提供了指导。
Abstract
Tuberculosis remains one of the leading causes of death from a single infectious pathogen worldwide, despite the availability of antituberculosis chemotherapy and Bacillus Calmette-Guérin vaccination. Tuberculosis pathogenesis is driven by a dynamic and prolonged interplay between host protective immunity and the immune evasion strategies of Mycobacterium tuberculosis (). During infection, bidirectional host- interactions, together with immunometabolic and epigenetic reprogramming, shape granuloma formation and organization, fibrotic encapsulation, liquefactive necrosis, and ultimately determine disease progression and transmission. However, a systematic framework linking host protective immunity, immune evasion, and granuloma evolution across distinct stages of infection remains incomplete. In this review, we summarize the host- interactions that shape early innate immune recruitment, adaptive immune activation, granuloma formation and remodeling, persistent infection, granuloma breakdown, and progression to active tuberculosis. We further integrate emerging concepts of metabolic reprogramming, epigenetic reprogramming, trained immunity, tissue-resident immunity, and myeloid-derived immunosuppressive networks. Finally, we discuss how these mechanistic insights may inform the design of next-generation tuberculosis vaccines and adjunctive therapies. This review establishes a comprehensive conceptual framework for understanding tuberculosis immunopathogenesis and provides guidance for the development of antituberculosis vaccines and therapeutic strategies.
如何引用
AMA
Xiaojuan Zhang, Ying Liu, Yilin Hou, Hongxia Niu. {"_":"Pathogenesis of Tuberculosis: Interplay Between Host Antituberculosis Immunity and Immune Evasion Strategies of .","i":["Mycobacterium Tuberculosis"]}. MedComm. 2026; doi:10.1002/mco2.70884.
APA
Xiaojuan Zhang, Ying Liu, Yilin Hou, Hongxia Niu (2026). {"_":"Pathogenesis of Tuberculosis: Interplay Between Host Antituberculosis Immunity and Immune Evasion Strategies of .","i":["Mycobacterium Tuberculosis"]}. MedComm. https://doi.org/10.1002/mco2.70884
GB/T 7714
Xiaojuan Zhang, Ying Liu, Yilin Hou, Hongxia Niu. {"_":"Pathogenesis of Tuberculosis: Interplay Between Host Antituberculosis Immunity and Immune Evasion Strategies of .","i":["Mycobacterium Tuberculosis"]}[J]. MedComm, 2026 doi:10.1002/mco2.70884.
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