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Shewade HD, Frederick A, Kalyanasundaram M, Chadwick J, Kiruthika G, Rajasekar TD, Gayathri K, Vijayaprabha R, Sabarinathan R, Shivakumar SVBY, Jeyashree K, Bhavani PK, Aarthi S, Suma KV, Pathinathan DP, Parthasarathy R, Nivetha MB, Thampi JG, Chidambaram D, Bhatnagar T, Lokesh S, Devika S, Laux TS, Viswanathan S, Sridhar R, Krishnamoorthy K, Sakthivel M, Karunakaran S, Rajkumar S, Ramachandran M, Kanagaraj KD, Kaleeswari M, Durai VP, Saravanan R, Sugantha A, Khan SZHM, Sangeetha P, Vasudevan R, Nedunchezhian R, Sankari M, Jeevanandam N, Ganapathy S, Rajasekaran V, Mathavi T, Rajaprakash AR, Murali L, Pugal U, Sundaralingam K, Savithri S, Vellasamy S, Dheenadayal D, Ashok P, Jayasree K, Sudhakar R, Rajan KP, Tharageshwari N, Chokkalingam D, Anandrajkumar SM, Selvavinayagam TS, Padmapriyadarsini C, Ramachandran R, Murhekar MV. --Eleven tips for operational researchers working with health programmes: our experience based on implementing differentiated tuberculosis care in south India. Glob Health Action 2023; 16:2161231. [PMID: 36621943 PMCID: PMC9833404 DOI: 10.1080/16549716.2022.2161231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Due to the workload and lack of a critical mass of trained operational researchers within their ranks, health systems and programmes may not be able to dedicate sufficient time to conducting operational research (OR). Hence, they may need the technical support of operational researchers from research/academic organisations. Additionally, there is a knowledge gap regarding implementing differentiated tuberculosis (TB) care in programme settings. In this 'how we did it' paper, we share our experience of implementing a differentiated TB care model along with an inbuilt OR component in Tamil Nadu, a southern state in India. This was a health system initiative through a collaboration of the State TB cell with the Indian Council of Medical Research institutes and the World Health Organisation country office in India. The learnings are in the form of eleven tips: four broad principles (OR on priority areas and make it a health system initiative, implement simple and holistic ideas, embed OR within routine programme settings, aim for long-term engagement), four related to strategic planning (big team of investigators, joint leadership, decentralised decision-making, working in advance) and three about implementation planning (conducting pilots, smart use of e-tools and operational research publications at frequent intervals). These may act as a guide for other Indian states, high TB burden countries that want to implement differentiated care, and for operational researchers in providing technical assistance for strengthening implementation and conducting OR in health systems and programmes (TB or other health programmes). Following these tips may increase the chances of i) an enriching engagement, ii) policy/practice change, and iii) sustainable implementation.
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Affiliation(s)
- Hemant Deepak Shewade
- ICMR – National Institute of Epidemiology, Chennai, India,CONTACT Hemant Deepak Shewade ; Department of Health Research, Government of India, ICMR-National Institute of Epidemiology, R-127, Second Main Road, TNHB, Ayapakkam, Chennai600077, India
| | | | | | | | - G. Kiruthika
- ICMR – National Institute of Epidemiology, Chennai, India
| | | | - K. Gayathri
- ICMR – National Institute of Epidemiology, Chennai, India
| | | | | | | | | | - P. K. Bhavani
- ICMR – National Institute for Research in Tuberculosis, Chennai, India
| | - S. Aarthi
- State TB Cell, Government of Tamil Nadu, Chennai, India
| | - K. V. Suma
- The WHO Country Office for India, New Delhi, India
| | | | | | | | | | | | | | - S. Lokesh
- ICMR – National Institute of Epidemiology, Chennai, India
| | | | | | - Stalin Viswanathan
- Department of Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - R. Sridhar
- Government Hospital of Thoracic Medicine, Tambaram, India
| | - K. Krishnamoorthy
- Department of Respiratory Medicine, Tirunelveli Medical College Hospital, Tirunelveli, India
| | - M. Sakthivel
- Directorate of Medical and Rural Health Services, Government of Tamil Nadu, Chennai, India
| | - S. Karunakaran
- Directorate of Medical and Rural Health Services, Government of Tamil Nadu, Chennai, India
| | - S. Rajkumar
- Directorate of Medical and Rural Health Services, Government of Tamil Nadu, Chennai, India
| | - M. Ramachandran
- Directorate of Medical and Rural Health Services, Government of Tamil Nadu, Chennai, India
| | - K. D. Kanagaraj
- Directorate of Medical and Rural Health Services, Government of Tamil Nadu, Chennai, India
| | - M. Kaleeswari
- Directorate of Medical and Rural Health Services, Government of Tamil Nadu, Chennai, India
| | - V. P. Durai
- Directorate of Medical and Rural Health Services, Government of Tamil Nadu, Chennai, India
| | - R. Saravanan
- Directorate of Medical and Rural Health Services, Government of Tamil Nadu, Chennai, India
| | - A. Sugantha
- Directorate of Medical and Rural Health Services, Government of Tamil Nadu, Chennai, India
| | | | - P. Sangeetha
- Directorate of Medical and Rural Health Services, Government of Tamil Nadu, Chennai, India
| | - R. Vasudevan
- Directorate of Medical and Rural Health Services, Government of Tamil Nadu, Chennai, India
| | - R. Nedunchezhian
- Directorate of Medical and Rural Health Services, Government of Tamil Nadu, Chennai, India
| | - M. Sankari
- Directorate of Medical and Rural Health Services, Government of Tamil Nadu, Chennai, India
| | - N. Jeevanandam
- Directorate of Medical and Rural Health Services, Government of Tamil Nadu, Chennai, India
| | - S. Ganapathy
- Directorate of Medical and Rural Health Services, Government of Tamil Nadu, Chennai, India
| | - V. Rajasekaran
- Directorate of Medical and Rural Health Services, Government of Tamil Nadu, Chennai, India
| | - T. Mathavi
- Directorate of Medical and Rural Health Services, Government of Tamil Nadu, Chennai, India
| | - A. R. Rajaprakash
- Directorate of Medical and Rural Health Services, Government of Tamil Nadu, Chennai, India
| | - Lakshmi Murali
- Directorate of Medical and Rural Health Services, Government of Tamil Nadu, Chennai, India
| | - U. Pugal
- Directorate of Medical and Rural Health Services, Government of Tamil Nadu, Chennai, India
| | - K. Sundaralingam
- Directorate of Medical and Rural Health Services, Government of Tamil Nadu, Chennai, India
| | - S. Savithri
- Directorate of Medical and Rural Health Services, Government of Tamil Nadu, Chennai, India
| | - S. Vellasamy
- Directorate of Medical and Rural Health Services, Government of Tamil Nadu, Chennai, India
