Tuberculosis susceptibility and protection in children
Robindra Basu Roy1, Elizabeth Whittaker2, James A Seddon2
1Centre for International Child Health, Department of Paediatrics, Imperial College London, London, UK; Vaccines and Immunity Theme MRC Unit The Gambia at London School of Hygiene and Tropical Medicine, Fajara, The Gambia.
The Lancet. Infectious Diseases
|October 17, 2018
Summary
Children under 5 are highly susceptible to tuberculosis (TB) disease. Identifying biomarkers like monocyte-to-lymphocyte ratio can help develop new TB vaccines for children.
Area of Science:
- Pediatric infectious diseases
- Immunology
- Vaccinology
Background:
- Children under 5 are highly susceptible to tuberculosis (TB) infection, disease, and mortality.
- Risk of TB increases again in adolescence, with a protective effect observed in children aged 5-10 years.
- Neonatal Bacillus Calmette-Guérin (BCG) vaccination offers the clearest proven benefit against TB.
Purpose of the Study:
- To identify host immune correlates of risk for developing tuberculosis in children.
- To guide the development of novel tuberculosis vaccines for pediatric populations.
- To contribute to the World Health Organization's goal of eliminating childhood TB deaths.
Main Methods:
- Analysis of large case-control cohorts comprising over 15,000 children and adolescents.
- Investigation of potential biomarkers including monocyte-to-lymphocyte ratio, CD4 T cell counts, and blood RNA signatures.
Main Results:
- Identified the monocyte-to-lymphocyte ratio, activated CD4 T cell count, and a blood RNA signature as potential correlates of risk for TB development.
- Highlighted distinct susceptibility patterns across different pediatric age groups.
Conclusions:
- Specific immune and molecular signatures correlate with tuberculosis risk in children.
- Further research into these correlates is crucial for developing effective pediatric TB vaccines.
- Understanding age-specific susceptibility is key to achieving global TB elimination goals in children.
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