Title |
MINIREVIEW] Importance of differential identification of Mycobacterium tuberculosis strains for understanding differences in their prevalence, treatment efficacy, and vaccine development |
Author |
Hansong Chae and Sung Jae Shin* |
Address |
Department of Microbiology, Institute for Immunology and Immunological Diseases, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul 03722, Republic of Korea |
Bibliography |
Journal of Microbiology, 56(5),300–311, 2018,
|
DOI |
10.1007/s12275-018-8041-3
|
Key Words |
Mycobacterium tuberculosis, Mycobacterium tuberculosis
lineage, genetic diversity, diagnosis, genotyping |
Abstract |
Tuberculosis (TB), caused by Mycobacterium tuberculosis
(Mtb), remains a serious global health problem in the 21st
century because of its high mortality. Mtb is an extremely
successful human-adapted pathogen that displays a multifactorial
ability to control the host immune response and to
evade killing by drugs, resulting in the breakdown of BCG
vaccine-conferred anti-TB immunity and development of
multidrug-resistant (MDR) and extensively drug-resistant
(XDR) Mtb. Although genetic components of the genomes
of the Mtb complex strains are highly conserved, showing
over 99% similarity to other bacterial genera, recently accumulated
evidence suggests that the genetic diversity of the
Mtb complex strains has implications for treatment outcomes,
development of MDR/XDR Mtb, BCG vaccine efficacy,
transmissibility, and epidemiological outbreaks. Thus, new
insights into the pathophysiological features of the Mtb complex
strains are required for development of novel vaccines
and for control of MDR/XDR Mtb infection, eventually leading
to refinement of treatment regimens and the health care
system. Many studies have focused on the differential identification
of Mtb complex strains belonging to different lineages
because of differences in their virulence and geographical
dominance. In this review, we discuss the impact of
differing genetic characteristics among Mtb complex strains
on vaccine efficacy, treatment outcome, development of MDR/
XDR Mtb strains, and epidemiological outbreaks by focusing
on the best-adapted human Mtb lineages. We further
explore the rationale for differential identification of Mtb
strains for more effective control of TB in clinical and laboratory
settings by scrutinizing current diagnostic methods. |