| | - D. Dheenadayal
- Directorate of Medical and Rural Health Services, Government of Tamil Nadu, Chennai, India
| | - P. Ashok
- Directorate of Medical and Rural Health Services, Government of Tamil Nadu, Chennai, India
| | - K. Jayasree
- Directorate of Medical and Rural Health Services, Government of Tamil Nadu, Chennai, India
| | - R. Sudhakar
- Directorate of Medical and Rural Health Services, Government of Tamil Nadu, Chennai, India
| | - K. P. Rajan
- Directorate of Medical and Rural Health Services, Government of Tamil Nadu, Chennai, India
| | | | | | | | - T. S. Selvavinayagam
- Directorate of Public Health and Preventive Medicine, Government of Tamil Nadu, Chennai, India
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Jeyakumar SM, Bhui NK, Singla N, Vilvamani S, Mariappan MV, Padmapriyadarsini C, Bhatnagar AK, Solanki R, Sridhar R. Long-Term Intake of Linezolid Elevates Drug Exposure and Reduces Drug Clearance and Elimination in Adults With Drug-Resistant Pulmonary Tuberculosis. Ther Drug Monit 2023; 45:754-759. [PMID: 37296501 DOI: 10.1097/ftd.0000000000001111] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 04/16/2023] [Indexed: 06/12/2023]
Abstract
PURPOSE Pharmacokinetic (PK) studies are critical for dose optimization, and there is a paucity of linezolid (LZD) PK data for prolonged use in drug-resistant tuberculosis (DR-TB). Therefore, the authors evaluated the pharmacokinetics of LZD at two-time intervals in DR-TB during long-term use. METHODS PK evaluation of LZD was performed at the end of the 8th and 16th weeks of treatment in a randomly selected subset of adult pre-extensively drug-resistant pulmonary tuberculosis patients (n = 18) from a multicentric interventional study (Building Evidence to Advance Treatment of TB/BEAT study; CTRI/2019/01/017310), wherein a daily dose of 600 mg LZD was used for 24 weeks. Plasma LZD levels were measured using a validated high-pressure liquid chromatography (HPLC) method. RESULTS The LZD median plasma C max was comparable between the 8th and 16th weeks [18.3 mg/L, interquartile range (IQR: 15.5-20.8 and 18.8 mg/L, IQR: 16.0-22.7, respectively)]. However, the trough concentration increased significantly in the 16th week (3.16 mg/L, IQR: 2.30-4.76), compared with the 8th week (1.98 mg/L, IQR: 0.93-2.75). Furthermore, compared with the 8th week, in the 16th week, there was a significant increase in drug exposure (AUC 0-24 = 184.2 mg*h/L, IQR: 156.4-215.8 versus 233.2 mg*h/L, IQR: 187.9-277.2), which corroborated with a longer elimination half-life (6.94 hours, IQR: 5.55-7.99 versus 8.47 hours, IQR:7.36-11.35) and decreased clearance (2.91 L/h, IQR: 2.45-3.33 versus 2.19 L/h, IQR: 1.49-2.78). CONCLUSIONS Long-term daily intake of 600 mg LZD resulted in a significant elevation in trough concentration (>2.0 mg/L) in 83% of the study participants. Furthermore, increased LZD drug exposure may be partly because of decreased clearance and elimination. Overall, the PK data underscore the need for dose adjustment when LZDs are intended for long-term treatment.
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Affiliation(s)
| | | | - Neeta Singla
- National Institute for Tuberculosis and Respiratory Diseases (NITRD), New Delhi, India
| | - Sudha Vilvamani
- ICMR-National Institute for Research in Tuberculosis (NIRT), Chennai, India
| | | | | | - Anuj K Bhatnagar
- Rajan Babu Institute of Pulmonary Medicine and Tuberculosis (RBIPMT), Delhi, India
| | - Rajesh Solanki
- B. J. Medical College and Hospital (BJMCH), Ahmedabad, India; and
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Shewade HD, Frederick A, Kiruthika G, Kalyanasundaram M, Chadwick J, Rajasekar TD, Gayathri K, Vijayaprabha R, Sabarinathan R, Kathiresan J, Bhavani P, Aarthi S, Suma K, Pathinathan DP, Parthasarathy R, Nivetha MB, Thampi JG, Chidambaram D, Bhatnagar T, Lokesh S, Devika S, Laux TS, Viswanathan S, Sridhar R, Krishnamoorthy K, Sakthivel M, Karunakaran S, Rajkumar S, Ramachandran M, Kanagaraj K, Kaleeswari M, Durai V, Saravanan R, Sugantha A, Khan SZHM, Sangeetha P, Vasudevan R, Nedunchezhian R, Sankari M, Jeevanandam N, Ganapathy S, Rajasekaran V, Mathavi T, Rajaprakash A, Murali L, Pugal U, Sundaralingam K, Savithri S, Vellasamy S, Dheenadayal D, Ashok P, Jayasree K, Sudhakar R, Rajan K, Tharageshwari N, Chokkalingam D, Anandrajkumar S, Selvavinayagam T, Padmapriyadarshini C, Ramachandran R, Murhekar MV. The First Differentiated TB Care Model From India: Delays and Predictors of Losses in the Care Cascade. Glob Health Sci Pract 2023; 11:e2200505. [PMID: 37116929 PMCID: PMC10141439 DOI: 10.9745/ghsp-d-22-00505] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 03/07/2023] [Indexed: 04/03/2023]
Abstract
To reduce TB deaths in resource-limited settings, a differentiated care strategy can be used to triage patients with high risk of severe illness (i.e., those with very severe undernutrition, respiratory insufficiency, or inability to stand without support) at diagnosis and refer them for comprehensive assessment and inpatient care. Globally, there are few examples of implementing this type of strategy in routine program settings. Beginning in April 2022, the Indian state of Tamil Nadu implemented a differentiated care strategy called Tamil Nadu-Kasanoi Erappila Thittam (TN-KET) for all adults aged 15 years and older with drug-susceptible TB notified by public facilities. Before evaluating the impact on TB deaths, we sought to understand the retention and delays in the care cascade as well as predictors of losses. During April-June 2022, 14,961 TB patients were notified and 11,599 (78%) were triaged. Of those triaged, 1,509 (13%) were at high risk of severe illness; of these, 1,128 (75%) were comprehensively assessed at a nodal inpatient care facility. Of 993 confirmed as severely ill, 909 (92%) were admitted, with 8% unfavorable admission outcomes (4% deaths). Median admission duration was 4 days. From diagnosis, the median delay in triaging and admission of severely ill patients was 1 day each. Likelihood of triaging decreased for people with extrapulmonary TB, those diagnosed in high-notification districts or teaching hospitals, and those transferred out of district. Predictors of not being comprehensively assessed included: aged 25-34 years, able to stand without support, and diagnosis at a primary or secondary-level facility. Inability to stand without support was a predictor of unfavorable admission outcomes. To conclude, the first quarter of implementation suggests that TN-KET was feasible to implement but could be improved by addressing predictors of losses in the care cascade and increasing admission duration.
