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Rogozynski NP, Dixon B. The Th1/Th2 paradigm: A misrepresentation of helper T cell plasticity. Immunol Lett 2024; 268:106870. [PMID: 38788801 DOI: 10.1016/j.imlet.2024.106870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Accepted: 05/21/2024] [Indexed: 05/26/2024]
Abstract
For decades, the Th1/2 paradigm has been used to classify immune responses as either Th1 or Th2-biased. However, in recent years, a staggering amount of evidence has emerged to support rejection of the classical Th1/Th2 paradigm, such as the discoveries of new helper T cell subsets, helper T cell plasticity and protective mixed-Th1/Th2 responses. This opinion piece investigates the shortcomings of classical Th1/Th2 paradigm in the context of recent works, with the goal of facilitating the development of newer models to represent the diversity of Th cells.
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Affiliation(s)
| | - Brian Dixon
- Department of Biology, University of Waterloo, Waterloo, Canada.
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2
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Shaukat SN, Eugenin E, Nasir F, Khanani R, Kazmi SU. Identification of immune biomarkers in recent active pulmonary tuberculosis. Sci Rep 2023; 13:11481. [PMID: 37460564 DOI: 10.1038/s41598-023-38372-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 07/07/2023] [Indexed: 07/20/2023] Open
Abstract
Tuberculosis (TB) has remained an unsolved problem and a major public health issue, particularly in developing countries. Pakistan is one of the countries with the highest tuberculosis infection rates globally. However, methods or biomarkers to detect early signs of TB infection are limited. Here, we characterized the mRNA profiles of immune responses in unstimulated Peripheral blood mononuclear cells obtained from treatment naïve patients with early signs of active pulmonary tuberculosis without previous history of clinical TB. We identified a unique mRNA profile in active TB compared to uninfected controls, including cytokines such as IL-27, IL-15, IL-2RA, IL-24, and TGFβ, transcription factors such as STAT1 and NFATC1 and immune markers/receptors such as TLR4, IRF1, CD80, CD28, and PTGDR2 from an overall 84 different transcripts analyzed. Among 12 significant differentially expressed transcripts, we identified five gene signatures which included three upregulated IL-27, STAT1, TLR4 and two downregulated IL-24 and CD80 that best discriminate between active pulmonary TB and uninfected controls with AUC ranging from 0.9 to 1. Our data identified a molecular immune signature associated with the early stages of active pulmonary tuberculosis and it could be further investigated as a potential biomarker of pulmonary TB.
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Affiliation(s)
- Sobia Naz Shaukat
- Immunology and Infectious Diseases Research Laboratory (IIDRL), Department of Microbiology, Karachi University, Karachi, Pakistan.
- Department of Biological and Biomedical Sciences, Aga Khan University Hospital, Stadium Road, P.O. Box 3500, Karachi, 74800, Pakistan.
| | - Eliseo Eugenin
- Department of Neurobiology, University of Texas Medical Branch (UTMB), Galveston, TX, USA
| | - Faizan Nasir
- Department of Immunology, Dadabhoy Institute of Higher Education, Karachi, Pakistan
| | - Rafiq Khanani
- Dow University of Health Sciences, Ojha Campus, Karachi, Pakistan
| | - Shahana Urooj Kazmi
- Immunology and Infectious Diseases Research Laboratory (IIDRL), Department of Microbiology, Karachi University, Karachi, Pakistan
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Tateosian NL, Morelli MP, Pellegrini JM, García VE. Beyond the Clinic: The Activation of Diverse Cellular and Humoral Factors Shapes the Immunological Status of Patients with Active Tuberculosis. Int J Mol Sci 2023; 24:5033. [PMID: 36902461 PMCID: PMC10002939 DOI: 10.3390/ijms24055033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 02/24/2023] [Accepted: 02/27/2023] [Indexed: 03/08/2023] Open
Abstract
Mycobacterium tuberculosis (Mtb), the etiologic agent of tuberculosis (TB), has killed nearly one billion people in the last two centuries. Nowadays, TB remains a major global health problem, ranking among the thirteen leading causes of death worldwide. Human TB infection spans different levels of stages: incipient, subclinical, latent and active TB, all of them with varying symptoms, microbiological characteristics, immune responses and pathologies profiles. After infection, Mtb interacts with diverse cells of both innate and adaptive immune compartments, playing a crucial role in the modulation and development of the pathology. Underlying TB clinical manifestations, individual immunological profiles can be identified in patients with active TB according to the strength of their immune responses to Mtb infection, defining diverse endotypes. Those different endotypes are regulated by a complex interaction of the patient's cellular metabolism, genetic background, epigenetics, and gene transcriptional regulation. Here, we review immunological categorizations of TB patients based on the activation of different cellular populations (both myeloid and lymphocytic subsets) and humoral mediators (such as cytokines and lipid mediators). The analysis of the participating factors that operate during active Mtb infection shaping the immunological status or immune endotypes of TB patients could contribute to the development of Host Directed Therapy.
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Affiliation(s)
- Nancy Liliana Tateosian
- Departamento de Química Biológica, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Intendente Güiraldes 2160, Pabellón II, 4°piso, Ciudad Universitaria, Buenos Aires C1428EGA, Argentina
- Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales (IQUIBICEN), Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Consejo Nacional de Investigaciones Científicas y Técnicas, Intendente Güiraldes 2160, Pabellón II, 4°piso, Ciudad Universitaria, Buenos Aires C1428EGA, Argentina
| | - María Paula Morelli
- Departamento de Química Biológica, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Intendente Güiraldes 2160, Pabellón II, 4°piso, Ciudad Universitaria, Buenos Aires C1428EGA, Argentina
- Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales (IQUIBICEN), Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Consejo Nacional de Investigaciones Científicas y Técnicas, Intendente Güiraldes 2160, Pabellón II, 4°piso, Ciudad Universitaria, Buenos Aires C1428EGA, Argentina
| | - Joaquín Miguel Pellegrini
- Centre d’Immunologie de Marseille Luminy, INSERM, CNRS, Aix-Marseille Université, Parc Scientifique et Technologique de Luminy, Case 906, CEDEX 09, 13288 Marseille, France
| | - Verónica Edith García
- Departamento de Química Biológica, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Intendente Güiraldes 2160, Pabellón II, 4°piso, Ciudad Universitaria, Buenos Aires C1428EGA, Argentina
- Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales (IQUIBICEN), Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Consejo Nacional de Investigaciones Científicas y Técnicas, Intendente Güiraldes 2160, Pabellón II, 4°piso, Ciudad Universitaria, Buenos Aires C1428EGA, Argentina
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4
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Peruhype-Magalhães V, de Araújo FF, de Morais Papini TF, Wendling APB, Campi-Azevedo AC, Coelho-Dos-Reis JG, de Almeida IN, do Valle Antonnelli LR, Amaral LR, de Souza Gomes M, Brito-de-Sousa JP, Elói-Santos SM, Augusto VM, Pretti Dalcolmo MM, Carneiro CM, Teixeira-Carvalho A, Martins-Filho OA. Serum biomarkers in patients with unilateral or bilateral active pulmonary tuberculosis: Immunological networks and promising diagnostic applications. Cytokine 2023; 162:156076. [PMID: 36417816 DOI: 10.1016/j.cyto.2022.156076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 10/08/2022] [Accepted: 10/14/2022] [Indexed: 11/21/2022]
Abstract
The present observational study was designed to characterize the integrative profile of serum soluble mediators to describe the immunological networks associated with clinical findings and identify putative biomarkers for diagnosis and prognosis of active tuberculosis. The study population comprises 163 volunteers, including 84 patients with active pulmonary tuberculosis/(TB), and 79 controls/(C). Soluble mediators were measured by multiplexed assay. Data analysis demonstrated that the levels of CCL3, CCL5, CXCL10, IL-1β, IL-6, IFN-γ, IL-1Ra, IL-4, IL-10, PDGF, VEGF, G-CSF, IL-7 were increased in TB as compared to C. Patients with bilateral pulmonary involvement/(TB-BI) exhibited higher levels of CXCL8, IL-6 and TNF with distinct biomarker signatures (CCL11, CCL2, TNF and IL-10) as compared to patients with unilateral infiltrates/(TB-UNI). Analysis of biomarker networks based in correlation power graph demonstrated small number of strong connections in TB and TB-BI. The search for biomarkers with relevant implications to understand the pathogenetic mechanisms and useful as complementary diagnosis tool of active TB pointed out the excellent performance of single analysis of IL-6 or CXCL10 and the stepwise combination of IL-6 → CXCL10 (Accuracy = 84 %; 80 % and 88 %, respectively). Together, our finding demonstrated that immunological networks of serum soluble biomarkers in TB patients differ according to the unilateral or bilateral pulmonary involvement and may have relevant implications to understand the pathogenetic mechanisms involved in the clinical outcome of Mtb infection.
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Affiliation(s)
- Vanessa Peruhype-Magalhães
- Grupo Integrado de Pesquisa em Biomarcadores, Instituto René Rachou, FIOCRUZ-Minas, Belo Horizonte, Minas Gerais, Brazil
| | - Fernanda Fortes de Araújo
- Grupo Integrado de Pesquisa em Biomarcadores, Instituto René Rachou, FIOCRUZ-Minas, Belo Horizonte, Minas Gerais, Brazil
| | - Tatiane Figueiredo de Morais Papini
- Grupo Integrado de Pesquisa em Biomarcadores, Instituto René Rachou, FIOCRUZ-Minas, Belo Horizonte, Minas Gerais, Brazil; Pós-graduação em Ciências Farmacêuticas (CIPHARMA), Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Ana Paula Barbosa Wendling
- Grupo Integrado de Pesquisa em Biomarcadores, Instituto René Rachou, FIOCRUZ-Minas, Belo Horizonte, Minas Gerais, Brazil
| | - Ana Carolina Campi-Azevedo
- Grupo Integrado de Pesquisa em Biomarcadores, Instituto René Rachou, FIOCRUZ-Minas, Belo Horizonte, Minas Gerais, Brazil
| | - Jordana Grazziela Coelho-Dos-Reis
- Laboratório de Virologia Básica e Aplicada, Departamento de Microbiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Isabela Neves de Almeida
- Departamento de Análises Clínicas, Escola de Farmácia, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Lis Ribeiro do Valle Antonnelli
- Laboratório de Biologia e Imunologia de Doenças Infecciosas e Parasitárias, Instituto René Rachou - FIOCRUZ, Belo Horizonte, Minas Gerais, Brazil
| | - Laurence Rodrigues Amaral
- Rede Multidisciplinar de Pesquisa, Ciência e Tecnologia, Laboratório de Bioinformática e Análises Moleculares, Universidade Federal de Uberlândia, Campus Patos de Minas, Patos de Minas, MG, Brazil
| | - Matheus de Souza Gomes
- Rede Multidisciplinar de Pesquisa, Ciência e Tecnologia, Laboratório de Bioinformática e Análises Moleculares, Universidade Federal de Uberlândia, Campus Patos de Minas, Patos de Minas, MG, Brazil
| | - Joaquim Pedro Brito-de-Sousa
- Pós-graduação em Imunologia e Parasitologia Aplicadas (PPIPA), Universidade Federal de Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Silvana Maria Elói-Santos
- Grupo Integrado de Pesquisa em Biomarcadores, Instituto René Rachou, FIOCRUZ-Minas, Belo Horizonte, Minas Gerais, Brazil; Departamento de Propedêutica Complementar, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Valéria Maria Augusto
- Departamento de Propedêutica Complementar, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Margareth Maria Pretti Dalcolmo
- Escola Nacional de Saúde Pública, Centro de Referência Professor Hélio Fraga, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Cláudia Martins Carneiro
- Pós-graduação em Ciências Farmacêuticas (CIPHARMA), Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil; Departamento de Análises Clínicas, Escola de Farmácia, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Andréa Teixeira-Carvalho
- Grupo Integrado de Pesquisa em Biomarcadores, Instituto René Rachou, FIOCRUZ-Minas, Belo Horizonte, Minas Gerais, Brazil.
| | - Olindo Assis Martins-Filho
- Grupo Integrado de Pesquisa em Biomarcadores, Instituto René Rachou, FIOCRUZ-Minas, Belo Horizonte, Minas Gerais, Brazil.
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5
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Xu F, Ma B, Wang D, Lu J, Xiong K, Wang J. Associating the blood vitamin A, C, D and E status with tuberculosis: a systematic review and meta-analysis of observational studies. Food Funct 2022; 13:4825-4838. [PMID: 35403633 DOI: 10.1039/d1fo02827h] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Vitamins may play an important role in preventing tuberculosis. The purpose of this work is to associate the vitamin A, C, D and E status with tuberculosis through a systematic review and meta-analysis of observational studies. Web of Science, Pubmed and Scopus were searched from the earliest date of the database to May 2021. The standardized mean differences (SMDs) of blood vitamin concentrations and odds ratios (ORs) of vitamin deficiency between the tuberculosis patients and the control subjects were used as the main effect sizes. The effect sizes were pooled by a random-effects model using the Stata software (Version 11). The vitamin A concentration was significantly lower in the tuberculosis group than in the control group [SMD (95% CI): -0.96 (-1.31, -0.61), p < 0.01]. Only two case-control studies reported the vitamin C concentrations in the tuberculosis group versus the control group, and the difference was not significant. The blood vitamin D concentration was significantly lower in the tuberculosis group than in the control group [SMD (95% CI): -0.53 (-0.75, -0.32), p < 0.01]. Consistently, the number of people with vitamin D deficiency was significantly higher in the tuberculosis group [OR (95% CI): 2.29 (1.55, 3.37), p < 0.01]. The vitamin E concentration was significantly lower in the tuberculosis group than in the control group [SMD (95% CI): -0.34 (-0.61, -0.08), p = 0.01]. The current meta-analysis suggested a negative association between the vitamin A, D and E status and tuberculosis, and the association between the vitamin C status and tuberculosis was inconclusive due to the limited studies available.
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Affiliation(s)
- Fei Xu
- Institute of Nutrition and Health, School of Public Health, Qingdao University, Qingdao, Shandong, China.
| | - Baolan Ma
- Health Management Center, The 971 Naval Hospital, Qingdao, Shandong, China
| | - Dandan Wang
- Nutritional Department, the Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Jialin Lu
- Institute of Nutrition and Health, School of Public Health, Qingdao University, Qingdao, Shandong, China.
| | - Ke Xiong
- Institute of Nutrition and Health, School of Public Health, Qingdao University, Qingdao, Shandong, China.
| | - Jinyu Wang
- Institute of Nutrition and Health, School of Public Health, Qingdao University, Qingdao, Shandong, China.
