TAILIEUCHUNG - Diversity of disease in childhood pulmonary tuberculosis

Many factors can influence the dynamic balance that exists between the host and the pathogen (M. tuberculosis), but the host immune response seems to be the most important. This is illustrated by the vulnerability of immune-compromised individuals to develop tuberculosis and by the age-related spectrum of disease witnessed in immune-competent children. This age-related spectrum of disease reflects the ontogeny of the host immune response towards M. tuberculosis. Renewing our focus on the ontogeny of the immune response in children might provide valuable insights to direct future research regarding tuberculosis prevention, vaccine development and treatment. Childhood covers the interval from birth to adolescence (defined as 0–15 years of. | Annals of Tropical Paediatrics 2005 25 79-86 Diversity of disease in childhood pulmonary tuberculosis B. J. MARAIS P. R. DONALD R. P. GIE H. S. SCHAAF N. BEYERS Centre for TB Research Education Department of Paediatrics Child Health Tygerberg Children s Hospital and Faculty of Health Sciences Stellenbosch University Cape Town South Africa Accepted March 2005 Abstract Many factors can influence the dynamic balance that exists between the host and the pathogen M. tuberculosis but the host immune response seems to be the most important. This is illustrated by the vulnerability of immune-compromised individuals to develop tuberculosis and by the age-related spectrum of disease witnessed in immune-competent children. This age-related spectrum of disease reflects the ontogeny of the host immune response towards M. tuberculosis. Renewing our focus on the ontogeny of the immune response in children might provide valuable insights to direct future research regarding tuberculosis prevention vaccine development and treatment. Background Childhood covers the interval from birth to adolescence defined as 0-15 years of age . It is a period of dynamic growth and maturation during which the natural response to infection undergoes profound change as the immune system develops. Few diseases illustrate this evolution of the immune response better than the diverse and changing spectrum of pathology seen in childhood A recently proposed radiological classification of childhood intra-thoracic tuberculosis highlights this disease diversity and its relevance to prognosis and Understanding the age-dependent differences in the immune response to Mycobacterium tuberculosis infection is crucial for Reprint requests to Dr B. J. Marais Department of Paediatrics Child Health Centre for TB Research and Education Faculty of Health Sciences Stellenbosch University PO Box 19063 Tygerberg 7505 South Africa. Fax 27 21 938 9138 e-mail bjmarais@ improved case .

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