Immune vulnerability of infants to tuberculosisShow others and affiliations
2013 (English)In: Clinical & Developmental Immunology, ISSN 1740-2522, E-ISSN 1740-2530, Vol. 2013, article id 781320
Article, review/survey (Refereed) Published
Abstract [en]
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.
Place, publisher, year, edition, pages
Hindawi Publishing Corporation, 2013. Vol. 2013, article id 781320
National Category
Immunology
Identifiers
URN: urn:nbn:se:oru:diva-76537DOI: 10.1155/2013/781320ISI: 000319588900001PubMedID: 23762096Scopus ID: 2-s2.0-84878637710OAI: oai:DiVA.org:oru-76537DiVA, id: diva2:1352755
2019-09-192019-09-192019-10-25Bibliographically approved