An international collaboration of American, British, and Vietnamese researchers have uncovered a gene that influences the inflammatory response to infection that may also predict the effectiveness of drug treatment for a particularly deadly form of tuberculosis (TB), TB meningitis. These findings, which appear in the journal Cell, suggest the possibility of tailoring tuberculosis treatment, based on a patient’s genetic sequence.

Treatment would specifically target the gene called LTA4H, which controls the balance between pro-inflammatory and anti-inflammatory substances produced during an infection.

Tuberculosis can take hold if disease-fighting inflammation is either too weak or too strong. The strength of the response is in part the result of a person’s LTA4H gene sequences. Knowing whether a patient has the gene sequence for one extreme response or the other could help guide medication decisions.

The researchers studied the gene among patients with TB and discovered that patients carrying one copy of the high-activity sequence of the gene and one copy of the low-activity sequence were relatively protected from TB meningitis. However, people with two copies of the high-activity sequence of the gene fared just as poorly as people with two copies of the low-activity sequence. By analyzing patients with TB meningitis, the researchers found that anti-inflammatory therapy only benefited patients with the gene sequence that corresponds to excess inflammation.

Source: University of Washington Health Sciences/University of Washington Medicine