title: N. meningitidis and TLR Polymorphisms: A Fascinating Immunomodulatory Network.
abstract: N. meningitidis infections represent a global health problem that can lead to the development of serious permanent sequelae. Although the use of antibiotics and prevention via vaccination have reduced the incidence of meningococcal disease, our understanding regarding N. meningitidis pathogenesis is still limited, especially of those mechanisms responsible for IMD and fulminant or deadly septic shock. These severe clinical presentations occur in a limited number of subjects, whereas about 10% of healthy individuals are estimated to carry the bacteria as a commensal. Since TLR activation is involved in the defense against N. meningitidis, several studies have highlighted the association between host TLR SNPs and a higher susceptibility and severity of N. meningitidis infections. Moreover, TLR SNPs induced variations in immunological responses and in their persistence upon vaccination against meningococcal disease. In the absence of mass vaccination programs, the early identification of risk factors for meningococcal disease would be recommended in order to start immunization strategies and antibiotic treatment in those subjects carrying the risk variants. In addition, it could allow us to identify individuals with a higher risk for severe disease and sequelae in order to develop a personalized healthcare of high-risk subjects based on their genomic profile. In this review, we have illustrated important preliminary correlations between TLR variants and meningococcal susceptibility/severity and with vaccine-induced immune responses.
authors.affiliation: Strada del Petriccio e Belriguardo, 53100 Siena, Italy. gianchecchi@vismederi.com.
authors.forename: Elena
authors.initials: E
authors.lastname: Gianchecchi
authors.affiliation: Strada del Petriccio e Belriguardo, 53100 Siena, Italy. torelli@vismederi.com.|Department of Life Sciences, University of Siena, 53100 Siena, Italy. torelli@vismederi.com.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Torelli
authors.affiliation: Strada del Petriccio e Belriguardo, 53100 Siena, Italy. piccini@vismederi.com.
authors.forename: Giulia
authors.initials: G
authors.lastname: Piccini
authors.affiliation: Strada del Petriccio e Belriguardo, 53100 Siena, Italy. piccirella@vismederi.com.
authors.forename: Simona
authors.initials: S
authors.lastname: Piccirella
authors.affiliation: Strada del Petriccio e Belriguardo, 53100 Siena, Italy. emanuele.montomoli@unisi.it.|Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy. emanuele.montomoli@unisi.it.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Montomoli
keywords: Neisseria meningitidis; TLR single nucleotide polymorphisms; immunological responses; invasive meningococcal disease; meningococcal vaccines; risk factors