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Affiliation(s)
- Hemant Deepak Shewade
- Indian Council of Medical Research, National Institute of Epidemiology, Chennai, India
| | | | - G. Kiruthika
- Indian Council of Medical Research, National Institute of Epidemiology, Chennai, India
| | | | - Joshua Chadwick
- Indian Council of Medical Research, National Institute of Epidemiology, Chennai, India
| | - T. Daniel Rajasekar
- Indian Council of Medical Research, National Institute of Epidemiology, Chennai, India
| | - K. Gayathri
- Indian Council of Medical Research, National Institute of Epidemiology, Chennai, India
| | - R. Vijayaprabha
- Indian Council of Medical Research, National Institute of Epidemiology, Chennai, India
| | - R. Sabarinathan
- Indian Council of Medical Research, National Institute of Epidemiology, Chennai, India
| | - Jeyashree Kathiresan
- Indian Council of Medical Research, National Institute of Epidemiology, Chennai, India
| | - P.K. Bhavani
- Indian Council of Medical Research, National Institute for Research in Tuberculosis, Chennai, India
| | - S. Aarthi
- State TB Cell, Government of Tamil Nadu, Chennai, India
| | - K.V. Suma
- World Health Organization Country Office for India, New Delhi, India
| | | | | | | | - Jerome G. Thampi
- World Health Organization Country Office for India, New Delhi, India
| | | | - Tarun Bhatnagar
- Indian Council of Medical Research, National Institute of Epidemiology, Chennai, India
| | - S. Lokesh
- Indian Council of Medical Research, National Institute of Epidemiology, Chennai, India
| | | | | | - Stalin Viswanathan
- Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - R. Sridhar
- Government Hospital of Thoracic Medicine, Tambaram, India
| | | | - M. Sakthivel
- Directorate of Medical and Rural Health Services, Government of Tamil Nadu, Chennai, India
| | - S. Karunakaran
- Directorate of Medical and Rural Health Services, Government of Tamil Nadu, Chennai, India
| | - S. Rajkumar
- Directorate of Medical and Rural Health Services, Government of Tamil Nadu, Chennai, India
| | - M. Ramachandran
- Directorate of Medical and Rural Health Services, Government of Tamil Nadu, Chennai, India
| | - K.D. Kanagaraj
- Directorate of Medical and Rural Health Services, Government of Tamil Nadu, Chennai, India
| | - M. Kaleeswari
- Directorate of Medical and Rural Health Services, Government of Tamil Nadu, Chennai, India
| | - V.P. Durai
- Directorate of Medical and Rural Health Services, Government of Tamil Nadu, Chennai, India
| | - R. Saravanan
- Directorate of Medical and Rural Health Services, Government of Tamil Nadu, Chennai, India
| | - A. Sugantha
- Directorate of Medical and Rural Health Services, Government of Tamil Nadu, Chennai, India
| | | | - P. Sangeetha
- Directorate of Medical and Rural Health Services, Government of Tamil Nadu, Chennai, India
| | - R. Vasudevan
- Directorate of Medical and Rural Health Services, Government of Tamil Nadu, Chennai, India
| | - R. Nedunchezhian
- Directorate of Medical and Rural Health Services, Government of Tamil Nadu, Chennai, India
| | - M. Sankari
- Directorate of Medical and Rural Health Services, Government of Tamil Nadu, Chennai, India
| | - N. Jeevanandam
- Directorate of Medical and Rural Health Services, Government of Tamil Nadu, Chennai, India
| | - S. Ganapathy
- Directorate of Medical and Rural Health Services, Government of Tamil Nadu, Chennai, India
| | - V. Rajasekaran
- Directorate of Medical and Rural Health Services, Government of Tamil Nadu, Chennai, India
| | - T. Mathavi
- Directorate of Medical and Rural Health Services, Government of Tamil Nadu, Chennai, India
| | - A.R. Rajaprakash
- Directorate of Medical and Rural Health Services, Government of Tamil Nadu, Chennai, India
| | - Lakshmi Murali
- Directorate of Medical and Rural Health Services, Government of Tamil Nadu, Chennai, India
| | - U. Pugal
- Directorate of Medical and Rural Health Services, Government of Tamil Nadu, Chennai, India
| | - K. Sundaralingam
- Directorate of Medical and Rural Health Services, Government of Tamil Nadu, Chennai, India
| | - S. Savithri
- Directorate of Medical and Rural Health Services, Government of Tamil Nadu, Chennai, India
| | - S. Vellasamy
- Directorate of Medical and Rural Health Services, Government of Tamil Nadu, Chennai, India
| | - D. Dheenadayal
- Directorate of Medical and Rural Health Services, Government of Tamil Nadu, Chennai, India
| | - P. Ashok
- Directorate of Medical and Rural Health Services, Government of Tamil Nadu, Chennai, India
| | - K. Jayasree
- Directorate of Medical and Rural Health Services, Government of Tamil Nadu, Chennai, India
| | - R. Sudhakar
- Directorate of Medical and Rural Health Services, Government of Tamil Nadu, Chennai, India
| | - K.P. Rajan
- Directorate of Medical and Rural Health Services, Government of Tamil Nadu, Chennai, India
| | | | - D. Chokkalingam
- Indian Council of Medical Research, National Institute of Epidemiology, Chennai, India
| | | | - T.S. Selvavinayagam
- Directorate of Public Health and Preventive Medicine, Government of Tamil Nadu, Chennai, India
| | - C. Padmapriyadarshini
- Indian Council of Medical Research, National Institute for Research in Tuberculosis, Chennai, India
| | | | - Manoj V. Murhekar
- Indian Council of Medical Research, National Institute of Epidemiology, Chennai, India
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Padmapriyadarsini C, Solanki R, Jeyakumar SM, Bhatnagar A, Muthuvijaylaksmi M, Jeyadeepa B, Reddy D, Shah P, Sridhar R, Vohra V, Bhui NK. Linezolid Pharmacokinetics and Its Association with Adverse Drug Reactions in Patients with Drug-Resistant Pulmonary Tuberculosis. Antibiotics (Basel) 2023; 12:antibiotics12040714. [PMID: 37107075 PMCID: PMC10135341 DOI: 10.3390/antibiotics12040714] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 03/30/2023] [Accepted: 03/31/2023] [Indexed: 04/29/2023] Open
Abstract
We evaluated the relationship between the pharmacokinetic parameters of linezolid (LZD) and development of adverse drug reactions (ADRs) in patients with pulmonary drug-resistant tuberculosis. A prospective cohort of adults with pulmonary multidrug-resistant tuberculosis with additional resistance to fluoroquinolone (MDR-TBFQ+) received treatment with bedaquiline, delamanid, clofazimine, and LZD. Blood samples were collected during weeks 8 and 16 at eight time points over 24 h. The pharmacokinetic parameters of LZD were measured using high-performance liquid chromatography and associated with ADRs. Of the 165 MDR-TBFQ+ patients on treatment, 78 patients developed LZD-associated anemia and 69 developed peripheral neuropathy. Twenty-three patients underwent intense pharmacokinetic testing. Plasma median trough concentration was 2.08 µg/mL and 3.41 µg/mL, (normal <2 µg/mL) and AUC0-24 was 184.5 µg/h/mL and 240.5 µg/h/mL at weeks 8 and 16, respectively, showing a linear relationship between duration of intake and plasma levels. Nineteen patients showed LZD-associated ADRs-nine at week 8, twelve at week 16, and two at both weeks 8 and 16. Thirteen of the nineteen had high plasma trough and peak concentrations of LZD. A strong association between LZD-associated ADRs and plasma LZD levels was noted. Trough concentration alone or combinations of trough with peak levels are potential targets for therapeutic drug monitoring.
