title: Current understanding of the immune response to tuberculosis in children.
abstract: OBJECTIVE
  Even in the era of promising molecular diagnostics for tuberculosis, understanding of the immune response remains urgent and fundamental to combating paediatric tuberculosis, given its paucibacillary nature.
  
  
  RESULTS
  Significant advances have been made in unravelling the contributions of previously underappreciated components of the immune response to Mycobacterium tuberculosis. Research into the role of the 'innate' immune system such as neutrophils alongside 'adaptive' cells such as CD4(+), CD8(+), polyfunctional and regulatory T cells has highlighted the complexity of their interactions. Lessons from children with congenital or acquired susceptibility to mycobacterial disease, including HIV, continue to illuminate a broader understanding of the host immune response. The role of vitamin D is becoming apparent and highlights the importance of the environmental and clinical context of patients, especially in high prevalence areas. Several approaches show promise as diagnostic tests and in monitoring treatment response, although distinguishing latent from active disease remains a challenge.
  
  
  CONCLUSIONS
  Research into novel immunological biomarkers, and greater understanding of the complex network of interactions between the innate and adaptive immune systems, is key to understanding why following exposure some children are unaffected, others latently infected and yet another group succumb to disease.
authors.affiliation: Department of Paediatric Allergy & Infection, Imperial College London, London, UK.
authors.forename: Robindra
authors.initials: R
authors.lastname: Basu Roy
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Whittaker
authors.forename: Beate
authors.initials: B
authors.lastname: Kampmann
mesh_terms: D056704:Adaptive Immunity / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D016207:Cytokines / Q000276:immunology; D006801:Humans; D007113:Immunity, Innate / Q000276:immunology; D009169:Mycobacterium tuberculosis / Q000276:immunology*; D013601:T-Lymphocytes / Q000276:immunology; D014376:Tuberculosis / Q000175:diagnosis / Q000276:immunology*
chemical_list: D016207:Cytokines