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The pathogenesis of tuberculous meningitis
Author(s) -
Davis Angharad Grace,
Rohlwink Ursula Karin,
Proust Alizé,
Figaji Anthony A.,
Wilkinson Robert J.
Publication year - 2019
Publication title -
journal of leukocyte biology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.819
H-Index - 191
eISSN - 1938-3673
pISSN - 0741-5400
DOI - 10.1002/jlb.mr0318-102r
Subject(s) - tuberculosis , disease , biology , tuberculous meningitis , immune system , pathogenesis , mycobacterium tuberculosis , immunology , meningitis , virulence , medicine , pathology , pediatrics , gene , biochemistry
Tuberculosis (TB) remains a leading cause of death globally. Dissemination of TB to the brain results in the most severe form of extrapulmonary TB, tuberculous meningitis (TBM), which represents a medical emergency associated with high rates of mortality and disability. Via various mechanisms the Mycobacterium tuberculosis ( M.tb ) bacillus disseminates from the primary site of infection and overcomes protective barriers to enter the CNS. There it induces an inflammatory response involving both the peripheral and resident immune cells, which initiates a cascade of pathologic mechanisms that may either contain the disease or result in significant brain injury. Here we review the steps from primary infection to cerebral disease, factors that contribute to the virulence of the organism and the vulnerability of the host and discuss the immune response and the clinical manifestations arising. Priorities for future research directions are suggested.