Novel Insights into the Pathogenesis of Human Post-Primary Tuberculosis from Archival Material of the Pre-Antibiotic Era, 1931–1947
Objectives: Primary and post-primary tuberculosis (TB) are distinct entities. The aim of this study was to study the histopathology of primary and post-primary TB by using the unique human autopsy material from the pre-antibiotic era, 1931–1947. Material and Methods: Autopsy data were collected from...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-12-01
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| Series: | Pathogens |
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| Online Access: | https://www.mdpi.com/2076-0817/12/12/1426 |
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| author | Syeda Mariam Riaz Kurt Hanevik Lars Helgeland Lisbet Sviland Robert L. Hunter Tehmina Mustafa |
| author_facet | Syeda Mariam Riaz Kurt Hanevik Lars Helgeland Lisbet Sviland Robert L. Hunter Tehmina Mustafa |
| author_sort | Syeda Mariam Riaz |
| collection | DOAJ |
| description | Objectives: Primary and post-primary tuberculosis (TB) are distinct entities. The aim of this study was to study the histopathology of primary and post-primary TB by using the unique human autopsy material from the pre-antibiotic era, 1931–1947. Material and Methods: Autopsy data were collected from the autopsy journals, and the human tissue was collected from the pathology archives at the Department of Pathology, the Gades Institute. Results: Histological presentations of TB lesions showed great diversity within a single lung. Post-primary TB starts as a pneumonia forming early lesions, characterized by the infiltration of foamy macrophages containing mycobacterial antigens within alveoli, and progressing to necrotic pneumonias with an increasing density of mycobacterial antigens in the lesions. These necrotic pneumonic lesions appeared to either resolve as fibrocaseous lesions or lead to cavitation. The typical granulomatous inflammation, the hallmark of TB lesions, appeared later in the post-primary TB and surrounded the pneumonic lesions. These post-primary granulomas contained lesser mycobacterial antigens as compared to necrotic pneumonia. Conclusions: Immunopathogenesis of post-primary TB is different from primary TB and starts as pneumonia. The early lesions of post-primary TB may progress or regress, holding the key to understanding how a host can develop the disease despite an effective TB immunity. |
| first_indexed | 2024-03-08T20:28:04Z |
| format | Article |
| id | doaj.art-7d135dc0c7dc440b9d456b4d0edabe96 |
| institution | Directory Open Access Journal |
| issn | 2076-0817 |
| language | English |
| last_indexed | 2024-03-08T20:28:04Z |
| publishDate | 2023-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Pathogens |
| spelling | doaj.art-7d135dc0c7dc440b9d456b4d0edabe962023-12-22T14:30:56ZengMDPI AGPathogens2076-08172023-12-011212142610.3390/pathogens12121426Novel Insights into the Pathogenesis of Human Post-Primary Tuberculosis from Archival Material of the Pre-Antibiotic Era, 1931–1947Syeda Mariam Riaz0Kurt Hanevik1Lars Helgeland2Lisbet Sviland3Robert L. Hunter4Tehmina Mustafa5Centre for International Health, Department of Global Public Health and Primary Care, Faculty of Medicine and Dentistry, University of Bergen, 5007 Bergen, NorwayDepartment of Clinical Science, Faculty of Medicine and Dentistry, University of Bergen, 5007 Bergen, NorwayDepartment of Pathology, Haukeland University Hospital, 5021 Bergen, NorwayDepartment of Pathology, Haukeland University Hospital, 5021 Bergen, NorwayDepartment of Pathology and Laboratory Medicine, University of Texas Health Sciences Centre at Houston, Houston, TX 77030, USACentre for International Health, Department of Global Public Health and Primary Care, Faculty of Medicine and Dentistry, University of Bergen, 5007 Bergen, NorwayObjectives: Primary and post-primary tuberculosis (TB) are distinct entities. The aim of this study was to study the histopathology of primary and post-primary TB by using the unique human autopsy material from the pre-antibiotic era, 1931–1947. Material and Methods: Autopsy data were collected from the autopsy journals, and the human tissue was collected from the pathology archives at the Department of Pathology, the Gades Institute. Results: Histological presentations of TB lesions showed great diversity within a single lung. Post-primary TB starts as a pneumonia forming early lesions, characterized by the infiltration of foamy macrophages containing mycobacterial antigens within alveoli, and progressing to necrotic pneumonias with an increasing density of mycobacterial antigens in the lesions. These necrotic pneumonic lesions appeared to either resolve as fibrocaseous lesions or lead to cavitation. The typical granulomatous inflammation, the hallmark of TB lesions, appeared later in the post-primary TB and surrounded the pneumonic lesions. These post-primary granulomas contained lesser mycobacterial antigens as compared to necrotic pneumonia. Conclusions: Immunopathogenesis of post-primary TB is different from primary TB and starts as pneumonia. The early lesions of post-primary TB may progress or regress, holding the key to understanding how a host can develop the disease despite an effective TB immunity.https://www.mdpi.com/2076-0817/12/12/1426primary tuberculosispost-primary tuberculosistuberculosis pneumoniacavity |
| spellingShingle | Syeda Mariam Riaz Kurt Hanevik Lars Helgeland Lisbet Sviland Robert L. Hunter Tehmina Mustafa Novel Insights into the Pathogenesis of Human Post-Primary Tuberculosis from Archival Material of the Pre-Antibiotic Era, 1931–1947 Pathogens primary tuberculosis post-primary tuberculosis tuberculosis pneumonia cavity |
| title | Novel Insights into the Pathogenesis of Human Post-Primary Tuberculosis from Archival Material of the Pre-Antibiotic Era, 1931–1947 |
| title_full | Novel Insights into the Pathogenesis of Human Post-Primary Tuberculosis from Archival Material of the Pre-Antibiotic Era, 1931–1947 |
| title_fullStr | Novel Insights into the Pathogenesis of Human Post-Primary Tuberculosis from Archival Material of the Pre-Antibiotic Era, 1931–1947 |
| title_full_unstemmed | Novel Insights into the Pathogenesis of Human Post-Primary Tuberculosis from Archival Material of the Pre-Antibiotic Era, 1931–1947 |
| title_short | Novel Insights into the Pathogenesis of Human Post-Primary Tuberculosis from Archival Material of the Pre-Antibiotic Era, 1931–1947 |
| title_sort | novel insights into the pathogenesis of human post primary tuberculosis from archival material of the pre antibiotic era 1931 1947 |
| topic | primary tuberculosis post-primary tuberculosis tuberculosis pneumonia cavity |
| url | https://www.mdpi.com/2076-0817/12/12/1426 |
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