Human Tuberculosis I. Epidemiology, Diagnosis and Pathogenetic Mechanisms

Curr Med Chem. 2016;23(25):2836-2873. doi: 10.2174/0929867323666160607222854.

Abstract

Mycobacterium tuberculosis (M. tuberculosis), an almost genetically monomorphic pathogen is a human parasite, transmitted mostly by humans and causes tuberculosis (TB). TB is firmly associated to poverty, although lack of proper nutrition and lowered immune status are contributing factors for disease development. TB remains second only to HIV/AIDS as the leading cause of mortality worldwide due to a single infectious agent and is responsible for nearly 1.5 million deaths annually. Some steps of the progress of our knowledge of M. tuberculosis physiology and its interactions with human beings, are reviewed here. This progress has provided fertile ground for improving diagnosis and cure of TB infection. For TB diagnostics laboratories in high-burden countries, primary isolation is the first step before performing drug susceptibility testing (DST) of M. tuberculosis. IGRA (interferon-γ release assay)-based tests for diagnosis of active TB are sufficiently fast, specific and sensitive to allow to contain infection and distinguish among latent TB infection and BCG vaccination individuals from those who have clinically resolved M. tuberculosis infection after anti-TB treatment.

Publication types

  • Review

MeSH terms

  • Antigens, Bacterial / metabolism
  • Antitubercular Agents / pharmacology
  • Antitubercular Agents / therapeutic use
  • Bacterial Proteins / metabolism
  • Carboxylic Ester Hydrolases / metabolism
  • Cell Wall / chemistry
  • Cell Wall / metabolism
  • Drug Resistance, Multiple, Bacterial
  • Humans
  • Macrophages / cytology
  • Macrophages / immunology
  • Macrophages / microbiology
  • Mycobacterium tuberculosis / drug effects
  • Mycobacterium tuberculosis / isolation & purification
  • Mycobacterium tuberculosis / metabolism
  • NADPH Oxidases / metabolism
  • Nitric Oxide / metabolism
  • Phagosomes / metabolism
  • Tuberculosis / diagnosis*
  • Tuberculosis / drug therapy
  • Tuberculosis / epidemiology
  • Tuberculosis / microbiology
  • Virulence Factors / metabolism

Substances

  • Antigens, Bacterial
  • Antitubercular Agents
  • Bacterial Proteins
  • ESAT-6 protein, Mycobacterium tuberculosis
  • Virulence Factors
  • Nitric Oxide
  • NADPH Oxidases
  • Carboxylic Ester Hydrolases
  • LipY protein, Mycobacterium tuberculosis