Roadmap for the development of diagnostic test for bTB

What are we trying to achieve and why? What is the problem we are trying to solve?

Establish the host immune response, including what it is responding to and when.

What are the scientific and technological challenges
(knowledge gaps needing to be addressed)?

• Investigating the kinetics of immune cell activation, cytokine production, antibody generation, and the transition between innate and adaptive immune responses.
• Cross-reactivity with other environmental mycobacteria and related organisms.
• Immunoreactivity indexes exposure and includes productive infection.
• Trade-off between antigen sensitivity and specificity.
• Heritable variation in bTB risk and outcomes of exposure.

What approaches could/should be taken to address the research question?

• Fractionation and characterisation of PPD
• Synthesis of molecularly defined PPDs.
• Investigating the migration and tissue localization patterns of immune cells during infection.
• Figure out how immune cells traffic to and accumulate at the site of infection, as well as their distribution within tissues; can provide insights into immune surveillance and effector mechanisms.
• Elucidating the development, maintenance, and durability of immune memory following infection.

What else needs to be done before we can solve this need?

An improved understanding of the host-pathogen interaction.

Existing knowledge including successes and failures