A diversidade genética do Mycobacterium tuberculosis e a sua contribuição para a tuberculose

Ana I. Fernandes; Margarida Saraiva; Tiago Beites

doi:10.25761/anaisihmt.463

Ana I. Fernandes i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal Programa Doutoral em Biologia Molecular e Celular, ICBAS - Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
Margarida Saraiva i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal; IBMC - Instituto de Biologia Molecular e Celular, Universidade do Porto, Porto, Portugal
Tiago Beites i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal

DOI: https://doi.org/10.25761/anaisihmt.463

Palavras-chave: Tuberculose, complexo do Mycobacterium tuberculosis, filogenia, severidade da doença

Resumo

Introdução: A tuberculose mantém-se um problema global, com mais de 10.6 milhões de novos casos e mais de 1.3 milhões de fatalidades por ano. Apesar de um declínio constante destes números ao longo das últimas décadas, a pandemia de COVID-19 reverteu esta tendência decrescente. É globalmente aceite que a luta contra a tuberculose passará por melhores meios de prevenção, diagnóstico e terapia. A investigação fundamental nestas áreas, e em particular a compreensão da resposta imunológica contra o Mycobacterium tuberculosis, é, pois, essencial. Muitos estudos mostram o papel central da resposta imunológica para o controlo da infeção por M. tuberculosis, evidenciando também que falhas nesta resposta conduzem frequentemente à progressão para uma doença ativa. Apesar de classicamente estes estudos serem focados nas características do hospedeiro, dados recentes apontam para um papel importante da diversidade genética do patógeno no moldar da resposta imunológica. Esta variável foi durante muito tempo negligenciada, dada a baixa diversidade genética do M. tuberculosis.
Objetivo: Com o advento da sequenciação de genomas completos, percebeu-se que apesar de diminuta, a diversidade genética do patógeno não é negligenciável. Nesta publicação pretendemos descrever como esta diversidade contribui ativamente para o resultado da infeção por M. tuberculosis.
Materiais e métodos: Neste artigo apresentamos uma revisão da literatura, baseada em artigos disponibilizados no PubMed e relatórios da Organização Mundial de Saúde pertinentes ao tema.
Resultados: Da análise efetuada apresentamos os principais argumentos que demonstram o impacto da diversidade genética do M. tuberculosis em vários aspetos da tuberculose e discutimos como a sua incorporação na investigação pode contribuir para o desenho de novas ferramentas mais eficazes contra esta doença.
Conclusão: As diferenças associadas às várias linhagens de M. tuberculosis realçam novos desafios para o estudo da tuberculose com implicações para a sua prevenção, diagnóstico e tratamento.

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