• 보건세계
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• v.40 no.3 s.439
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• pp.24-24
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• 1993

• 보건세계
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• v.40 no.6 s.442
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• pp.4-7
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• 1993

과거 몇십년간 세계적으로 감소추세에 있던 결핵이 보건 당국의 감시소홀과 에이즈의 확산 및 약제내성 결핵균에 힘입어 다시 살아나고 있다. 현재 해마다 800만명의 결핵환자 발병. 사망자 300만명으로 이런 추세로 간다면 2000년에는 370만명에 달하는 사람이 결핵으로 사망할 것으로 WHO는 추정했다. 다시 고개든 결핵균은 인체면역결핍 바이러스양성인 집단 제3세계의 가난한 국가와 서방의 특수고립집단을 새로운 번식처로 자리잡고 있어 그 실태를 알아본다.

• 보건세계
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• v.55 no.5
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• pp.52-55
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• 2008

결핵은 인류의 역사와 함께한 오래된 질병이다. 과거 우리나라의 결핵유병률은 5%에 이를 정도로 심각하였으나 국가결핵관리를 통해 급격하게 유병률이 낮아졌는데, 이에 따라 비결핵성 항산균에 의한 감염이 상대적으로 증가하고 있다. 강력한 결핵관리사업으로 의료인은 물론 일반인들도 결핵에 관해 많은 지식을 갖고있으나, 비결핵성 항산균에 대한 인식수준은 그리 높지 못하다. 이 글에서는 얼마 전 사회적으로 문제가 되었던 한의원 집단발병 사건을 중심으로 비결핵성 항산균에 대해서 설명하고자 한다.

• Tuberculosis and Respiratory Diseases
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• v.53 no.1
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• pp.5-16
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• 2002

Background : Though mononuclear phagocytes serve as the final effectors in killing intracellular Mycobacterium tuberculosis, the bacilli readily survive in the intracellular environment of resting cells. The mechanisms through which cellular activation results in the intracellular killing is unclear. In this study, we sought to explore an in vitro model of a low-level infection of human mononuclear phagocytes with MAC and $H_{37}Ra$ and determine the extent of the lymphocyte dependent cytotoxicity of human monocytes and alveolar macrophages. Materials and Methods : The peripheral monocytes were prepared using the Ficoll gradient method from PPD positive healthy people and tuberculosis patients. The alveolar macrophages were prepared from PPD positive healthy people via a bronchoalveolar lavage. The human mononuclear phagocytes were infected at a low infection rate (bacilli:phagocyte 1:10) with MAC(Mycobacterium avium) and Mycobacterium tuberculosis $H_{37}Ra$. Non-adherent cells(lymphocyte) were added at a 10:1 ratio. After 1,4, and 7 days culture in $37^{\circ}C$, 5% CO2 incubator, the cells were harvested and inoculated in a 7H10/OADC agar plate for the CFU assay. The bacilli were calculated with the CFU/$1{\times}10^6$ of the cells and the cytotoxicity was expressed as the log killing ratio. Results : The intracellular killing of MAC and $H_{37}Ra$ within the monocyte was greater in patients with tuberculosis compared to the PPD positive controls (p<0.05). Intracellular killing of MAC and $H_{37}Ra$ within the alveolar macrophage appeared to be greater than that within the monocytes of the PPD positive controls. There was significant lymphocyte dependent inhibition of intracellular growth of the mycobacteria within the monocytes in both the controls and tuberculosis patients and within the macrophages in the controls(p<0.05). There was no specific difference in the virulence between the MAC and the $H_{37}Ra$. Conclusion : This study is an in vitro model of a low-level infection with MAC and $H_{37}Ra$ of human mononuclear phagocytes. The intracellular cytotoxicity of the mycobacteria within the phagocytic cells was significantly lymphocyte dependent. During the 7 days culture after the intracellular phagocytosis, the actual confinement of the mycobacteria was observed within the monocytes of tuberculosis patients and the alveolar macrophages of the controls as in the case of adding lymphocytes.

• 건강소식
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• v.30 no.5 s.330
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• pp.30-31
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• 2006

결핵균은 주로 사람에서 사람으로 공기를 통해 전파 결핵균만이 공중으로 떠돌아다니다가 주위에 있는 사람들이 숨을 들이쉴 때 공기와 함께 폐 속으로 들어가 증식을 함으로써 감염

• Tuberculosis and Respiratory Diseases
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• v.48 no.5
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• pp.699-708
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• 2000

Background : A presumptive histopathologic diagnosis of tuberculosis is commonly based on the finding of acid-fast bacilli upon microscopic examination of a diagnostic specimens. Although this traditional histochemical staining method is satisfactory, it is time-consuming and not species-specific. For more specific assessment, in situ hybridization assay with oligonucleotide probes is introduced. Methods : The human surgical specimens were obtained from tuberculosis patients, and experimental specimens were made by injecting cultured M. tuberculosis organisms into fresh rat liver. Oligonucleotide probes complementary to ribosomal RNA portion were synthesized and labeled with multiple biotin molecules. For a rapid detection, all procedures were carried out using manual capillary action technology on the Microprobe staining system. Results : The in situ hybridization assay produced a positive reaction in experimental specimens (80-90% sensitivity) after pepsin-HCl pre-treatment for a good permeabilization of probes, but reliable result was not obtained from human surgical specimens. Conclusion : It is, therefore, suggested that biotin-labeled oligonucleotide probes have considerable potential for identification and in situ detection of M. tuberculosis but, there are some barriers to overcome for the diagnostic use of this method.

