Key assumptions when extrapolating data to humans
Levels of evidence (in decreasing order of translatability to humans)
Human studies—direct clinical and translational data
Non-human primates—models with high biological proximity for a number of immune mechanisms
Murine models—useful for testing mechanisms but require cautious extrapolation
in vitro/ex vivo—allow a mechanism to be isolated but do not reproduce the entire tissue context
Principal limitations of interpretation
Vγ9Vδ2/BTN3A1–BTN2A1—the pAg-reactive system is characteristic of humans and primates; standard laboratory mice have no direct functional counterpart.
Granulysin—participates in the direct anti-mycobacterial activity of cytotoxic cells in humans and primates; absent in ordinary mice.
Intravenous BCG—pronounced protection has been shown in macaques, but this route of administration cannot be transferred directly to clinical practice.
COPD → γδ T cells → Mtb—direct data are insufficient; the emphysema model with the IL-17A → G-CSF → neutrophil axis is not equivalent to clinical COPD in TB.
M1/M2 polarization—a convenient but simplified scheme; single-cell sequencing data reveal a spectrum of coexisting macrophage states.
|