Alteraciones en fagocitos mononucleares: un viraje al significado de la muerte de monocitos y macrófagos en la inmunopatogénesis de la tuberculosis

Diana Castaño, Mauricio Rojas


Los fagocitos mononucleares, en particular los monocitos y los macrófagos, han sido considerados los blancos primarios de la infección por Mycobacterium tuberculosis y, a su vez, las principales células efectoras y reservorios de la micobacteria. La heterogeneidad de estas células, así como su plasticidad, hacen que las respuestas ante la infección sean diversas y complejas. Las diferencias que presentan los fagocitos mononucleares de animales naturalmente resistentes a la infección, la expresión de los genes asociados al control de las infecciones micobacterianas y las discrepancias que se observan entre los monocitos en circulación de los pacientes con tuberculosis y los controles sanos en la expresión de CD14, CD36 y HLA-DR, así como en la muerte celular, nos ha sugerido que puede haber alteraciones en la distribución de las subpoblaciones de monocitos o en su estado de madurez.En humanos, las subpoblaciones de monocitos de sangre periférica se definieron inicialmente de acuerdo con la expresión de las moléculas de superficie CD14 y CD16. Hay dos tipos principales de monocitos, unos con alta expresión de CD14 y carentes de CD16 (CD14+CD16-) y otros con baja expresión de CD14 y que expresan CD16 (CD14+CD16+).En los pacientes con tuberculosis hay alteraciones en los recuentos de las subpoblaciones de monocitos, lo que nos hace considerar que el entendimiento de estos eventos podría ser fundamental en la comprensión de la inmunopatogénesis de esta enfermedad.

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