Immune responses and immunostimulation in tuberculosis therapy

Area of Science:

• Immunology
• Infectious Diseases
• Microbiology

Background:

• Extensive research exists on immune responses in tuberculosis.
• Immune abnormalities in TB are typically secondary, not primary causes.
• No specific immune deficiency explains progression from infection to disease.

Purpose of the Study:

• To review the role of immune responses in tuberculosis.
• To evaluate the potential use of immunostimulants in TB therapy.
• To identify patient subgroups that might benefit from immunostimulants.

Main Methods:

• Literature review of cellular and humoral immune responses in tuberculosis.
• Analysis of evidence for TB occurring on a spectrum.
• Discussion of the current understanding of immunostimulant mechanisms and targets.

Main Results:

• No discrete immune deficiency identified as predisposing to tuberculosis.
• Tuberculosis disease spectrum suggested, analogous to leprosy.
• Current immunostimulants lack specific targets in tuberculosis.

Conclusions:

• Immune responses in tuberculosis are generally secondary to the disease.
• Immunostimulants, if used, should target non-reactive tuberculosis patients.
• The indiscriminate action and uncertain targets of immunostimulants limit their therapeutic role.