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Age-Stratified T Cell Responses in Children Infected with Mycobacterium tuberculosis

Tuberculosis (TB) in young children differs from adult TB in that the risk of rapid progression to active TB (aTB) is higher in children than in adults. The reasons for this increased risk are not fully understood. Early differentiation remains difficult between children at risk to develop aTB from...

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Autores principales: Dreesman, Alexandra, Corbière, Véronique, Dirix, Violette, Smits, Kaat, Debulpaep, Sara, De Schutter, Iris, Libin, Myriam, Singh, Mahavir, Malfroot, Anne, Locht, Camille, Mascart, Françoise
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5591888/
https://www.ncbi.nlm.nih.gov/pubmed/28928738
http://dx.doi.org/10.3389/fimmu.2017.01059
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author Dreesman, Alexandra
Corbière, Véronique
Dirix, Violette
Smits, Kaat
Debulpaep, Sara
De Schutter, Iris
Libin, Myriam
Singh, Mahavir
Malfroot, Anne
Locht, Camille
Mascart, Françoise
author_facet Dreesman, Alexandra
Corbière, Véronique
Dirix, Violette
Smits, Kaat
Debulpaep, Sara
De Schutter, Iris
Libin, Myriam
Singh, Mahavir
Malfroot, Anne
Locht, Camille
Mascart, Françoise
author_sort Dreesman, Alexandra
collection PubMed
description Tuberculosis (TB) in young children differs from adult TB in that the risk of rapid progression to active TB (aTB) is higher in children than in adults. The reasons for this increased risk are not fully understood. Early differentiation remains difficult between children at risk to develop aTB from those who will remain healthy and develop a latent TB infection (LTBI). Biomarkers to differentiate aTB from LTBI in children, especially in very young children, are urgently needed. To identify M. tuberculosis-specific functional T cell subsets related to clinical manifestations in children, we enrolled 87 children exposed to M. tuberculosis. After standard clinical assessment, the children were classified as aTB, LTBI, or uninfected. Their CD4(+) T cell cytokine profiles (IFN-γ, TNF-α, IL-2, IL-17) were analyzed at the single-cell level by flow cytometry after stimulation with three mycobacterial antigens, purified protein derivative (PPD), early-secreted-antigenic target-6 (ESAT-6), or heparin-binding hemagglutinin (HBHA). This approach identified age-related discriminative markers between aTB and LTBI. Whereas among the 3- to 15-year-old children, an excellent discrimination between aTB and LTBI was provided by comparing the ratio between the proportions of ESAT-6-induced IFN-γ(single+) and ESAT-6-induced TNF-α(single+)CD4(+) T lymphocytes, this was not the case for children younger than 3 years. By contrast, in this group (<3years), the analysis of HBHA-induced IL-17(single+)CD4(+) T lymphocytes allowed us to identify children with LTBI by the high proportion of this cellular lymphocyte subset, whereas this was not the case for children with aTB. The analysis at the single-cell level of T cell immune responses induced by mycobacterial antigens are, thus, different in infected children younger or older than 3 years of age. HBHA-induced IL-17 production by CD4(+) T lymphocytes was associated with protection only in children under 3 years who are at high risk for rapid progression to aTB. This suggests that the HBHA-induced IL-17 production by CD4(+) T lymphocytes is a potential new correlate of protection against M. tuberculosis in humans, and that the distinction between children with LTBI and those with aTB is possible based on age-related diagnostic markers.
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spelling pubmed-55918882017-09-19 Age-Stratified T Cell Responses in Children Infected with Mycobacterium tuberculosis Dreesman, Alexandra Corbière, Véronique Dirix, Violette Smits, Kaat Debulpaep, Sara De Schutter, Iris Libin, Myriam Singh, Mahavir Malfroot, Anne Locht, Camille Mascart, Françoise Front Immunol Immunology Tuberculosis (TB) in young children differs from adult TB in that the risk of rapid progression to active TB (aTB) is higher in children than in adults. The reasons for this increased risk are not fully understood. Early differentiation remains difficult between children at risk to develop aTB from those who will remain healthy and develop a latent TB infection (LTBI). Biomarkers to differentiate aTB from LTBI in children, especially in very young children, are urgently needed. To identify M. tuberculosis-specific functional T cell subsets related to clinical manifestations in children, we enrolled 87 children exposed to M. tuberculosis. After standard clinical assessment, the children were classified as aTB, LTBI, or uninfected. Their CD4(+) T cell cytokine profiles (IFN-γ, TNF-α, IL-2, IL-17) were analyzed at the single-cell level by flow cytometry after stimulation with three mycobacterial antigens, purified protein derivative (PPD), early-secreted-antigenic target-6 (ESAT-6), or heparin-binding hemagglutinin (HBHA). This approach identified age-related discriminative markers between aTB and LTBI. Whereas among the 3- to 15-year-old children, an excellent discrimination between aTB and LTBI was provided by comparing the ratio between the proportions of ESAT-6-induced IFN-γ(single+) and ESAT-6-induced TNF-α(single+)CD4(+) T lymphocytes, this was not the case for children younger than 3 years. By contrast, in this group (<3years), the analysis of HBHA-induced IL-17(single+)CD4(+) T lymphocytes allowed us to identify children with LTBI by the high proportion of this cellular lymphocyte subset, whereas this was not the case for children with aTB. The analysis at the single-cell level of T cell immune responses induced by mycobacterial antigens are, thus, different in infected children younger or older than 3 years of age. HBHA-induced IL-17 production by CD4(+) T lymphocytes was associated with protection only in children under 3 years who are at high risk for rapid progression to aTB. This suggests that the HBHA-induced IL-17 production by CD4(+) T lymphocytes is a potential new correlate of protection against M. tuberculosis in humans, and that the distinction between children with LTBI and those with aTB is possible based on age-related diagnostic markers. Frontiers Media S.A. 2017-09-05 /pmc/articles/PMC5591888/ /pubmed/28928738 http://dx.doi.org/10.3389/fimmu.2017.01059 Text en Copyright © 2017 Dreesman, Corbière, Dirix, Smits, Debulpaep, De Schutter, Libin, Singh, Malfroot, Locht and Mascart. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Immunology
Dreesman, Alexandra
Corbière, Véronique
Dirix, Violette
Smits, Kaat
Debulpaep, Sara
De Schutter, Iris
Libin, Myriam
Singh, Mahavir
Malfroot, Anne
Locht, Camille
Mascart, Françoise
Age-Stratified T Cell Responses in Children Infected with Mycobacterium tuberculosis
title Age-Stratified T Cell Responses in Children Infected with Mycobacterium tuberculosis
title_full Age-Stratified T Cell Responses in Children Infected with Mycobacterium tuberculosis
title_fullStr Age-Stratified T Cell Responses in Children Infected with Mycobacterium tuberculosis
title_full_unstemmed Age-Stratified T Cell Responses in Children Infected with Mycobacterium tuberculosis
title_short Age-Stratified T Cell Responses in Children Infected with Mycobacterium tuberculosis
title_sort age-stratified t cell responses in children infected with mycobacterium tuberculosis
topic Immunology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5591888/
https://www.ncbi.nlm.nih.gov/pubmed/28928738
http://dx.doi.org/10.3389/fimmu.2017.01059
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