Immunology in Tuberculosis: Challenges in Monitoring of Disease Activity and Identifying Correlates of Protection

Richard Altena ,van, Sridevi Duggirala, M. I. Gröschel, Tjip S. van der Werf*

*Corresponding author for this work

    Research output: Contribution to journalReview articlepeer-review

    13 Citations (Scopus)

    Abstract

    Humans have always lived with tubercle bacilli. Host susceptibility - both inherited and acquired - determines whether an individual infected with Mycobacterium tuberculosis will eventually fall ill and develop tuberculosis (TB). After infection with M. tuberculosis, a latent TB infection may ensue reflected by immune recognition of specific antigenic epitopes expressed by M. tuberculosis - the Region of Difference 1 proteins ESAT-6 and CFP-10 leading to interferon gamma release in vitro. Multi-Drug-Resistant TB has emerged as an enormous infectious threat in certain regions in the world, and the Acquired immunodeficiency by co-infection with HIV has accelerated the TB epidemic even further. A paradoxical response - or Immune Response Inflammatory Syndrome in the context of treatment of HIV co-infection - is an increased inflammatory reaction during effective reduction in the bacterial load. This should be differentiated from treatment failure. A huge challenge is to develop novel markers that can differentiate paradoxical responses from treatment failure. We discuss the role of protection of vaccines - especially BCG, iron metabolism and the role of vitamin D.

    Original languageEnglish
    Pages (from-to)2853-2862
    Number of pages10
    JournalCurrent Pharmaceutical Design
    Volume17
    Issue number27
    Publication statusPublished - Sep-2011

    Keywords

    • Mycobacterium tuberculosis
    • immune response
    • interferon gamma
    • BCG
    • vitamin D
    • iron
    • immune response inflammatory syndrome
    • RECONSTITUTION INFLAMMATORY SYNDROME
    • D-RECEPTOR POLYMORPHISMS
    • GAMMA RELEASE ASSAYS
    • HIV-ASSOCIATED TUBERCULOSIS
    • ELECTRONIC-NOSE TECHNOLOGY
    • MYCOBACTERIUM-TUBERCULOSIS
    • VITAMIN-D
    • PULMONARY TUBERCULOSIS
    • ANTIRETROVIRAL THERAPY
    • GENETIC SUSCEPTIBILITY

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