Clinical Recovery in Tuberculosis is Associated With the Functional Remodelling of Ag85A-Specific Antibody Avidity and Phagocytic Activity.

Authors

Juan Diego Jibaja, Cheaylhi Sanchez, Alessia Piamonte, Sandra Palma Albornoz, Iskra Tuero

Published in

Scandinavian journal of immunology. Volume 104. Issue 4. Pages e70156.

Abstract

Tuberculosis (TB) remains a critical global health threat. While research has historically prioritized T-cell immunity, antibodies against highly immunogenic candidates like the Mtb antigen Ag85A are increasingly recognized for their protective roles via Fcγ receptor-mediated effector functions. This study characterized the longitudinal dynamics of B-cells and phagocyte populations alongside Mtb-specific antibody features during TB treatment. A cohort of 20 patients with active TB was followed prospectively for 6 months, with peripheral blood samples collected at baseline (T0), at two (T2) and 6 months (T6) of therapy. The frequencies of circulating immune cells were analysed by flow cytometry, while Ag85A-specific avidity and phagocytic activity were evaluated in patient plasma. Our findings demonstrate a significant, coordinated shift in the host immune profile during anti-TB therapy. We observed a progressive increase in Mtb-specific phagocytic activity and antibody avidity after treatment completion, indicating a functional remodelling of the immune response. Specifically, Ag85A-specific IgG1 levels correlated with phagocytic activity, suggesting it acts as a primary mediator of this effector response. Concurrently, maturation of antibody avidity correlated negatively with bacillary burden. As bacterial load, quantified by sputum smear test (SST), diminished, we noted a concomitant declining trend in circulating CD14⁺ monocyte and CD66⁺ granulocytes, indicating a gradual resolution of the inflammatory response. Strikingly, this contraction of the myeloid compartment inversely mirrored a progressive rise in circulating B cell frequencies. This integrated framework outperforms conventional metrics, providing a multi-parametric fingerprint that would be used to track treatment responses and design the next generation of TB immunotherapy.

PMID:
42834560
Bibliographic data and abstract were imported from PubMed on 06 Oct 2026.

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