2つの Mycobacterium tuberculosis サブクローンによって引き起こされた内生および副次再活性化のケース
Junji Seto1, Sumito Inoue2, Shuichi Abe3
1Yamagata Prefectural Institute of Public Health, 1-6-6 Toka-machi, Yamagata, Yamagata, 990-0031, Japan.
まとめ
ミコバクテリアの結核は 異なる肺の病変で再活性化され 元のクローンから離れることができます 全ゲノム配列解析によって証明された この付随的な再活性化は 結核の再発に関する以前の理解に 異議を唱えます
科学分野:
- 微生物学
- ゲノミクス
- 肺科
背景:
- 結核の内生的な再活性化 (TB) は,通常,初期分離物から突然変異を蓄積するMycobacterium tuberculosisサブクローンを含む.
- 以前の理解では,TB再活性化時に単一のサブクローン内で線形変異の蓄積が想定されていました.
研究 の 目的:
- 結核の再発症例を調査し,原発病と再発のミコバクテリアが元のクローンから異なった.
- 結核の副次再活性化現象とその伝染と進化への影響を調査する.
主な方法:
- 再発性結核のコホート研究 (2012年および2020年).
- コンピュータトモグラフィー (CT) 画像を含む臨床評価
- 遡及的な接触追跡と分子疫学 (変数数タンデムリピートタイピング)
- ミコバクテリアの全ゲノム配列解析
主要な成果:
- CT画像は2012年から2020年の間に異なる肺部部に新しい病変を示しました.
- 外因的な再感染は接触者追跡と 分子監視によって排除された.
- 全ゲノム配列解析により,二つの単離体間で14の単一ヌクレオチドの変異が明らかになり,それぞれが元のクローンから7の変異を蓄積し,付随の分岐を示した.
結論:
- 同じ宿主内の異なる肺の病変における Mycobacterium tuberculosis のサブクローンは,副次的に変異を蓄積することができます.
- 付随的な再活性化を認識することで,結核の伝播追跡や薬剤耐性の進化の理解が改善されます.
- 確固たる証拠を備えた 付随的な再活性化症例を 特定するには さらに研究が必要です
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