Polimorfismos genéticos asociados a la inmunidad innata y la susceptibilidad genética a la tuberculosis

Abstract

Tuberculosis is a global health problem exacerbated by the absence of an effective vaccine and emergence of extensive antibiotic-resistant strains. Innate immunity is key to tuberculosis susceptibility, since it is associated with genetic polymorphisms in TLRs (Toll Like Receptors), VDR (Vitamin D Receptor), INF-γ, TNF-α, among others. Recently, also to nine Mendelian Susceptibility Mycobacterial Diseases (MSMD) -causing genes, including autosomal and X-linked genes. After decades of successful management, Chile reported maintenance of mortality and increase in tuberculosis under 15 years and multidrug resistant cases incidence. Moreover, incidence is higher in the North and the Center, where Metropolitan Region showed a sustained increment of the Latin American migrant population. Consequently, the high incidence persistence in such geographic areas could be associated with populations carrying SNPs genetic polymorphisms types and/or MSMD that confer genetic susceptibility to tuberculosis and/or BCG dissemination and other intramacrophagic pathogens, similar to that described in certain populations in Europe, Asia, Africa and America. Corollary, we propose to consider genetic predisposition of the current population, at the time of designing national public health policies to eradicate tuberculosis.