Immunological Evaluation for Personalized Interventions in Children with Tuberculosis: Should It Be Routinely Performed?

Carreto-Binaghi, Laura E.; Juárez, Esmeralda; Guzmán-Beltrán, Silvia; Herrera, María Teresa; Torres, Martha; Alejandre, Alejandro; Martínez-Orozco, José Arturo; Becerril-Vargas, Eduardo; González, Yolanda

doi:10.1155/2020/8235149

Cited by 6 publications

(5 citation statements)

References 39 publications

(38 reference statements)

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“…In addition, within the first year of life, infants do not have fully mature Toll-like receptors to allow for phagocytosis of the pathogen, so this could also impair children’s immune responses to mycobacterium [ 60 ]. In a study conducted by Carreto-Binaghi, it was found that some pediatric patients infected with tuberculosis had a lessened innate immune response due to low levels of IL-8, which prevented them from clearing the infection out of their system with their first line of defense [ 61 ]. A summary of immunodeficiencies in infants are shown in Figure 1 .…”

Section: Pediatric Immunology and Increased Susceptibilitymentioning

confidence: 99%

“…As pediatric tuberculosis elicits different cytokines and T cells, as well as manifests in different organs, and has fewer mycobacteria in the system when compared to adults, this should be kept in mind when managing pediatric patients. Due to their immune system being weaker at eliciting the most beneficial innate host defense mechanisms, pediatric patients are more susceptible to Mtb and more detrimental prognoses [ 61 ].…”

Section: Pediatric Immunology and Increased Susceptibilitymentioning

confidence: 99%

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Review of Pediatric Tuberculosis in the Aftermath of COVID-19

Rangchaikul

Ahn

Nguyen

et al. 2022

Clinics and Practice

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In 2014, the World Health Organization developed the End Tuberculosis Strategy with the goal of a 95% reduction in deaths from tuberculosis (TB) by 2035. The start of the COVID-19 pandemic and global lockdown has had a major impact on TB awareness, screening, diagnosis, and prompt initiation of treatment, inevitably leading to a significant setback. We explore pediatric tuberculosis through the lens of the COVID-19 era, investigating how COVID-19 has impacted pediatric TB cases in different regions of the world and what the implications are for management moving forward to mitigate these effects. Furthermore, in light of recent findings showing how exposed infants and children are at higher risk than we thought of contracting the disease, greater attention and resources are needed to prevent further downward trends.

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Section: Pediatric Immunology and Increased Susceptibilitymentioning

confidence: 99%

Section: Pediatric Immunology and Increased Susceptibilitymentioning

confidence: 99%

Review of Pediatric Tuberculosis in the Aftermath of COVID-19

Rangchaikul

Ahn

Nguyen

et al. 2022

Clinics and Practice

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“…В литературе описан феномен «иммунного паралича» у детей и новорожденных при сепсисе, вирусных инфекциях, травмах и асфиксии и во всех случаях оно было w w w . r e a n i m a 2 0 2 2 , 1 8 ; 6 Обзоры ассоциировано с высоким уровнем смертности [98][99][100]. К внешним и внутренним факторам, способствующим развитию этого феномена, относят наследственность, применение кортикостероидов, химиотерапии, иммуносупрессивной терапии [101,102].…”

Section: этиология и патогенез спон у новорожденныхunclassified

Pathogenesis, Prognosis and Outcomes of Multiple Organ Failure in Newborns (Review)

