抗酸菌L型感染与前列腺癌的关系

应用抗酸（ＩＫ）染色和结核菌抗体（ＢＣＧ）免疫组化染色方法,对３０例前列腺癌及２０例前列腺增生症进行检测。结果显示：ＩＫ抗酸染色和ＢＣＧ免疫组化染色阳性率,前列腺癌分别为４３３％、４６７％;前列腺增生症为４５％、５５％,ＩＫ抗酸染色与ＢＣＧ免疫组化染色结果基本一致,两者符合率为９４％。提示结核菌Ｌ型感染与肿瘤的发生和发展可能有一定的关系     

恶性肿瘤中抗酸菌L型检出意义的研究

本文用改良抗酸染色法和卡介苗抗体免疫组化染色法对４２０例恶性肿瘤（乳腺癌１１２例肠腺癌１００例、恶性淋巴病５４例、子宫颈癌７０例、绒毛膜癌８４例）进行了研究。结果发现４２０例恶性肿瘤中４７例（１１．２％）,１Ｋ抗酸染色阳性和４９例（１１．６％）免疫组化染色阳性,其中以恶性淋巴瘤抗酸菌Ｌ型检出率最高（４４．４％）绒毛膜癌最低（２．４％）,抗酸菌Ｌ型主要（８５％）分布于癌巢或肿瘤实质内该区５１．１％癌细胞呈增生活跃状态,３４％癌细胞呈空泡样变性,颇似病毒感染的凹空细胞,２．１％的瘤细胞发生坏死。结合文献复习,提示抗酸菌Ｌ型感染可能与肿瘤发生有关。     

结核菌L型在淋巴结中检出的意义

本文用改良抗酸染色及免疫组化染色对９０例淋巴结（恶性淋巴瘤５４例、淋巴结慢性炎３６例）进行研究。结果发现恶性淋巴瘤与慢性淋巴结炎,结核菌Ｌ型感染率分别为５０％和７５％;两者结核菌抗体染色阳性率分别为５３．７％和７７．８％。组织病理学检查无典型的结核结节形成,提示结核菌Ｌ型感染可能与无反应性结核病及肿瘤的发生有关。     

PCNA和BCG在膀胱肿瘤及炎症中的表达

应用抗酸（ＩＫ）染色和结核菌抗体（ＢＣＧ）、增殖细胞核抗原（ＰＣＮＡ）免疫组化染色方法,对１１９例膀胱肿瘤及炎症进行了检测。结果显示：ＩＫ抗酸染色、ＢＣＧ免疫组化染色阳性率分别为：膀胱癌为３５２、３６７％;乳头状瘤为４０％、４４％;慢性炎为４２３％、５０％。ＰＣＮＡ阳性细胞指数膀胱癌与粘膜慢性炎比较差异非常显著（Ｐ＜０００１）;乳头状瘤与慢性炎比较差异显著（Ｐ＜００５）。提示结核菌Ｌ型感染与肿瘤的发生和发展可能有关     

肺癌中抗酸菌L型感染与PCNA及癌基因蛋白表达关系的研究

用改良抗酸染色及免疫组化染色（Ｓ—Ｐ）法探讨抗酸菌Ｌ型感染、增殖细胞核抗原（ＰＣＮＡ）、Ｐ２１、ｃ－ｅｒｂＢ－２等癌基因蛋白表达在肺癌发生、发展中的作用及其相互关系。结果显示：（１）５０例肺癌中抗酸菌Ｌ型感染率为４２０％,伴抗酸菌Ｌ型感染者,ＰＣＮＡ指数显著增高;（２）５０例肺癌中Ｐ２１、ｃ－ｅｒｂＢ－２阳性表达率分别为４４０％和３４０％;且随肺癌分期的增加及淋巴结转移而显著增高。结果表明抗酸菌Ｌ型感染可能是肺癌的重要因素之一;Ｐ２１、ｃ－ｅｒｂＢ－２表达预示肺癌预后不良;抗酸菌Ｌ型感染和癌基因蛋白可能在肺癌的不同发展阶段起作用。     

