Postprimary Tuberculosis and Macrophage Necrosis: Is There a Big ConNECtion?

ABSTRACT Adult or postprimary tuberculosis (TB) accounts for most TB cases. Its hallmark is pulmonary cavitation, which occurs as a result of necrosis in the lung in individuals with tuberculous pneumonia. Postprimary TB has previously been known to be associated with vascular thrombosis and delayed...

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Autores principales:	Ka-Wing Wong, William R. Jacobs
Formato:	article
Lenguaje:	EN
Publicado:	American Society for Microbiology 2016
Materias:	Microbiology QR1-502
Acceso en línea:	https://doaj.org/article/ca15a941af7747689113d0ddb366d969
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spelling	oai:doaj.org-article:ca15a941af7747689113d0ddb366d9692021-11-15T15:49:40ZPostprimary Tuberculosis and Macrophage Necrosis: Is There a Big ConNECtion?10.1128/mBio.01589-152150-7511https://doaj.org/article/ca15a941af7747689113d0ddb366d9692016-03-01T00:00:00Zhttps://journals.asm.org/doi/10.1128/mBio.01589-15https://doaj.org/toc/2150-7511ABSTRACT Adult or postprimary tuberculosis (TB) accounts for most TB cases. Its hallmark is pulmonary cavitation, which occurs as a result of necrosis in the lung in individuals with tuberculous pneumonia. Postprimary TB has previously been known to be associated with vascular thrombosis and delayed-type hypersensitivity, but their roles in pulmonary cavitation are unclear. A necrosis-associated extracellular cluster (NEC) refers to a cluster of drug-tolerant Mycobacterium tuberculosis attached to lysed host materials and is proposed to contribute to granulomatous TB. Here we suggest that NECs, perhaps due to big size, produce a distinct host response leading to postprimary TB. We propose that vascular thrombosis and pneumonia arise from NEC and that these processes are promoted by inflammatory cytokines produced from cell-mediated delayed-type hypersensitivity, such as interleukin-17 and gamma interferon, eventually triggering necrosis in the lung and causing cavitation. According to this view, targeting NEC represents a necessary strategy to control adult TB.Ka-Wing WongWilliam R. JacobsAmerican Society for MicrobiologyarticleMicrobiologyQR1-502ENmBio, Vol 7, Iss 1 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	Microbiology QR1-502
spellingShingle	Microbiology QR1-502 Ka-Wing Wong William R. Jacobs Postprimary Tuberculosis and Macrophage Necrosis: Is There a Big ConNECtion?
description	ABSTRACT Adult or postprimary tuberculosis (TB) accounts for most TB cases. Its hallmark is pulmonary cavitation, which occurs as a result of necrosis in the lung in individuals with tuberculous pneumonia. Postprimary TB has previously been known to be associated with vascular thrombosis and delayed-type hypersensitivity, but their roles in pulmonary cavitation are unclear. A necrosis-associated extracellular cluster (NEC) refers to a cluster of drug-tolerant Mycobacterium tuberculosis attached to lysed host materials and is proposed to contribute to granulomatous TB. Here we suggest that NECs, perhaps due to big size, produce a distinct host response leading to postprimary TB. We propose that vascular thrombosis and pneumonia arise from NEC and that these processes are promoted by inflammatory cytokines produced from cell-mediated delayed-type hypersensitivity, such as interleukin-17 and gamma interferon, eventually triggering necrosis in the lung and causing cavitation. According to this view, targeting NEC represents a necessary strategy to control adult TB.
format	article
author	Ka-Wing Wong William R. Jacobs
author_facet	Ka-Wing Wong William R. Jacobs
author_sort	Ka-Wing Wong
title	Postprimary Tuberculosis and Macrophage Necrosis: Is There a Big ConNECtion?
title_short	Postprimary Tuberculosis and Macrophage Necrosis: Is There a Big ConNECtion?
title_full	Postprimary Tuberculosis and Macrophage Necrosis: Is There a Big ConNECtion?
title_fullStr	Postprimary Tuberculosis and Macrophage Necrosis: Is There a Big ConNECtion?
title_full_unstemmed	Postprimary Tuberculosis and Macrophage Necrosis: Is There a Big ConNECtion?
title_sort	postprimary tuberculosis and macrophage necrosis: is there a big connection?
publisher	American Society for Microbiology
publishDate	2016
url	https://doaj.org/article/ca15a941af7747689113d0ddb366d969
work_keys_str_mv	AT kawingwong postprimarytuberculosisandmacrophagenecrosisisthereabigconnection AT williamrjacobs postprimarytuberculosisandmacrophagenecrosisisthereabigconnection
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Postprimary Tuberculosis and Macrophage Necrosis: Is There a Big ConNECtion?

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