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PubMed · 6702546

Tuberculosis screening.

P Murata·R A Johnson
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Abstract

In view of the decreasing prevalence of tuberculosis, it is important to be aware of the factors influencing the sensitivity, specificity and predictive value of tuberculin testing. The small predictive value of tuberculin testing in a low-risk population makes it an ineffective means for screening. Even in high-risk populations, factors such as geographic location, reaction size, previous skin testing and BCG vaccination significantly influence interpretation of the skin test.

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BCG VaccineHumansMass ScreeningTuberculinTuberculin TestTuberculosisJournal Article

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P Murata, R A Johnson. 1984. Tuberculosis screening.. https://pubmed.ncbi.nlm.nih.gov/6702546/

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Tuberculosis and cancer: parallels in host responses and therapeutic approaches?

Mycobacteria elicit two quite different immune responses. One is protective and is partly based on recognition and lysis of stressed, bacilli-laden cells expressing heat-shock proteins. The other suppresses this recognition and instead leads to indiscriminate necrosis of tissues containing mycobacteria (the Koch phenomenon). The type of response depends on the predominant T-cell maturation pathway, Th1 or Th2, which in turn is determined by priming by prior contact with environmental mycobacteria. Vaccination by BCG induces whichever response the recipient is primed to make, and this is a likely explanation of the variable efficacy of this vaccine in prevention of tuberculosis and therapy of cancer. Thus; BCG is a two-edged sword. We postulate that by using other mycobacterial preparations, such as killed Mycobacterium vaccae, it might be possible to suppress the indiscriminate necrosis and enhance Th1-regulated selective destruction of tumour cells.

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