前列腺增生症中抗酸菌L型检出及其意义

本文用ＩＫ抗酸染色和免疫组化染色等方法对４９例前列腺增生症进行了研究。结果发现：４９例前列腺增生症中,３０例（６１２％）抗酸菌Ｌ型阳性,其中前列腺增生症Ｉ型中抗酸菌Ｌ型检出率最高（８３３％）;６０％抗酸菌Ｌ型主要分布于前列腺上皮细胞浆内,其中４３３％腺上皮细胞呈空泡样变性,颇似凹空样细胞;抗酸菌Ｌ型阳性病例中前列腺间质内炎细胞浸润明显高于Ｌ型阴性病例,Ｐ＜００２５。提示抗酸菌Ｌ型感染不仅是引起前列腺间质炎症反应的重要原因,炎症过程中可产生的活性物质可能也是导致前列腺增生不可忽视的原因之一。     

恶性淋巴瘤组织切片中结核菌L型的检出及其意义

本文应用Ｉｎｔｅｎｓｉｆｉｅｄｋｉｎｙｏｕｎ（ＩＫ）改良抗酸染色和结核菌抗休免疫组织化学染色检测了５１例恶性淋巴瘤组织功片内结核菌及其Ｌ型感染率。结果发现５１例恶性淋巴瘤组织功片中,ＩＫ染色阳性２５例（４９％）,免疫组化染色阳性２６例（５０．９％）,并发现结核菌Ｌ型感染与恶性淋巴瘤的疗效有关（Ｐ＜０．０１）。故认为恶性淋巴瘤中,结核菌Ｌ型感染是一个值得进一步研究的课题。     

乳腺肿瘤中抗酸菌L型感染的研究

用ＩＫ抗酸染色和卡介苗抗体免疫组化染色等方法对乳腺癌（９７例）,和乳腺纤维腺瘤（２１例）进行了研究。结果发现Ｌ型阳性例数在乳腺癌和乳腺纤维腺瘤间无显著差异（Ｐ〉０．０５）。乳腺癌中抗酸菌Ｌ型主要分布于癌细胞巢及其间质内,常集聚成堆,且该处癌细胞有不同程度变性或坏死。乳腺纤维腺瘤中的抗酸菌Ｌ型主要存在于间质巨噬细胞中。并讨论了抗酸菌Ｌ型感染与乳腺癌发生的可能关系。     

荧光定量PCR诊断结核性脑膜炎的临床价值

目的 探讨荧光定量PCR检测脑脊液（CSF）结核分枝杆菌评估其临床意义。方法 应用荧光定量PCR技术检测45例CSF结核分枝杆菌并与抗酸杆菌染色。结核抗体酶联免疫吸附试验（结核抗体ELISA,简称酶联OT）进行比较。结果 荧光定量检测CSF结核杆菌的阳性率为11．1％,酶联OT为13．3％,抗酸杆菌染色为0％。结论 荧光定量PCR用于检测CSF结核分枝杆菌不具有灵敏度,阳性率低,对临床诊断结核性脑膜炎（简称结脑）无多少价值,不值得在临床上推广应用,必须寻找更有价值的诊断方法。     

结核菌L型与恶性淋巴瘤关系的研究

对５３例恶性淋巴瘤，做细菌Ｌ型检测，肿瘤间质内细菌Ｌ型感染率为５４．７２％，抗酸染色阳性率５０．９４％。结核菌抗体检测阳性率５４．７２％。提示细菌Ｌ型感染与肿瘤的关系密切。     

THE TUBERCULOUS DISEASES Originating from Different Species of Acid-Fast Bacilli

Disease due to the typical human type tubercle bacillus is rapidly diminishing as a result of public health measures and specific chemotherapy. Lesions in man resulting from other kinds of acid-fast bacilli are now being recognized in increasing numbers. Some of these bacilli had been seen before but were confused with typical M. hominis, others were considered to be harmless saprophytes, while others could not be found with the methods used. Special culture media, different conditions for cultivation, new physical, chemical and biological tests, and inoculation into a variety of animal hosts are now available. With their use more than a dozen different strains of human type tubercle bacilli, and more than a score of other species of acid-fast bacilli may now be distinguished. A simple chemical test readily separates the human type tubercle bacilli from all other kinds of acid-fast bacilli. The differentiation of the different human and animal pathogenic acid-fast bacilli from the avirulent saprophytes and other harmless mycobacteria presents great difficulties, but methods are becoming available which usually make this possible. Since the distinction may be of great therapeutic and epidemiologic importance, the effort should be made.     

