Immune Vulnerability of Infants to Tuberculosis
One of the challenges faced by the infant immune system is learning to distinguish the myriad of foreign but nonthreatening antigens encountered from those expressed by true pathogens. This balance is reflected in the diminished production of proinflammatory cytokines by both innate and adaptive imm...
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| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2013-01-01
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| Series: | Clinical and Developmental Immunology |
| Online Access: | http://dx.doi.org/10.1155/2013/781320 |
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| author | Koen Vanden Driessche Alexander Persson Ben J. Marais Pamela J. Fink Kevin B. Urdahl |
| author_facet | Koen Vanden Driessche Alexander Persson Ben J. Marais Pamela J. Fink Kevin B. Urdahl |
| author_sort | Koen Vanden Driessche |
| collection | DOAJ |
| description | One of the challenges faced by the infant immune system is learning to distinguish the myriad of foreign but nonthreatening antigens encountered from those expressed by true pathogens. This balance is reflected in the diminished production of proinflammatory cytokines by both innate and adaptive immune cells in the infant. A downside of this bias is that several factors critical for controlling Mycobacterium tuberculosis infection are significantly restricted in infants, including TNF, IL-1, and IL-12. Furthermore, infant T cells are inherently less capable of differentiating into IFN-γ-producing T cells. As a result, infected infants are 5–10 times more likely than adults to develop active tuberculosis (TB) and have higher rates of severe disseminated disease, including miliary TB and meningitis. Infant TB is a fundamentally different disease than TB in immune competent adults. Immunotherapeutics, therefore, should be specifically evaluated in infants before they are routinely employed to treat TB in this age group. Modalities aimed at reducing inflammation, which may be beneficial for adjunctive therapy of some forms of TB in older children and adults, may be of no benefit or even harmful in infants who manifest much less inflammatory disease. |
| format | Article |
| id | doaj-art-42642cad7b164602b32637415215078d |
| institution | Kabale University |
| issn | 1740-2522 1740-2530 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Clinical and Developmental Immunology |
| spelling | doaj-art-42642cad7b164602b32637415215078d2025-02-03T05:46:50ZengWileyClinical and Developmental Immunology1740-25221740-25302013-01-01201310.1155/2013/781320781320Immune Vulnerability of Infants to TuberculosisKoen Vanden Driessche0Alexander Persson1Ben J. Marais2Pamela J. Fink3Kevin B. Urdahl4Centre for Understanding and Preventing Infections in Children, Child & Family Research Institute, University of British Columbia, Vancouver, BC, V5Z 4H4, CanadaCentre for Understanding and Preventing Infections in Children, Child & Family Research Institute, University of British Columbia, Vancouver, BC, V5Z 4H4, CanadaSydney Institute for Emerging Infectious Diseases and Biosecurity and The Children's Hospital at Westmead, University of Sydney, Locked Bag 4100, Sydney, NSW 2145, AustraliaDepartment of Immunology, University of Washington, Seattle, WA 98195, USADepartment of Immunology, University of Washington, Seattle, WA 98195, USAOne of the challenges faced by the infant immune system is learning to distinguish the myriad of foreign but nonthreatening antigens encountered from those expressed by true pathogens. This balance is reflected in the diminished production of proinflammatory cytokines by both innate and adaptive immune cells in the infant. A downside of this bias is that several factors critical for controlling Mycobacterium tuberculosis infection are significantly restricted in infants, including TNF, IL-1, and IL-12. Furthermore, infant T cells are inherently less capable of differentiating into IFN-γ-producing T cells. As a result, infected infants are 5–10 times more likely than adults to develop active tuberculosis (TB) and have higher rates of severe disseminated disease, including miliary TB and meningitis. Infant TB is a fundamentally different disease than TB in immune competent adults. Immunotherapeutics, therefore, should be specifically evaluated in infants before they are routinely employed to treat TB in this age group. Modalities aimed at reducing inflammation, which may be beneficial for adjunctive therapy of some forms of TB in older children and adults, may be of no benefit or even harmful in infants who manifest much less inflammatory disease.http://dx.doi.org/10.1155/2013/781320 |
| spellingShingle | Koen Vanden Driessche Alexander Persson Ben J. Marais Pamela J. Fink Kevin B. Urdahl Immune Vulnerability of Infants to Tuberculosis Clinical and Developmental Immunology |
| title | Immune Vulnerability of Infants to Tuberculosis |
| title_full | Immune Vulnerability of Infants to Tuberculosis |
| title_fullStr | Immune Vulnerability of Infants to Tuberculosis |
| title_full_unstemmed | Immune Vulnerability of Infants to Tuberculosis |
| title_short | Immune Vulnerability of Infants to Tuberculosis |
| title_sort | immune vulnerability of infants to tuberculosis |
| url | http://dx.doi.org/10.1155/2013/781320 |
| work_keys_str_mv | AT koenvandendriessche immunevulnerabilityofinfantstotuberculosis AT alexanderpersson immunevulnerabilityofinfantstotuberculosis AT benjmarais immunevulnerabilityofinfantstotuberculosis AT pamelajfink immunevulnerabilityofinfantstotuberculosis AT kevinburdahl immunevulnerabilityofinfantstotuberculosis |