The dual face of central nervous system tuberculosis: A new Janus Bifrons?.

SAENZ B; HERNANDEZ PANDO RA; FRAGOSO G; BOTTASSO O; CARDENAS G

Tuberculosis (Edinb)

CHURCHILL LIVINGSTONE

Lugar: ESCOCIA; Año: 2013 vol. 93 p. 130 - 135

1472-9792

Tuberculosis (TB) is still a common infectious disease in developing countries, but also re-emerging in industrialized nations, due to the HIV pandemic. In addition to bacillary virulence, the host immune response plays a major role in the development of an active disease (either as a primary infection or as a reactivation) and in the control of the infection. Even though several mechanisms are involved in regulating the human immune response, the biological environment seems to be determinant. In this context, the integrated neuro-immune-endocrine system strongly influences TB clinical outcome. One of the most important clinical aspects of TB manifests when it locates in the central nervous system (CNS), in which a very different set of immune responses is induced. Herein we review several aspects of the paradoxical immune response triggered during CNS TB infection, and discuss the implications of this response in the cerebral infection outcome.