Unique biological properties of Mycobacterium tuberculosis L-form variants: impact for survival under stress

Bacteria can, under certain conditions, enter into a cell-less state known as L-form conversion. This phenomenon is universal, but also recognized with difficultly by microbiologists. The current study addresses several aspects concerning the ability of tubercle bacilli to use L-form conversion as a unique adaptive strategy to survive and reproduce under unfavorable conditions. Nutrient starvation of M. tuberculosis in vitro followed by passages in Middlebrook 7H9 semisolid medium was used for stress induction and the selective isolation of mycobacterial L-form variants. Light and electron microscopy images evidence the peculiar characteristics of mycobacterial L-forms. For example, mycobacterial L-forms were observed to lose their acid-fastness and change their morphology. In addition, wide morphological variability, the presence of large and elementary bodies, coccoids and small granular forms, as well as the appearance of unusual modes of irregular cell division were observed. Unlike classical tubercle bacilli, L-form variants grew and developed typical "fried-egg" colonies faster. L-forms were verified as M. tuberculosis by spoligotyping. The results provide insights into the nature of L-form phenomena in M. tuberculosis and link them to the mechanisms allowing mycobacterial survival under stress.     

结核分枝杆菌L型致病性的实验研究

以结核分枝杆菌稳定Ｌ型感染豚鼠,证明结核分枝杆菌变为Ｌ型后致病性减弱,发病时间延长,ＯＴ试验阴性,引起的病理变化主要表现为组织的间质性炎症,有干酪样坏死,而无典型结核结节形成。原因在于细菌变为Ｌ型后细胞壁缺损,磷脂减少,不足以刺激巨噬细胞转变为上皮样组胞与郎罕氏巨细胞,而形成结核结节。在诊断上容易造成误诊或漏诊。     

介绍一种用卡介苗进行改良抗酸染色的实验教学方法

利用卡介苗取代结核分枝杆菌阳性痰液作为实验标本,使用改良后的抗酸染液进行抗酸染色实验教学。卡介苗水溶液为标本,石炭酸复红染色液中加入5%的Tween-80进行抗酸染色。染色后,卡介苗标本片与结核菌阳性痰液标本比较,菌体形态与染色均无明显差异。此法具有染色效果好、标本来源方便、安全无污染等优点,满足抗酸染色实验教学需要。     

Exhibition of persistent and drug-tolerant L-form habit of <Emphasis Type="Italic">Mycobacterium tuberculosis</Emphasis> during infection in rats

A model for studying mycobacterial L-form formation in vivo was established to demonstrate the ability of M. tuberculosis to behave as a drug-tolerant L-form persister. Rats were infected by intranasal (i.n.) and intraperitoneal (i.p.) routes with 1×108 cells/ml of M. tuberculosis. At weekly intervals during a period of five weeks, samples from lung, spleen, liver, kidney, mesenterial and inguinal lymph nodes, broncho-alveolar and peritoneal lavage liquid were plated simultaneously on Löwenstein-Jensen (LJ) medium or inoculated into specially supplemented for L-forms Dubos broth (drug-free and drug-containing variants). The use of liquid media enabled isolation of mycobacterial L-form cultures during the whole period of experiment including the last two weeks, when tubercle bacilli were not isolated on LJ medium. An unique feature of mycobacterial L-forms was their ability to grow faster than the classical tubercle bacilli. Isolation and growth of L-form cultures in primary drug-containing media demonstrated their drug-tolerant properties. Electron microscopy of liquid media isolates showed that they consisted of morphologically heterogenous populations of membrane-bound and of variable sized L-bodies that completely lack cell walls. The identity of the isolated non-acid fast and morphologically modified L-forms as M. tuberculosis was verified by specific spoligotyping test. The results contribute to special aspects concerning the importance of mycobacterial L-form phenomenon for persistence and latency in tuberculosis, phenotypic drug tolerance, as well as for diagnosis of difficult to identify morphologically changed tubercle bacilli which are often mistaken for contaminants.     

