The pathogenesis of tuberculous meningitis (360G-Wellcome-211159_Z_18_Z)

Tuberculosis is an infection affecting people in many countries throughout the world. In some cases the infection can occur in the lining of the brain (the meninges) leading to a condition called tuberculous meningitis. This is particularly dangerous when the immune system is also suppressed by infection with Human Immunodeficiency Virus (HIV) which is also a common problem worldwide. In this context 40% of patients with tuberculous meningitis will die. When tuberculous infects the brain, the body’s own immune system is activated to fight the bacteria. This is usually helpful, but often the immune system goes into overdrive, causing more damage to the brain than the bacteria itself. This research aims to find out exactly what happens when the immune system works hard to fight the bacteria. The experiments will isolate the building blocks within the blood which dictate which molecules are involved in fighting the infection. We will discover what happens in the immune system at different points during the patient’s illness and treatment. In doing so we hope to find targets for new medicines to control the immune response therefore in the future reducing the number of people who die or are disabled due to tuberculous meningitis.