Laboratory Evaluation of the IFN-γ Circuit for the Molecular Diagnosis of Mendelian Susceptibility to Mycobacterial Disease

Overview

Journal Crit Rev Clin Lab Sci

Publisher Informa Healthcare

Specialty Pathology

Date 2018 Mar 6

PMID 29502462

Citations 25

Authors

Ana Esteve-Sole

Ithaisa Sologuren

Maria Teresa Martinez-Saavedra

Angela Deya-Martinez

Carmen Oleaga-Quintas

Ruben Martinez-Barricarte

Andrea Martin-Nalda

Manel Juan

Jean-Laurent Casanova

Carlos Rodriguez-Gallego

Laia Alsina

Jacinta Bustamante

Affiliations

Soon will be listed here.

Abstract

The integrity of the interferon (IFN)-γ circuit is necessary to mount an effective immune response to intra-macrophagic pathogens, especially Mycobacteria. Inherited monogenic defects in this circuit that disrupt the production of, or response to, IFN-γ underlie a primary immunodeficiency known as Mendelian susceptibility to mycobacterial disease (MSMD). Otherwise healthy patients display a selective susceptibility to clinical disease caused by poorly virulent mycobacteria such as BCG (bacille Calmette-Guérin) vaccines and environmental mycobacteria, and more rarely by other intra-macrophagic pathogens, particularly Salmonella and M. tuberculosis. There is high genetic and allelic heterogeneity, with 19 genetic etiologies due to mutations in 10 genes that account for only about half of the patients reported. An efficient laboratory diagnostic approach to suspected MSMD patients is important, because it enables the establishment of specific therapeutic measures that will improve the patient's prognosis and quality of life. Moreover, it is essential to offer genetic counseling to affected families. Herein, we review the various genetic and immunological diagnostic approaches that can be used in concert to reach a molecular and cellular diagnosis in patients with MSMD.

Citing Articles

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