Recent trends in the immunopathogenesis of tuberculosis.
Ramanathan, V.D.; Shakila, H.
Journal of Immunology and Immunopathology; 2004; 6; 7-12.
Preamble: Tuberculosis kills about 500,000 Indians every year, i.e. one person every minute. For every patient who dies of the disease, there are at least two individuals who develop disability. Further, the advent of infection by human immunodeficiency virus and drug resistant forms of Mycobacterium tuberculosis have made the management and control of tuberculosis more difficult. Although the genome of M. tuberculosis has been sequenced, diagnosis of the infectious sputum positive case is straightforward, simple and inexpensive and effective short course chemotherapy is available, morbidity and mortality due to the disease have not appreciably decreased.
Among the several reasons cited for this failure are the inadequacy of the BCG vaccine in preventing post primary tuberculosis and the relatively long duration (six months) of chemotherapy which encourages irregularity and incomplete treatment. Furthermore, two more aspects which deserve consideration are (a) lack of appropriate tests to identify the individual who is likely to develop clinical illness and b) disability caused by the disease process.
This presentation will limit itself to two major areas of the immunopathology of the disease. These are a) host immune mechanisms underlying the varied clinical and pathological manifestations and b) events that led to tissue damage and disability. Back to List of publications / Home |