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Universidad de Antioquia

Artículos de Revista en Ciencias Médicas · 2024

Tuberculosis in otherwise healthy adults with inherited TNF deficiency

Arias Sierra, Andrés Augusto · Arango Franco, Carlos Andrés · Franco Restrepo, José Luis · Orrego Arango, Julio César · Rojas Silva, Julián · Erazo Borrás, Lucía Victoria · Moncada Vélez, Marcela · Carmona Ramírez, María Camila · Obando Gil, Catalina · Álvarez Álvarez, Jesús Armando · Sánchez Correa, Juan Pablo · Tejada Giraldo, Manuela · Agudelo Agudelo, María Lucía · Pérez Zapata, Lizet Jazmin · Arboleda Sepúlveda, Diana Marcela · Cataño Correa, Juan Carlos · Alzate Restrepo, Juan Fernando · Cabarcas Jaramillo, Felipe · Velásquez Lopera, Margarita María · Neehus, Anna Lena · Ogishi, Masato · Meynier, Vincent · Krebs, Adam · Lazarov, Tomi · Lee, Angela M. · Yang, Rui · Corcini Berndt, Melissa · Li, Hailun · Rinchai, Darawan · Eun Han, Ji · Pillay, Bethany · Ponsin, Khoren · Chaldebas, Matthieu · Philippot, Quentin · Bohlen, Jonathan · Rosain, Jérémie · Voyer, Tom Le · Till, Janotte · Amarajeeva, Krishnajina · Soudée, Camille · Brollo, Marion · Wiegmann, Katja · Marquant, Quentin · Seeleuthner, Yoann · Lee, Danyel · Lainé, Candice · Kloos, Doreen · Bailey, Rasheed · Bastard, Paul · Keating, Narelle · Rapaport, Franck · Khan, Taushif · Martínez Rosado, Larry Luber · L'Honneur, Anne Sophie · Zuluaga Rodríguez, Alejandra · Pelham, Simon J. · Ensser, Armin · Schmidt, Monika · Jouanguy, Emmanuelle · Puel, Anne · Krönke, Martin · Ghirardello, Stefano · Borghesi, Alessandro · Pahari, Susanta · Boisson, Bertrand · Pittaluga, Stefania · Ma, Cindy S. · Emile, Jean François · Notarangelo, Luigi D. · Tangye, Stuart G. · Marr, Nico · Lachmann, Nico · Salvator, Hélène · Schlesinger, Larry S. · Zhang, Peng · Glickman, Michael S. · Nathan, Carl F. · Geissmann, Frédéric · Abel, Laurent · Bustamante, Jacinta · Casanova, Jean Laurent · Boisson Dupuis, Stéphanie

Severe defects in human IFNγ immunity predispose individuals to both Bacillus Calmette–Guérin disease and tuberculosis, whereas milder defects predispose only to tuberculosis. Here we report two adults with recurrent pulmonary tuberculosis who are homozygous for a private loss-of-function TNF variant. Neither has any other clinical phenotype and both mount normal clinical and biological inflammatory responses. Their leukocytes, including monocytes and monocyte-derived macrophages (MDMs) do not produce TNF, even after stimulation with IFNγ. Blood leukocyte subset development is normal in these patients. However, an impairment in the respiratory burst was observed in granulocyte–macrophage colony-stimulating factor (GM-CSF)-matured MDMs and alveolar macrophage-like (AML) cells from both patients with TNF deficiency, TNF- or TNFR1-deficient induced pluripotent stem (iPS)-cell-derived GM-CSF-matured macrophages, and healthy control MDMs and AML cells differentiated with TNF blockers in vitro, and in lung macrophages treated with TNF blockers ex vivo. The stimulation of TNF-deficient iPS-cell-derived macrophages with TNF rescued the respiratory burst. Human TNF is required for respiratory-burst-dependent immunity to Mycobacterium tuberculosis in macrophages but is surprisingly redundant otherwise, including for inflammation and immunity to weakly virulent mycobacteria and many other infectious agents.

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