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Immunological research in tuberculosis: Memorandum from a WHO meeting
This Memorandum discusses the application of modern immunological techniques to various problem areas in tuberculosis. The recent isolation of highly purified mycobacterial antigens will have important application in providing specific skin-test reagents for diagnosis, classification, and epidemiological investigations, and agents for use as immunogens and adjuvants. The development of monoclonal antibodies obtained by immunization of susceptible animals with partially purified antigens is considered a most promising approach to the identification and isolation of antigens.In vitro studies of the mechanisms of immunity and the effects of immunization in tuberculosis are needed. Several methods have been proposed recently which require further validation, e.g., through correlation of in vivo resistance with results in vitro, and comparison of different antigens in the in vitro tests.The specific antigens as well as the in vitro tests of tuberculosis immunity would be readily applicable in clinical investigations of immunological parameters and the effects of immunization. New serological tests using purified antigens would also be of value in this regard. In vitro tests for cell-mediated immunity could be used to study the effect of various BCG vaccines in different populations, in order to investigate the role of genetic and environmental factors in determining the response to immunization. Specific antigens and serological tests should prove useful in the diagnosis of different forms of extrapulmonary disease, especially in children. A test that could distinguish between infection with Mycobacterium tuberculosis and sensitivity induced by BCG immunization or environmental mycobacteria would be very useful both in diagnosis and in epidemiological studies. Investigations are needed on the mechanisms of endogenous reactivation of disease and the breakdown of apparently quiescent disease, in order to try to identify high-risk groups.
This Memorandum discusses the application of modern immunological techniques to various problem areas in tuberculosis. The recent isolation of highly purified mycobacterial antigens will have important application in providing specific skin-test reagents for diagnosis, classification, and epidemiological investigations, and agents for use as immunogens and adjuvants. The development of monoclonal antibodies obtained by immunization of susceptible animals with partially purified antigens is considered a most promising approach to the identification and isolation of antigens.In vitro studies of the mechanisms of immunity and the effects of immunization in tuberculosis are needed. Several methods have been proposed recently which require further validation, e.g., through correlation of in vivo resistance with results in vitro, and comparison of different antigens in the in vitro tests.The specific antigens as well as the in vitro tests of tuberculosis immunity would be readily applicable in clinical investigations of immunological parameters and the effects of immunization. New serological tests using purified antigens would also be of value in this regard. In vitro tests for cell-mediated immunity could be used to study the effect of various BCG vaccines in different populations, in order to investigate the role of genetic and environmental factors in determining the response to immunization. Specific antigens and serological tests should prove useful in the diagnosis of different forms of extrapulmonary disease, especially in children. A test that could distinguish between infection with Mycobacterium tuberculosis and sensitivity induced by BCG immunization or environmental mycobacteria would be very useful both in diagnosis and in epidemiological studies. Investigations are needed on the mechanisms of endogenous reactivation of disease and the breakdown of apparently quiescent disease, in order to try to identify high-risk groups.