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Affiliation(s)
| | - Rajesh Solanki
- B.J. Medical College and Hospital, Ahmedabad 380016, India
| | - S M Jeyakumar
- ICMR-National Institute for Research in Tuberculosis, Chennai 600031, India
| | - Anuj Bhatnagar
- Rajan Babu Institute of Pulmonary Medicine and Tuberculosis, New Delhi 110009, India
| | - M Muthuvijaylaksmi
- ICMR-National Institute for Research in Tuberculosis, Chennai 600031, India
| | - Bharathi Jeyadeepa
- ICMR-National Institute for Research in Tuberculosis, Chennai 600031, India
| | - Devarajulu Reddy
- ICMR-National Institute for Research in Tuberculosis, Chennai 600031, India
| | - Prashanth Shah
- B.J. Medical College and Hospital, Ahmedabad 380016, India
| | | | - Vikram Vohra
- National Institute for Tuberculosis and Respiratory Diseases, New Delhi 110030, India
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Sachdeva KS, Bhatnagar AK, Bhaskar A, Singla N, Sridhar R, Ramraj B, Athawale A, Solanki R, Baruah SR, Patel Y, Ramachandran R, Padmapriyadarsini C. QTc prolongation with bedaquiline treatment for drug-resistant pulmonary TB in a programmatic setting. Int J Tuberc Lung Dis 2023; 27:329-331. [PMID: 37035973 DOI: 10.5588/ijtld.22.0406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2023] Open
Affiliation(s)
- K S Sachdeva
- Central TB Division, Ministry of Health and Family Welfare, Government of India, New Delhi, India, The Union South East Asia, New Delhi, India
| | - A K Bhatnagar
- Rajan Babu Institute of Pulmonary Medicine and Tuberculosis, New Delhi, India
| | - A Bhaskar
- Indian Council of Medical Research-National Institute for Research in Tuberculosis, Chennai, India
| | - N Singla
- National Institute of Tuberculosis and Respiratory Diseases, New Delhi, India
| | - R Sridhar
- Government Hospital of Thoracic Medicine, Chennai, India
| | - B Ramraj
- Indian Council of Medical Research-National Institute for Research in Tuberculosis, Chennai, India
| | - A Athawale
- Seth GS Medical College & KEM Hospital and Group of TB Hospitals, Mumbai, India
| | - R Solanki
- BJ Medical College, Ahmedabad, India
| | | | - Y Patel
- Central TB Division, Ministry of Health and Family Welfare, Government of India, New Delhi, India, WHO Country Office for India, New Delhi, India
| | | | - C Padmapriyadarsini
- Indian Council of Medical Research-National Institute for Research in Tuberculosis, Chennai, India
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Parthiban A, Sachithanandam V, Lalitha P, Muthukumaran J, Misra R, Jain M, Sridhar R, Mageswaran T, Purvaja R, Ramesh R. Isolation, characterisation, anticancer and anti-oxidant activities of 2-methoxy mucic acid from Rhizophora apiculata: an in vitro and in silico studies. J Biomol Struct Dyn 2023; 41:1424-1436. [PMID: 34963406 DOI: 10.1080/07391102.2021.2020688] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
The main objective of the present study is to isolate and characterise the novel bioactive molecule, 2-methoxy mucic acid (4) from Rhizophora apiculate Blume under the Rhizophoraceae family. In this study, the 2-methoxy mucic acid (4) was isolated for the first time from the methanolic extract of the leaves of R. apiculata. Anticancer activity of 2-methoxy mucic acid (4) was evaluated against HeLa and MDA-MB-231 cancer cell lines and they displayed promising activity with IC50 values of 22.88283 ± 0.72 µg/ml in HeLa and 2.91925 ± 0.52 µg/ml in the case of MDA-MB-231, respectively. Furthermore, the antioxidant property of 2-methoxy mucic acid (4) was found to be (IC50) 21.361 ± 0.41 µg/ml. Apart from in vitro studies, we also performed extensive in silico studies (molecular docking and molecular dynamics simulation) on four critical antiapoptotic Bcl-2 family members (Bcl-2, Bcl-w, Bcl-xL and Bcl-B) towards 2-methoxy mucic acid (4). The results revealed that this molecule showed higher binding affinity towards Bcl-B protein (ΔG = -5.8 kcal/mol) and the structural stability of this protein was significantly improved upon binding of this molecule. The present study affords vital insights into the importance of 2-methoxy mucic acid (4) from R. apiculata. Furthermore, it opens the therapeutic route for the discovery of anticancer drugs. Research HighlightsThis is a first report on a bioactive compound identified and characterised; a novel 2-methoxy mucic acid derived from methanolic crude extract from the leaves of R. apiculata from ANI.Estimated binding free energy of 2-methoxy mucic acid is found to be -5.8 kcal/mol to the anti-apoptotic Bcl-B protein.2-methoxy mucic acid showed both significant anti-cancer and anti-oxidant activity.Communicated by Ramaswamy H. Sarma.
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Affiliation(s)
- A Parthiban
- National Centre for Sustainable Coastal Management, Ministry of Environment, Forest and Climate Change, Anna University Campus, Chennai, India
| | - V Sachithanandam
- National Centre for Sustainable Coastal Management, Ministry of Environment, Forest and Climate Change, Anna University Campus, Chennai, India
| | - P Lalitha
- National Centre for Sustainable Coastal Management, Ministry of Environment, Forest and Climate Change, Anna University Campus, Chennai, India
| | - Jayaraman Muthukumaran
- Department of Biotechnology, School of Engineering and Technology, Sharda University, Greater Noida, India
| | - Ranjita Misra
- Centre for Nanoscience and Nanotechnology, Sathyabama Institute of Science and Technology, Chennai, Tamil Nadu, India
| | - Monika Jain
- Department of Biotechnology, School of Engineering and Technology, Sharda University, Greater Noida, India
| | - R Sridhar
- National Centre for Sustainable Coastal Management, Ministry of Environment, Forest and Climate Change, Anna University Campus, Chennai, India
| | - T Mageswaran
- National Centre for Sustainable Coastal Management, Ministry of Environment, Forest and Climate Change, Anna University Campus, Chennai, India
| | - Ramachandran Purvaja
- National Centre for Sustainable Coastal Management, Ministry of Environment, Forest and Climate Change, Anna University Campus, Chennai, India
| | - Ramachandran Ramesh
- National Centre for Sustainable Coastal Management, Ministry of Environment, Forest and Climate Change, Anna University Campus, Chennai, India
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Kathamuthu GR, Moideen K, Sridhar R, Baskaran D, Babu S. Systemic Levels of Pro-Inflammatory Cytokines and Post-Treatment Modulation in Tuberculous Lymphadenitis. Trop Med Infect Dis 2023; 8:tropicalmed8030150. [PMID: 36977151 PMCID: PMC10053505 DOI: 10.3390/tropicalmed8030150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 02/13/2023] [Accepted: 02/21/2023] [Indexed: 03/08/2023] Open
Abstract
Pro-inflammatory cytokines are potent stimulators of inflammation and immunity and markers of infection severity and bacteriological burden in pulmonary tuberculosis (PTB). Interferons could have both host-protective and detrimental effects on tuberculosis disease. However, their role has not been studied in tuberculous lymphadenitis (TBL). Thus, we evaluated the systemic pro-inflammatory (interleukin (IL)-12, IL-23, interferon (IFN)α, and IFNβ) cytokine levels in TBL, latent tuberculosis (LTBI), and healthy control (HC) individuals. In addition, we also measured the baseline (BL) and post-treatment (PT) systemic levels in TBL individuals. We demonstrate that TBL individuals are characterized by increased pro-inflammatory (IL-12, IL-23, IFNα, IFNβ) cytokines when compared to LTBI and HC individuals. We also show that after anti-tuberculosis treatment (ATT) completion, the systemic levels of pro-inflammatory cytokines were significantly modulated in TBL individuals. A receiver operating characteristic (ROC) analysis revealed IL-23, IFNα, and IFNβ significantly discriminated TBL disease from LTBI and/or HC individuals. Hence, our study demonstrates the altered systemic levels of pro-inflammatory cytokines and their reversal after ATT, suggesting that they are markers of disease pathogenesis/severity and altered immune regulation in TBL disease.
