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Macrophages in tuberculosis: friend or foe

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Abstract

Tuberculosis (TB) remains one of the greatest threats to human health. The causative bacterium, Mycobacterium tuberculosis (Mtb), is acquired by the respiratory route. It is exquisitely human adapted and a prototypic intracellular pathogen of macrophages, with alveolar macrophages (AMs) being the primary conduit of infection and disease. The outcome of primary infection is most often a latently infected healthy human host, in whom the bacteria are held in check by the host immune response. Such individuals can develop active TB later in life with impairment in the immune system. In contrast, in a minority of infected individuals, the host immune response fails to control the growth of bacilli, and progressive granulomatous disease develops, facilitating spread of the bacilli via infectious aerosols coughed out into the environment and inhaled by new hosts. The molecular details of the Mtb–macrophage interaction continue to be elucidated. However, it is clear that a number of complex processes are involved at the different stages of infection that may benefit either the bacterium or the host. Macrophages demonstrate tremendous phenotypic heterogeneity and functional plasticity which, depending on the site and stage of infection, facilitate the diverse outcomes. Moreover, host responses vary depending on the specific characteristics of the infecting Mtb strain. In this chapter, we describe a contemporary view of the behavior of AMs and their interaction with various Mtb strains in generating unique immunologic lung-specific responses.

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Authors and Affiliations

  1. Department of Microbial Infection and Immunity, Center for Microbial Interface Biology, The Ohio State University, Biomedical Research Tower, 460 W 12th ave, Rm 798, Columbus, OH, 43210, USA

    Evelyn Guirado & Larry S. Schlesinger

  2. Laboratory of Mycobacterial Immunity and Pathogenesis, The Public Health Research Institute (PHRI), University of Medicine and Dentistry of New Jersey (UMDNJ), 225 Warren Street, Newark, NJ, 07103-3535, USA

    Gilla Kaplan

Authors
  1. Evelyn Guirado
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  2. Larry S. Schlesinger
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  3. Gilla Kaplan
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Corresponding authors

Correspondence to Larry S. Schlesinger or Gilla Kaplan.

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This article is a contribution to the special issue on Macrophage Heterogeneity, Subsets and Human Disease - Guest Editor: Siamon Gordon

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Guirado, E., Schlesinger, L.S. & Kaplan, G. Macrophages in tuberculosis: friend or foe. Semin Immunopathol 35, 563–583 (2013). https://doi.org/10.1007/s00281-013-0388-2

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