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Increased Th1 Cells with Disease Resolution of Active Pulmonary Tuberculosis in Non-Atopic Patients. Biomedicines 2021; 9:biomedicines9070724. [PMID: 34202662 PMCID: PMC8301453 DOI: 10.3390/biomedicines9070724] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 06/13/2021] [Accepted: 06/21/2021] [Indexed: 11/17/2022] Open
Abstract
Type 1 CD4+ T helper (Th1) cells mediate resistance to Mycobacterium tuberculosis (Mtb), and Th2 immunity generates specific immunoglobulin E upon allergen exposure. We investigated the impact of active tuberculosis (TB), atopic status, and anti-TB treatment on the balance between Th1 and Th2 (type 2 CD4+ T helper) immunity. CD4+/interferon (IFN)-γ+ Th1 cells (%Th1) and CD4+/interleukin-4+ Th2 cells (%Th2) in bronchoalveolar lavage (BAL) fluid and peripheral blood mononuclear cells (PBMCs) were measured by flow cytometry. The BAL %Th1 was higher in TB patients at baseline, compared to that in non-TB subjects, and was further increased in TB patients after stimulation with phorbol myristate acetate and ionomycin. The stimulated BAL %Th1 was inversely correlated with the severity score of chest radiography in TB patients. Heat-killed Mtb triggered more IFN-γ and nitrite production, as determined by enzyme-linked immunosorbent assay and the Griess reaction, respectively, from the alveolar macrophages of TB patients than that of non-TB subjects. Non-atopic TB participants had a higher %Th1 in PBMCs, compared to atopic individuals, and their %Th1 decreased after 3-month anti-TB treatment. Th1 response is provoked by active TB infection, is associated with less severe radiographic changes, is reduced in atopic patients with active TB infection, and is attenuated after anti-TB treatment.
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Marin-Luevano SP, Rodriguez-Carlos A, Jacobo-Delgado Y, Valdez-Miramontes C, Enciso-Moreno JA, Rivas-Santiago B. Steroid hormone modulates the production of cathelicidin and human β-defensins in lung epithelial cells and macrophages promoting Mycobacterium tuberculosis killing. Tuberculosis (Edinb) 2021; 128:102080. [PMID: 33799143 DOI: 10.1016/j.tube.2021.102080] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 03/18/2021] [Accepted: 03/19/2021] [Indexed: 11/18/2022]
Abstract
Several studies have documented the interaction between the immune and endocrine systems as an effective defense strategy against tuberculosis, involving the production of several molecules and immunological processes. In this study, we determined the effect of cortisol and dehydroepiandrosterone (DHEA) on the production of antimicrobial peptides such as cathelicidin and human β-defensin (HBD) -2, and HBD-3 and their effect on intracellular growth of Mycobacterium tuberculosis (Mtb) in lung epithelial cells and macrophages. Our results showed that DHEA promotes the production of these antimicrobial peptides in infected cells, correlating with the decrease of Mtb bacilli loads. These results suggest the use of exogenous DHEA as an adjuvant for tuberculosis therapy.
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Affiliation(s)
- Sara P Marin-Luevano
- Medical Research Unit-Zacatecas, Mexican Institute for Social Security-IMSS, Zacatecas, Mexico; Center for Research in Health Sciences and Biomedicine, Autonomous University of San Luis Potosí, Mexico
| | - Adrian Rodriguez-Carlos
- Medical Research Unit-Zacatecas, Mexican Institute for Social Security-IMSS, Zacatecas, Mexico
| | - Yolanda Jacobo-Delgado
- Medical Research Unit-Zacatecas, Mexican Institute for Social Security-IMSS, Zacatecas, Mexico
| | | | - Jose A Enciso-Moreno
- Medical Research Unit-Zacatecas, Mexican Institute for Social Security-IMSS, Zacatecas, Mexico
| | - Bruno Rivas-Santiago
- Medical Research Unit-Zacatecas, Mexican Institute for Social Security-IMSS, Zacatecas, Mexico.
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Estévez O, Anibarro L, Garet E, Martínez A, Pena A, Barcia L, Peleteiro M, González-Fernández Á. Multi-parameter flow cytometry immunophenotyping distinguishes different stages of tuberculosis infection. J Infect 2020; 81:57-71. [PMID: 32330526 DOI: 10.1016/j.jinf.2020.03.064] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 03/20/2020] [Accepted: 03/24/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVES To identify new potential host biomarkers in blood to discriminate between active TB patients, uninfected (NoTBI) and latently infected contacts (LTBI). METHODS A blood cell count was performed to study parent leukocyte populations. Peripheral blood mononuclear cells (PBMCs) were isolated and a multi-parameter flow cytometry assay was conducted to study the distribution of basal and Mycobacterium tuberculosis (Mtb)-stimulated lymphocytes. Differences between groups and the area under the ROC curve (AUC) were investigated to assess the diagnostic accuracy. RESULTS Active TB patients presented higher Monocyte-to-lymphocyte and Neutrophil-to-lymphocyte ratios than LTBI and NoTBI contacts (p<0.0001; AUC>0.8). Lymphocyte subsets with differences (p >0.05; AUC >0.7) between active TB and both contact groups include the basal distribution of Th1/Th2 ratio, Th1-Th17, CD4+ Central Memory (TCM) or MAIT cells. Expression of CD154 is increased in Mtb-activated CD4+ TCM and Effector Memory T cells in active TB and LTBI compared to NoTBI. In CD4+T cells, expression of CD154 showed a higher accuracy than IFNγ to discriminate Mtb-specific activation. CONCLUSIONS We identified different cell subsets with potential use in tuberculosis diagnosis. Among them, distribution of CD4 TCM cells and their expression of CD154 after Mtb-activation are the most promising candidates.
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Affiliation(s)
- Olivia Estévez
- CINBIO, Universidade de Vigo, Immunology Group, Campus universitario Lagoas, Marcosende, 36310 Vigo, Spain; Instituto de Investigación Sanitaria Galicia Sur (IIS-GS), Spain
| | - Luis Anibarro
- Instituto de Investigación Sanitaria Galicia Sur (IIS-GS), Spain; GEIM -Grupo de Estudio de Micobacterias de la Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica, Spain; Tuberculosis Unit, Department of Infectious Diseases and Internal Medicine, Pontevedra Hospital Complex, Pontevedra, Spain
| | - Elina Garet
- CINBIO, Universidade de Vigo, Immunology Group, Campus universitario Lagoas, Marcosende, 36310 Vigo, Spain; Instituto de Investigación Sanitaria Galicia Sur (IIS-GS), Spain
| | - Amparo Martínez
- CINBIO, Universidade de Vigo, Immunology Group, Campus universitario Lagoas, Marcosende, 36310 Vigo, Spain; Instituto de Investigación Sanitaria Galicia Sur (IIS-GS), Spain
| | - Alberto Pena
- Instituto de Investigación Sanitaria Galicia Sur (IIS-GS), Spain; Tuberculosis Unit, Department of Infectious Diseases and Internal Medicine, Pontevedra Hospital Complex, Pontevedra, Spain
| | - Laura Barcia
- Instituto de Investigación Sanitaria Galicia Sur (IIS-GS), Spain; Tuberculosis Unit, Department of Infectious Diseases and Internal Medicine, Pontevedra Hospital Complex, Pontevedra, Spain
| | - Mercedes Peleteiro
- CINBIO, Universidade de Vigo, Flow Cytometry Core Facility, Campus universitario Lagoas, Marcosende, 36310 Vigo, Spain
| | - África González-Fernández
- CINBIO, Universidade de Vigo, Immunology Group, Campus universitario Lagoas, Marcosende, 36310 Vigo, Spain; Instituto de Investigación Sanitaria Galicia Sur (IIS-GS), Spain.
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9
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Moideen K, Kumar NP, Bethunaickan R, Banurekha VV, Nair D, Babu S. Heightened systemic levels of anti-inflammatory cytokines in pulmonary tuberculosis and alterations following anti-tuberculosis treatment. Cytokine 2020; 127:154929. [DOI: 10.1016/j.cyto.2019.154929] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 10/21/2019] [Accepted: 11/13/2019] [Indexed: 01/29/2023]
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10
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Bongiovanni B, Marín-Luevano S, D'Attilio L, Díaz A, Fernández RDV, Santucci N, Bértola D, Bay ML, Rivas-Santiago B, Bottasso O. Evidence that changes in antimicrobial peptides during tuberculosis are related to disease severity, clinical presentation, specific therapy and levels of immune-endocrine mediators. Cytokine 2019; 126:154913. [PMID: 31731048 DOI: 10.1016/j.cyto.2019.154913] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 09/03/2019] [Accepted: 10/30/2019] [Indexed: 01/19/2023]
Abstract
Given the role of host defense peptides (HDPs) in the defensive response against mycobacteria, we analyzed the circulating levels of LL-37, β-defensin-2 and -3 in newly diagnosed patients with pulmonary (PTB) or pleural tuberculosis (PLTB) in whom measurements of pleural fluids were also performed. Severe PTB patients displayed higher circulating amounts of β-defensin-3, statistically different from controls, further decreasing upon antimycobacterial treatment. LL-37 concentrations appeared within the normal range at diagnosis, but tended to increase during treatment, becoming statistically upon its completion in moderate cases. PLTB patients revealed decreased levels of β-defensin-2 in presence of increased amounts of β-defensin-3 and LL-37; in their plasma or pleural fluids. Considering the immune-endocrine dysregulation of tuberculosis, we also performed correlation analysis detecting positive associations between levels of cortisol, IL-6 and β-defensin-3 in plasma from untreated severe patients as did their dehydroepiandrosterone and LL-37 values. Increased presence of β-defensins, may represent an attempt to improve defensive mechanisms; which also take part in the inflammatory reaction accompanying TB, reinforced by the association with immune-endocrine mediators. The divergent profile of PLTB patients, decreased β-defensin-2 but increased β-defensin-3 and LL-37 levels, suggests a differential role of these HDPs in a situation characterized for its better protective response.
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Affiliation(s)
- Bettina Bongiovanni
- Instituto de Inmunología Clínica y Experimental de Rosario (IDICER CONICET-UNR), Suipacha 590 (S2002LRL), Rosario, Argentina; Facultad de Cs. Bioquímicas y Farmacéuticas, Universidad Nacional de Rosario (UNR), Suipacha 570 (S2002LRL), Rosario, Argentina.
| | - Sara Marín-Luevano
- Unidad Médica del Instituto Mexicano del Seguro Social (IMSS), Zacatecas Centro, 98053 Zacatecas, Mexico.
| | - Luciano D'Attilio
- Instituto de Inmunología Clínica y Experimental de Rosario (IDICER CONICET-UNR), Suipacha 590 (S2002LRL), Rosario, Argentina; Facultad de Cs. Médicas, UNR, Santa Fe 3100 (S2002KTR) Rosario, Argentina.
| | - Ariana Díaz
- Instituto de Inmunología Clínica y Experimental de Rosario (IDICER CONICET-UNR), Suipacha 590 (S2002LRL), Rosario, Argentina; Facultad de Cs. Médicas, UNR, Santa Fe 3100 (S2002KTR) Rosario, Argentina.
| | - Rocío Del Valle Fernández
- Instituto de Inmunología Clínica y Experimental de Rosario (IDICER CONICET-UNR), Suipacha 590 (S2002LRL), Rosario, Argentina; Facultad de Cs. Médicas, UNR, Santa Fe 3100 (S2002KTR) Rosario, Argentina.
| | - Natalia Santucci
- Instituto de Inmunología Clínica y Experimental de Rosario (IDICER CONICET-UNR), Suipacha 590 (S2002LRL), Rosario, Argentina; Facultad de Cs. Médicas, UNR, Santa Fe 3100 (S2002KTR) Rosario, Argentina.
| | - Diego Bértola
- Hospital Provincial del Centenario, Urquiza 3101 (S2002KDT), Rosario, Argentina.
| | - María Luisa Bay
- Instituto de Inmunología Clínica y Experimental de Rosario (IDICER CONICET-UNR), Suipacha 590 (S2002LRL), Rosario, Argentina; Facultad de Cs. Médicas, UNR, Santa Fe 3100 (S2002KTR) Rosario, Argentina.
| | - Bruno Rivas-Santiago
- Unidad Médica del Instituto Mexicano del Seguro Social (IMSS), Zacatecas Centro, 98053 Zacatecas, Mexico.
| | - Oscar Bottasso
- Instituto de Inmunología Clínica y Experimental de Rosario (IDICER CONICET-UNR), Suipacha 590 (S2002LRL), Rosario, Argentina; Facultad de Cs. Médicas, UNR, Santa Fe 3100 (S2002KTR) Rosario, Argentina.
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11
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Stek C, Allwood B, Walker NF, Wilkinson RJ, Lynen L, Meintjes G. The Immune Mechanisms of Lung Parenchymal Damage in Tuberculosis and the Role of Host-Directed Therapy. Front Microbiol 2018; 9:2603. [PMID: 30425706 PMCID: PMC6218626 DOI: 10.3389/fmicb.2018.02603] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 10/11/2018] [Indexed: 12/20/2022] Open
Abstract
Impaired lung function is common in people with a history of tuberculosis. Host-directed therapy added to tuberculosis treatment may reduce lung damage and result in improved lung function. An understanding of the pathogenesis of pulmonary damage in TB is fundamental to successfully predicting which interventions could be beneficial. In this review, we describe the different features of TB immunopathology that lead to impaired lung function, namely cavities, bronchiectasis, and fibrosis. We discuss the immunological processes that cause lung damage, focusing on studies performed in humans, and using chest radiograph abnormalities as a marker for pulmonary damage. We highlight the roles of matrix metalloproteinases, neutrophils, eicosanoids and cytokines, like tumor necrosis factor-α and interleukin 1β, as well as the role of HIV co-infection. Finally, we focus on various existing drugs that affect one or more of the immunological mediators of lung damage and could therefore play a role as host-directed therapy.
