Characterization and monitoring of host immune responses to infectious agents: what a future for microbiological diagnostics?

Our knowledge on the mechanisms underlying microbial pathogenesis and host-microbe interactions has greatly improved over the last decade. In particular, the development of new and specific analytical methods has allowed the detailed characterization of innate and adaptive immune responses against clinically relevant microbial infections. Immunogenetic studies are continuously providing new insights on the genetic bases of individual differences in susceptibility to specific pathogens and most of the genetic markers identified so far include polymorphisms in genes controlling both innate and adaptive immune responses. Moreover, new standardized T cell assays allow reliable and reproducible evaluations of T cell phenotype and functions (i.e.: ELISPOT), including the identification of distinct functional signatures that are associated with the control of the infection.Although the number of these assays currently used in clinical practice is limited, a considerable increase is foreseen for the near future.This perspective constitutes an unprecedented opportunity for Clinical Microbiologists, who may now develop and apply integrated microbiologic/immunologic assays that may be useful for a more precise diagnostic definition and a more accurate clinical monitoring of the disease.