Golomidov¹,

Grigoriev

Moses

et al. 2022

Obŝaâ reanimatologiâ

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Multiple organ failure (MOF) is the leading cause of neonatal mortality in intensive care units. The prevalence of MOF in newborns is currently unclear, since its incidence varies in asphyxia, sepsis, prematurity, and comorbidity, and depends on the level of development and funding of health care in different countries. Sepsis and acute respiratory distress syndrome prevail among the causes of MOF in this category of patients.Aim of the review. To summarize the available literature data on the pathogenesis, therapeutic strategies and outcomes of MOF in newborns.Material and methods. We searched PubMed, Scopus, Web of Science, and RSCI databases using the following keywords: «newborns, multiple organ failure, etiology, pathogenesis, premature, diagnosis, treatment, respiratory support, cardiotonic support», without language limitations. A total of 144 full-text sources were selected for analysis, 70% of which were published in the last five years and 50% were published in the last three years. Criteria for exclusion were low information value and outdated data.Results. The prevalence of MOF in neonates is currently unclear. This could be due to common association of neonatal MOF (as well as the adult one) with various diseases; thus, its incidence is not the same for asphyxia, sepsis, prematurity, and comorbidities. There is no precise data on neonatal mortality in MOF, but according to some reports, it may be as high as 13-50%.In newborns, MOF can be caused by two major causes, intrapartum/postnatal asphyxia and sepsis, but could also be influenced by other intranatal factors such as intrauterine infections and acute interruption of placental blood flow.The key element in the pathogenesis of neonate MOF is cytokinemia, which triggers universal critical pathways. Attempts to identify different clinical trajectories of critical illness in various categories of patients have led to the discovery of MOF phenotypes with specific patterns of systemic inflammatory response. This scientific trend is very promising for the creation of new classes of drugs and individual therapeutic pathways in neonates with MOF of various etiologies.The pSOFA scale is used to predict the outcome of neonatal MOF, however, the nSOFA scale has higher validity in premature infants with low birth weight.Central nervous system damage is the major MOF-associated adverse outcome in newborns, with gestational age and the timing of treatment initiation being key factors affecting risk of MOF development in both full-term and premature infants.Conclusion. The study of cellular messengers of inflammation, MOF phenotypes, mitochondrial insufficiency, and immunity in critically ill infants with MOF of various etiologies is a promising area of research. The pSOFA scale is suggested for predicting the outcome of MOF in full-term infants, while the nSOFA scale should be used in premature infants with low birth weight.

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“…We recently proposed a simple method to assess the immune status of children that could provide information on whether a patient should receive immunotherapy together with their standard antituberculosis regime. 147 When immune profiles are available, it would be straightforward to determine whether a patient needs an immunostimulant, an immunosuppressor, or the supplementation of the absent immune effector.…”

Section: Immunomodulators Towards Personalized Tb Treatmentmentioning

confidence: 99%

Immunological Aspects of Diagnosis and Management of Childhood Tuberculosis

Gutiérrez‐González

Juárez

Carranza

et al. 2021

IDR

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The diagnosis of tuberculosis (TB) in children is difficult because of the low sensitivity and specificity of traditional microbiology techniques in this age group. Whereas in adults the culture of Mycobacterium tuberculosis (M. tuberculosis) , the gold standard test, detects 80% of positive cases, it only detects around 30–40% of cases in children. The new methods based on the immune response to M. tuberculosis infection could be affected by many factors. It is necessary to evaluate the medical record, clinical features, presence of drug-resistant M. tuberculosis strains, comorbidities, and BCG vaccination history for the diagnosis in children. There is no ideal biomarker for all TB cases in children. A new strategy based on personalized diagnosis could be used to evaluate specific molecules produced by the host immune response and make therapeutic decisions in each child, thereby changing standard immunological signatures to personalized signatures in TB. In this way, immune diagnosis, prognosis, and the use of potential immunomodulators as adjunct TB treatments will meet personalized treatment.

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Immunological Evaluation for Personalized Interventions in Children with Tuberculosis: Should It Be Routinely Performed?

Cited by 6 publications

References 39 publications

Review of Pediatric Tuberculosis in the Aftermath of COVID-19

Review of Pediatric Tuberculosis in the Aftermath of COVID-19

Pathogenesis, Prognosis and Outcomes of Multiple Organ Failure in Newborns (Review)

Immunological Aspects of Diagnosis and Management of Childhood Tuberculosis

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