Blood transcriptomics have revealed major characteristics of the immune response in active TB, but the signature early after infection is unknown. In a unique clinically and temporally well-defined cohort of household contacts of active TB patients that progressed to TB, we define minimal changes in gene expression in incipient TB increasing in subclinical and clinical TB. While increasing with time, changes in gene expression were highest at 30 d before diagnosis, with heterogeneity in the response in household TB contacts and in a published cohort of TB progressors as they progressed to TB, at a bulk cohort level and in individual progressors. Blood signatures from patients before and during anti-TB treatment robustly monitored the treatment response distinguishing early and late responders. Blood transcriptomics thus reveal the evolution and resolution of the immune response in TB, which may help in clinical management of the disease.

中文翻译：

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血液转录组学揭示结核病免疫反应的演变和解决

血液转录组学揭示了活动性结核病免疫反应的主要特征，但感染后早期的特征尚不清楚。在一个独特的临床和时间上明确定义的进展为结核病的活动性结核病患者的家庭接触者队列中，我们定义了亚临床和临床结核病早期结核病基因表达的最小变化。虽然随着时间的推移而增加，但基因表达的变化在诊断前 30 天最高，家庭结核病接触者和已发表的结核病进展者队列中，随着他们发展为结核病，在大批量队列水平和个体进展者中，反应存在异质性。在抗结核治疗之前和治疗期间，来自患者的血液特征强有力地监测了区分早期和晚期反应者的治疗反应。