臨床検査52巻10号

2008年10月発行

今月の主題 結核 総論

結核の微生物学と免疫

著者： 冨岡治明¹

所属機関： ¹島根大学医学部微生物免疫学教室

ページ範囲：P.1077 - P.1084

　結核菌はgenus Mycobacteriumに属する病原菌であるが，脂質に富む堅牢な細胞壁をもつため，物理的・化学的な処理に対する抵抗性が強い．さらに体内にあっては，様々な病原因子の働きにより，宿主マクロファージの殺菌メカニズムに対して強い抵抗性を示し，感染部位での滞留性が高い．このように，結核菌はヒトや動物に強い病原性を示し持続感染を引き起こす．そしてその感染症は適切な化学療法なしには極めて難治性である．

参考文献

1) 冨岡治明：抗酸菌の細菌学．化学療法の領域　21：166-175, 2005

2) Ernst JD, Trevejo-Nuñez G, Banaiee N：Genomics and the evolution, pathogenesis, and diagnosis of tuberculosis. J Clin Invest　117：1738-1745, 2007

from the complete genome sequence. Nature　393：537-544, 1998

：Dawn of a discipline. Cell　104：477-485, 2001

pathogenesis and molecular determinants of virulence. Clin Microbiol Rev　16：463-496, 2003

6) Houben EN, Nguyen L, Pieters J：Interaction of pathogenic mycobacteria with the host immune system. Curr Opin Microbiol　9：76-85, 2006

7) 冨岡治明：抗酸菌症と免疫．臨床と微生物　24：45-52, 1997

. Microbiology　144：1205-1211, 1998

in resistance to peroxynitrite and stage-specific survival in macrophages. Microbiology　148：3139-3144, 2002

expresses a novel pH-dependent divalent cation transporter belonging to the Nramp family. J Exp Med　190：717-724, 1999

BCG. Infect Immun　64：16-22, 1996

in mice. Nature　402：79-83, 1999

13) Pieters J：Entry and survival of pathogenic mycobacteria in macrophages. Microbes Infect　3：249-255, 2001

14) Koul A, Herget T, Klebl B, et al：Interplay between mycobacteria and host signalling pathways. Nat Rev Microbiol　2：189-202, 2004

15) Mueller P, Pieters J：Modulation of macrophage antimicrobial mechanisms by pathogenic mycobacteria. Immunobiology　211：549-556, 2006

and the environment within the phagosome. Immunol Rev　219：37-54, 2007

/calmodulin signals the completion of docking and triggers a late step of vacuole fusion. Nature　396：575-580, 1998

18) Via LE, Deretic D, Ulmer RJ, et al：Arrest of mycobacterial phagosome maturation is caused by a block in vesicle fusion between stages controlled by rab5 and rab7. J Biol Chem　272：13326-13331, 1997

phagosome and evidence that phagosomal maturation is inhibited. J Exp Med　181：257-270, 1995

phagosomes produced by exclusion of the vesicular proton-ATPase. Science　263：678-681, 1994

21) Fratti RA, Backer JM, Gruenberg J, et al：Role of phosphatidylinositol 3-kinase and Rab5 effectors in phagosomal biogenesis and mycobacterial phagosome maturation arrest. J Cell Biol　154：631-644, 2001

22) Ferrari G, Langen H, Naito M, et al：A coat protein on phagosomes involved in the intracellular survival of mycobacteria. Cell　97：435-447, 1999

H37Ra. J Immunol　166：7469-7476, 2001

-dependent process inducing bacterial death by phagosome-lysosome fusion. J Immunol　167：3300-3307, 2001

strains evade apoptosis of infected alveolar macrophages. J Immunol　164：2016-2020, 2000

promotes macrophage survival by phosphorylating Bad through a phosphatidylinositol 3-kinase/Akt pathway. J Biol Chem　276：329-333, 2001

is mediated by a novel caspase-independent pathway. J Immunol　176：4267-4274, 2006

28) Tomioka H：Adjunctive immunotherapy of mycobacterial infections. Curr Pharm Des　10：3297-3312, 2004