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Affiliation(s)
- Cari Stek
- Wellcome Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa.,Department of Clinical Sciences, Institute of Tropical Medicine Antwerp, Antwerp, Belgium.,Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Brian Allwood
- Division of Pulmonology, Department of Medicine, Stellenbosch University, Stellenbosch, South Africa
| | - Naomi F Walker
- Wellcome Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa.,Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Robert J Wilkinson
- Wellcome Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa.,Department of Medicine, University of Cape Town, Cape Town, South Africa.,Department of Medicine, Imperial College London, London, United Kingdom.,Francis Crick Institute, London, United Kingdom
| | - Lutgarde Lynen
- Department of Clinical Sciences, Institute of Tropical Medicine Antwerp, Antwerp, Belgium
| | - Graeme Meintjes
- Wellcome Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa.,Department of Medicine, University of Cape Town, Cape Town, South Africa
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12
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Kroesen VM, Rodríguez-Martínez P, García E, Rosales Y, Díaz J, Martín-Céspedes M, Tapia G, Sarrias MR, Cardona PJ, Vilaplana C. A Beneficial Effect of Low-Dose Aspirin in a Murine Model of Active Tuberculosis. Front Immunol 2018; 9:798. [PMID: 29740435 PMCID: PMC5924809 DOI: 10.3389/fimmu.2018.00798] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 04/03/2018] [Indexed: 12/15/2022] Open
Abstract
An excessive, non-productive host-immune response is detrimental in active, chronic tuberculosis (TB) disease as it typically leads to tissue damage. Given their anti-inflammatory effect, non-steroidal anti-inflammatory drugs can potentially attenuate excessive inflammation in active TB disease. As such, we investigated the prophylactic and therapeutic effect of low-dose aspirin (LDA) (3 mg/kg/day), either alone or in combination with common anti-TB treatment or BCG vaccination, on disease outcome in an experimental murine model of active TB. Survival rate, bacillary load (BL) in lungs, and lung pathology were measured. The possible mechanism of action of LDA on the host's immune response was also evaluated by measuring levels of CD5L/AIM, selected cytokines/chemokines and other inflammatory markers in serum and lung tissue. LDA increased survival, had anti-inflammatory effects, reduced lung pathology, and decreased bacillary load in late-stage TB disease. Moreover, in combination with common anti-TB treatment, LDA enhanced survival and reduced lung pathology. Results from the immunological studies suggest the anti-inflammatory action of LDA at both a local and a systemic level. Our results showed a systemic decrease in neutrophilic recruitment, decreased levels of acute-phase reaction cytokines (IL-6, IL-1β, and TNF-α) at late stage and a delay in the decrease in T cell response (in terms of IFN-γ, IL-2, and IL-10 serum levels) that occurs during the course of Mycobacterium tuberculosis infection. An anti-inflammatory milieu was detected in the lung, with less neutrophil recruitment and lower levels of tissue factor. In conclusion, LDA may be beneficial as an adjunct to standard anti-TB treatment in the later stage of active TB by reducing excess, non-productive inflammation, while enhancing Th1-cell responses for elimination of the bacilli.
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Affiliation(s)
- Vera Marie Kroesen
- Experimental Tuberculosis Unit (UTE), Fundació Institut Germans Trias i Pujol (IGTP), Universitat Autònoma de Barcelona (UAB), Badalona, Spain.,Carl-von-Ossietzky University Oldenburg, Oldenburg, Germany
| | - Paula Rodríguez-Martínez
- Pathology Department, Hospital Universitari Germans Trias i Pujol (HUGTIP), Universitat Autònoma de Barcelona (UAB), Badalona, Spain
| | - Eric García
- Experimental Tuberculosis Unit (UTE), Fundació Institut Germans Trias i Pujol (IGTP), Universitat Autònoma de Barcelona (UAB), Badalona, Spain
| | - Yaiza Rosales
- Experimental Tuberculosis Unit (UTE), Fundació Institut Germans Trias i Pujol (IGTP), Universitat Autònoma de Barcelona (UAB), Badalona, Spain
| | - Jorge Díaz
- Experimental Tuberculosis Unit (UTE), Fundació Institut Germans Trias i Pujol (IGTP), Universitat Autònoma de Barcelona (UAB), Badalona, Spain
| | - Montse Martín-Céspedes
- Pathology Department, Hospital Universitari Germans Trias i Pujol (HUGTIP), Universitat Autònoma de Barcelona (UAB), Badalona, Spain
| | - Gustavo Tapia
- Pathology Department, Hospital Universitari Germans Trias i Pujol (HUGTIP), Universitat Autònoma de Barcelona (UAB), Badalona, Spain
| | - Maria Rosa Sarrias
- Innate Immunity Group, Fundació Institut Germans Trias i Pujol (IGTP), Badalona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREhD), Madrid, Spain
| | - Pere-Joan Cardona
- Experimental Tuberculosis Unit (UTE), Fundació Institut Germans Trias i Pujol (IGTP), Universitat Autònoma de Barcelona (UAB), Badalona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Cristina Vilaplana
- Experimental Tuberculosis Unit (UTE), Fundació Institut Germans Trias i Pujol (IGTP), Universitat Autònoma de Barcelona (UAB), Badalona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
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13
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Ranaivomanana P, Raberahona M, Rabarioelina S, Borella Y, Machado A, Randria MJDD, Rakotoarivelo RA, Rasolofo V, Rakotosamimanana N. Cytokine Biomarkers Associated with Human Extra-Pulmonary Tuberculosis Clinical Strains and Symptoms. Front Microbiol 2018. [PMID: 29515555 PMCID: PMC5826350 DOI: 10.3389/fmicb.2018.00275] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Background: The primary site of infection for Mycobacterium tuberculosis (Mtb) is the alveolar macrophages. However, Mtb can disseminate into other organs and causes extrapulmonary tuberculosis (EPTB). The diagnosis of EPTB is challenging due to relatively inaccessible infectious sites that may be paucibacillary and with clinical symptoms varying by site that are similar to those seen in other diseases. Hence, we sought to identify the expression patterns of a variety of cytokines that may be specific to EPTB from in vitro infections and in the plasma of TB patients. Methods: To define those cytokine secretions associated with EPTB, human THP-1 derived macrophages were first infected with Mtb clinical isolates from pulmonary and EPTB. Infected macrophages supernatants were harvested at different time points and cytokines known to play key roles in TB immune responses including TNF-α, IL-6, IL-10, IFN-γ, and VEGF-A were measured by ELISA. Those cytokines that were in vitro associated to EPTB were also measured in the plasma from patients with PTB, EPTB, non-EPTB-confirmed-like symptoms and healthy controls. Results: While all of the studied cytokine secretions varied after in vitro infection, higher levels of TNF-α and VEGF secretions were observed in vitro in the infected macrophages respectively in the PTB and EPTB infecting clinical isolates. Similar trends were observed from the plasma of patients where patients with PTB showed significantly higher level of TNF-α compared to EPTB and healthy control groups. The patients with EPTB showed higher plasma level of VEGF compared to those patients with the non-EPTB (p < 0.01) and to healthy controls group (p < 0.0001). Using Receiver Operating Curves (ROC), we showed that TNF-α and VEGF concentrations could distinguish EPTB from non-confirmed EPTB with high sensitivity and specificity. Conclusion: Pulmonary and extrapulmonary Mtb clinical isolates showed different cytokine induction pattern in human macrophages that is also found in the plasma level of the EPTB patients. Further investigations are needed to define cytokine secretions that can lead to the definition of bio-signatures to differentiate EPTB from other pathologies with confusing symptoms that hampered the diagnosis of TB.
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Affiliation(s)
- Paulo Ranaivomanana
- Unité des Mycobactéries, Institut Pasteur de Madagascar, Antananarivo, Madagascar
| | - Mihaja Raberahona
- Infectious Diseases, Joseph Raseta Befelatanana University Hospital, Antananarivo, Madagascar
| | - Sedera Rabarioelina
- Unité des Mycobactéries, Institut Pasteur de Madagascar, Antananarivo, Madagascar
| | - Ysé Borella
- Unité des Mycobactéries, Institut Pasteur de Madagascar, Antananarivo, Madagascar
| | - Alice Machado
- Unité des Mycobactéries, Institut Pasteur de Madagascar, Antananarivo, Madagascar
| | - Mamy J De Dieu Randria
- Infectious Diseases, Joseph Raseta Befelatanana University Hospital, Antananarivo, Madagascar
| | - Rivo A Rakotoarivelo
- Infectious Diseases, Joseph Raseta Befelatanana University Hospital, Antananarivo, Madagascar.,Faculté de Médecine, University of Fianarantsoa, Fianarantsoa, Madagascar
| | - Voahangy Rasolofo
- Unité des Mycobactéries, Institut Pasteur de Madagascar, Antananarivo, Madagascar
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14
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Rolandelli A, Hernández Del Pino RE, Pellegrini JM, Tateosian NL, Amiano NO, de la Barrera S, Casco N, Gutiérrez M, Palmero DJ, García VE. The IL-17A rs2275913 single nucleotide polymorphism is associated with protection to tuberculosis but related to higher disease severity in Argentina. Sci Rep 2017; 7:40666. [PMID: 28098168 PMCID: PMC5241634 DOI: 10.1038/srep40666] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Accepted: 12/09/2016] [Indexed: 01/24/2023] Open
Abstract
Mycobacterium tuberculosis (Mtb) causes nearly 10 millions of new tuberculosis disease cases annually. However, most individuals exposed to Mtb do not develop tuberculosis, suggesting the influence of a human genetic component. Here, we investigated the association of the rs2275913 SNP (G → A) from IL-17A and tuberculosis in Argentina by a case-control study. Furthermore, we evaluated in vitro the functional relevance of this SNP during the immune response of the host against Mtb and analyzed its impact on clinical parameters of the disease. We found an association between the AA genotype and tuberculosis resistance. Additionally, within the healthy donors population, AA cells stimulated with a Mtb lysate (Mtb-Ag) produced the highest amounts of IL-17A and IFN-γ, which further support the genetic evidence found. In contrast, within the tuberculosis patients population, AA Mtb-Ag stimulated cells showed the lowest immunological parameters and we evidenced an association between the AA genotype and clinical parameters of disease severity, such as severe radiological lesions and higher bacilli burden in sputum. Overall, our findings demonstrated that the AA genotype from the IL-17A rs2275913 SNP is positively associated with protection to active tuberculosis but related to higher disease severity in the Argentinean population.
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Affiliation(s)
- A. Rolandelli
- Departamento de Química Biológica. Facultad de Ciencias Exactas y Naturales. UBA, Intendente Güiraldes 2160, Pabellón II, 4°piso, Ciudad Universitaria (C1428EGA), Buenos Aires, Argentina
- Instituto de Química Biológica, Facultad de Ciencias Exactas y Naturales (IQUIBICEN), UBA (Universidad de Buenos Aires)-CONICET, Intendente Güiraldes 2160, Pabellón II, 4°piso, Ciudad Universitaria (C1428EGA), Buenos Aires, Argentina
| | - R. E. Hernández Del Pino
- Departamento de Química Biológica. Facultad de Ciencias Exactas y Naturales. UBA, Intendente Güiraldes 2160, Pabellón II, 4°piso, Ciudad Universitaria (C1428EGA), Buenos Aires, Argentina
- Centro de Investigaciones y Transferencia del Noroeste de Buenos Aires (CIT NOBA), CONICET. Newbery 261, Junín (6000), Buenos Aires, Argentina
| | - J. M. Pellegrini
- Departamento de Química Biológica. Facultad de Ciencias Exactas y Naturales. UBA, Intendente Güiraldes 2160, Pabellón II, 4°piso, Ciudad Universitaria (C1428EGA), Buenos Aires, Argentina
- Instituto de Química Biológica, Facultad de Ciencias Exactas y Naturales (IQUIBICEN), UBA (Universidad de Buenos Aires)-CONICET, Intendente Güiraldes 2160, Pabellón II, 4°piso, Ciudad Universitaria (C1428EGA), Buenos Aires, Argentina
| | - N. L. Tateosian
- Departamento de Química Biológica. Facultad de Ciencias Exactas y Naturales. UBA, Intendente Güiraldes 2160, Pabellón II, 4°piso, Ciudad Universitaria (C1428EGA), Buenos Aires, Argentina
- Instituto de Química Biológica, Facultad de Ciencias Exactas y Naturales (IQUIBICEN), UBA (Universidad de Buenos Aires)-CONICET, Intendente Güiraldes 2160, Pabellón II, 4°piso, Ciudad Universitaria (C1428EGA), Buenos Aires, Argentina
| | - N. O. Amiano
- Departamento de Química Biológica. Facultad de Ciencias Exactas y Naturales. UBA, Intendente Güiraldes 2160, Pabellón II, 4°piso, Ciudad Universitaria (C1428EGA), Buenos Aires, Argentina
- Instituto de Química Biológica, Facultad de Ciencias Exactas y Naturales (IQUIBICEN), UBA (Universidad de Buenos Aires)-CONICET, Intendente Güiraldes 2160, Pabellón II, 4°piso, Ciudad Universitaria (C1428EGA), Buenos Aires, Argentina
| | - S. de la Barrera
- Instituto de Medicina Experimental-CONICET-Academia Nacional de Medicina. Pacheco de Melo 3081 (CP1425), Buenos Aires, Argentina
| | - N. Casco
- División Tisioneumonología Hospital F.J. Muñiz, Uspallata 2272, (C1282AEN) Buenos Aires, Argentina
| | - M. Gutiérrez
- Sección Bacteriología de la Tuberculosis, Hospital General de Agudos “Dr. E. Tornu”, Combatientes de Malvinas 3002, (C1427ARN) Buenos Aires, Argentina
| | - D. J. Palmero
- División Tisioneumonología Hospital F.J. Muñiz, Uspallata 2272, (C1282AEN) Buenos Aires, Argentina
| | - V. E. García
- Departamento de Química Biológica. Facultad de Ciencias Exactas y Naturales. UBA, Intendente Güiraldes 2160, Pabellón II, 4°piso, Ciudad Universitaria (C1428EGA), Buenos Aires, Argentina
- Instituto de Química Biológica, Facultad de Ciencias Exactas y Naturales (IQUIBICEN), UBA (Universidad de Buenos Aires)-CONICET, Intendente Güiraldes 2160, Pabellón II, 4°piso, Ciudad Universitaria (C1428EGA), Buenos Aires, Argentina
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15
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Chen DY, Li JP, Chen YM, Liao TL, Chen HH, Hsieh CW, Yeh YW, Lan JL. Elevated Neopterin Levels Are Associated with Increased Tuberculosis Risk in Rheumatoid Arthritis Patients with QuantiFERON Conversion during Biologic Therapy. PLoS One 2016; 11:e0166301. [PMID: 27861525 PMCID: PMC5115727 DOI: 10.1371/journal.pone.0166301] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 10/26/2016] [Indexed: 11/18/2022] Open
Abstract
QuantiFERON-TB-Gold (QFT-G) conversion is frequently observed in rheumatoid arthritis (RA) patients receiving biologic therapy. However, there have not been any known biomarkers available for detecting tuberculosis (TB) in QFT-G converters. We aimed to evaluate clinical utility of cytokines/chemokines for detecting TB in patients with QFT-G conversion. Among a total of 227 RA patients who underwent QFT-G assay, 187 QFT-G-negative patients received biologic therapy without isoniazid prophylaxis. QFT-G assay was repeated at week 52 of biologic therapy or at the time of TB diagnosis. Levels of cytokines/chemokines were determined by magnetic bead array or ELISA in QFT-G converters and 12 non-RA patients with TB (non-RA TB). QFT-G conversion was found in 54 (28.9%) of 187 baseline QFT-G-negative patients, of which 7 (13.0%) developed active TB during the one-year follow-up period. Among the examined cytokines/chemokines, non-stimulated and TB-antigen-stimulated neopterin levels were significantly higher in RA patients who developed TB (RA-TB) (median, 24.5pg/ml and 23053pg/ml, respectively) and non-RA TB patients (12.2pg/ml and 9633pg/ml, respectively) compared with QFT-G converters without TB (3.0pg/ml and 2720pg/ml, respectively, both p<0.001). Rising levels of neopterin relative to baseline (non-stimulated levels, 4.4pg/ml vs. 24.5pg/ml; TB-antigen-stimulated levels, 1801pg/ml vs. 23053pg/ml) were observed in QFT-G converters who developed TB. A high proportion (85.7%) of QFT-G converters with high plasma neopterin levels developed TB during the one-year follow-up period. In conclusion, RA patients with QFT-G conversion during the period of biologic therapy should be carefully monitored for elevation of neopterin levels, which is associated with TB risk in QFT-G converters, particularly in TB-endemic areas.
