由两个Mycobacterium肺结核亚克隆引起的内源性和附带性重新激活的情况
Junji Seto1, Sumito Inoue2, Shuichi Abe3
1Yamagata Prefectural Institute of Public Health, 1-6-6 Toka-machi, Yamagata, Yamagata, 990-0031, Japan.
概括
结核菌可以在不同肺部病变中重新激活,与原始克隆不同. 这种由全基因组测序证明的附带重新激活挑战了以前对结核病复发的理解.
科学领域:
- 微生物学
- 基因组学
- 肺病学
背景情况:
- 结核病的内源性重新激活通常涉及Mycobacterium结核病亚克隆从初始分离物中积累突变.
- 之前的理解假定结核病重新激活期间在单个亚克隆内发生线性突变积累.
研究的目的:
- 调查一种复发性结核病病例,其中从原始疾病和复发中分离出来的 Mycobacterium 结核病与原始克隆不同.
- 探索结核病的附带再激活现象及其对传播和演变的影响.
主要方法:
- 一个复发性结核病例的回顾性队列研究 (2012年和2020年).
- 临床评估包括计算机断层扫描 (CT) 影像.
- 追溯接触和分子流行病学 (可变数组重复类型).
- 全基因组测序Mycobacterium结核病分离物
主要成果:
- 在2012年至2020年间,CT影像显示了不同肺部区域的新病变.
- 通过接触追踪和分子监测排除了外源性再感染.
- 整个基因组测序揭示了两种分离物之间的14个单核酸变异,每种从原始克隆中积累了7个变异,表明了附带分歧.
结论:
- 在同一宿主体内的不同肺病变中, Mycobacterium 结核菌子克隆可以并发累积突变.
- 识别并发性重新激活可以改善结核病传播的追踪和对抗药性演变的理解.
- 需要进一步的研究,以确定更多具有强有力的证据的附带再激活病例.
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