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Immunology: How Does the Immune System Affect the Development of Pulmonary TB? How Does an Understanding of TB Immunology Help Clinicians Manage their Patients with Pulmonary TB?

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Pulmonary Tuberculosis and Its Prevention

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Abstract

TB is the leading cause of death from a single infectious agent. Mycobacterium tuberculosis—the causative agent of TB—is an intracellular pathogen that is transmitted through the air. When tuberculous bacilli first enter the lung, innate and acquired immune responses are induced. The fact that experimental TB cavities can be formed by the administration of dead Mycobacterium tuberculosis alone indicates how important TB immunity is in the formation of TB lesions. TB bacteria have a variety of defense mechanisms that allow them to survive within macrophages. Thus, low exposure to Mycobacterium tuberculosis is bactericidal, but high exposure can lead to the development of TB and latent infection. The IFN-γ/IL-12 axis—a positive feedback mechanism between macrophages and Th1 cells—is indispensable for the control of TB infection. Recently, TNF-α inhibitors and PD-1 pathway inhibitors have been frequently used in clinical practice. However, recent studies reported that these drugs were associated with the exacerbation of TB infection. Therefore, it is important for clinicians to understand TB immunity.

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Change history

  • 08 March 2023

    Figure 3 of chapter 2 was initially published with errors. This has been corrected.

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Acknowledgments

We thank J. Ludovic Croxford, PhD, from Edanz (https://jp.edanz.com/ac) for editing a draft of this chapter.

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Authors and Affiliations

  1. Department of Respiratory Medicine, University of Tsukuba, Ibaraki, Japan

    Masashi Matsuyama & Yukio Ishii

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  1. Masashi Matsuyama
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  2. Yukio Ishii
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Correspondence to Yukio Ishii .

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Editors and Affiliations

  1. Respiratory Medicine, NHO Ibarakihigashi National Hosp, Ibaraki, Japan

    Takefumi Saito

  2. Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington, Seattle, WA, USA

    Masahiro Narita

  3. National Jewish Health, Denver, CO, USA

    Charles L. Daley

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Matsuyama, M., Ishii, Y. (2022). Immunology: How Does the Immune System Affect the Development of Pulmonary TB? How Does an Understanding of TB Immunology Help Clinicians Manage their Patients with Pulmonary TB?. In: Saito, T., Narita, M., Daley, C.L. (eds) Pulmonary Tuberculosis and Its Prevention. Respiratory Disease Series: Diagnostic Tools and Disease Managements. Springer, Singapore. https://doi.org/10.1007/978-981-19-3995-2_2

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  • DOI: https://doi.org/10.1007/978-981-19-3995-2_2

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