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Affiliation(s)
- Der-Yuan Chen
- Division of Allergy, Immunology and Rheumatology, Department of Medical Education and Research, Taichung Veterans General Hospital, Taichung, Taiwan
- Faculty of Medicine, National Yang Ming University, Taipei, Taiwan
- Institute of Biomedical Science and Rong Hsing Research Center for Translational Medicine, National Chung Hsing University, Taichung, Taiwan
- Institute of Biochemistry, Microbiology and Immunology, Chung Shan Medical University, Taichung, Taiwan
| | - Ju-Pi Li
- Division of Immunology and Rheumatology, Department of Medicine, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
| | - Yi-Ming Chen
- Division of Allergy, Immunology and Rheumatology, Department of Medical Education and Research, Taichung Veterans General Hospital, Taichung, Taiwan
- Faculty of Medicine, National Yang Ming University, Taipei, Taiwan
| | - Tsai-Ling Liao
- Institute of Biomedical Science and Rong Hsing Research Center for Translational Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Hsin-Hua Chen
- Division of Allergy, Immunology and Rheumatology, Department of Medical Education and Research, Taichung Veterans General Hospital, Taichung, Taiwan
- Institute of Biomedical Science and Rong Hsing Research Center for Translational Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Chia-Wei Hsieh
- Division of Allergy, Immunology and Rheumatology, Department of Medical Education and Research, Taichung Veterans General Hospital, Taichung, Taiwan
- Faculty of Medicine, National Yang Ming University, Taipei, Taiwan
| | - Yea-Wen Yeh
- Division of Allergy, Immunology and Rheumatology, Department of Medical Education and Research, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Joung-Liang Lan
- Division of Immunology and Rheumatology, Department of Medicine, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
- * E-mail:
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16
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Marín ND, García LF. The role of CD30 and CD153 (CD30L) in the anti-mycobacterial immune response. Tuberculosis (Edinb) 2016; 102:8-15. [PMID: 28061955 DOI: 10.1016/j.tube.2016.10.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 10/10/2016] [Accepted: 10/29/2016] [Indexed: 12/01/2022]
Abstract
The establishment of a protective T-cell response against mycobacterial infections involves different co-stimulatory molecules and their respective ligands. Among these molecules the Tumor Necrosis Factor Receptor Super-family (TNFRSF) and the Tumor Necrosis Factor Super-family (TNFSF) are known to be important members. This review analyzes the evidence that CD30 and CD153 (CD30L), members of the TNFRSF and TNSF, play key roles in the T cell-dependent anti-mycobacterial immune response. Mice deficient in either CD30 or CD153, or treated with antibodies blocking the effects or CD30 and CD153, and infected with M.avium or M.bovis BCG exhibit higher bacterial burden, abnormal inflammatory responses with decreased Th1 responses, this is evidenced by the reduced number of IFN-γ-producing cells. Recent evidence also showed that CD30+ CD153+ Tγδ cells participate in the early stages of M.bovis BCG infection by producing IL-17A. In humans, stimulation of T-cells with mycobacterial antigens induces CD30 expression mainly by CD4+ cells; CD30+ cells have been demonstrated in tissues of patients with tuberculosis (TB) and in positive tuberculin skin test reactions. In addition, the levels of soluble CD30 are increased in serum and BAL of TB patients and these levels seems to correlate with the severity of the disease. These findings suggest that CD30/CD153 interactions during the anti-mycobacterial immune response are important for the establishment and maintenance of a protective response. Further studies would be required to determine whether these molecules may be good clinical biomarkers or potential targets for immune manipulation.
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Affiliation(s)
- Nancy D Marín
- Grupo de Inmunología Celular e Inmunogenética, Sede de Investigación Universitaria, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia; Escuela de Microbiología, Universidad de Antioquia, Medellín, Colombia
| | - Luis F García
- Grupo de Inmunología Celular e Inmunogenética, Sede de Investigación Universitaria, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia.
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17
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Diabetes Mellitus as Hub for Tuberculosis Infection: A Snapshot. Int J Chronic Dis 2016; 2016:5981574. [PMID: 27819024 PMCID: PMC5080504 DOI: 10.1155/2016/5981574] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 08/16/2016] [Accepted: 09/14/2016] [Indexed: 11/28/2022] Open
Abstract
Tuberculosis (TB) still remains the thorn in the flesh of efficient therapeutics affecting one-third of global population annually. There are several factors that enhance the susceptibility to TB infections including malnutrition, smoking, and immunocompromised conditions such as AIDS. In the recent years, growing body of evidence has gained considerable prominence which suggests that Diabetes Mellitus (DM) is individual risk factor leading to complicated TB infections. In this article the authors have attempted to summarize the link of type 2 DM with TB, the mechanistic action of how DM sensitizes for developing the active TB infection from the latent infection, and problems faced during treatment followed by possible preventive measures. We have tried to give account of the alterations that occurred in DM making a person more prone to develop TB.
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18
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Goyal N, Kashyap B, Kaur IR. Significance of IFN-ɤ/IL-2 Ratio as a Circulating Diagnostic Biomarker in Extrapulmonary Tuberculosis. Scand J Immunol 2016; 83:338-44. [DOI: 10.1111/sji.12424] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 02/23/2016] [Indexed: 12/14/2022]
Affiliation(s)
- N. Goyal
- Department of Microbiology; University College of Medical Sciences & Guru Teg Bahadur Hospital; New Delhi India
| | - B. Kashyap
- Department of Microbiology; Maulana Azad Medical College and Associated Hospitals; New Delhi India
| | - I. R. Kaur
- Department of Microbiology; University College of Medical Sciences & Guru Teg Bahadur Hospital; New Delhi India
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19
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High IL-6 and low IL-15 levels mark the presence of TB infection: A preliminary study. Cytokine 2016; 81:57-62. [PMID: 26878649 DOI: 10.1016/j.cyto.2016.02.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2015] [Revised: 02/06/2016] [Accepted: 02/09/2016] [Indexed: 11/23/2022]
Abstract
The host immune response, apart from mycobacterial factors, is a significant determinant in the development of tuberculosis (TB). The purpose of the study was to examine whether the differential serum profiles of cytokines IL-1β, IL-2, IL-4, IL-6, IL-10, IL-15, IFN-γ, TGF-β, and TNF-α could discriminate between TB patients and healthy controls and provide insights into pathogenesis. Serum samples from TB patients, TB patient contacts and healthy controls were collected and analyzed by ELISA. The cytokine concentrations obtained were stratified into three groups: below detection limit (BDL), low values, and high values. The differences in cytokine concentrations were analyzed by Fisher's exact test. The statistically significant results were interpreted based on post-hoc analysis of the chi square contingency table using the adjusted residual method. Among the assayed cytokines, there was a statistically significant difference in the detection levels of IL-6, IL-15 and IFN-γ. Levels of IL-1β, IL-2, IL-4, IL-10, TGF-β and TNF-α did not vary. Post-hoc analysis of the significant results revealed that dynamic changes in the BDL and high values of cytokines influenced the post-infection cytokine milieu in the study subjects. The study concludes that altered balance in the levels of serum cytokines can be indicative of TB pathogenesis. Hence, profiling of dynamic changes in cytokines would facilitate effective TB diagnostic and treatment strategies.
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20
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Complexity and Controversies over the Cytokine Profiles of T Helper Cell Subpopulations in Tuberculosis. J Immunol Res 2015; 2015:639107. [PMID: 26495323 PMCID: PMC4606092 DOI: 10.1155/2015/639107] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Accepted: 02/03/2015] [Indexed: 12/24/2022] Open
Abstract
Tuberculosis (TB) is a contagious infectious disease caused by the TB-causing bacillus Mycobacterium tuberculosis and is considered a public health problem with enormous social impact. Disease progression is determined mainly by the balance between the microorganism and the host defense systems. Although the immune system controls the infection, this control does not necessarily lead to sterilization. Over recent decades, the patterns of CD4+ T cell responses have been studied with a goal of complete understanding of the immunological mechanisms involved in the maintenance of latent or active tuberculosis infection and of the clinical cure after treatment. Conflicting results have been suggested over the years, particularly in studies comparing experimental models and human disease. In recent years, in addition to Th1, Th2, and Th17 profiles, new standards of cellular immune responses, such as Th9, Th22, and IFN-γ-IL-10 double-producing Th cells, discussed here, have also been described. Additionally, many new roles and cellular sources have been described for IL-10, demonstrating a critical role for this cytokine as regulatory, rather than merely pathogenic cytokine, involved in the establishment of chronic latent infection, in the clinical cure after treatment and in keeping antibacillary effector mechanisms active to prevent immune-mediated damage.
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Masood KI, Pervez S, Rottenberg ME, Umar B, Hasan Z. Suppressor of cytokine signaling-1 and chemokine (C-X-C Motif) receptor 3 expressions are associated with caseous necrosis in granulomas from patients with tuberculous lymphadenitis. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2015; 49:984-987. [PMID: 26455487 DOI: 10.1016/j.jmii.2015.08.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Revised: 07/24/2015] [Accepted: 08/17/2015] [Indexed: 11/16/2022]
Abstract
We investigated the role of suppressor of cytokine signaling-1 (SOCS1) and SOCS3 molecules in lymph nodes from tuberculous lymphadenitis patients (LNTB). Fewer T cells were noted in LNTB cases, which also had raised chemokine (C-X-C motif) receptor 3 (CXCR3) levels. In addition, we observed a positive correlation between CXCR3 and SOCS1 expression. Our data suggest that upregulation of SOCS1 molecules may contribute to the dissemination of Mycobacterium tuberculosis from granulomas.
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Affiliation(s)
- Kiran I Masood
- Department of Pathology and Laboratory Medicine, The Aga Khan University, Karachi, Pakistan
| | - Shahid Pervez
- Department of Pathology and Laboratory Medicine, The Aga Khan University, Karachi, Pakistan
| | - Martin E Rottenberg
- Department of Microbiology and Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Beena Umar
- Department of Pathology and Laboratory Medicine, The Aga Khan University, Karachi, Pakistan
| | - Zahra Hasan
- Department of Pathology and Laboratory Medicine, The Aga Khan University, Karachi, Pakistan.
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Hasan Z, Rao N, Salahuddin N, Islam M, Ashraf M, Rottenberg ME, Hussain R. Mycobacterium tuberculosis Sonicate-Induced IFNγ, CXCL10 and IL10 can Differentiate Severity in Tuberculosis. Scand J Immunol 2015; 75:220-6. [PMID: 21958213 DOI: 10.1111/j.1365-3083.2011.02642.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Improved tools are required to study immunopathogenesis of tuberculosis (TB). Mycobacterium tuberculosis antigen-stimulated T cell-based assays can detect TB but are less effective when responses are compromised such as in severe disease. We investigated immune responses to M. tuberculosis whole sonicate (MTBs), recombinant antigens ESAT6 and CFP10 in whole blood cells of healthy endemic controls (EC, n = 42) and patients with pulmonary (PTB, n = 36) or extrapulmonary (ETB, n = 41) disease. Biomarkers of T cell activation (IFNγ) or modulation (IL10) and chemokines, CXCL9, CXCL10 and CCL2, secretion were measured. MTBs, ESAT6 and CFP10 all induced IFNγ responses in TB. ESAT6-induced IFNγ was elevated in TB as compared with EC. MTBs stimulated the highest IFNγ levels but did not differentiate between TB and EC. However, MTBs-induced CXCL10 (P = 0.004) was reduced, while IL10 (P < 0.001) was raised in TB as compared with EC. Between sites, MTBs-induced CCL2 (P = 0.001) and IL10 secretion was higher in PTB than ETB (P < 0.001). In comparison of disease severity, MTBs-induced IFNγ (P = 0.014) and CXCL10 (P = 0.022) levels were raised in moderate as compared with far advanced PTB. In ETB, MTBs-induced IL10 levels were greater in less-severe (L-ETB) than in severe disseminated (D-ETB) cases, P = 0.035. Within the L-ETB group, MTBs-induced IFNγ was greater in patients with tuberculous lymphadenitis than those with pleural TB (P = 0.002). As immune responses to MTBs were differentially activated in TB of different sites and severity, we propose the utility of MTBs-induced IFNγ, CXCL10 and IL10 as biomarkers in TB.
