Version 1
: Received: 1 November 2021 / Approved: 5 November 2021 / Online: 5 November 2021 (14:50:58 CET)
How to cite:
Brown, R.E.E.; Hunter, R.L. Early Lesion of Post-Primary Tuberculosis: Subclinical Driver of Disease and Target for Vaccines and Host-directed Therapies.. Preprints2021, 2021110124. https://doi.org/10.20944/preprints202111.0124.v1
Brown, R.E.E.; Hunter, R.L. Early Lesion of Post-Primary Tuberculosis: Subclinical Driver of Disease and Target for Vaccines and Host-directed Therapies.. Preprints 2021, 2021110124. https://doi.org/10.20944/preprints202111.0124.v1
Brown, R.E.E.; Hunter, R.L. Early Lesion of Post-Primary Tuberculosis: Subclinical Driver of Disease and Target for Vaccines and Host-directed Therapies.. Preprints2021, 2021110124. https://doi.org/10.20944/preprints202111.0124.v1
APA Style
Brown, R.E.E., & Hunter, R.L. (2021). Early Lesion of Post-Primary Tuberculosis: Subclinical Driver of Disease and Target for Vaccines and Host-directed Therapies.. Preprints. https://doi.org/10.20944/preprints202111.0124.v1
Chicago/Turabian Style
Brown, R.E.E. and Robert L Hunter. 2021 "Early Lesion of Post-Primary Tuberculosis: Subclinical Driver of Disease and Target for Vaccines and Host-directed Therapies." Preprints. https://doi.org/10.20944/preprints202111.0124.v1
Abstract
The characteristic lesion of primary tuberculosis is the granuloma as is widely studied in human tissues and animal models. Post-primary tuberculosis is different. It develops only in human lungs and begins as a prolonged subclinical obstructive lobular pneumonia that slowly accumulates mycobacterial antigens and host lipids in alveolar macrophages with nearby highly sensitized T cells. After several months, the lesions undergo necrosis to produce a mass of caseous pneumonia large enough to fragment and be coughed out to produce a cavity or be retained as the focus of a post-primary granuloma. Here we extend these findings with the demonstration of mycobacterial antigen, but not AFB, of M. tuberculosis in the cytoplasm of ciliated bronchiolar epithelium and alveolar pneumocytes in association with elements of the programmed death ligand 1 (PD-L1), cyclo-oxygenase (COX)-2, and fatty acid synthase (FAS) pathways in the early lesion. This suggests that M. tuberculosis uses its secreted antigens to coordinate prolonged subclinical development of the early le-sions in preparation for a necrotizing reaction sufficient to produce a cavity, post-primary granulomas and fibrocaseous disease.
Medicine and Pharmacology, Pathology and Pathobiology
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
