Infectious diseases. Tuberculosis. Etiology. Epidemiology. Immunology (most important)

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Infectious diseases. Tuberculosis. Etiology. Epidemiology. Immunology (most important)

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50. Tuberculosis. Etiology. Epidemiology. Immunology

Etiology. Tuberculosis is caused by tubercle bacilli belonging to the family of mycobacteria, a group of actinomycetes. In humans, the leading role is played by M. tuberculosis, responsible for most cases of the disease; M. bovis is the causative agent of tuberculosis in cattle, rabbits, M. avium causes disease in birds and white mice. All mycobacteria are non-motile, aerobic, polymorphic rods that do not form spores. They are difficult to stain due to the high lipid content in their cell wall, but once stained, they are no longer discolored by alcohol and acids. A feature of Mycobacterium tuberculosis is their very slow growth on nutrient media. Under the influence of various environmental factors, the causative agent of tuberculosis exhibits a wide range of variability in the morphology of bacterial cells - from the smallest filtering particles and grains to giant branched forms, which affects their functional properties.

Epidemiology. Tuberculosis is a relatively common disease, with adults with active tuberculosis and tuberculosis-affected cattle being the main source of infection in children.

The most dangerous are patients with bacterial excretion. The main route of infection transmission is airborne. The rest - alimentary, contact, through damaged skin and mucous membranes - are rare and do not have great epidemiological significance.

Immunology. Immune responses in tuberculosis are a complex set of interactions between the pathogen, specific populations of lymphocytes, and tissue macrophages. Various types of antibodies produced during the development of infection do not play a significant role in suppressing the growth of mycobacteria and in the development of anti-tuberculosis immunity. Cellular reactions of immunity begin to manifest themselves after the ingestion of live and pathogenic mycobacteria. Lung macrophages phagocytize them, but are unable to destroy them. In macrophages, the pathogen continues to multiply, with them mycobacteria enter the regional lymph nodes. Subsequently, the infection spreads along the hematogenous and lymphogenous pathways with the formation of numerous extrapulmonary foci.

Immunological processes are completed within 6-10 weeks, leading to the development of primary infection and elimination of metastatic foci.

The development of natural immunity to this life-threatening infection depends on the influence of:

1) genetic factors;

2) age determining the severity of tuberculosis;

3) factors affecting the function of T-lymphocytes and thereby contributing to the development of severe forms of the disease: malnutrition, various infections, primarily measles and whooping cough, pregnancy, diseases of the reticuloendothelial system, lymphocytic leukemia.

Author: Pavlova N.V.

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