Pulmonale Immunität bei Tuberkulose

Zusammenfassung

Tuberkulose wird durch Inhalation von bakterienhaltigen Aerosolen übertragen und 75 % der Erkrankungen betreffen die Lunge. Die Immunprozesse zwischen Exposition und Krankheitsentwicklung sind großenteils auf die Lunge beschränkt und nur teilweise entschlüsselt. Der Erreger wird in den meisten Fällen vermutlich durch Zellen des angeborenen Immunsystems kontrolliert oder eradiziert, ohne dass dies mit Standardmethoden in vivo nachgewiesen werden kann. Die anschließende adaptive Immunantwort wird wesentlich von CD4⁺- und CD8⁺-T-Lymphozyten vermittelt, während die humorale Immunität nur eine untergeordnete Bedeutung hat. Der Artikel gibt eine Übersicht über den aktuellen Wissensstand der intrapulmonalen Mechanismen, die im Verlauf von Exposition, latenter Infektion, aktiver Erkrankung und Therapie beobachtet werden.

Abstract

Tuberculosis is transmitted by inhalation of Mycobacterium tuberculosis-containing aerosols; 75 % of all patients show pulmonary manifestation. Immune responses after exposure that lead to clinical symptoms occur mainly in the respiratory tract and are only poorly understood. In most cases, cells of the innate immune system are believed to control the growth of or eradicate inhaled mycobacteria. However, this cannot be verified in vivo using standard methods. Subsequently, CD4⁺ and CD8⁺ T cell-driven adaptive immune responses are induced that attempt to control bacterial growth. The humoral defence appears to be less important. This article gives an overview of the current understanding of pulmonary immune mechanisms during exposure, latent infection, active disease and therapy of tuberculosis.

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