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Mechanisms of Anergy in Tuberculosis

  • Chapter
Tuberculosis

Part of the book series: Current Topics in Microbiology and Immunology ((CT MICROBIOLOGY,volume 215))

Abstract

Immunological hyporesponsiveness (anergy) is a concomitant of diseases due to intracellular pathogens and well-demonstrated in tuberculosis. The expression of anergy in tuberculosis encompasses depression of both delayed-type hypersensitivity (DTH), manifest as depressed tuberculin skin test reaction, and in vitro lymphocyte responses to antigens of Mycobacterium tuberculosis. Evidence for immunosuppression, which appears to be mostly limited to mycobacterial antigens, has been documented in different populations with active tuberculosis worldwide, regardless of prior BCG vaccination status. Whether attenuation of the host responses to antigens of M. tuberculosis that stimulate or maintain protective immunity is a factor in the development of tuberculosis or contributes to the chronicity of the disease is not known. However, it appears that anergy in active tuberculosis is mediated largely through monocytes that display signs of activation, possibly by exposure to mycobacterial antigens or cytokines in situ. M. tuberculosis and its constituents are potent in stimulation of monocytes to produce an array of cytokines, notably transforming growth factor β (TGF-(β), which is suppressive to lymphocytes, deactivates macrophage effector functions, and promotes fibrosis (Wahl 1992). Immunosuppressive circuits are activated in situ as newly recruited monocytes encounter M. tuberculosis and its products; at the site of infection these circuits may contribute to immunopathogenesis, while at local sites of exposure to antigens (skin test) they may modulate the expression of DTH.

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  1. Department of Medicine, Case Western Reserve University, University Hospitals of Cleveland and Veterans Administration Medical Center, Cleveland, 10701 East Boulevard, Cleveland, OH, 44106, USA

    Z. Toossi & J. J. Ellner

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  1. Department of Health and Human Services, Immunology and Molecular Pathogenesis Section, Division of AIDS, STD and TB Laboratory Research, Centers for Disease Control and Prevention, 30333, Atlanta, GA, USA

    Thomas M. Shinnick Ph.D. (Chief) (Chief)

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Toossi, Z., Ellner, J.J. (1996). Mechanisms of Anergy in Tuberculosis. In: Shinnick, T.M. (eds) Tuberculosis. Current Topics in Microbiology and Immunology, vol 215. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-80166-2_10

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