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Reconsidering the Optimal Immune Response to Mycobacterium tuberculosis

2019; American Thoracic Society; Volume: 201; Issue: 4 Linguagem: Inglês

10.1164/rccm.201908-1506pp

1535-4970

Liku B. Tezera, Salah Mansour, Paul Elkington,

vaccines and immunoinformatics approaches

Tuberculosis is unfortunately once again killing more people than any other infection.Despite global biomedical and public health efforts, standard interventions to control the pandemic have not advanced in most resource-poor settings, in contrast to other global diseases such as malaria and HIV infection.The authors propose that reconsidering concepts of the optimal host immune response to Mycobacterium tuberculosis is required to develop a paradigm that will inform novel interventions.The development of active tuberculosis associated with cancer treatment by immune checkpoint inhibition highlights that merely driving a stronger immune response may not improve control of the pathogen.Here, we present different models of the host-pathogen interaction that are consistent with the complexity of human infection.We consider both the protective and harmful components of the immune response in tuberculosis and develop a multiparameter framework that predicts disease risk.This novel conceptual model is important to inform emerging interventions to improve outcomes in tuberculosis by defining the ideal host response to target.