Immunological Aspects of Diagnosis and Management of Childhood Tuberculosis.
Luis Horacio Gutiérrez-GonzálezEsmeralda JuárezClaudia CarranzaLaura E Carreto-BinaghiAlejandro AlejandreCarlos Cabello-GutiérrrezYolanda GonzalezPublished in: Infection and drug resistance (2021)
The diagnosis of tuberculosis (TB) in children is difficult because of the low sensitivity and specificity of traditional microbiology techniques in this age group. Whereas in adults the culture of Mycobacterium tuberculosis (M. tuberculosis), the gold standard test, detects 80% of positive cases, it only detects around 30-40% of cases in children. The new methods based on the immune response to M. tuberculosis infection could be affected by many factors. It is necessary to evaluate the medical record, clinical features, presence of drug-resistant M. tuberculosis strains, comorbidities, and BCG vaccination history for the diagnosis in children. There is no ideal biomarker for all TB cases in children. A new strategy based on personalized diagnosis could be used to evaluate specific molecules produced by the host immune response and make therapeutic decisions in each child, thereby changing standard immunological signatures to personalized signatures in TB. In this way, immune diagnosis, prognosis, and the use of potential immunomodulators as adjunct TB treatments will meet personalized treatment.
Keyphrases
- mycobacterium tuberculosis
- drug resistant
- pulmonary tuberculosis
- young adults
- immune response
- healthcare
- multidrug resistant
- hiv aids
- escherichia coli
- genome wide
- acinetobacter baumannii
- mental health
- emergency department
- gene expression
- pseudomonas aeruginosa
- toll like receptor
- hepatitis c virus
- adverse drug
- antiretroviral therapy
- hiv infected