Hidden face of tuberculosis

Occurrence of cell wall deficiency (L-form conversion) in hosts suggests one of the possible pathways by which tubercle bacilli can survive, replicate and persist within the body for a long period harboring latent tuberculosis. Non-acid fast and morphologically modified L-forms of Mycobacterium tuberculosis are difficult to identify and remain often unrecognized or are mistaken for contaminants.     

Location of intra- and extracellular M. tuberculosis populations in lungs of mice and guinea pigs during disease progression and after drug treatment

The lengthy treatment regimen for tuberculosis is necessary to eradicate a small sub-population of M. tuberculosis that persists in certain host locations under drug pressure. Limited information is available on persisting bacilli and their location within the lung during disease progression and after drug treatment. Here we provide a comprehensive histopathological and microscopic evaluation to elucidate the location of bacterial populations in animal models for TB drug development.To detect bacilli in tissues, a new combination staining method was optimized using auramine O and rhodamine B for staining acid-fast bacilli, hematoxylin QS for staining tissue and DAPI for staining nuclei. Bacillary location was studied in three animal models used in-house for TB drug evaluations: C57BL/6 mice, immunocompromised GKO mice and guinea pigs. In both mouse models, the bacilli were found primarily intracellularly in inflammatory lesions at most stages of disease, except for late stage GKO mice, which showed significant necrosis and extracellular bacilli after 25 days of infection. This is also the time when hypoxia was initially visualized in GKO mice by 2-piminidazole. In guinea pigs, the majority of bacteria in lungs are extracellular organisms in necrotic lesions and only few, if any, were ever visualized in inflammatory lesions. Following drug treatment in mice a homogenous bacillary reduction across lung granulomas was observed, whereas in guinea pigs the remaining extracellular bacilli persisted in lesions with residual necrosis. In summary, differences in pathogenesis between animal models infected with M. tuberculosis result in various granulomatous lesion types, which affect the location, environment and state of bacilli. The majority of M. tuberculosis bacilli in an advanced disease state were found to be extracellular in necrotic lesions with an acellular rim of residual necrosis. Drug development should be designed to target this bacillary population and should evaluate drug regimens in the appropriate animal models.     

Survival of tubercle bacilli in heat-fixed and stained sputum smears

We used a slide culture technique to detect tubercle bacilli surviving in sputum smears (n=46) after conventional heat fixation and Ziehl-Neelsen staining. In all heat-fixed sputum smears, tubercle bacilli survived after time 0 (n=22), 24 h (n=7), 48 h (n=7), 72 h (n=4), and seven days (n=6). None of the stained sputum smears showed growth on slide cultures. Viable tubercle bacilli remaining in heat-fixed sputum smears for at least seven days may present an infection risk to laboratory staff. Thus, sputum smears should be stained immediately by the Ziehl-Neelsen method or stored in a safe container to avoid transmission of tuberculosis.     

Bancroftian microfilariasis in association with pulmonary tuberculosis. Report of a case with diagnosis by fine needle aspiration

A 25-year-old man presented with clinical and radiologic features suggestive of pulmonary tuberculosis. Since the examination of Ziehl-Neelsen-stained sputum smears for acid-fast bacilli was repeatedly negative, a transthoracic fine needle aspiration biopsy was performed. Papanicolaou-stained smears of the aspirate showed microfilariae of Wuchereria bancrofti and a tuberculous exudate but no acid-fast bacilli or classic granulomas. Subsequent sputum samples did show acid-fast bacilli, while a nocturnal peripheral blood sample showed microfilariae.