Spectrum of latent tuberculosis — existing tests cannot resolve the underlying phenotypes: author's reply

We agree with the comments in response to our Review (The spectrum of latent tuberculosis: rethinking the biology and intervention strategies. Nature Rev. Microbiol. 7, 845–855 (2009))1 from Pai (Spectrum of latent tuberculosis — existing tests cannot resolve the underlying phenotypes. Nature Rev. Microbiol. 8, 19 Jan 2010 (doi:10.1038/nrmicro2236-c1))2 stating that current diagnostic tests do not address the challenge of identifying subgroups of individuals in the latent tuberculosis (TB) spectrum who would benefit most from preventive therapy. Indeed, we hope that the framework set out in our Review will help to target efforts towards the development of improved diagnostic tools. The strategy of serial IGRA testing as proposed by Pai is likely to be one element in progressing towards this goal, although broadening the range of cytokines beyond a reliance solely on interferon-γ may well be important. A key limitation to the time-dependent approach that is illustrated by Pai is that accurate information about the time of initial exposure is unavailable in most endemic settings. Parallel studies based on experimental challenge in the non-human primate model may be helpful in establishing a clear time course for the correlation of immune markers with microbiological and clinical changes.

References

  1. 1

    Barry, C. E. 3rd et al. The spectrum of latent tuberculosis: rethinking the biology and intervention strategies. Nature Rev. Microbiol. 7, 845–855 (2009).

    CAS  Article  Google Scholar 

  2. 2

    Madhukar Pai. Spectrum of latent tuberculosis — existing tests cannot resolve the underlying phenotypes. Nature Rev. Microbiol. 8, 19 Jan 2010 (doi:10.1038/nrmicro2236-c1).

    CAS  Article  Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to Douglas Young.

Ethics declarations

Competing interests

The authors declare no competing financial interests.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Barry, C., Boshoff, H., Dartois, V. et al. Spectrum of latent tuberculosis — existing tests cannot resolve the underlying phenotypes: author's reply. Nat Rev Microbiol 8, 242 (2010). https://doi.org/10.1038/nrmicro2236-c2

Download citation

Further reading

Search

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing