Moving toward Tuberculosis Elimination. Critical Issues for Research in Diagnostics and Therapeutics for Tuberculosis Infection

[...]it is hypothesized that some exposed individuals can mount effective immune responses that eradicate all viable bacilli, a phenotype distinct from persons in whom immune responses can only contain the infection, thereby harboring populations of bacilli that intermittently replicate in macrophag...

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Published in:American journal of respiratory and critical care medicine 2019-03, Vol.199 (5), p.564-571
Main Authors: Keshavjee, Salmaan, Amanullah, Farhana, Cattamanchi, Adithya, Chaisson, Richard, Dobos, Karen M, Fox, Gregory J, Gendelman, Howard E, Gordon, Richard, Hesseling, Anneke, Le Van, Hoi, Kampmann, Beate, Kana, Bavesh, Khuller, Gopal, Lewinsohn, David M, Lewinsohn, Deborah A, Lin, Philiana Ling, Lu, Lenette Lin, Maartens, Gary, Owen, Andrew, Protopopova, Marina, Rengarajan, Jyothi, Rubin, Eric, Salgame, Padmini, Schurr, Erwin, Seddon, James A, Swindells, Susan, Tobin, David M, Udwadia, Zarir, Walzl, Gerhard, Srinivasan, Sudha, Rustomjee, Roxana, Nahid, Payam
Format: Article
Language:English
Subjects:
Antitubercular Agents - administration & dosage
Antitubercular Agents - therapeutic use
Bacteria
Biomedical Research - methods
Chemotherapy
Disease
Disease Eradication - methods
Disease Progression
Drugs
Epidemics - prevention & control
Health Priorities
HIV
Human immunodeficiency virus
Humans
Infections
Latent Tuberculosis - diagnosis
Latent Tuberculosis - pathology
Medical diagnosis
Metabolism
Pulmonary
Tuberculosis
Tuberculosis, Pulmonary - diagnosis
Tuberculosis, Pulmonary - drug therapy
Tuberculosis, Pulmonary - pathology
Tuberculosis, Pulmonary - prevention & control
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Summary:[...]it is hypothesized that some exposed individuals can mount effective immune responses that eradicate all viable bacilli, a phenotype distinct from persons in whom immune responses can only contain the infection, thereby harboring populations of bacilli that intermittently replicate in macrophages, granulomata, and other tissues (4). [...]the fundamental challenge of how to optimize the evaluation of diagnostics for TB infection, for which there is no gold standard, needs to be addressed. Once infected with M. tuberculosis, the risk of disease progression is much higher in children, especially those younger than 5 years of age (79). Because of differences in host immunity between young children and older children and adults, this population faces a different series of gaps in diagnostics and therapeutics. [...]generation multiple reaction monitoring assays for enhanced detection of ultra-low abundance Mycobacterium tubercu/osis peptides in human serum.
ISSN:1073-449X
1535-4970
DOI:10.1164/rccm.201806-1053PP