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The knowns and unknowns of latent Mycobacterium tuberculosis infection
W. Henry Boom, … , Ulrich E. Schaible, Jacqueline M. Achkar
W. Henry Boom, … , Ulrich E. Schaible, Jacqueline M. Achkar
Published February 1, 2021
Citation Information: J Clin Invest. 2021;131(3):e136222. https://doi.org/10.1172/JCI136222.
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The knowns and unknowns of latent Mycobacterium tuberculosis infection

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Abstract

Humans have been infected with Mycobacterium tuberculosis (Mtb) for thousands of years. While tuberculosis (TB), one of the deadliest infectious diseases, is caused by uncontrolled Mtb infection, over 90% of presumed infected individuals remain asymptomatic and contain Mtb in a latent TB infection (LTBI) without ever developing disease, and some may clear the infection. A small number of heavily Mtb-exposed individuals appear to resist developing traditional LTBI. Because Mtb has mechanisms for intracellular survival and immune evasion, successful control involves all of the arms of the immune system. Here, we focus on immune responses to Mtb in humans and nonhuman primates and discuss new concepts and outline major knowledge gaps in our understanding of LTBI, ranging from the earliest events of exposure and infection to success or failure of Mtb control.

Authors

W. Henry Boom, Ulrich E. Schaible, Jacqueline M. Achkar

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Figure 2

Potential protective roles of antibodies and B cells in the lung during both initial Mtb exposure and LTBI.

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Potential protective roles of antibodies and B cells in the lung during ...
(A) Antibody isotypes (IgA, IgG, and IgM) could impact Mtb in the lower airways through binding, opsonization, complement activation, and FcR-mediated enhanced phagocytosis and intracellular growth reduction by phagocytes. (B) B cells located in germinal centers of lymphoid tissues could control infection through (i) enhancing antigen presentation to T cells; (ii) production of helper cytokines for T cells; and (iii) generation of antibodies that could modulate innate and adaptive immune responses. (C) Both the presence of B cells and the pro- and antiinflammatory capacities of antibodies could influence the formation of functional granulomas and thereby contribute to the control of Mtb.

Copyright © 2025 American Society for Clinical Investigation
ISSN: 0021-9738 (print), 1558-8238 (online)

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