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Affiliation(s)
- Z Hasan
- Department of Pathology and Microbiology, The Aga Khan University, Karachi, PakistanOJHA Institute for Chest Diseases, DOW University of Healthy Sciences, Karachi, PakistanIndus Hospital, Karachi, PakistanDepartment of Microbiology and Tumor Cell Biology, Karolinska Institute, Stockholm, Sweden
| | - N Rao
- Department of Pathology and Microbiology, The Aga Khan University, Karachi, PakistanOJHA Institute for Chest Diseases, DOW University of Healthy Sciences, Karachi, PakistanIndus Hospital, Karachi, PakistanDepartment of Microbiology and Tumor Cell Biology, Karolinska Institute, Stockholm, Sweden
| | - N Salahuddin
- Department of Pathology and Microbiology, The Aga Khan University, Karachi, PakistanOJHA Institute for Chest Diseases, DOW University of Healthy Sciences, Karachi, PakistanIndus Hospital, Karachi, PakistanDepartment of Microbiology and Tumor Cell Biology, Karolinska Institute, Stockholm, Sweden
| | - M Islam
- Department of Pathology and Microbiology, The Aga Khan University, Karachi, PakistanOJHA Institute for Chest Diseases, DOW University of Healthy Sciences, Karachi, PakistanIndus Hospital, Karachi, PakistanDepartment of Microbiology and Tumor Cell Biology, Karolinska Institute, Stockholm, Sweden
| | - M Ashraf
- Department of Pathology and Microbiology, The Aga Khan University, Karachi, PakistanOJHA Institute for Chest Diseases, DOW University of Healthy Sciences, Karachi, PakistanIndus Hospital, Karachi, PakistanDepartment of Microbiology and Tumor Cell Biology, Karolinska Institute, Stockholm, Sweden
| | - M E Rottenberg
- Department of Pathology and Microbiology, The Aga Khan University, Karachi, PakistanOJHA Institute for Chest Diseases, DOW University of Healthy Sciences, Karachi, PakistanIndus Hospital, Karachi, PakistanDepartment of Microbiology and Tumor Cell Biology, Karolinska Institute, Stockholm, Sweden
| | - R Hussain
- Department of Pathology and Microbiology, The Aga Khan University, Karachi, PakistanOJHA Institute for Chest Diseases, DOW University of Healthy Sciences, Karachi, PakistanIndus Hospital, Karachi, PakistanDepartment of Microbiology and Tumor Cell Biology, Karolinska Institute, Stockholm, Sweden
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Patil T, Garg RK, Jain A, Goel MM, Malhotra HS, Verma R, Singh GP, Sharma PK. Serum and CSF cytokines and matrix metalloproteinases in spinal tuberculosis. Inflamm Res 2014; 64:97-106. [DOI: 10.1007/s00011-014-0786-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Revised: 11/12/2014] [Accepted: 11/19/2014] [Indexed: 12/12/2022] Open
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Landolfi JA, Terio KA, Miller M, Junecko BF, Reinhart T. Pulmonary tuberculosis in Asian elephants (Elephas maximus): histologic lesions with correlation to local immune responses. Vet Pathol 2014; 52:535-42. [PMID: 25228055 DOI: 10.1177/0300985814548517] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Although Mycobacterium tuberculosis infection is an important health concern for Asian elephants (Elephas maximus), no studies have evaluated the associated local immune responses or histologic lesions. In primates including humans, latent tuberculosis is distinguished by well-organized granulomas with TH1 cytokine expression, whereas active disease is characterized by poorly organized inflammation and local imbalance in TH1/TH2 cytokines. This study examined archival, formalin-fixed, paraffin-embedded lung samples from 5 tuberculosis-negative and 9 tuberculosis-positive Asian elephants. Lesions were assessed by light microscopy, and lymphoid infiltrates were characterized by CD3 and CD20 immunolabeling. Expression of TH1 (interferon [IFN]-γ, tumor necrosis factor [TNF]-α) and TH2 (interleukin [IL]-4, IL-10, transforming growth factor [TGF]-β) cytokines was determined using in situ hybridization. In 6 of 9 samples, inflammation was similar to the pattern of primate active disease with low to moderate numbers of lymphocytes, most of which were CD20 positive. In 1 sample, inflammation was most similar to latent tuberculosis in primates with numerous CD3-positive lymphocytes. Expression of IFN-γ was detected in 3 of 8 tuberculosis-positive samples. Expression of TNF-α was detected in 3 of 8 positive samples, including the one with latent morphology. Low-level expression of IL-4 was present in 4 of 8 positive samples. Only single positive samples displayed expression of IL-10 and TGF-β. Tuberculosis-negative samples generally lacked cytokine expression. Results showed heterogeneity in lesions of elephant tuberculosis similar to those of latent and active disease in primates, with variable expression of both TH1 and TH2 cytokines.
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Affiliation(s)
- J A Landolfi
- University of Illinois Zoological Pathology Program, Loyola University Medical Center, Maywood, IL, USA
| | - K A Terio
- University of Illinois Zoological Pathology Program, Loyola University Medical Center, Maywood, IL, USA
| | - M Miller
- DST/MRC Centre of Excellence for Biomedical Tuberculosis Research, Division of Molecular Biology and Human Genetics, Stellenbosch University, Tygerberg, South Africa
| | - B F Junecko
- Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - T Reinhart
- Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
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25
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Interferon-gamma assay in combination with tuberculin skin test are insufficient for the diagnosis of culture-negative pulmonary tuberculosis. PLoS One 2014; 9:e107208. [PMID: 25221998 PMCID: PMC4164613 DOI: 10.1371/journal.pone.0107208] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Accepted: 08/07/2014] [Indexed: 11/23/2022] Open
Abstract
Objective Early diagnosis of infectious cases and treatment of tuberculosis (TB) are important strategies for reducing the incidence of this disease. Unfortunately, traditional TB diagnostic methods are time-consuming and often unreliable. This study compared the accuracy and reliability of the tuberculin skin test (TST) and interferon (IFN)-γ-based assay (IGRA) for the diagnosis of active pulmonary TB Polish cases that could or could not be confirmed by M. tuberculosis (M.tb) culture. Methods In total, 126 adult patients with clinically active TB or non-mycobacterial, community-acquired lung diseases (NMLD) hospitalised at the Regional Specialised Hospital of Tuberculosis, Lung Diseases and Rehabilitation in Tuszyn, Poland were enrolled in the present study. Sensitivity, specificity, positive predicted value (PPV), negative predicted value (NPV), and analytic accuracy (Acc) of TST and IGRA testing for the diagnosis of culture-positive and culture-negative TB patients were calculated. The quantities of IFN-γ produced in the response to M.tb specific antigens (TB Ag – Nil) in the cultures of blood from patients with active TB and NMLD patients were also analysed. Results The IGRA sensitivity in culture-positive and culture-negative TB patients was similar, measuring 65.1% and 55.6%, respectively. The sensitivity of TST did not differ from the parameters designated for IGRA, measuring 55.8% in culture-positive and 64.9% in culture-negative TB. The sensitivity of TST and IGRA was age-dependent and decreased significantly with the age of the patients. No differences in the frequency or intensity of M.tb-stimulated IFN-γ production, as assessed by IGRA testing between culture-positive and culture-negative TB were noticed. Significantly lower concentrations of IFN-γ were observed in patients with advanced TB forms compared with those with mild or moderate TB pathologies. Conclusions Our results do not show that a combination of IGRA and TST might be a step forward in the diagnosis of culture-negative TB cases. However, M. tuberculosis-stimulated IFN-γ levels might help to assess the extent of pulmonary TB lesions.
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Landolfi JA, Miller M, Maddox C, Zuckermann F, Langan JN, Terio KA. Differences in immune cell function between tuberculosis positive and negative Asian elephants. Tuberculosis (Edinb) 2014; 94:374-82. [PMID: 24836563 DOI: 10.1016/j.tube.2014.03.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Revised: 01/23/2014] [Accepted: 03/01/2014] [Indexed: 11/25/2022]
Abstract
Tuberculosis is an important health concern for Asian elephant (Elephas maximus) populations worldwide, however, mechanisms underlying susceptibility to Mycobacterium tuberculosis are unknown. Proliferative responses assessed via brominated uridine incorporation and cytokine expression measured by real-time RT-PCR were evaluated in peripheral blood mononuclear cell (PBMC) cultures from 8 tuberculosis negative and 8 positive Asian elephants. Cultures were stimulated with Mycobacterium bovis purified protein derivative (PPD-B), M. tuberculosis culture filtrate protein (CFP)-10, and Mycobacterium avium PPD (PPD-A). Following stimulation with PPD-B, proliferation was higher (α = 0.005) in positive samples; no significant differences were detected following CFP-10 or PPD-A stimulation. Tumor necrosis factor (TNF)-α, interleukin (IL)-12, and interferon (IFN)-γ expression was greater in samples from positive elephants following stimulation with PPD-B (α = 0.025) and CFP-10 (α = 0.025 TNF-α and IL-12; α = 0.005 IFN-γ). Stimulation with PPD-A also produced enhanced IL-12 expression in positive samples (α = 0.025). Findings suggested that differences in immune cell function exist between tuberculosis positive and negative elephants. Proliferative responses and expression of TNF-α, IL-12, and IFN-γ in response to stimulation with PPD-B and CFP-10 differ between tuberculosis positive and negative elephants, suggesting these parameters may be important to tuberculosis immunopathogenesis in this species.
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Affiliation(s)
- Jennifer A Landolfi
- University of Illinois, Zoological Pathology Program, Loyola University Medical Center, Building 101, Room 0745, 2160 South First Avenue, Maywood, IL 60153, USA.
| | - Michele Miller
- Rare Species Conservatory Foundation, 1222 E Road, Loxahatchee, FL 33470, USA.
| | - Carol Maddox
- University of Illinois, Department of Pathobiology, 1219 VMVSB, 2001 South Lincoln, Urbana, IL 61802, USA.
| | - Federico Zuckermann
- University of Illinois, Department of Pathobiology, 2834 VMBSC, 2001 South Lincoln, Urbana, IL 61802, USA.
| | - Jennifer N Langan
- University of Illinois, Department of Veterinary Clinical Medicine, 1008 West Hazelwood Drive, Urbana, IL 61802, USA; Chicago Zoological Society, Brookfield Zoo, Brookfield, IL 60513, USA.
| | - Karen A Terio
- University of Illinois, Zoological Pathology Program, Loyola University Medical Center, Building 101, Room 0745, 2160 South First Avenue, Maywood, IL 60153, USA.
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Gunluoglu G, Yazar EE, Veske NS, Seyhan EC, Altin S. Mean platelet volume as an inflammation marker in active pulmonary tuberculosis. Multidiscip Respir Med 2014; 9:11. [PMID: 24581084 PMCID: PMC3995664 DOI: 10.1186/2049-6958-9-11] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2013] [Accepted: 01/27/2014] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND The mean platelet volume (MPV) reflects the size of platelets. It has been shown to be inversely correlated with level of the inflammation in some chronic inflammatory diseases. This prospective study aims to show the usability of MPV as an inflammation marker in patients with active pulmonary tuberculosis (PTB) by comparison with healthy controls. In addition, its relationships with other inflammatory markers such as C-reactive protein (CRP) and the erythrocyte sedimentation rate (ESR) as well as with the radiological extent of disease were examined. METHODS This study included 82 patients with active PTB and 95 healthy subjects (control group). Whole blood counts, CRP level, and ESR were compared between the two groups. In the PTB group, the relationships between the radiological extent of disease and the MPV and other inflammation markers were investigated. RESULTS The MPV was 7.74 ± 1.33/μL in the PTB group and 8.20 ± 1.13/μL in the control group (p = 0.005). The blood platelet count, CRP level, and ESR were significantly higher in the active PTB group than in the control group (p < 0.0001). In the PTB group, CRP levels (r = 0.26, p = 0.003) and ESR (r = 0.39, p = 0.003), but not MPV (p = 0.80), were significantly correlated with the radiologic extent of the disease. CONCLUSIONS The MPV was lower in patients with PTB than in healthy controls, however, the difference was limited. The MPV does not reflect the severity of the disease. The use of MPV as an inflammation marker and a negative acute-phase reactant in PTB does not seem to be reliable.
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Affiliation(s)
- Gulsah Gunluoglu
- Yedikule Teaching Hospital for Chest Diseases and Thoracic Surgery, Istanbul, Turkey.
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Vir Singh S, Dhama K, Chaubey KK, Kumar N, Singh PK, Sohal JS, Gupta S, Vir Singh A, Verma AK, Tiwari R, Mahima, Chakraborty S, Deb R. Impact of host genetics on susceptibility and resistance to Mycobacterium avium subspecies Paratuberculosis infection in domestic ruminants. Pak J Biol Sci 2014; 16:251-66. [PMID: 24498788 DOI: 10.3923/pjbs.2013.251.266] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Johne's disease or Paratuberculosis has emerged as major infectious disease of animals in general and domestic livestock in particular on global basis. There have been major initiatives in developed countries for the control of this incurable malady of animals and human beings alike (inflammatory bowel disease or Crohn's disease). Disease has not received similar attention due to inherent complexities of disease, diagnosis and control, in resource poor counties around the world. However, the rich genetic diverstiy of the otherwise low productive animal population offers opportunity for the control of Johne's disease and improve per animal productivity. Present review aims to gather and compile information available on genetics or resistance to Johne's disease and its future exploitation by resource poor countries rich in animal diversity. This review will also help to create awareness and share knowledge and experience on prevalence and opportunities for control of Johne's disease in the livestock population to boost per animal productivity among developing and poor countries of the world. Breeding of animals for disease resistance provides good, safe, effective and cheaper way of controlling Johne's disease in animals, with especial reference to domestic livestock of developing and poor countries. Study will help to establish better understanding of the correlation between host cell factors and resistance to MAP infection which may have ultimately help in the control of Johne's disease in future.
