Imperial College London
Alternate

ProfessorJonFriedland

Faculty of Medicine, Department of Infectious Disease

Visiting Professor
 
 
 
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Contact

 

+44 (0)20 3313 8521j.friedland Website

 
 
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Assistant

 

Ms Teyanna Gaeta +44 (0)20 3313 1943

 
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Location

 

8N21ACommonwealth BuildingHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Elkington:2015:10.1016/S1473-3099(15)00135-8,
author = {Elkington, PT and Friedland, JS},
doi = {10.1016/S1473-3099(15)00135-8},
journal = {Lancet Infectious Diseases},
pages = {1357--1360},
title = {Permutations of time and place in tuberculosis},
url = {http://dx.doi.org/10.1016/S1473-3099(15)00135-8},
volume = {15},
year = {2015}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Tuberculosis remains a global health pandemic. The current depiction of the Mycobacterium tuberculosis life cycle proposes that airborne bacilli are inhaled and phagocytosed by alveolar macrophages, resulting in the formation of a granuloma that ruptures into the airways to reinitiate the infectious cycle. However, this widely proposed model overlooks the fact, established 100 years ago, that the initial site of M tuberculosis implantation is in the lower zones of the lungs, whereas infectious cavitary pulmonary disease develops at the lung apices. The immunological events at these two pulmonary locations are different—cavitation only occurs in the apices and not in the bases. Yet the current conceptual model of tuberculosis renders the immunology of these two temporally and spatially separated events identical. One key consequence is that prevention of primary childhood tuberculosis at the lung bases is regarded as adequate immunological protection, but extensive evidence shows that greater immunity could predispose to immunopathology and transmission at the lung apex. A much greater understanding of time and place in the immunopathological mechanisms underlying human tuberculosis is needed before further pre-exposure vaccination trials can be done.
AU  - Elkington,PT
AU  - Friedland,JS
DO  - 10.1016/S1473-3099(15)00135-8
EP  - 1360
PY  - 2015///
SN  - 1473-3099
SP  - 1357
TI  - Permutations of time and place in tuberculosis
T2  - Lancet Infectious Diseases
UR  - http://dx.doi.org/10.1016/S1473-3099(15)00135-8
UR  - http://hdl.handle.net/10044/1/41347
VL  - 15
ER  -
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