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Immunität gegen Mycobacterium tuberculosis

Immune response to Mycobacterium tuberculosis

  • Schwerpunkt: Tuberkulose
  • Published:
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Zusammenfassung

Auf die Infektion mit Mycobacterium tuberculosis (MTB) folgt eine komplexe Immunantwort, die durch ein distinktes Zusammenspiel von angeborenen und adaptiven Komponenten und Mechanismen des Immunsystems charakterisiert ist. Warum die Immunantwort auf MTB nicht zur anhaltenden Eliminierung der Erreger führt, sondern bestenfalls eine stabile Kontrolle der Infektion im Stadium der latenten Infektion erreicht, ist auch über 100 Jahre nach der Entdeckung von MTB durch Robert Koch noch nicht abschließend geklärt. Diese Übersichtsarbeit stellt einen Paradigmenwechsel vor, der voraussetzt, dass sich MTB in der latenten Phase der Infektion keineswegs in einem Ruhezustand befindet und dass die latente Tuberkulose nicht lediglich einen Zustand der bakteriellen Stase beschreibt, sondern ein dynamisches und immunologisches Äquilibrium darstellt, dessen detailliertes Verständnis für die Entwicklung neuer wirksamer Antibiotika und Vakzinekandidaten unverzichtbar ist.

Abstract

Infections with Mycobacterium tuberculosis (MTB) induce complex immune responses involving an orchestrated interplay of innate and adaptive immune mechanisms. Why the immune system fails to eradicate the pathogen and at best achieves control of infection in the latent stage, still remains an unsolved mystery even more than 100 years after the discovery of MTB by Robert Koch. This article provides an overview of the current state of the art in the constantly evolving field of tuberculosis (TB) immunology. This review focuses on a change of paradigm proposing that in the latent stage MTB is anything but dormant and that latent TB is not merely a state of bacterial stasis but a state of dynamic bacterial and immunological equilibrium. The understanding of these dynamics is crucial for the development of new drugs against MTB as well as vaccines that aim to provide effective protection against the disease.

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Authors and Affiliations

  1. Klinik I für Innere Medizin, Uniklinik Köln, Gleueler Str. 129–131, Gebäude 57, 50937, Köln, Deutschland

    A. Nowag &  P. Hartmann

  2. Zentrale Krankenhaushygiene, Uniklinik Köln, Gleueler Str. 129–131, Gebäude 57, 50937, Köln, Deutschland

    P. Hartmann

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Correspondence to P. Hartmann.

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A. Nowag und P. Hartmann geben an, dass kein Interessenkonflikt besteht.

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B. Salzberger, Regensburg

T. Welte, Hannover

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Nowag, A., Hartmann, P. Immunität gegen Mycobacterium tuberculosis . Internist 57, 107–116 (2016). https://doi.org/10.1007/s00108-015-0016-4

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