Overactive Immune Response Linked to Poor TB Treatment Outcomes, ICMR Research Shows
People whose immune systems launch an unusually aggressive early attack against tuberculosis may face reduced effectiveness from standard drug treatments, according to a groundbreaking study conducted by the ICMR National Institute for Tuberculosis Research in Chennai. The research highlights that a specific group of immune proteins, known as the complement system, can act as an early warning indicator for such cases.
Complement System as a Key Predictor in TB Therapy
The study, funded by the Department of Biotechnology and published in the peer-reviewed journal 'Frontiers in Immunology', analyzed blood samples from 68 patients with pulmonary tuberculosis who experienced poor treatment responses, comparing them with 108 patients who successfully completed therapy. While over 90% of TB patients typically recover with standard regimens, this subset showed persistent challenges, prompting scientists to investigate immune-related causes.
The complement system comprises proteins in the blood that enhance the body's defences by marking pathogens like bacteria for destruction, recruiting immune cells to infection sites, and sometimes directly attacking microbial membranes. Dr. Vijay Vishwanathan, a senior diabetologist from MV Hospital for Diabetes, explained, "It's a group of proteins that acts like a back-up force for the immune system, aiding in finding and destroying invaders. When functioning properly, they clear infections rapidly, but excessive or prolonged activity can lead to harmful inflammation and damage to healthy tissues."
Imbalance in Immune Proteins Leads to Treatment Complications
In the study, patients with adverse outcomes exhibited higher levels of active complement components—such as C3, C4b, C5, C5a, and C1q—at the start of treatment and after two months. Concurrently, they had lower levels of natural regulatory proteins like Factor H, which serve as "brakes" to keep the complement system in check. This imbalance suggests that early and sustained activation of the complement system, particularly through the classical pathway, is associated with poor TB treatment results.
Nathella Pavan Kumar, the study's first author, noted, "The findings indicate that early and sustained complement activation is linked to adverse outcomes in tuberculosis." The research concludes that simple blood tests measuring these proteins could enable doctors to identify high-risk patients early, allowing for adjusted therapies and closer monitoring before the disease progresses. However, the study does not specify the exact percentage of patients affected by this overactive immune response.
Potential for Early Intervention and Improved Patient Care
This discovery opens avenues for personalized medicine in tuberculosis management. By utilizing blood tests to detect immune dysregulation, healthcare providers could tailor treatments to individual immune profiles, potentially improving recovery rates and reducing complications. The study underscores the importance of balancing immune responses to optimize therapeutic outcomes, offering hope for more effective strategies against TB in the future.
