Post-tuberculosis (post-TB) lung disease is increasingly recognized as a major contributor to the global burden of chronic lung disease, with recent estimates indicating that over half of TB survivors have impaired lung function after successful completion of TB treatment. However, the pathologic mechanisms that contribute to post-TB lung disease are not well understood, thus limiting the development of therapeutic interventions to improve long-term outcomes after TB. This report summarizes the work of the Pathogenesis and Risk Factors Committee for the Second International Post-Tuberculosis Symposium, which took place in Stellenbosch, South Africa, in April 2023. The committee first identified six areas with high translational potential: 1) tissue matrix destruction, including the role of matrix metalloproteinase dysregulation and neutrophil activity; 2) fibroblasts and profibrotic activity; 3) granuloma fate and cell death pathways; 4) mycobacterial factors, including pathogen burden; 5) animal models; and 6) the impact of key clinical risk factors, including HIV, diabetes, smoking, malnutrition, and alcohol. We share the key findings from a literature review of those areas, highlighting knowledge gaps and areas where further research is needed.

中文翻译：

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结核病后肺病的发病机制：在第二届国际结核病后研讨会上定义知识差距和研究重点。


结核病后 （post-TB） 肺病越来越被认为是全球慢性肺病负担的主要因素，最近的估计表明，超过一半的结核病幸存者在成功完成结核病治疗后肺功能受损。然而，导致结核病后肺病的病理机制尚不清楚，从而限制了治疗干预措施的发展以改善结核病后的长期预后。本报告总结了 2023 年 4 月在南非斯泰伦博斯举行的第二届国际结核病后研讨会的发病机制和风险因素委员会的工作。该委员会首先确定了六个具有高翻译潜力的领域：1） 组织基质破坏，包括基质金属蛋白酶失调和中性粒细胞活性的作用;2） 成纤维细胞和促纤维化活性;3） 肉芽肿命运和细胞死亡途径;4） 分枝杆菌因子，包括病原体负荷;5） 动物模型;6） 关键临床风险因素的影响，包括 HIV、糖尿病、吸烟、营养不良和酒精。我们分享了这些领域的文献综述的主要发现，强调了知识差距和需要进一步研究的领域。