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Affiliation(s)
- Gokul Raj Kathamuthu
- National Institutes of Health-NIRT-International Center for Excellence in Research, Chennai 600 031, India
- National Institute for Research in Tuberculosis (NIRT), Chennai 600 031, India
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, 171 77 Solna, Sweden
- Correspondence:
| | - Kadar Moideen
- National Institutes of Health-NIRT-International Center for Excellence in Research, Chennai 600 031, India
| | | | - Dhanaraj Baskaran
- National Institute for Research in Tuberculosis (NIRT), Chennai 600 031, India
| | - Subash Babu
- National Institutes of Health-NIRT-International Center for Excellence in Research, Chennai 600 031, India
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892-0425, USA
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Kathamuthu GR, Rajamanickam A, Sridhar R, Baskaran D, Babu S. Strongyloidiasis stercoralis coinfection is associated with altered iron status biomarkers in tuberculous lymphadenitis. Front Immunol 2022; 13:999614. [PMID: 36341407 PMCID: PMC9632344 DOI: 10.3389/fimmu.2022.999614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 10/07/2022] [Indexed: 11/26/2022] Open
Abstract
Soil-transmitted helminth [mainly Strongyloidiasis stercoralis (Ss)] and tuberculous lymphadenitis (TBL) coinfection in humans is a significant public health problem. We have previously shown that TBL+Ss+ coinfection significantly alters diverse cytokine, matrix metalloproteinase, and tissue inhibitors of metalloproteinase profiles. However, no data is available to understand the influence of Ss coinfection in TBL disease with respect to iron status biomarkers. Hence, we have studied the effect of Ss coinfection on the circulating levels of iron status (ferritin, transferrin [TF], apotransferrin [ApoT], hepcidin, hemopexin) biomarkers in TBL disease. Our results show that TBL+Ss+ and/or TBL+Ss- individuals are associated with significantly altered biochemical and hematological (red blood cell (RBC) counts, hemoglobin (Hb), hematocrit (HCT), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH) were decreased, and platelets were increased) parameters compared to TBL-Ss+ individuals. Our results also show that TBL+Ss+ coinfection is associated with diminished circulating levels of ferritin, ApoT, hepcidin, and hemopexin compared to TBL+Ss- individuals. TBL+Ss+ and TBL+Ss- groups are associated with altered iron status biomarkers (decreased ferritin [TBL+Ss+ alone] and increased TF, ApoT, hepcidin and hemopexin [TBL+Ss- alone]) compared to TBL-Ss+ group. The heat map expression profile and principal component analysis (PCA) analysis of iron status biomarkers were significantly altered in TBL+Ss+ compared to TBL+Ss- and/or TBL-Ss+ individuals. A significant correlation (positive/negative) was obtained among the biochemical and hematological parameters (white blood cells (WBC)/ferritin, TF, and hepcidin, mean corpuscular hemoglobin concentration (MCHC)/ferritin and hemopexin) with iron status biomarkers. Finally, receiver operating characteristic (ROC) analysis revealed that hemopexin was significantly associated with greater specificity and sensitivity in discriminating TBL+Ss+ and TBL+Ss- coinfected individuals. Thus, our data conclude that Ss coinfection is associated with altered iron status biomarkers indicating that coinfection might alter the host-Mtb interface and could influence the disease pathogenesis.
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Affiliation(s)
- Gokul Raj Kathamuthu
- National Institutes of Health-NIRT-International Center for Excellence in Research, Chennai, India
- Indian Council of Medical Research-National Institute for Research in Tuberculosis (ICMR-NIRT), Chennai, India
- *Correspondence: Gokul Raj Kathamuthu,
| | - Anuradha Rajamanickam
- National Institutes of Health-NIRT-International Center for Excellence in Research, Chennai, India
| | | | - Dhanaraj Baskaran
- Indian Council of Medical Research-National Institute for Research in Tuberculosis (ICMR-NIRT), Chennai, India
| | - Subash Babu
- National Institutes of Health-NIRT-International Center for Excellence in Research, Chennai, India
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States
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Srinivasan C, Mohamed Jasim K, Sridhar R. Measurement of D-M model on competitiveness of 3PL in Indian automobile industry through partial least square (PLS) estimation. Journal of Statistics and Management Systems 2022. [DOI: 10.1080/09720510.2022.2052447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- C. Srinivasan
- Department of Commerce, B. S. Abdur Rahman Crescent Institute of Science and Technology, Chennai, India
| | - K. Mohamed Jasim
- VIT Business School, Vellore Institute of Technology, Vellore, Tamil Nadu, India
| | - R. Sridhar
- KMG College of Education, Gudiyatham, Vellore dt., Tamil Nadu, India
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Padmapriyadarsini C, Vohra V, Bhatnagar A, Solanki R, Sridhar R, Anande L, Muthuvijaylakshmi M, Rana MB, Jeyadeepa B, Taneja G, Balaji S, Shah P, Saravanan N, Chavan V, Kumar H, Ponnuraja C, Livchits V, Bahl M, Alavadi U, Sachdeva KS, Swaminathan S. Bedaquiline, Delamanid, Linezolid and Clofazimine for Treatment of Pre-extensively Drug-Resistant Tuberculosis. Clin Infect Dis 2022; 76:ciac528. [PMID: 35767251 PMCID: PMC9907500 DOI: 10.1093/cid/ciac528] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 06/18/2022] [Accepted: 06/24/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Treatment success rates for multidrug-resistant tuberculosis (MDR-TB) remain low globally. Availability of newer drugs has given scope to develop regimens that can be patient-friendly, less toxic, with improved outcomes. We proposed to determine the effectiveness of an entirely oral, short-course regimen with Bedaquiline and Delamanid in treating MDR-TB with additional resistance to fluoroquinolones (MDR-TBFQ+) or second-line injectable (MDR-TBSLI+). METHODS We prospectively determined the effectiveness and safety of combining two new drugs with two repurposed drugs - Bedaquiline, Delamanid, Linezolid, and Clofazimine for 24-36 weeks in adults with pulmonary MDR-TBFQ+ or/and MDR-TBSLI+. The primary outcome was a favorable response at end of treatment, defined as two consecutive negative cultures taken four weeks apart. The unfavorable outcomes included bacteriologic or clinical failure during treatment period. RESULTS Of the 165 participants enrolled, 158 had MDR-TBFQ+. At the end of treatment, after excluding 12 patients due to baseline drug susceptibility and culture negatives, 139 of 153 patients (91%) had a favorable outcome. Fourteen patients (9%) had unfavorable outcomes: four deaths, seven treatment changes, two bacteriological failures, and one withdrawal. During treatment, 85 patients (52%) developed myelosuppression, 69 (42%) reported peripheral neuropathy, and none had QTc(F) prolongation >500msec. At 48 weeks of follow-up, 131 patients showed sustained treatment success with the resolution of adverse events in the majority. CONCLUSION After 24-36 weeks of treatment, this regimen resulted in a satisfactory favorable outcome in pulmonary MDR-TB patients with additional drug resistance. Cardiotoxicity was minimal, and myelosuppression, while common, was detected early and treated successfully.