• 보건세계
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• v.53 no.5 s.597
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• pp.35-39
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• 2006

다제내성 결핵은 치료 성공률이 낮은데 그 원인으로 사용할 수 있는 효과적인 항결핵 약제의 숫자가 제한되어 있고, 약제 부작용이 많고, 장기간의 치료기간으로 인해 환자의 순응도(compliance)가 낮기 때문이다. 치료에 실패한 다제내성 결핵환자는 본인의 고통뿐만 아니라 지속적으로 결핵균을 배출하는 만성배균자가 되어 수 많은 사람들에게 다제내성 결핵균을 퍼뜨리는 전염원이 된다.

• Tuberculosis and Respiratory Diseases
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• v.53 no.5
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• pp.497-509
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• 2002

Background : The mechanisms through which cellular activation results in intracellular mycobacterial killing is only partially understood. However, in vitro studies of human immunity to Mycobacterium tuberculosis have been largely modeled on the work reported by Crowle, which is complicated by several factors. The whole blood culture is simple and allows the simultaneous analysis of the relationship between bacterial killing and the effect of effector cells and humoral factors. In this study, we attempted to determine the extent to which M. tuberculosis is killed in a human whole blood culture and to explore the role of the host and microbial factor in this process. Methods : The PPD positive subject were compared to the umbilical cord blood and patients with tuberculosis, diabetes and lung cancer. The culture is performed using heparinized whole blood diluted with a culture medium and infected with a low number of M. avium or M. tuberculosis $H_{37}Ra$ for 4 days by rotating the culture in a $37^{\circ}C$, 5% $CO_2$ incubator. In some experiments, methlprednisolone- or pentoxifyline were used to inhibit the immune response. To assess the role of the T-cell subsets, CD4+, CD8+ T-cells or both were removed from the blood using magnetic beads. The ${\Delta}$ log killing ratio was defined using a CFU assay as the difference in the log number of viable organisms in the completed culture compared to the inoculum. Results : 1. A trend was noted toward the improved killing of mycobacteria in PPD+ subjects comparing to the umbilical cord blood but there was no specific difference in the patients with tuberculosis, diabetes and lung cancer. 2. Methylprednisolone and pentoxifyline adversely affected the killing in the PPD+ subjects umbilical cord blood and patients with tuberculosis. 3. The deletion of CD4+ or CD8+ T-lymphocytes adversely affected the killing of M. avium and M. tuberculosis $H_{37}Ra$ by PPD+ subjects. Deletion of both cell types had an additive effect, particularly in M. tuberculosis $H_{37}Ra$. 4. A significantly improved mycobacterial killing was noted after chemotherapy in patients with tuberculosis and the ${\Delta}$ logKR continuously decreased in a 3 and 4 days of whole blood culture. Conclusion : The in vitro bactericidal assay by human whole blood culture model was settled using a CFU assay. However, the host immunity to M. tuberculosis was not apparent in the human whole blood culture bactericidal assay, and patients with tuberculosis showed markedly improved bacterial killing after anti-tuberculous chemotherapy compared to before. The simplicity of a whole blood culture facilitates its inclusion in a clinical trial and it may have a potential role as a surrogate marker in a TB vaccine trial.

• Tuberculosis and Respiratory Diseases
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• v.58 no.2
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• pp.142-152
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• 2005

Background : Priming and boosting vaccination strategy has been widely explored for new vaccine development against tuberculosis. As an effort to identify other vaccine candidates, this study was initiated to evaluate protective efficacy of adenylate kinase (AK), nucleoside diphosphate kinase (NdK), and heat shock protein 70 (Hsp70) of Mycobacterium tuberculosis. Method : M. tuberculosis genes encoding AK, NdK, and Hsp70 proteins were amplified by PCR and cloned into E. coli expression vector, pQE30. Recombinant AK, NdK, and Hsp70 was purified through Ni-NTA resin. To evaluate immune responses, we performed enzyme-linked immunosorbent assay (ELISA) for IgG isotype and $IFN-{\gamma}$ after mice were immunized subcutaneously with recombinant proteins delivered in dimethyl dioctadecylammonium bromide (DDA). Immunized- and control groups were challenged by aerosol with M. tuberculosis. The spleens and lungs of mice were removed aseptically and cultured for CFU of M. tuberculosis. Result : Vaccination with recombinant proteins AK, NdK, and Hsp70 delivered in DDA elicited significant level of antibody and $IFN-{\gamma}$ responses to corresponding antigens but no protective immunity comparable to that achieved with Mycobacterium bovis BCG. Conclusion : Recombinant proteins AK, NdK, and Hsp70 do not effectively control growth of M. tuberculosis in mice when immunized with DDA as an adjuvant.

• Korean Journal of Food Science and Technology
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• v.46 no.1
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• pp.94-99
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• 2014

The present study aimed to evaluate the in vitro antimycobacterial effects of hop plant, Humulus japonicus. Methanol extract of H. japonicus (MeOH extract) showed strong direct bactericidal effects against Mycobacterium tuberculosis in vitro. Furthermore, the MeOH extract significantly inhibited M. tuberculosis growth in human macrophages. When five fractions obtained from MeOH extract were examined using the same methods, the hexane and ethyl acetate fractions showed bactericidal effects against M. tuberculosis in vitro, whereas the butanol and water fractions inhibited M. tuberculosis growth in macrophages. Because H. japonicus extract exhibited antimycobacterial activity against both free M. tuberculosis in culture medium and intracellular M. tuberculosis in human macrophages, this plant might be a good candidate for development of a new anti-tuberculosis drug.