[Genetic susceptibility to mycobacterial disease: Mendelian disorders of the interleukin-12 -interferon-gamma axis].
BACKGROUND
Environmental non tuberculous mycobacteria and Bacillus Calmette-Guerin vaccines are weakly virulent mycobacteria. Nevertheless they may cause severe diseases in otherwise healthy children with no overt immunodeficiency. Parental consanguinity and familial forms are frequently observed among these patients, therefore this syndrome was named "Mendelian Susceptibility to Mycobacterial Disease".


BACKGROUND
In the last nine years, fife genes have been found to be mutated in patients with this syndrome: IFNGR1, IFNGR2, STAT1, IL12B, IL12RB1. Allelic heterogeneity accounts for ten distinct genetic disorders. Clinical phenotype differs between patients. The spectrum of disease extends from early-onset overwhelming mycobacterial infection to adult-onset localized disease and tuberculosis. Impaired IFN-gamma-mediated immunity is the common mechanism of the disease, outlining its major role in mycobacterial immunity.


CONCLUSIONS
Better understanding of these disorders reveals an expanding clinical phenotype which justifies studying adult patients with pulmonary non tuberculous mycobacterial infection without known risk factors, severe BCGitis and recurrent tuberculosis. Molecular diagnosis makes it possible to introduce a specific regimen based on physiopathology.
Catherinot
E
E
Laboratoire de Génétique Humaine des Maladies Infectieuses, Université René Descartes - INSERM U550, Faculté de Médecine Necker, Paris, France. e.catherinot@mail.com
Fieschi
C
C
Feinberg
J
J
Casanova
J-L
JL
Couderc
L-J
LJ
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016207:Cytokines / Q000627:therapeutic use; D020022:Genetic Predisposition to Disease; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007371:Interferon-gamma / Q000172:deficiency / Q000235:genetics; D018664:Interleukin-12 / Q000172:deficiency / Q000235:genetics; D009164:Mycobacterium Infections / Q000235:genetics* / Q000628:therapy; D017471:Receptors, Interferon / Q000172:deficiency / Q000235:genetics; D018123:Receptors, Interleukin / Q000172:deficiency / Q000235:genetics
D000900:Anti-Bacterial Agents; D016207:Cytokines; D017471:Receptors, Interferon; D018123:Receptors, Interleukin; D018664:Interleukin-12; D007371:Interferon-gamma