Tubercular DNA PCR of ocular fluids and blood in cases of presumed ocular tuberculosis: a pilot study

Comparison of uveitis manifestations in patients with active systemic tuberculosis and those with positive interferon-gamma release assay without active disease

OBJECTIVE

To evaluate the clinical manifestations of uveitis in patients with active systemic tuberculosis (TB) and compare them to those with uveitis of undetermined cause who were positive for the interferon-gamma release assay (IGRA) but did not have active systemic TB.

METHODS

This retrospective study included 118 patients: 51 with uveitis and active systemic TB, 52 with undetermined cause of uveitis and positive IGRA but no active systemic TB, and 15 with positive Mycobacterium tuberculosis (Mtb) polymerase chain reaction (PCR) results from ocular fluids but no active systemic TB. Demographic data, ocular findings, and systemic TB investigations were analysed and compared.

RESULTS

Patients with evidence of active TB were predominantly younger. Typical manifestations of ocular TB (OTB) were more frequently observed in patients with active systemic TB (p < 0.001) and were significantly associated with younger age (p = 0.002). In patients without active systemic TB but positive Mtb PCR from ocular fluid, ocular manifestations closely resembled those of patients with active systemic TB, particularly with respect to the presence of choroidal granulomas. In contrast, patients with an undetermined cause of uveitis who tested positive for IGRA were older, and their clinical features were more often atypical.

CONCLUSIONS

Uveitis associated with active systemic TB was characterised by typical OTB manifestations and occurred more frequently in younger patients. These findings highlight the importance of considering TB in the differential diagnosis of uveitis, especially in younger individuals, and suggest that atypical manifestations may be more common in older patients and in patients without active TB.

Research Trends of Ocular Tuberculosis: A Bibliometric Analysis

PURPOSE

Ocular tuberculosis (OTB), an extrapulmonary manifestation of tuberculosis (TB), significantly impacts vision acuity and presents challenges in diagnosis and treatment. With ongoing research efforts, new insights into its pathogenesis and treatment have emerged. This study employed bibliometric methods to investigate key research areas and emerging trends, aiming to provide a comprehensive overview of the field.

METHODS

The documents about OTB from January 1, 2003 to December 31, 2023, were retrieved from the Web of Science Core Collection (WoSCC). VOSviewer, CiteSpace, R package bibliometrix, and GraphPad were utilized to analyze the data and visualize the network of the country, organization, author, journal, and keyword related to the field of OTB.

RESULTS

300 articles in the past 21 years were included in this research. The overall number of annual publications exhibits an upward trend. The most productive country, institution, author, and journal were India, Post Graduate Institute of Medical Education & Research (PGIMER), Gupta Vishali, and Ocular Immunology and Inflammation. The main keywords focused on ocular tuberculosis, intraocular tuberculosis, and uveitis. The time trend of keyword occurrences indicated that "T cells" and "aqueous humor" have become new hotspots. Burst detection analysis of keywords shows that "pattern" and "standardization" have emerged as new focal points.

CONCLUSIONS

This study represents the first bibliometric analysis on OTB, offering insights into hot topics and emerging trends within this field. T cells and aqueous humor are identified as novel directions for ongoing research endeavors. The latest research focus is on the standardization of OTB in diagnosis, treatment, and other aspects.

Detection of microRNAs expression signatures in vitreous humor of intraocular tuberculosis

BACKGROUND

MicroRNA (miRNA) expression analysis has been shown to provide them as biomarkers in several eye diseases and has a regulatory role in pathogenesis. However, miRNA expression analysis in the vitreous humor (VH) of intraocular tuberculosis (IOTB) is not studied. Thus, we aim to find miRNA expression signatures in the VH of IOTB patients to identify their regulatory role in disease pathogenesis and to find them as potential biomarkers for IOTB.

METHODS AND RESULTS

First, we profiled miRNAs in VH of three IOTB and three Macular hole (MH) samples as controls through small-RNA deep sequencing using Illumina Platform. In-house bioinformatics analysis identified 81 dysregulated miRNAs in IOTB. Further validation in VH of IOTB (n = 15) compared to MH (n = 15) using Real-Time quantitative PCR (RT-qPCR) identified three significantly upregulated miRNAs, hsa-miR-150-5p, hsa-miR-26b-5p, and hsa-miR-21-5p. Based on the miRNA target prediction, functional network analysis, and RT-qPCR analysis of target genes, the three miRNAs downregulating WNT5A, PRKCA, MAP3K7, IL7, TGFB2, IL1A, PRKCB, TNFA, and TP53 genes involving MAPK signaling pathway, PI3K-AKT signaling pathway, WNT signaling pathway, Cell cycle, TGF-beta signaling pathway, Long-term potentiation, and Sphingolipid signaling pathways, have a potential role in disease pathogenesis. The ROC analysis of RT-qPCR data showed that hsa-miR-150-5p with AUC = 0.715, hsa-miR-21-5p with AUC = 0.789, and hsa-miR-26b-5p with AUC = 0.738; however, the combination of hsa-miR-21-5p and hsa-miR-26b-5p with AUC = 0.796 could serve as a potential biomarker for IOTB.

CONCLUSIONS

This study provides the first report on miRNA expression signatures detected in VH for IOTB pathogenesis and also provides a potential biomarker for IOTB.