白细胞介素32与结核病的研究进展

白细胞介素32(interleukin 32,IL-32)是一种潜在性非常高的促炎症细胞因子(cytokine,CK),在很多炎症性疾病中都能检测到它的存在。相关疾病的研究中,其在传染性结核病(tuberculosis,TB)领域的研究于最近几年有一定的进展,有研究表明IL-32与结核病的免疫机制相关。这对于结核病致病机理研究、有效诊断和治疗可能有重要意义。     

Mycobacterium abscessus Complex – a Particular Challenge in the Setting of Lung Transplantation

Mycobacterium abscessus complex is an emerging pathogen in lung transplant candidates and recipients. M. abscessus complex is widespread in the environment and can cause pulmonary, skin and soft tissue, and disseminated infection, particularly in lung transplant recipients. It is innately resistant to many antibiotics making it difficult to treat. Herein we describe the epidemiology, clinical manifestations, diagnosis and treatment of M. abscessus with an emphasis on lung transplant candidates and recipients. We also outline the areas where data are lacking and the areas where further research is urgently needed.     

Distinct Strategies Employed by Dendritic Cells and Macrophages in Restricting Mycobacterium tuberculosis Infection: Different Philosophies but Same Desire

Dendritic cells (DCs) and macrophages (M?s) are professional antigen-presenting cells (APCs) that can efficiently phagocytose Mycobacterium tuberculosis (Mtb), the etiological agent of tuberculosis (TB). It is quite interesting to mention here that DCs and M?s use distinct strategies to combat and eliminate Mtb. Similarly, Mtb employs different mechanisms to counteract the action of DCs and M?s. M?s are evolved with specialized, innate, defensive machinery to restrict growth of Mtb at the initial phase of infection. However, DCs are more endowed toward initiating adaptive immunity by activating naïve T cells. During encounter with Mtb, DCs and M?s deliver discrete functions via triggering through different pattern recognition receptors (PRRs) expressed by these APCs. Mtb-infected DCs and M?s show differential expression of genes encoding cytokines, chemokines, costimulatory molecules, and adhesion molecules. Interestingly, Mtb impairs the immune defensive machinery by exploiting various PRRs. Remarkably, selective signaling through PRRs by Mtb abrogates the bactericidal activity of M?s, but subverts differentiation of monocytes to DCs. In this article, we highlight the role of PRRs in inducing distinct immune response by DCs and M?s against Mtb. Concurrently, we also discuss smart strategies exploited by Mtb to impair the function of host DCs and M?s.     

Respiratory tract infection caused by Mycobacterium bovis in a black swan (Cygnus atratus)

A 3-year-old male black swan (Cygnus atratus), belonging to a private collection, died suddenly and was subjected to post mortem examination. At necropsy, caseous exudate was observed in the lungs and air sacs; granulomatous lesions characterized by epithelioid macrophages and abundant mycobacteria were observed microscopically. Avian tuberculosis associated with Mycobacterium bovis was confirmed by bacteriologic isolation, biochemical tests and molecular methods. The organism was identified as spoligotype SB0140, which is frequently found in cattle and people in North America. In this case, interspecies transmission could have been the source of infection because the swan cohabited with cattle.     

Nontuberculous mycobacterial infection with concurrent IgG4‐related lymphadenopathy

Disseminated nontuberculous mycobacteria (NTM) infection with concurrent IgG4‐related lymphadenopathy has not been reported. We described a patient with neutralizing autoantibodies to interferon‐gamma (IFN‐γ) and elevated levels of serum IgG4 presenting with generalized lymphadenopathy and reactive dermatosis. Histologically, lymph nodes (LNs) showed effaced nodal architecture with polymorphic infiltrates, mimicking angioimmunoblastic T‐cell lymphoma. Both the absolute number and the ratio of IgG4+ plasma cells to IgG+ plasma cells were increased. Mycobacterium abscessus was isolated from cultures of LNs, and demonstrated by polymerase chain reaction‐restriction fragment length polymorphism. The skin biopsy showed neutrophilic dermatosis, consistent with Sweet syndrome. The patient met the criteria of both adult‐onset immunodeficiency syndrome and IgG4‐related lymphadenopathy. This case provides evidence of disseminated NTM infection with concurrent type III IgG4‐related lymphadenopathy in the patient with anti‐IFN‐γ autoantibodies.     

高分辨率CT在非结核分枝杆菌肺病诊治中的价值

搜集广州市胸科医院2015年3月至2017年9月经菌种鉴定为非结核分枝杆菌(NTM)肺病、并行胸部高分辨率CT(HRCT)检查的99例患者,回顾性分析肺内病灶部位、数量、形态、大小、密度、边界、分布及淋巴结的CT征象;评估99例NTM肺病患者治疗前后HRCT的表现。HRCT检查表现为斑点片状渗出、实变93例,支气管扩张78例,空洞60例,纤维条索状影59例,结节状影58例,树芽征55例,磨玻璃样影46例,淋巴结肿大45例,胸膜增厚18例,胸腔积液9例,病变通常以多种形态混杂存在。91例NTM肺病患者经克拉霉素、利福平、乙胺丁醇及阿米卡星治疗6~18个月后CT复查,显示病灶均减少;8例患者经HRCT精准定位后行患侧肺叶切除术,术后肺部病灶明显减少,但均出现术侧胸膜肥厚粘连。胸部HRCT对NTM肺病的诊断及治疗具有重要的应用价值。     

Mycobacterium Species Related to M. leprae and M. lepromatosis from Cows with Bovine Nodular Thelitis

Bovine nodular thelitis is a granulomatous dermatitis associated with infection with acid-fast bacteria. To identify the mycobacterium responsible for this infection, we conducted phylogenetic investigations based on partial sequencing of 6 genes. These bacteria were identified as an undescribed Mycobacterium species that was phylogenetically related to M. leprae and M. lepromatosis.     

Boarding issue in a commercial flight for patients with cavitary pulmonary tuberculosis: A case report

BACKGROUND Several studies have demonstrated that airborne transmission of Mycobacterium tuberculosis bacteria from patients with active pulmonary tuberculosis(TB) to other passengers or crew members can occur during long flights. As such, non-infectious TB patients are usually allowed to undertake air travel after taking the appropriate anti-TB drugs. However, the global guidelines for air travel for patients with TB are inconsistent and insufficiently detailed with respect to cavitary pulmonary TB(CPTB).CASE SUMMARY Here, we report a case in which a patient with multiple CPTB was permitted air travel, following negative sputum acid-fast bacilli smear tests after administration of proper anti-TB medication. The patient’s culture results were pending.CONCLUSION This case revealed that more specific guidelines regulating air travel for patients with CPTB are necessary.