Abstract:
Tuberculosis has been present in the world\'s population for as long as there has been written language. It is a disease known to the ancient Egyptians, Greeks, Romans, and Hebrews, but its etiology eluded the world for thousands of years. Even after the germ theory was accepted and early scientists hypothesized a pathogen as the cause, the identity of the sleeping killer in society remained a mystery. That is until Robert Koch was able to grow and visualize Mycobacterium tuberculosis. Koch introduced his Old Tuberculin solution as a diagnostic therapy of tuberculosis (TB), with the intent to reduce the number of infected persons and stop its spread. Old Tuberculin\'s ability to treat TB proved minimal, but its diagnostic potential paved the way for more effective tests from von Pirquet, Calmette, Wolff-Eisner, and Mantoux. Florence Seibert set out to identify and purify the active principle in Koch\'s Old Tuberculin and ended up creating purified protein derivative (PPD) tuberculin which is still used as the standard for the tuberculin skin test (TST). Interferon-γ release assays (IGRAs) are a more modern diagnostic tool for detecting latent TB infection that offer some benefits (and some disadvantages) to TST. TSTs and IGRAs can determine if an individual has been infected with M. tuberculosis but are equally unable to predict progression to active tuberculosis, the diagnosis of which relies on assessment of clinical symptoms, radiographic imaging, and sample culture.
摘要:
只要有书面语言,结核病就已经存在于世界人口中。这是古埃及人已知的一种疾病,希腊人,罗马人,希伯来人,但是它的病因学在世界上消失了数千年。即使在细菌理论被接受并且早期科学家假设病原体是病因之后,社会上沉睡的杀手的身份仍然是个谜。直到RobertKoch能够生长并可视化结核分枝杆菌。Koch介绍了他的旧Tuberculin解决方案作为结核病(TB)的诊断疗法,旨在减少感染人数并阻止其传播。老结核菌素治疗结核病的能力被证明是微乎其微的,但是它的诊断潜力为vonPirquet进行更有效的测试铺平了道路,卡介特,Wolff-Eisner,还有Mantoux.FlorenceSeibert着手鉴定和纯化Koch'sOldTuberculin中的活性成分,并最终产生了纯化的蛋白质衍生物(PPD)结核菌素,其仍被用作结核菌素皮肤试验(TST)的标准。干扰素-γ释放测定(IGRAs)是用于检测潜伏性TB感染的更现代的诊断工具,其为TST提供一些益处(和一些缺点)。TSTs和IGRA可以确定个体是否感染了结核分枝杆菌,但同样无法预测活动性结核病的进展。其诊断依赖于临床症状的评估,射线成像,和样本文化。