PURPOSE OF REVIEW: Even in the era of promising molecular diagnostics for tuberculosis, understanding of the immune response remains urgent and fundamental to combating paediatric tuberculosis, given its paucibacillary nature. RECENT FINDINGS: Significant advances have been made in unravelling the contributions of previously underappreciated components of the immune response to Mycobacterium tuberculosis. Research into the role of the 'innate' immune system such as neutrophils alongside 'adaptive' cells such as CD4(+), CD8(+), polyfunctional and regulatory T cells has highlighted the complexity of their interactions. Lessons from children with congenital or acquired susceptibility to mycobacterial disease, including HIV, continue to illuminate a broader understanding of the host immune response. The role of vitamin D is becoming apparent and highlights the importance of the environmental and clinical context of patients, especially in high prevalence areas. Several approaches show promise as diagnostic tests and in monitoring treatment response, although distinguishing latent from active disease remains a challenge. SUMMARY: Research into novel immunological biomarkers, and greater understanding of the complex network of interactions between the innate and adaptive immune systems, is key to understanding why following exposure some children are unaffected, others latently infected and yet another group succumb to disease.
PURPOSE OF REVIEW: Even in the era of promising molecular diagnostics for tuberculosis, understanding of the immune response remains urgent and fundamental to combating paediatric tuberculosis, given its paucibacillary nature. RECENT FINDINGS: Significant advances have been made in unravelling the contributions of previously underappreciated components of the immune response to Mycobacterium tuberculosis. Research into the role of the 'innate' immune system such as neutrophils alongside 'adaptive' cells such as CD4(+), CD8(+), polyfunctional and regulatory T cells has highlighted the complexity of their interactions. Lessons from children with congenital or acquired susceptibility to mycobacterial disease, including HIV, continue to illuminate a broader understanding of the host immune response. The role of vitamin D is becoming apparent and highlights the importance of the environmental and clinical context of patients, especially in high prevalence areas. Several approaches show promise as diagnostic tests and in monitoring treatment response, although distinguishing latent from active disease remains a challenge. SUMMARY: Research into novel immunological biomarkers, and greater understanding of the complex network of interactions between the innate and adaptive immune systems, is key to understanding why following exposure some children are unaffected, others latently infected and yet another group succumb to disease.
Authors: Tiffany A Claeys; Oscar Rosas Mejia; Samuel Marshall; Jason A Jarzembowski; Don Hayes; Natalie M Hull; Namal P M Liyanage; Robert H Chun; Cecille G Sulman; Anna R Huppler; Richard T Robinson Journal: J Infect Dis Date: 2019-10-22 Impact factor: 5.226
Authors: Novel N Chegou; Paulin N Essone; Andre G Loxton; Kim Stanley; Gillian F Black; Gian D van der Spuy; Paul D van Helden; Kees L Franken; Shreemanta K Parida; Michel R Klein; Stefan H E Kaufmann; Tom H M Ottenhoff; Gerhard Walzl Journal: PLoS One Date: 2012-06-05 Impact factor: 3.240
Authors: Synne Jenum; Sumithra Selvam; Diana Mahelai; Nelson Jesuraj; Vicky Cárdenas; John Kenneth; Anneke C Hesseling; Timothy Mark Doherty; Mario Vaz; Harleen M S Grewal Journal: Pediatr Infect Dis J Date: 2014-10 Impact factor: 2.129
Authors: Salmaan Keshavjee; Farhana Amanullah; Adithya Cattamanchi; Richard Chaisson; Karen M Dobos; Gregory J Fox; Howard E Gendelman; Richard Gordon; Anneke Hesseling; Hoi Le Van; Beate Kampmann; Bavesh Kana; Gopal Khuller; David M Lewinsohn; Deborah A Lewinsohn; Philiana Ling Lin; Lenette Lin Lu; Gary Maartens; Andrew Owen; Marina Protopopova; Jyothi Rengarajan; Eric Rubin; Padmini Salgame; Erwin Schurr; James A Seddon; Susan Swindells; David M Tobin; Zarir Udwadia; Gerhard Walzl; Sudha Srinivasan; Roxana Rustomjee; Payam Nahid Journal: Am J Respir Crit Care Med Date: 2019-03-01 Impact factor: 21.405