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Affiliation(s)
| | - Vikram Vohra
- National Institute for Tuberculosis and Respiratory Diseases, New Delhi, India
| | - Anuj Bhatnagar
- Rajan Babu Institute of Pulmonary Medicine and Tuberculosis, Delhi, India
| | | | | | | | | | - Meera Bhatia Rana
- National Institute for Tuberculosis and Respiratory Diseases, New Delhi, India
| | | | - Gaurav Taneja
- Rajan Babu Institute of Pulmonary Medicine and Tuberculosis, Delhi, India
| | - S Balaji
- ICMR–National Institute for Research in Tuberculosis, Chennai, India
| | - Prashant Shah
- B. J. Medical College and Hospital, Ahmedabad, India
| | - N Saravanan
- ICMR–National Institute for Research in Tuberculosis, Chennai, India
| | | | - Hemanth Kumar
- ICMR–National Institute for Research in Tuberculosis, Chennai, India
| | | | | | - Monica Bahl
- Clinical Development Service Agency, New Delhi, India
| | - Umesh Alavadi
- US Agency for International Development, Washington D.C., USA
| | - K S Sachdeva
- Central TB Division, Ministry of Health and Family Welfare, New Delhi, India
| | - Soumya Swaminathan
- Indian Council of Medical Research, New Delhi, India
- World Health Organization, Geneva, Switzerland
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Kathamuthu GR, Sridhar R, Baskaran D, Babu S. Dominant expansion of CD4+, CD8+ T and NK cells expressing Th1/Tc1/Type 1 cytokines in culture-positive lymph node tuberculosis. PLoS One 2022; 17:e0269109. [PMID: 35617254 PMCID: PMC9135291 DOI: 10.1371/journal.pone.0269109] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 05/15/2022] [Indexed: 01/11/2023] Open
Abstract
Lymph node culture-positive tuberculosis (LNTB+) is associated with increased mycobacterial antigen-induced pro-inflammatory cytokine production compared to LN culture-negative tuberculosis (LNTB-). However, the frequencies of CD4+, CD8+ T cells and NK cells expressing Th1/Tc1/Type 1 (IFNγ, TNFα, IL-2), Th17/Tc17/Type 17 (IL-17A, IL-17F, IL-22) cytokines and cytotoxic (perforin [PFN], granzyme [GZE] B, CD107a) markers in LNTB+ and LNTB- individuals are not known. Thus, we have studied the unstimulated (UNS) and mycobacterial antigen-induced frequencies of CD4+, CD8+ T and NK cells expressing Th1, Th17 cytokines and cytotoxic markers using flow cytometry. The frequencies of CD4+, CD8+ T and NK cells expressing cytokines and cytotoxic markers were not significantly different between LNTB+ and LNTB- individuals in UNS condition. In contrast, upon Mtb antigen stimulation, LNTB+ individuals are associated with significantly increased frequencies of CD4+ T cells (PPD [IFNγ, TNFα], ESAT-6 PP [IFNγ, TNFα], CFP-10 PP [IFNγ, TNFα, IL-2]), CD8+ T cells (PPD [IFNγ], ESAT-6 PP [IFNγ], CFP-10 PP [TNFα]) and NK cells (PPD [IFNγ, TNFα], ESAT-6 PP [IFNγ, TNFα], CFP-10 PP [TNFα]) expressing Th1/Tc1/Type 1, but not Th17/Tc17/Type 17 cytokines and cytotoxic markers compared to LNTB- individuals. LNTB+ individuals did not show any significant alterations in the frequencies of CD4+, CD8+ T cells and NK cells expressing cytokines and cytotoxic markers compared to LNTB- individuals upon HIV Gag PP and P/I antigen stimulation. Increased frequencies of CD4+, CD8+ T and NK cells expressing Th1/Tc1/Type 1 cytokines among the LNTB+ group indicates that the presence of mycobacteria plays a dominant role in the activation of key correlates of immune protection or induces higher immunopathology.
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Affiliation(s)
- Gokul Raj Kathamuthu
- National Institutes of Health-NIRT-International Center for Excellence in Research, Chennai, India
- National Institute for Research in Tuberculosis (NIRT), Chennai, India
- * E-mail:
| | | | - Dhanaraj Baskaran
- National Institute for Research in Tuberculosis (NIRT), Chennai, India
| | - Subash Babu
- National Institutes of Health-NIRT-International Center for Excellence in Research, Chennai, India
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
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Palani N, Premkumar M, Vaishnavee V, Dinesh V, Thiruvengadam K, Lavanya J, Sridhar R, Frederick A, Sivaramakrishnan G, Mondal R, Padmapriyadarsini C, Shanmugam S. Trends in rifampicin and isoniazid resistance in patients with presumptive TB. Int J Tuberc Lung Dis 2022; 26:446-453. [PMID: 35505474 DOI: 10.5588/ijtld.21.0455] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND: Early diagnosis of drug-resistant TB (DR-TB) is crucial in preventing the spread of the disease in the community. Introduction of upfront decentralised drug susceptibility testing to district-level as part of universal drug susceptibility testing (UDST) policy increased the feasibility of rapid and early testing for drug resistance closer to the patient and has resulted in reduced circumstances for transmission. The introduction of the first-line line-probe assay (FL-LPA), GenoType® MTBDRplus v2, has had an extensive impact on the management of multidrug-resistant TB (MDR-TB) in India.MATERIALS and METHODS: Sputum samples of patients with presumptive TB and DR-TB from selected districts of Tamil Nadu received through National TB Elimination Programme (NTEP) were subjected to FL-LPA as per programme guidelines. In this study, we present trends in genotypic resistance to isoniazid (INH) and rifampicin (RIF) during the 4 years (2016-2019) among these patients. Band patterns were analysed as per the updated GLI (Global Laboratory Initiative) LPA interpretation and reporting guidelines.RESULTS: A total of 26,349 samples were received during the study period. Smear-positive samples (n = 20231) were directly subjected to FL-LPA; smear-negative samples were cultured in liquid media and M. tuberculosis-positive cultures were tested using FL-LPA. A total of 18,441 were MTB-positive on FL-LPA. INH monoresistance, RIF monoresistance and MDR-TB was observed in respectively 8.7%, 1.1% and 3.3% of the samples. There was a decreasing trend in all types of resistance observed particularly after 2017 (P < 0.001). MDR-TB showed a steady decrease from 5.6% to 1.8%. S531L (19.5%) and S315T (61.1%) were the most common mutations identified in the rpoB and katG genes, respectively. The percentage of inhA-c-15t promoter mutation, indicating low-level INH resistance, showed a consistent increase (P < 0.001).CONCLUSION: The impact of the UDST policy on the NTEP may have led to this decreasing trend in RIF and INH resistance observed in the study period. The increase in low-level INH resistance mutation inhA-c-15t may be associated with ethionamide/prothionamide resistance, and this should be taken into account when designing DR-TB regimen.
