The application of transcriptional blood signatures to enhance our understanding of the host response to infection: the example of tuberculosis

Abstract

Despite advances in antimicrobials, vaccination and public health measures, infectious diseases remain a leading cause of morbidity and mortality worldwide. With the increase in antimicrobial resistance and the emergence of new pathogens, there remains a need for new and more accurate diagnostics, the ability to monitor adequate treatment response as well as the ability to predict prognosis for an individual. Transcriptional approaches using blood signatures have enabled a better understanding of the host response to diseases, leading not only to new avenues of basic research, but also to the identification of potential biomarkers for use in diagnosis, prognosis and treatment monitoring.

Keywords: immune response; infection; tuberculosis.

Figure 1.

Using a systems biology approach in infectious disease research. Adapted from O‘Garra et al. [51].

Figure 2.

Transcriptional signatures in tuberculosis. (a) A 393 transcript signature was able to broadly distinguish active TB from latently infected and healthy controls (from Berry et al. [15]). (b) A modular approach is able to identify the key transcriptional differences between TB and other inflammatory diseases (modified from Berry et al. [15]). (c) A 1446 transcript signature reveals that pulmonary granulomatous diseases display similar transcriptional signatures that are distinct from pneumonia and lung cancer (modified from Bloom et al. [16]). (d) Modular approach showing the differences between active sarcoidosis, TB compared with pneumonias and lung cancer (modified from Bloom et al. [16]). (e) A 664 transcript signature is seen to change on treatment by as early as two weeks (modified from Bloom et al. [25]). SLE, systemic lupus erythematosus; TB, tuberculosis.