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Affiliation(s)
- Shoor Vir Singh
- Microbiology Lab., Animal Health Division, Central Institute for Research on Goats, Makhdoom, PO-Farah, Mathura (UP)-281122, India
| | - Kuldeep Dhama
- Division of Pathology, Indian Veterinary Research Institute, Izatnagar, Bareilly (UP)-243 122, India
| | - Kundan Kumar Chaubey
- Microbiology Lab., Animal Health Division, Central Institute for Research on Goats, Makhdoom, PO-Farah, Mathura (UP)-281122, India
| | - Naveen Kumar
- Microbiology Lab., Animal Health Division, Central Institute for Research on Goats, Makhdoom, PO-Farah, Mathura (UP)-281122, India
| | - Pravin Kumar Singh
- National JALMA Institute for Leprosy and Other Mycobacterial Diseases (NJIL and OMD), TajGanj, Agra (UP)-282001, India
| | - Jagdip Singh Sohal
- Canadian Food Inspection Agency, 3400 W Casavant, St. Hyacihthe (QC), Canada-J2S 8E3, Canada
| | - Saurabh Gupta
- Microbiology Lab., Animal Health Division, Central Institute for Research on Goats, Makhdoom, PO-Farah, Mathura (UP)-281122, India
| | - Ajay Vir Singh
- Microbiology Lab., Animal Health Division, Central Institute for Research on Goats, Makhdoom, PO-Farah, Mathura (UP)-281122, India
| | - Amit Kumar Verma
- Department of Veterinary Epidemiology and Preventive Medicine, Uttar Pradesh Pandit Deen Dayal Upadhyaya Pashu-Chikitsa Vigyan Vishwavidyalaya Evam Go-Anusandhan Sansthan (DUVASU), Mathura, (UP)-281001, India
| | - Ruchi Tiwari
- Department of Microbiology and Immunology, Uttar Pradesh Pandit Deen Dayal Upadhyaya Pashu-Chikitsa Vigyan Vishwavidyalaya Evam Go-Anusandhan Sansthan (DUVASU), Mathura, (UP)-281001, India
| | - Mahima
- Department of Animal Nutrition, Uttar Pradesh Pandit Deen Dayal Upadhyaya Pashu-Chikitsa Vigyan Vishwavidyalaya Evam Go-Anusandhan Sansthan (DUVASU), Mathura, (UP)-281001, India
| | - S Chakraborty
- Animal Resource Development Department, Pt. Nehru Complex, Agartala, Tripura-799001, India
| | - Rajib Deb
- Animal Genetics and Breeding, Project Directorate on Cattle, Indian Council of Agricultural Research, Grass farm Road, Meerut, Uttar Pradesh-250001, India
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Ashenafi S, Aderaye G, Bekele A, Zewdie M, Aseffa G, Hoang ATN, Carow B, Habtamu M, Wijkander M, Rottenberg M, Aseffa A, Andersson J, Svensson M, Brighenti S. Progression of clinical tuberculosis is associated with a Th2 immune response signature in combination with elevated levels of SOCS3. Clin Immunol 2014; 151:84-99. [PMID: 24584041 DOI: 10.1016/j.clim.2014.01.010] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Revised: 01/08/2014] [Accepted: 01/30/2014] [Indexed: 02/06/2023]
Abstract
In this study, we explored the local cytokine/chemokine profiles in patients with active pulmonary or pleural tuberculosis (TB) using multiplex protein analysis of bronchoalveolar lavage and pleural fluid samples. Despite increased pro-inflammation compared to the uninfected controls; there was no up-regulation of IFN-γ or the T cell chemoattractant CCL5 in the lung of patients with pulmonary TB. Instead, elevated levels of IL-4 and CCL4 were associated with high mycobacteria-specific IgG titres as well as SOCS3 (suppressors of cytokine signaling) mRNA and progression of moderate-to-severe disease. Contrary, IL-4, CCL4 and SOCS3 remained low in patients with extrapulmonary pleural TB, while IFN-γ, CCL5 and SOCS1 were up-regulated. Both SOCS molecules were induced in human macrophages infected with Mycobacterium tuberculosis in vitro. The Th2 immune response signature found in patients with progressive pulmonary TB could result from inappropriate cytokine/chemokine responses and excessive SOCS3 expression that may represent potential targets for clinical TB management.
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Affiliation(s)
- Senait Ashenafi
- Karolinska Institutet, Center for Infectious Medicine (CIM), F59, Department of Medicine, Karolinska University Hospital Huddinge, Stockholm, Sweden; Black Lion University Hospital and Addis Ababa University, Department of Pathology, Faculty of Medicine, Addis Ababa, Ethiopia
| | - Getachew Aderaye
- Black Lion University Hospital and Addis Ababa University, Department of Internal Medicine, Faculty of Medicine, Addis Ababa, Ethiopia
| | - Amsalu Bekele
- Black Lion University Hospital and Addis Ababa University, Department of Internal Medicine, Faculty of Medicine, Addis Ababa, Ethiopia
| | - Martha Zewdie
- Armauer Hansen Research Institute (AHRI), Addis Ababa, Ethiopia
| | - Getachew Aseffa
- Black Lion University Hospital and Addis Ababa University, Department of Radiology, Faculty of Medicine, Addis Ababa, Ethiopia
| | - Anh Thu Nguyen Hoang
- Karolinska Institutet, Center for Infectious Medicine (CIM), F59, Department of Medicine, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Berit Carow
- Karolinska Institutet, Department of Microbiology, Tumor and Cell Biology (MTC), Stockholm, Sweden
| | - Meseret Habtamu
- Armauer Hansen Research Institute (AHRI), Addis Ababa, Ethiopia
| | - Maria Wijkander
- Karolinska Institutet, Center for Infectious Medicine (CIM), F59, Department of Medicine, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Martin Rottenberg
- Karolinska Institutet, Department of Microbiology, Tumor and Cell Biology (MTC), Stockholm, Sweden
| | - Abraham Aseffa
- Armauer Hansen Research Institute (AHRI), Addis Ababa, Ethiopia
| | - Jan Andersson
- Karolinska Institutet, Center for Infectious Medicine (CIM), F59, Department of Medicine, Karolinska University Hospital Huddinge, Stockholm, Sweden; Karolinska University Hospital Huddinge, Department of Medicine, Division of Infectious Diseases, Stockholm, Sweden
| | - Mattias Svensson
- Karolinska Institutet, Center for Infectious Medicine (CIM), F59, Department of Medicine, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Susanna Brighenti
- Karolinska Institutet, Center for Infectious Medicine (CIM), F59, Department of Medicine, Karolinska University Hospital Huddinge, Stockholm, Sweden.
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Ethnicity-tailored novel set of ESAT-6 peptides for differentiating active and latent tuberculosis. Tuberculosis (Edinb) 2013; 93:618-24. [PMID: 24011630 DOI: 10.1016/j.tube.2013.08.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2012] [Revised: 07/30/2013] [Accepted: 08/04/2013] [Indexed: 11/23/2022]
Abstract
Differentiation between active and latent TB is a diagnostic challenge in TB-endemic regions. The commercially available IFN-γ-release assays are unsuitable for achieving this discrimination. We, therefore, screened ESAT-6 and CFP-10 proteins through population coverage analysis to identify minimal sets of peptides that can discriminate between these two forms of TB in a North Indian population. Comparing the diagnostic performance of a set of 2 ESAT-6 peptides (positions: 16-36; 59-79) to that of the QuantiFERON(®)-TB Gold IT (QFTGIT) assay, we observed significant difference in IFN-γ and TNF-α levels between patients (n = 15) and their age- and sex-matched healthy household contacts (n = 15). While the mean (±SD) IFNγ titer was 241.8 (±219.24) IU/ml for patients, the same in controls was 564.2 (±334.82) IU/ml (p = 0.039). Similarly the TNFα response was significantly higher in patients, compared to controls (796.47 ± 175.21 IU/ml vs. 481.81 ± 378.72 IU/ml; p = 0.047). IL-4 response to these peptides was non- discriminatory between the two groups. The QFTGIT Assay, however, elicited no significant difference in IFN-γ, TNF-α or IL-4 levels. Hence we conclude that IFN-γ or TNF-α response to these ESAT-6 peptides has the potential to differentiate between active and latent TB in our population.
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Pinheiro RO, de Oliveira EB, Dos Santos G, Sperandio da Silva GM, de Andrade Silva BJ, Teles RMB, Milagres A, Sarno EN, Dalcolmo MP, Sampaio EP. Different immunosuppressive mechanisms in multi-drug-resistant tuberculosis and non-tuberculous mycobacteria patients. Clin Exp Immunol 2013; 171:210-9. [PMID: 23286948 DOI: 10.1111/cei.12007] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2012] [Indexed: 11/30/2022] Open
Abstract
Previous studies have demonstrated that cells from both multi-drug-resistant tuberculosis (MDR-TB) and non-tuberculous mycobacteria (NTM) patients respond poorly to mycobacterial antigens in vitro. In the present study, we compared the in vitro response of cells isolated from sensitive TB (NR-TB)-, MDR-TB- and NTM-infected patients. Analysis of T cell phenotype ex vivo revealed that both MDR-TB and NTM patients present an increased percentage of CD4(+) CD25(+-) forkhead box protein 3 (FoxP3)(+) and CD4(+) CD25(+) CD127(-) regulatory T (T(reg) ) cells when compared to NR-TB. Increased numbers of T(reg) cells and interleukin (IL)-10 serum levels were detected in MDR-TB, whereas elevated serum transforming growth factor (TGF)-β was found in the NTM group. Cells of MDR-TB patients stimulated with early secretory antigenic target (ESAT)-6, but not purified protein derivative (PPD), showed a lower frequency of CD4(+) /interferon (IFN)-γ(+) T cells and enhanced CD4(+) CD25(+) FoxP3(+) , CD4(+) CD25(+) CD127(-) and CD4(+) CD25(+) IL-10(+) T cell population. In addition, increased IL-10 secretion was observed in cultured MDR-TB cells following ESAT-6 stimulation, but not in NR-TB or NTM patients. In vitro blockade of IL-10 or IL-10Rα decreased the CD4(+) CD25(+) FoxP3(+) frequencies induced by ESAT-6 in MDR-TB, suggesting a role of IL-10 on impaired IFN-γ responses seen in MDR-TB. Depletion of CD4(+) CD25(+) T lymphocytes restored the capacity of MDR-TB T cells to respond to ESAT-6 in vitro, which suggests a potential role for T(reg) /T regulatory 1 cells in the pathogenesis of MDR-TB. Together, our results indicate that although the similarities in chronicity, NTM- and MDR-TB-impaired antigenic responses involve different mechanisms.
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Affiliation(s)
- R O Pinheiro
- Leprosy Laboratory, Instituto Oswaldo Cruz, Oswaldo Cruz Foundation, Fiocruz, Brazil
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Kim SY, Park MS, Kim YS, Kim SK, Chang J, Lee HJ, Cho SN, Kang YA. The responses of multiple cytokines following incubation of whole blood from TB patients, latently infected individuals and controls with the TB antigens ESAT-6, CFP-10 and TB7.7. Scand J Immunol 2013; 76:580-6. [PMID: 22946827 DOI: 10.1111/j.1365-3083.2012.02776.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The development of clinically relevant biomarkers is important for diagnosing latent tuberculosis infection (LTBI) and active tuberculosis (TB) and predicting their prognoses. This study examined whether the responses of multiple cytokines can be used as a biomarker to distinguish the TB infection status and mycobacterial load. We analysed the responses of multiple cytokines (IFN-γ, IL-2, IL-10, IL-13, IL-17 and TNF-α) in the supernatant from the QuantiFERON-TB Gold In-Tube assay following stimulation of whole blood from the TB group (n = 32), LTBI group (n = 19) and healthy controls (n = 30) with TB antigens (ESAT-6, CFP-10 and TB7.7). The median responses of IFN-γ, IL-2, IL-10 and IL-13 were higher in the LTBI and active TB groups than in the non-TB control group (IFN-γ, P < 0.001; IL-2, P < 0.001; IL-10, P = 0.012; IL-13, P < 0.001). The median IL-2/IFN-γ ratio of the LTBI group was higher than that of the active TB group (P = 0.014) and differed significantly between patients with LTBI, patients with smear-negative TB and patients with smear-positive TB (P = 0.027). This difference was especially evident between the patients with LTBI and patients with smear-positive TB (P = 0.047). In conclusion, IFN-γ, IL-2, IL-10 and IL-13 can serve as biomarkers for distinguishing TB infection. In addition, the IL-2/IFN-γ ratio appears to be a biomarker for diagnosing LTBI and may be useful as a prognostic factor and for evaluating treatment responses.
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Affiliation(s)
- S Y Kim
- Division of Pulmonology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
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Pitabut N, Sakurada S, Tanaka T, Ridruechai C, Tanuma J, Aoki T, Kantipong P, Piyaworawong S, Kobayashi N, Dhepakson P, Yanai H, Yamada N, Oka S, Okada M, Khusmith S, Keicho N. Potential function of granulysin, other related effector molecules and lymphocyte subsets in patients with TB and HIV/TB coinfection. Int J Med Sci 2013; 10:1003-14. [PMID: 23801887 PMCID: PMC3691799 DOI: 10.7150/ijms.6437] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Accepted: 05/30/2013] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Host effector mechanism against Mycobacterium tuberculosis (Mtb) infection is dependent on innate immune response by macrophages and neutrophils and the alterations in balanced adaptive immunity. Coordinated release of cytolytic effector molecules from NK cells and effector T cells and the subsequent granule-associated killing of infected cells have been documented; however, their role in clinical tuberculosis (TB) is still controversy. OBJECTIVE To investigate whether circulating granulysin and other effector molecules are associated with the number of NK cells, iNKT cells, Vγ9(+)Vδ2(+) T cells, CD4(+) T cells and CD8(+) T cells, and such association influences the clinical outcome of the disease in patients with pulmonary TB and HIV/TB coinfection. METHODS Circulating granulysin, perforin, granzyme-B and IFN-γ levels were determined by ELISA. The isoforms of granulysin were analyzed by Western blot analysis. The effector cells were analyzed by flow cytometry. RESULTS Circulating granulysin and perforin levels in TB patients were lower than healthy controls, whereas the granulysin levels in HIV/TB coinfection were much higher than in any other groups, TB and HIV with or without receiving HAART, which corresponded to the number of CD8(+) T cells which kept high, but not with NK cells and other possible cellular sources of granulysin. In addition, the 17kDa, 15kDa and 9kDa isoforms of granulysin were recognized in plasma of HIV/TB coinfection. Increased granulysin and decreased IFN-γ levels in HIV/TB coinfection and TB after completion of anti-TB therapy were observed. CONCLUSION The results suggested that the alteration of circulating granulysin has potential function in host immune response against TB and HIV/TB coinfection. This is the first demonstration so far of granulysin in HIV/TB coinfection.