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Affiliation(s)
- N Palani
- Indian Council of Medical Research (ICMR)-National Institute for Research in Tuberculosis, Chennai, India
| | - M Premkumar
- Indian Council of Medical Research (ICMR)-National Institute for Research in Tuberculosis, Chennai, India
| | - V Vaishnavee
- Indian Council of Medical Research (ICMR)-National Institute for Research in Tuberculosis, Chennai, India
| | - V Dinesh
- Indian Council of Medical Research (ICMR)-National Institute for Research in Tuberculosis, Chennai, India
| | - K Thiruvengadam
- Indian Council of Medical Research (ICMR)-National Institute for Research in Tuberculosis, Chennai, India
| | | | - R Sridhar
- Goverment Hospital for Thoracic Medicine, Tambaram, India
| | | | - G Sivaramakrishnan
- Indian Council of Medical Research (ICMR)-National Institute for Research in Tuberculosis, Chennai, India
| | - R Mondal
- Indian Council of Medical Research (ICMR)-National Institute for Research in Tuberculosis, Chennai, India, ICMR-Bhopal Memorial Hospital & Research Centre, Bhopal, India
| | - C Padmapriyadarsini
- Indian Council of Medical Research (ICMR)-National Institute for Research in Tuberculosis, Chennai, India
| | - S Shanmugam
- Indian Council of Medical Research (ICMR)-National Institute for Research in Tuberculosis, Chennai, India
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Sridhar R, Amith V, Aditya S, Gangadhar A, Vishnumurthy K. Electrospun PVDF/Cloisite-30B and PVDF/BaTio3/graphene nanofiber mats for development of nanogenerators. J INDIAN CHEM SOC 2022. [DOI: 10.1016/j.jics.2022.100501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Sridhar R, Tanki UF, Jain A, Thomas S, Agarwal S, Verma N. Incidence and effectiveness of manipulation under anaesthesia for stiffness following primary total knee arthroplasty. Acta Orthop Belg 2022; 88:113-120. [PMID: 35512161 DOI: 10.52628/88.1.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background There are various modalities of cor- rection of stiffness following total knee arthro-plasty. Manipulation under anaesthesia (MUA) is generally indicated for people who fail to achieve their pre operative range of motion at 12 weeks. The purpose of this study was to determine: (1) the effect of MUA on Flexion arc (2) the influence of timing of MUA from index procedure and of diabetes mellitus on final flexion achieved. Methods We retrospectively evaluated patients who underwent manipulation following total knee arthroplasty at our institution between January 2016 to December 2018. For the purpose of analysis, we have divided the patients into two groups. Those who underwent manipulation within 12 weeks and later than 12 weeks. We have also compared the effect of MUA between diabetic and non-diabetic patients. All were operated with posterior stabilised (PS) prosthesis by a single senior arthroplasty surgeon. The final flexion achieved during their last clinical follow-up were recorded and compared with the pre MUA flexion. Results The incidence of MUA after TKA at our institute during this period is about 1.14 %. There was a significant statistical difference between the pre and post manipulation flexion, with p value <0.01. There was no significant statistical difference between those who were manipulated before 12 weeks and after 12 weeks in improving the Flexion of the operated knees. We have found that both the diabetic and non diabetic group had comparable flexion after the manipulation in our study. Conclusion Manipulation after anaesthesia is a safe first intervention to improve post operative stiffness and gain additional range of motion following TKA in patients who develop stiffness. It can be done even after 12 weeks of surgery with reasonably good gain in range of motion.
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Parthiban A, Sachithanandam V, Lalitha P, Elumalai D, Asha RN, Jeyakumar TC, Muthukumaran J, Jain M, Jayabal K, Mageswaran T, Sridhar R, Purvaja R, Ramesh R. Isolation and biological evaluation 7-hydroxy flavone from Avicennia officinalis L: insights from extensive in vitro, DFT, molecular docking and molecular dynamics simulation studies. J Biomol Struct Dyn 2022; 41:2848-2860. [PMID: 35193476 DOI: 10.1080/07391102.2022.2039771] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The flavonoid based 7-hydroxy flavone (PubChem CID: 5281894; molecular formula: C15H10O3) molecule has been isolated for the first time from the methanolic extract from the leaves of Avicennia officinalis L. in the tropical mangrove ecosystem of Andaman and Nicobar Islands (ANI), India. The molecular structure of bioactive compound was characterized by spectroscopic analysis, including FT-IR, 1H, 13C NMR spectroscopy and ESI-HRMS and elucidated as 7-hydroxy flavone. An anticancer activity of isolated 7-hydroxy flavone was evaluated by in vitro study against two different human cancer cell lines namely, HeLa (cervical cells) and MDA-MB231 (breast cells) and they exhibited promising anticancer activity with IC50 values are 22.5602 ± 0.21 µg/mL and 3.86474 ± 0.35 µg/mL, respectively. The antioxidant property of 7-hydroxy flavone at a standard concentration of 50 µg, was found to be (IC50) 5.5486 ± 0.81 µg/mL. In summary, this investigation provides evidence that 7-hydroxy flavone exhibits both anticancer and antioxidant properties. Meanwhile, the antimicrobial activity ability of 7-hydroxy flavone were also evaluated using three Gram positive and two Gram negative strain exhibited no antimicrobial activities. Density-functional theory (DFT) studies confirm the structure is global minima in the PES, from the optimized geometry FMO and MESP map analyzed. Further, the molecular docking and molecular dynamics simulation studies result shows that 7-hydroxy flavone has the better binding ability with anti-apoptotic Bcl-2 protein with the estimated free energy of binding of -6.3 kcal/mol. This bioactive compound may be act as drug candidate for treating various kinds of cancers. HighlightsA 7-hydroxy flavone molecule has been isolated from Avicennia officinalis.The isolated pure compound was subjected to spectral analysis such as FT-IR, 1H NMR, 13C NMR spectral data and HRMS analysis for skeleton of the molecule.The anticancer activity of 7-hydroxy flavone studied against Cervical (HeLa) cancer cell lines and breast (MDA-MB231) cancer cell lines with the IC50 values of 22.5602 ± 0.21 µg/mL and 3.86474 ± 0.35 µg/mL), respectively.The antioxidant properties of 7-hydroxy flavone were found to be (IC50) 5.5486 ± 0.81 µg/mL at a standard concentration of 50 µg.DFT, molecular docking and MD simulation results explained that 7-hydroxy flavone could be the most promising candidate to inhibit the function of anti-apoptotic Bcl-2 protein in cancerous cell.Communicated by Ramaswamy H. Sarma.
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Affiliation(s)
- A Parthiban
- National Centre for Sustainable Coastal Management, Ministry of Environment, Forest and Climate Change, Anna University Campus, Chennai, Tamil Nadu, India
| | - V Sachithanandam
- National Centre for Sustainable Coastal Management, Ministry of Environment, Forest and Climate Change, Anna University Campus, Chennai, Tamil Nadu, India
| | - P Lalitha
- National Centre for Sustainable Coastal Management, Ministry of Environment, Forest and Climate Change, Anna University Campus, Chennai, Tamil Nadu, India
| | | | - Radhakrishnan Nandini Asha
- Department of Chemistry, Pondicherry University, Puducherry, India.,Department of Chemistry, Pope's College (Autonomous), Thoothukudi, Tamil Nadu, India
| | - Thayalaraj Christopher Jeyakumar
- Department of Chemistry, Pondicherry University, Puducherry, India.,Department of Chemistry, The American College, Madurai, Tamil Nadu, India
| | - J Muthukumaran
- Department of Biotechnology, School of Engineering and Technology, Sharda University, Greater Noida, P.C, India
| | - Monika Jain
- Department of Biotechnology, School of Engineering and Technology, Sharda University, Greater Noida, P.C, India
| | | | - T Mageswaran
- National Centre for Sustainable Coastal Management, Ministry of Environment, Forest and Climate Change, Anna University Campus, Chennai, Tamil Nadu, India
| | - R Sridhar
- National Centre for Sustainable Coastal Management, Ministry of Environment, Forest and Climate Change, Anna University Campus, Chennai, Tamil Nadu, India
| | - R Purvaja
- National Centre for Sustainable Coastal Management, Ministry of Environment, Forest and Climate Change, Anna University Campus, Chennai, Tamil Nadu, India
| | - R Ramesh
- National Centre for Sustainable Coastal Management, Ministry of Environment, Forest and Climate Change, Anna University Campus, Chennai, Tamil Nadu, India
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Kathamuthu GR, Moideen K, Sridhar R, Baskaran D, Babu S. Plasma adipocytokines distinguish tuberculous lymphadenitis from pulmonary tuberculosis. Tuberculosis (Edinb) 2021; 132:102161. [PMID: 34891038 DOI: 10.1016/j.tube.2021.102161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 11/30/2021] [Accepted: 12/03/2021] [Indexed: 10/19/2022]
Abstract
Adipocytokines are the major secretory products of adipose tissue and potential markers of metabolism and inflammation. However, their association in host immune response against tuberculous lymphadenitis (TBL) disease is not known. Thus, we measured the systemic levels of adipocytokines in TBL (n = 44) and compared to pulmonary tuberculosis (PTB, n = 44) and healthy control (HC, n = 44) individuals. We also examined the pre and post-treatment adipocytokine levels in TBL individuals upon completion of standard anti-tuberculosis treatment (ATT). The receiver operating characteristics (ROC) were performed between TBL, PTB and HCs to find the potential discriminatory markers. Finally, principal component (PCA) analysis was performed to reveal the expression patterns of adipocytokines among study groups. Our results demonstrate that TBL is associated with significantly higher systemic levels of adipocytokines (except resistin) when compared with PTB and significantly lower levels when compared with HC (except adiponectin) individuals. Upon completion of ATT, the systemic levels of adiponectin and resistin were significantly decreased when compared to pre-treatment levels. Upon ROC analysis, all the three adipocytokines discriminated TBL from PTB but not with HCs, respectively. Similarly, adipocytokines were differentially clustered in TBL in comparison to PTB in PCA analysis. Therefore, adipocytokines are a distinguishing feature in TBL compared to PTB individuals.
