被忽视,驳回和淡化:Mycobacterium tuberculosis免疫反活性的逆转
Katie D Dale1, Alvaro Schwalb2,3,4, Anna K Coussens5,6,7
1Victorian Tuberculosis Program, Royal Melbourne Hospital, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia katie.dale@mh.org.au.
概括
结核菌菌 (Mtb) 免疫活性是动态的,不是终身的. 逆转,Mtb免疫活性的丧失,表明暴露减少,对于准确的结核病风险评估和政策至关重要.
科学领域:
- 免疫学 免疫学 免疫学
- 传染性疾病 传染性疾病
- 流行病学 流行病学
背景情况:
- 结核病 (TB) 是由结核菌菌 (Mtb) 引起的.
- 通过皮肤或干扰素γ释放试验测量的mtb免疫活性通常被认为是终身的.
- 转换 (负到正) 表示Mtb暴露,但反转 (正到负) 被忽视了.
研究的目的:
- 审查Mtb免疫活性逆转的证据.
- 解释为什么将回归排除在常识之外的原因.
- 突出忽视逆转对结核病研究和政策的影响.
主要方法:
- 对队列研究的批判性审查.
- 生态研究的分析.
- 检查结核病进展风险研究.
主要成果:
- 证据支持mtb免疫活性逆转,表明mtb暴露减少或不存在.
- 逆转表明Mtb免疫活性是动态的,而不是静态的.
- 忽视逆转会扭曲结核病风险估计,传播建模和政策.
结论:
- Mtb免疫活性是动态的,转化和逆转都显著.
- 逆转意味着减少了Mtb的暴露.
- 将逆转纳入结核病自然史的理解对于准确的风险评估和有效的公共卫生战略至关重要.
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