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Affiliation(s)
- Nada Pitabut
- Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
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Ibrahim L, Salah M, Rahman AAE, Zeidan A, Ragb M. Crucial Role of CD4+CD 25+ FOXP3+ T Regulatory Cell, Interferon-γ and Interleukin-16 in Malignant and Tuberculous Pleural Effusions. Immunol Invest 2012; 42:122-36. [DOI: 10.3109/08820139.2012.736116] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Role of TNF-Alpha, IFN-Gamma, and IL-10 in the Development of Pulmonary Tuberculosis. Pulm Med 2012; 2012:745483. [PMID: 23251798 PMCID: PMC3515941 DOI: 10.1155/2012/745483] [Citation(s) in RCA: 166] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2012] [Revised: 10/31/2012] [Accepted: 11/05/2012] [Indexed: 01/04/2023] Open
Abstract
Host immune response against Mycobacterium tuberculosis is mediated by cellular immunity, in which cytokines and Th1 cells play a critical role. In the process of control of the infection by mycobacteria, TNF-alpha seems to have a primordial function. This cytokine acts in synergy with IFN-gamma, stimulating the production of reactive nitrogen intermediates (RNIs), thus mediating the tuberculostatic function of macrophages, and also stimulating the migration of immune cells to the infection site, contributing to granuloma formation, which controls the disease progression. IFN-gamma is the main cytokine involved in the immune response against mycobacteria, and its major function is the activation of macrophages, allowing them to exert its microbicidal role functions. Different from TNF-alpha and IFN-gamma, IL-10 is considered primarily an inhibitory cytokine, important to an adequate balance between inflammatory and immunopathologic responses. The increase in IL-10 levels seems to support the survival of mycobacteria in the host. Although there is not yet conclusive studies concerning a clear dichotomy between Th1 and Th2 responses, involving protective immunity and susceptibility to the disease, respectively, we can suggest that the knowledge about this responses based on the prevailing cytokine profile can help to elucidate the immune response related to the protection against M. tuberculosis.
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Masood KI, Rottenberg ME, Carow B, Rao N, Ashraf M, Hussain R, Hasan Z. SOCS1 gene expression is increased in severe pulmonary tuberculosis. Scand J Immunol 2012; 76:398-404. [PMID: 22670716 DOI: 10.1111/j.1365-3083.2012.02731.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Suppressors of cytokine signalling (SOCS) molecules inhibit cytokine signalling and may regulate protective immunity in tuberculosis (TB). We investigated the association of SOCS with disease progression in patients with pulmonary TB. For this purpose, we studied peripheral blood mononuclear cells (PBMCs) and T cells from patients with pulmonary TB (TB, n=33) and healthy endemic controls (EC, n=15). Cases were stratified into those with moderately advanced (Mod-PTB) or far advanced disease (Adv-PTB). Interferon-gamma (IFN-γ), SOCS1 and SOCS3 gene expression was determined by RT-PCR. Statistical analysis was performed using the Mann-Whitney test. Levels of IL6 (P=0.018) and IL10 (P=0.013) were found to be elevated in PBMC supernatants from patients with TB as compared with EC. SOCS1 mRNA gene expression in T cells from patients with TB was increased as compared with that of EC (P=0.02). In addition, levels of SOCS1 mRNA transcripts were found to be elevated in PBMCs of Adv-PTB as compared with Mod-PTB (P=0.008) cases. Our data show that raised SOCS1 levels are associated with increased disease severity in TB. As SOCS1 regulates IFN-γ-driven immunity and SOCS1 can be further upregulated by IL6 levels, the increase in SOCS1 in severe disease indicates a mechanism by which mycobacteria impede disease control in TB.
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Affiliation(s)
- K I Masood
- Department of Pathology and Microbiology, The Aga Khan University, Karachi, Pakistan
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Immune responses to ESAT-6 and CFP-10 by FASCIA and multiplex technology for diagnosis of M. tuberculosis infection; IP-10 is a promising marker. PLoS One 2012; 7:e43438. [PMID: 23144772 PMCID: PMC3493549 DOI: 10.1371/journal.pone.0043438] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2011] [Accepted: 07/23/2012] [Indexed: 12/05/2022] Open
Abstract
Background There is a need for reliable markers to diagnose active and latent tuberculosis (TB). The interferon gamma release assays (IGRAs) are compared to the tuberculin skin test (TST) more specific, but cannot discriminate between recent or remote TB infection. Here the Flow-cytometric Assay for Specific Cell-mediated Immune-response in Activated whole blood (FASCIA), which quantifies expanded T-lymphoblasts by flow-cytometric analysis after long-term antigen stimulation of whole blood, is combined with cytokine/chemokine analysis in the supernatant by multiplex technology for diagnosis of Mycobacterium tuberculosis (Mtb) infection. Methods and Findings Consecutive patients with suspected TB (n = 85), with microbiologically verified active pulmonary TB (n = 33), extra pulmonary TB (n = 21), clinical TB (n = 11), presumed latent TB infection (LTBI) (n = 23), patients negative for TB (n = 8) and 21 healthy controls were studied. Blood samples were analyzed with FASCIA and multiplex technology to determine and correlate proliferative responses and the value of 14 cytokines for diagnosis of Mtb infection: IFN- γ, IL-2, TNF-α, IP-10, IL-12, IL-6, IL-4, IL-5, IL-13, IL-17, MIP-1β, GM-CSF, IFN-α2 and IL-10. Cytokine levels for IFN-γ, IP-10, MIP-1β, IL-2, TNF-α, IL-6, IL-10, IL-13 and GM-CSF were significantly higher after stimulation with the Mtb specific antigens ESAT-6 and CFP-10 in patients with active TB compared to healthy controls (p<0.05) and correlated with proliferative responses. IP-10 was positive in all patients with verified TB, if using a combination of ESAT-6 and CFP-10 and was the only marker significantly more sensitive in detecting active TB then IFN-γ (p = 0.012). Cytokine responses in patients with active TB were more frequent and detected at higher levels than in patients with LTBI. Conclusions IP-10 seems to be an important marker for diagnosis of active and latent TB. Patients with active TB and LTBI responded with similar cytokine profiles against TB antigens but proliferative and cytokine responses were generally higher in patients with active TB.
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Hui-feng Yang, Zhang ZH, Xiang LB, Tang KL, Luo F, Liu CY, Zhou JB, Li JQ, Xu JZ. 25(OH)D(3) affects the maturation and function of mouse bone marrow-derived dendritic cells stimulated by Mycobacterium bovis BCG. PLoS One 2012; 7:e48062. [PMID: 23144845 PMCID: PMC3489893 DOI: 10.1371/journal.pone.0048062] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2012] [Accepted: 09/20/2012] [Indexed: 01/07/2023] Open
Abstract
It has been shown that vitamin D deficiency increases an individual's susceptibility to tuberculosis (TB). However, very little is known about the effect of vitamin D on the immune response to Mycobacterium tuberculosis (M. tb) in dendritic cells (DCs). Because DCs play an important role in TB infection, we investigated the phenotypic characteristics and functional capabilities of mouse bone marrow-derived dendritic cells (BMDCs) after stimulation with Bacillus Calmette-Guérin (BCG) in the presence or absence of 25(OH)D(3)(100 nM). Bone marrow cells from mice were cultured with GM-CSF (20 ng/ml) and were then treated with 25(OH)D(3) for 7 days. On day 6, 5 µg/ml of BCG (≥1.0×10(6) CFU/mg) was added to the cells for 24 hours, and on day 7, the non-adherent cells were harvested for phenotypic and functional analyses. After incubation with 25(OH)D(3), the expression levels of MHC-II and CD86 on the surface of the dendritic cells (DCs) and the ability of the DCs to stimulate proliferation of allogeneic mixed lymphocytes were lower than control cells (p<0.05). Furthermore, the level of Interleukin (IL) -4 secreted by the BMDCs in the 25(OH)D(3) culture was lower than that in the control culture (p<0.01). However, the BMDCs cultured with 25(OH)D(3) produced significantly higher levels of IL-2, IL-6, IL-10 and interferon gamma(IFN-γ) than those in the control culture (p<0.05). These findings suggest that 25(OH)D(3) modulates the immune response during mycobacterial infection by affecting the maturation and function of DCs.
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Affiliation(s)
- Hui-feng Yang
- Department of Orthopedic Surgery, Southwest Hospital, Third Military Medical University, Chongqing, People’s Republic of China
| | - Ze-hua Zhang
- Department of Orthopedic Surgery, Southwest Hospital, Third Military Medical University, Chongqing, People’s Republic of China
| | - Liang-bi Xiang
- Department of Orthopedic Surgery, General Hospital of Shenyang Military Command, Shenyang, People’s Republic of China
| | - Kang-lai Tang
- Department of Orthopedic Surgery, Southwest Hospital, Third Military Medical University, Chongqing, People’s Republic of China
| | - Fei Luo
- Department of Orthopedic Surgery, Southwest Hospital, Third Military Medical University, Chongqing, People’s Republic of China
| | - Chun-yu Liu
- Department of Orthopedic Surgery, Southwest Hospital, Third Military Medical University, Chongqing, People’s Republic of China
| | - Jian-bo Zhou
- Department of Orthopedic Surgery, Southwest Hospital, Third Military Medical University, Chongqing, People’s Republic of China
| | - Jin-qing Li
- Department of Orthopedic Surgery, Southwest Hospital, Third Military Medical University, Chongqing, People’s Republic of China
| | - Jian-zhong Xu
- Department of Orthopedic Surgery, Southwest Hospital, Third Military Medical University, Chongqing, People’s Republic of China
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Verhagen LM, Hermans PWM, Warris A, de Groot R, Maes M, Villalba JA, del Nogal B, van den Hof S, Mughini Gras L, van Soolingen D, Pinelli E, de Waard JH. Helminths and skewed cytokine profiles increase tuberculin skin test positivity in Warao Amerindians. Tuberculosis (Edinb) 2012; 92:505-12. [PMID: 22877977 DOI: 10.1016/j.tube.2012.07.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2012] [Revised: 07/14/2012] [Accepted: 07/16/2012] [Indexed: 01/09/2023]
Abstract
The immune regulatory mechanisms involved in the acquisition of Mycobacterium tuberculosis infection in children are largely unknown. We investigated the influence of parasitic infections, malnutrition and plasma cytokine profiles on tuberculin skin test (TST) positivity in Warao Amerindians in Venezuela. Pediatric household contacts of sputum smear-positive tuberculosis (TB) cases were enrolled for TST, chest radiograph, plasma cytokine analyses, QuantiFERON-TB Gold In-Tube (QFT-GIT) testing and stool examinations. Factors associated with TST positivity were studied using generalized estimation equations logistic regression models. Of the 141 asymptomatic contacts, 39% was TST-positive. After adjusting for age, gender and nutritional status, TST positivity was associated with Trichuris trichiura infections (OR 3.5, 95% CI 1.1-11.6) and low circulating levels of T helper 1 (Th1) cytokines (OR 0.51, 95% CI 0.33-0.79). Ascaris lumbricoides infections in interaction with Th2- and interleukin (IL)-10-dominated cytokine profiles were positively associated with TST positivity (OR 3.1, 95% CI 1.1-8.9 and OR 2.4, 95% CI 1.04-5.7, respectively). A negative correlation of QFT-GIT mitogen responses with Th1 and Th2 levels and a positive correlation with age were observed (all p < 0.01). We conclude that helminth infections and low Th1 cytokine plasma levels are significantly associated with TST positivity in indigenous Venezuelan pediatric TB contacts.
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Affiliation(s)
- L M Verhagen
- Laboratorio de Tuberculosis, Instituto de Biomedicina, Caracas, Venezuela.
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Tomioka H, Tatano Y, Maw WW, Sano C, Kanehiro Y, Shimizu T. Characteristics of suppressor macrophages induced by mycobacterial and protozoal infections in relation to alternatively activated M2 macrophages. Clin Dev Immunol 2012; 2012:635451. [PMID: 22666284 PMCID: PMC3361169 DOI: 10.1155/2012/635451] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2011] [Revised: 02/22/2012] [Accepted: 02/23/2012] [Indexed: 01/15/2023]
Abstract
In the advanced stages of mycobacterial infections, host immune systems tend to change from a Th1-type to Th2-type immune response, resulting in the abrogation of Th1 cell- and macrophage-mediated antimicrobial host protective immunity. Notably, this type of immune conversion is occasionally associated with the generation of certain types of suppressor macrophage populations. During the course of Mycobacterium tuberculosis (MTB) and Mycobacterium avium-intracellulare complex (MAC) infections, the generation of macrophages which possess strong suppressor activity against host T- and B-cell functions is frequently encountered. This paper describes the immunological properties of M1- and M2-type macrophages generated in tumor-bearing animals and those generated in hosts with certain microbial infections. In addition, this paper highlights the immunological and molecular biological characteristics of suppressor macrophages generated in hosts with mycobacterial infections, especially MAC infection.
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Affiliation(s)
- Haruaki Tomioka
- Department of Microbiology and Immunology, Shimane University School of Medicine, Izumo, Shimane 693-8501, Japan.
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Tallman PS, Kuzawa C, Adair L, Borja JB, McDade TW. Microbial exposures in infancy predict levels of the immunoregulatory cytokine interleukin-4 in Filipino young adults. Am J Hum Biol 2012; 24:446-53. [PMID: 22307655 DOI: 10.1002/ajhb.22244] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2011] [Revised: 12/12/2011] [Accepted: 12/27/2011] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVES Infancy represents a window of development during which long-term immunological functioning can be influenced. In this study, we evaluate proxies of microbial exposures in infancy as predictors of interleukin-4 (IL-4) in young adulthood. IL-4 is an immunoregulatory cytokine that plays a role in the pathogenesis of atopic and allergic diseases. METHODS Data were obtained from 1,403 participants in the Cebu Longitudinal Health and Nutrition Survey, an ongoing population-based study in the Philippines. Relationships between microbial and nutritional environments in infancy and plasma IL-4 concentrations in adulthood were evaluated using tobit regression models. RESULTS Having older siblings and more episodes of respiratory illness in infancy significantly predicted lower concentrations of plasma IL-4 in adulthood. Unexpectedly, more episodes of diarrheal illness in infancy were associated with higher IL-4 in adulthood. Interactions between a composite household pathogen exposure score and the duration of exclusive breastfeeding approached significance. This interaction showed that the negative association between household pathogen exposure in infancy and adult IL-4 was only significant for individuals who had been exclusively breastfed for a short duration of time. Finally, currently living in an urban household was unexpectedly, negatively associated with adult IL-4. Associations were independent of early nutrition, socioeconomic status (SES), and urbanicity, as well as current measures of infection, body fat, SES, and smoking. CONCLUSIONS This study builds on a growing body of literature demonstrating that early ecological conditions have long-term effects on human biology by providing evidence that multiple proxies of microbial exposures in infancy are associated with adult IL-4.
