Research Summary

Differential Cytokine Patterns during Treatment of Tuberculosis: Can we Monitor Therapeutic Response in Children by a Simple Blood Test?

Childhood tuberculosis, being pauci-bacillary in nature, poses a number of unique challenges in diagnosis and monitoring of treatment. Extra-pulmonary TB is even more challenging due to lack of appropriate samples for bacteriological confirmation. Till date, two month sputum conversion is the most reliable predictor of therapeutic outcome. However in children, 80-90% of the TB cases are smear/culture negative to begin with. Hence, we have to rely on the clinico-radiological improvement to monitor therapeutic response, which may not always be accurate. In this scenario, it would be advantageous to have simple, easy to perform tests on whole blood to monitor treatment response; early prediction of relapse will be an added advantage. The immunological response to infection by Mycobacterium tuberculosis (MTB) is complex involving the NK cells, ΥδT, CD4 and CD8 T cells amongst many others. The immunological milieu as represented by the cytokines secreted by immunologically active cells and the transcriptional biomarkers is expected to be different according to the outcome of the disease. We hope to identify a host immune bio-signature, as early as a few weeks after initiation of ATT, so that response can be predicted and appropriate measures taken.

Figure Legend: Schematic representation of the aim of the proposed research - to identify host immune bio-signature which can be used for early prediction of therapeutic response in children with pulmonary or extra-pulmonary tuberculosis. ATT: anti-tubercular therapy