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The immune response upon infection with the pathogen Mycobacterium tuberculosis is poorly understood, hampering the discovery of new treatments and the improvements in diagnosis. In the last years, a blood transcriptional signature in tuberculosis has provided knowledge on the immune response occurring during active tuberculosis disease. This signature was absent in the majority of asymptomatic individuals who are latently infected with M. tuberculosis (referred to as latent). Using modular and pathway analyses of the complex data has shown, now in multiple studies, that the signature of active tuberculosis is dominated by overexpression of interferon-inducible genes (consisting of both type I and type II interferon signaling), myeloid genes, and inflammatory genes. There is also downregulation of genes encoding B and T-cell function. The blood signature of tuberculosis correlates with the extent of radiographic disease and is diminished upon effective treatment suggesting the possibility of new improved strategies to support diagnostic assays and methods for drug treatment monitoring. The signature suggested a previously under-appreciated role for type I interferons in development of active tuberculosis disease, and numerous mechanisms have now been uncovered to explain how type I interferon impedes the protective response to M. tuberculosis infection.

Original publication

DOI

10.1111/imr.12269

Type

Journal article

Journal

Immunol Rev

Publication Date

03/2015

Volume

264

Pages

88 - 102

Keywords

immune response, transcriptional signature, tuberculosis, Animals, Gene Expression Profiling, Gene Expression Regulation, Host-Pathogen Interactions, Humans, Mycobacterium tuberculosis, Prognosis, Transcriptome, Treatment Outcome, Tuberculosis