Tuberculosis (TB) kills more people than any other single infectious disease globally. Despite decades of research, there is no vaccine to prevent TB transmission. Bacille Calmette–Guérin (BCG) vaccine, developed a century ago, is effective against childhood (disseminated and miliary) TB. However, its protective efficacy against pulmonary TB varies from 0 to 80% in different populations. One of the main reasons for the lack of an effective vaccine against TB is the lack of complete understanding about correlates of protective immunity on which to base vaccine design and development. However, some household contacts who are extensively exposed to Mtb infection remain persistently negative to tuberculin skin test and interferon‐gamma assay. These individuals, called ‘resisters’, clear Mtb infection early before the development of acquired immunity. The immunological basis of early Mtb clearance is yet to be established; however, innate lymphocytes such as monocytes/macrophages, dendritic cells, neutrophils and natural killer cells, and innate‐like T cells such as mucosal‐associated invariant T cells, invariant natural killer (NK) T cells and gamma‐delta (γδ) T cells, have been implicated in this early protection. In recent years, NK cells have attracted increasing attention because of their role in controlling Mtb infection. Emerging data from animal and epidemiological studies indicate that NK cells play a significant role in the fight against Mtb. NK cells express various surface markers to recognize and kill both Mtb and Mtb‐infected cells. This review presents recent advances in our understanding of NK cells in the fight against Mtb early during infection, with emphasis on cohort studies.

中文翻译：

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结核分枝杆菌感染早期清除的免疫学基础：自然杀伤细胞的作用

结核病 (TB) 造成的死亡人数超过全球任何其他单一传染病。尽管进行了数十年的研究，但仍没有预防结核病传播的疫苗。一个世纪前开发的 Bacille Calmette-Guérin (BCG) 疫苗对儿童（播散性和粟粒性）结核病有效。然而，它对肺结核的保护作用在不同人群中从 0% 到 80% 不等。缺乏有效的结核病疫苗的主要原因之一是缺乏对作为疫苗设计和开发基础的保护性免疫相关性的完整理解。然而，一些广泛暴露于Mtb感染的家庭接触者对结核菌素皮肤试验和干扰素-γ 试验仍然持续阴性。这些被称为“抵抗者”的人清除了 Mtb在获得性免疫发展之前的早期感染。早期Mtb清除的免疫学基础尚未确定；然而，先天性淋巴细胞，如单核细胞/巨噬细胞、树突状细胞、中性粒细胞和自然杀伤细胞，以及先天样 T 细胞，如黏膜相关的不变 T 细胞、不变自然杀伤 (NK) T 细胞和 γ-δ (γδ) T细胞，与这种早期保护有关。近年来，NK细胞因其在控制Mtb感染中的作用而受到越来越多的关注。来自动物和流行病学研究的新数据表明，NK 细胞在对抗Mtb中发挥着重要作用。NK 细胞表达各种表面标志物以识别和杀死两种Mtb和Mtb感染的细胞。这篇综述介绍了我们在感染早期对 NK 细胞对抗Mtb的理解方面取得的最新进展，重点是队列研究。