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Affiliation(s)
- Paula Skye Tallman
- Department of Anthropology, Northwestern University, Chicago, Illinois 60201, USA.
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Cowan J, Pandey S, Filion LG, Angel JB, Kumar A, Cameron DW. Comparison of interferon-γ-, interleukin (IL)-17- and IL-22-expressing CD4 T cells, IL-22-expressing granulocytes and proinflammatory cytokines during latent and active tuberculosis infection. Clin Exp Immunol 2012; 167:317-29. [PMID: 22236009 PMCID: PMC3278699 DOI: 10.1111/j.1365-2249.2011.04520.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2011] [Indexed: 01/17/2023] Open
Abstract
In this study, we investigated the role and expression of T helper type 17 (Th17) cells and Th17 cytokines in human tuberculosis. We show that the basal proportion of interferon (IFN)-γ-, interleukin (IL)-17- and IL-22-expressing CD4(+) T cells and IL-22-expressing granulocytes in peripheral blood were significantly lower in latently infected healthy individuals and active tuberculosis patients compared to healthy controls. In contrast, CD4(+) T cells expressing IL-17, IL-22 and IFN-γ were increased significantly following mycobacterial antigens stimulation in both latent and actively infected patients. Interestingly, proinflammatory IFN-γ and tumour necrosis factor (TNF)-α were increased following antigen stimulation in latent infection. Similarly, IL-1β, IL-4, IL-8, IL-22 and TNF-α were increased in the serum of latently infected individuals, whereas IL-6 and TNF-α were increased significantly in actively infected patients. Overall, we observed differential induction of IL-17-, IL-22- and IFN-γ-expressing CD4(+) T cells, IL-22-expressing granulocytes and proinflammatory cytokines in circulation and following antigenic stimulation in latent and active tuberculosis.
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Affiliation(s)
- J Cowan
- Ottawa Hospital Research Institute, Ottawa, ON, Canada
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Pitabut N, Mahasirimongkol S, Yanai H, Ridruechai C, Sakurada S, Dhepakson P, Kantipong P, Piyaworawong S, Moolphate S, Hansudewechakul C, Yamada N, Keicho N, Okada M, Khusmith S. Decreased plasma granulysin and increased interferon-gamma concentrations in patients with newly diagnosed and relapsed tuberculosis. Microbiol Immunol 2011; 55:565-73. [PMID: 21545511 DOI: 10.1111/j.1348-0421.2011.00348.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Granulysin and interferon-gamma (IFN-γ) have broad antimicrobial activity which controls Mycobacterium tuberculosis (M. tuberculosis) infection. Circulating granulysin and IFN-γ concentrations were measured and correlated with clinical disease in Thai patients with newly diagnosed, relapsed and chronic tuberculosis (TB). Compared to controls, patients with newly diagnosed, relapsed and chronic TB had lower circulating granulysin concentrations, these differences being significant only in newly diagnosed and relapsed TB (P < 0.001 and 0.004, respectively). Granulysin concentrations in patients with newly diagnosed and relapsed TB were significantly lower than in those with chronic TB (P= 0.003 and P= 0.022, respectively). In contrast, significantly higher circulating IFN-γ concentrations were found in patients with newly diagnosed and relapsed TB compared to controls (P < 0.001). The IFN-γ concentrations in newly diagnosed and relapsed patients were not significantly different from those of patients with chronic TB. However, in vitro stimulation of peripheral blood mononuclear cells (PBMCs) from patients with newly diagnosed, relapsed and chronic TB with purified protein derivative (PPD) or heat killed M. tuberculosis (H37Ra) enhanced production of granulysin by PBMCs. In vitro, stimulation of PBMCs of newly diagnosed TB patients with PPD produced greater amounts of IFN-γ than did controls, while those stimulated with H37Ra did not. The results demonstrate that patients with active pulmonary TB have low circulating granulysin but high IFN-γ concentrations, suggesting possible roles in host defense against M. tuberculosis for these agents.
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Affiliation(s)
- Nada Pitabut
- Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
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Katti MK. Assessment of serum IL-1, IL-2 and IFN-γ levels in untreated pulmonary tuberculosis patients: role in pathogenesis. Arch Med Res 2011; 42:199-201. [PMID: 21722815 DOI: 10.1016/j.arcmed.2011.04.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2011] [Accepted: 04/08/2011] [Indexed: 10/14/2022]
Abstract
BACKGROUND AND AIMS Tuberculosis (Tb) infection is controlled by cell-mediated immunity through mediation of IL-1, IL-2 and IFN-γ. In this study IL-1, IL-2 and IFN-γ were determined in serum samples of untreated pulmonary Tb and control group including apparently healthy individuals or contacts and normal healthy blood donors with an objective of understanding defect(s), if any, in synthesis of any of these cytokines that may lead to a diseased state of Tb. METHODS IL-1, IL-2 and IFN-γ were measured in serum samples of untreated Tb patients (n=33), contacts (n=19) and healthy individuals (n=20) by commercially available monoclonal antibody-based ELISA. RESULTS Statistically significant differences in IL-1 and IFN-γ concentrations between groups of pulmonary Tb and controls were observed, whereas no significant difference in IL-2 was seen. CONCLUSIONS In the present study, increased levels of cytokines in patients with pulmonary Tb are indicative of Th1 response. An increased level of cytokine (IFN-γ) in patients with untreated pulmonary Tb appears to be functionally defective.
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Affiliation(s)
- Muralidhar K Katti
- Department of Microbiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India.
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Hussain R, Talat N, Ansari A, Shahid F, Hasan Z, Dawood G. Endogenously activated interleukin-4 differentiates disease progressors and non-progressors in tuberculosis susceptible families: a 2-year biomarkers follow-up study. J Clin Immunol 2011; 31:913-23. [PMID: 21755390 DOI: 10.1007/s10875-011-9566-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2011] [Accepted: 06/29/2011] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Dynamic cytokine profiles from endogenously activated T cells in transit from lymph node to the infected sites via the blood compartment after recent exposure to Mycobacterium tuberculosis may differentiate disease progressors from non-disease progressors in a BCG-vaccinated population. METHODS Household contacts (N = 107) from families with (six families) or without (14 families) secondary cases were assessed for Types 1 and 2 cytokines serially in plasma of whole blood cultures without exogenous stimulation. "ARMS" PCR was carried out for detection of single nucleotide polymorphism T/A in IFN-γ +874. RESULTS In the absence of IFN-γ expansion, raised IL-4 at 6 months was associated with disease progression in TB-susceptible families. Resistant families on the other hand showed overrepresentation of IFN-γ +874 A allele and expansion of IFN-γ secreting cells at 6 months followed by contraction at 12 months. CONCLUSION Six months may be an important checkpoint for biomarker assessment in high-risk individuals post-exposure.
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Affiliation(s)
- Rabia Hussain
- Department of Pathology and Microbiology, Aga Khan University, Stadium Road, P.O. Box 3500, Karachi, 74800, Pakistan.
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Effect of IFN-γ and IL-4 levels on the expression of Fas and Bcl-2 in peripheral blood lymphocytes in hemodialysis patients. J Artif Organs 2011; 14:120-4. [DOI: 10.1007/s10047-011-0559-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2010] [Accepted: 02/18/2011] [Indexed: 10/18/2022]
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Dlugovitzky D, Stanford C, Stanford J. Immunological basis for the introduction of immunotherapy with Mycobacterium vaccae into the routine treatment of TB. Immunotherapy 2011; 3:557-68. [DOI: 10.2217/imt.11.6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
An account is given of the immunological investigations carried out in Rosario (Argentina) to identify suitable methods for the assessment of the efficacy of immunotherapy for TB. Some of these were then applied to three small studies: one of a single injected dose of heat-killed, borate-buffered Mycobacterium vaccae administered early in treatment, another of three such doses administered at monthly intervals from the start of treatment, and the third of ten oral doses at frequent intervals throughout short-course chemotherapy. All three displayed better clearance of bacilli from the sputum, faster improvement in clinical symptoms, better radiological resolution of lesions and a return of most immunological parameters towards those of healthy persons. In principle, the immune change achieved is an increase in Th1 mechanisms, notably IL-2 and -12 with downregulation of the tissue damaging aspects of Th2. As an addition to chemotherapy for drug-susceptible or drug-resistant TB, with or without concomitant HIV infection, this immunotherapy offers a safe and effective improvement.
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Affiliation(s)
- Diana Dlugovitzky
- Cátedra de Microbiologia, Virologia y Parasitologia, Facultad de Ciencias Medicas, Universidad Nacional de Rosario, Santa Fe 3100, 2000 Rosario, Argentina
| | - Cynthia Stanford
- Centre for Infectious Diseases & International Health, Windeyer Institute of Medical Sciences, University College London, 46 Cleveland Street, London W1T 4JF, UK
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Mattila JT, Diedrich CR, Lin PL, Phuah J, Flynn JL. Simian immunodeficiency virus-induced changes in T cell cytokine responses in cynomolgus macaques with latent Mycobacterium tuberculosis infection are associated with timing of reactivation. THE JOURNAL OF IMMUNOLOGY 2011; 186:3527-37. [PMID: 21317393 DOI: 10.4049/jimmunol.1003773] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Understanding the early immunologic events accompanying reactivated tuberculosis (TB) in HIV-infected individuals may yield insight into causes of reactivation and improve treatment modalities. We used the cynomolgus macaque (Macaca fascicularis) model of HIV-Mycobacterium tuberculosis coinfection to investigate the dynamics of multifunctional T cell responses and granuloma T cell phenotypes in reactivated TB. CD4(+) and CD8(+) T cells expressing Th1 cytokines (IFN-γ, IL-2, TNF) and Th2 cytokines (IL-4 and IL-10) were followed from latent M. tuberculosis infection to reactivation after coinfection with a pathogenic SIV. Coinfected animals experienced increased Th1 cytokine responses to M. tuberculosis Ags above the latent-response baseline 3-5 wk post-SIV infection that corresponded with peak plasma viremia. Th2 cytokine expression was not Ag specific, but strong, transient IL-4 expression was noted 4-7 wk post-SIV infection. Animals reactivating <17 wk post-SIV infection had significantly more multifunctional CD4(+) T cells 3-5 wk post-SIV infection and more Th2-polarized and fewer Th0-, Th1-polarized CD8(+) T cells during weeks 1-10 post-SIV infection than animals reactivating >26 wk post-SIV infection. Granuloma T cells included Th0-, Th1-, and Th2-polarized phenotypes but were particularly rich in cytolytic (CD107(+)) T cells. When combined with the changes in peripheral blood T cells, these factors indicate that events during acute HIV infection are likely to include distortions in proinflammatory and anti-inflammatory T cell responses within the granuloma that have significant effects on reactivation of latent TB. Moreover, it appears that mycobacteria-specific multifunctional T cells are better correlates of Ag load (i.e., disease status) than of protection.
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Affiliation(s)
- Joshua T Mattila
- Department of Microbiology and Molecular Genetics, University of Pittsburgh School of Medicine, Pittsburgh, PA 15261, USA
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Cannas A, Calvo L, Chiacchio T, Cuzzi G, Vanini V, Lauria FN, Pucci L, Girardi E, Goletti D. IP-10 detection in urine is associated with lung diseases. BMC Infect Dis 2010; 10:333. [PMID: 21092156 PMCID: PMC2995466 DOI: 10.1186/1471-2334-10-333] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2010] [Accepted: 11/22/2010] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Blood cytokines and chemokines have been proposed as biomarkers for tuberculosis (TB). Recently, some immune mediators found in the urine of patients with renal dysfunctions have also been suggested as potential biomarkers. Finding biomarkers for TB in urine would present several advantages over blood in terms of collection and safety. The objective of this study was to investigate the presence of cytokines and chemokines in the urine of patients with pulmonary TB at the time of diagnosis. In a subgroup, the evaluation was also performed during TB treatment and at therapy completion. Patients with lung diseases other than TB, and healthy subjects were also enrolled. METHODS Urine samples from 138 individuals, after exclusion of renal dysfunctions, were collected during an 18 month-period. Among them, 58 received a diagnosis of pulmonary TB, 28 resulted having lung diseases other than TB, and 34 were healthy subjects. Moreover, 18 TB patients, 9 of whom were tested 2 months after AFB smear sputum reversion and 9 of whom were cured of TB were also included. Cytokines and chemokines in urine were evaluated using a Cytometric-Bead-Array-Flex-Set. IP-10 detection in 49 subjects was also carried out in parallel by using an Enzyme Linked ImmunoSorbent Assay (ELISA). RESULTS IFN-γ, TNF-α, IL-2, IL-8, MIP-1α, MIP-1β and RANTES were poorly detected in all urine samples. Conversely, IP-10 was consistently detected in urine and its level was significantly increased in patients with lung disease compared to healthy subjects (p < 0.001). Increased IP-10 levels were found in both pulmonary TB and lung diseases other than TB. Moreover lower IP-10 levels were found in cured-TB patients compared to the levels at the time of diagnosis, and this difference was close to significance (p = 0.06). Interestingly, we demonstrated a significant correlation between the data obtained by flow cytometry and ELISA (r² 0.82, p < 0.0001). CONCLUSIONS IP-10, in contrast to IFN-γ, TNF-α, IL-2, IL-8, MIP-1α, MIP-1β and RANTES, is detectable in the urine of patients with pulmonary diseases in the absence of renal dysfunctions. Moreover, the IP-10 level in cured-TB patients is comparable to that found in healthy subjects. More studies are needed to further investigate the clinical utility of these findings.
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Affiliation(s)
- Angela Cannas
- Department of Epidemiology and Preclinical Research, L. Spallanzani National Institute for Infectious Diseases (INMI), Rome, Italy
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