Mycobacteriosis in the compromised host

The studies of rare genetic defects, the preliminary results of population- based studies, being validated by the experimental immunocompromised animal models and the current observations accumulated in immunocompromised patie nts with mycobacterial diseases provide us with insights into the importanc e of the macrophage activation pathway in controlling human infection with pathogenic and non pathogenic intracellular multiplying mycobacteria. Initial cytokine production by infected macrophages and/or dendritic cells could be crucial in the overall regulation of self cure, acquired protectio n or immunopathological sequelae expressing the disease. Knowledge of molec ular and generic cross-talks between phagocytic and specialized antigen pre senting cells and different mycobacterial products associated with persiste nce or replication of the intracellular bacteria, could provide further inf ormations on the global immune regulation of the early host responses to in fection and the following events. It seems likely that the development of m ycobacterial infections in humans will turn out to be as much dependent on the genetic make up of the host as or the virulence of the bacteria.