Abstract
Childhood tuberculosis (TB) is a significant public health problem and the ninth leading cause of death worldwide. Progression of Mycobacterium tuberculosis infection to active disease depends on mycobacterial virulence, environmental diversity, and host susceptibility and immune response. In children, malnutrition and immaturity of the immune system contribute to an inadequate immune response. Coinfections, though rarely described in TB, might be associated with host immune deficiencies. Here, we describe the immunological evaluation of eight pediatric patients infected with a member of the M. tuberculosis complex, most of them with concomitant pulmonary infections (bacteria, viruses, or fungi). We assessed the functionality of several innate immunity receptors, IL-12 receptor, and IFN-γ receptor, as well as the antioxidant levels (glutathione), which are essential mechanisms for fighting intracellular pathogens such as M. tuberculosis. This study is aimed at developing a thorough immunological evaluation of patients with TB and a coinfection.
Highlights
Tuberculosis (TB) is a leading infectious disease in adults, and children within the household contact are at a high risk of developing TB
The Human Immunodeficiency Virus (HIV) coinfection in childhood TB is highly prevalent [1], suggesting an impaired immune response associated with age
We suggest an evaluation of immune responses to help the physicians to manage the complementary therapy according to immune response impaired
Summary
Tuberculosis (TB) is a leading infectious disease in adults, and children within the household contact are at a high risk of developing TB. Children are more susceptible to developing the disseminated form of the disease; there is a high rate of extrapulmonary TB. Diagnosis of TB in children is difficult, considering that they develop a paucibacillary infection that might not be detected with the conventional laboratory techniques: Ziehl-Neelsen staining, culture, or polymerase chain reaction for Mycobacterium tuberculosis [2]. Current immunological tests, such as the tuberculin skin test and the interferon-γ (IFN-γ) release assays, usually standardized for adult patients, present different responses in children, probably related to the age of disease presentation and their recent BCG vaccination status [4], and it is essential to consider that the diagnosis based in immunological responses could be affected by the impaired immune response of the patient
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