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Affiliation(s)
- Gokul Raj Kathamuthu
- National Institutes of Health-NIRT-International Center for Excellence in Research, Chennai, India; National Institute for Research in Tuberculosis (NIRT), Chennai, India.
| | - Kadar Moideen
- National Institutes of Health-NIRT-International Center for Excellence in Research, Chennai, India
| | | | - Dhanaraj Baskaran
- National Institute for Research in Tuberculosis (NIRT), Chennai, India
| | - Subash Babu
- National Institutes of Health-NIRT-International Center for Excellence in Research, Chennai, India; Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
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Kathamuthu GR, Moideen K, Thiruvengadam K, Sridhar R, Baskaran D, Babu S. Helminth Coinfection Is Associated With Enhanced Plasma Levels of Matrix Metalloproteinases and Tissue Inhibitor of Metalloproteinases in Tuberculous Lymphadenitis. Front Cell Infect Microbiol 2021; 11:680665. [PMID: 34350132 PMCID: PMC8326810 DOI: 10.3389/fcimb.2021.680665] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 06/03/2021] [Indexed: 01/06/2023] Open
Abstract
Matrix metalloproteinases (MMPs) are crucial for tissue remodeling and repair and are expressed in diverse infections, whereas tissue inhibitors of metalloproteinases (TIMPs) are endogenous inhibitors of MMPs. However, the interaction of MMPs and TIMPs in tuberculous lymphadenitis (TBL), an extra-pulmonary form of tuberculosis (EPTB) and helminth (Hel+) coinfection is not known. Therefore, this present study investigates the levels of circulating MMPs (1, 2, 3, 7, 8, 9, 12, 13) and TIMPs (1, 2, 3, 4) in TBL individuals with helminth (Strongyloides stercoralis [Ss], hereafter Hel+) coinfection and without helminth coinfection (hereafter, Hel-). In addition, we have also carried out the regression analysis and calculated the MMP/TIMP ratios between the two study groups. We describe that the circulating levels of MMPs (except MMP-8 and MMP-12) were elevated in TBL-Hel+ coinfected individuals compared to TBL-Hel- individuals. Similarly, the systemic levels of TIMPs (1, 2, 3, 4) were increased in TBL-Hel+ compared to TBL-Hel- groups indicating that it is a feature of helminth coinfection per se. Finally, our multivariate analysis data also revealed that the changes in MMPs and TIMPs were independent of age, sex, and culture status between TBL-Hel+ and TBL-Hel- individuals. We show that the MMP-2 ratio with all TIMPs were significantly associated with TBL-helminth coinfection. Thus, our results describe how helminth infection has a profound effect on the pathogenesis of TBL and that both MMPs and TIMPs could dampen the immunity against the TBL-Hel+ coinfected individuals.
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Affiliation(s)
- Gokul Raj Kathamuthu
- National Institutes of Health-NIRT-International Center for Excellence in Research, Chennai, India.,National Institute for Research in Tuberculosis (NIRT), Chennai, India
| | - Kadar Moideen
- National Institutes of Health-NIRT-International Center for Excellence in Research, Chennai, India
| | | | | | - Dhanaraj Baskaran
- National Institute for Research in Tuberculosis (NIRT), Chennai, India
| | - Subash Babu
- National Institutes of Health-NIRT-International Center for Excellence in Research, Chennai, India.,Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States
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Kathamuthu GR, Moideen K, Sridhar R, Baskaran D, Babu S. Reduced neutrophil granular proteins and post-treatment modulation in tuberculous lymphadenitis. PLoS One 2021; 16:e0253534. [PMID: 34153068 PMCID: PMC8216526 DOI: 10.1371/journal.pone.0253534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 06/07/2021] [Indexed: 11/29/2022] Open
Abstract
Background Neutrophils are important for host innate immune defense and mediate inflammatory responses. Pulmonary tuberculosis (PTB) is associated with increased neutrophil granular protein (NGP) levels in the circulation. However, the systemic levels of neutrophil granular proteins were not examined in tuberculous lymphadenitis (TBL) disease. Methods We measured the systemic levels of NGP (myeloperoxidase [MPO], elastase and proteinase 3 [PRTN3]) in TBL and compared them to latent tuberculosis (LTB) and healthy control (HC) individuals. We also measured the pre-treatment (Pre-T) and post-treatment (Post-T) systemic levels of neutrophil granular proteins in TBL individuals upon anti-tuberculosis treatment (ATT) completion. In addition, we studied the correlation and discriminatory ability of NGPs using receiver operating characteristic (ROC) analysis. Results Our data suggests that systemic levels of NGPs (MPO, PRTN3, elastase) were significantly reduced in TBL individuals compared to LTB and HC individuals. Similarly, after ATT, the plasma levels of MPO and elastase but not PRTN3 were significantly elevated compared to pre-treatment levels. NGPs (except PRTN3) were positively correlated with absolute neutrophil count of TBL, LTB and HC individuals. Further, NGPs were able to significantly discriminate TBL from LTB and HC individuals. Conclusion Hence, we conclude reduced neutrophil granular protein levels might be associated with disease pathogenesis in TBL.
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Affiliation(s)
- Gokul Raj Kathamuthu
- National Institutes of Health-NIRT-International Center for Excellence in Research, Chennai, India
- National Institute for Research in Tuberculosis (NIRT), Chennai, India
- * E-mail:
| | - Kadar Moideen
- National Institutes of Health-NIRT-International Center for Excellence in Research, Chennai, India
| | | | - Dhanaraj Baskaran
- National Institute for Research in Tuberculosis (NIRT), Chennai, India
| | - Subash Babu
- National Institutes of Health-NIRT-International Center for Excellence in Research, Chennai, India
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
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Sachithanandam V, Lalitha P, Parthiban A, Muthukumaran J, Jain M, Misra R, Mageswaran T, Sridhar R, Purvaja R, Ramesh R. A comprehensive in silico and in vitro studies on quinizarin: a promising phytochemical derived from Rhizophora mucronata Lam. J Biomol Struct Dyn 2021; 40:7218-7229. [PMID: 33682626 DOI: 10.1080/07391102.2021.1894983] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Mangrove plants are a great source of phytomedicines, since from the beginning of human civilization and the origin of traditional medicines. In the present study, ten different mangrove leaf methanolic extracts were screened for the type of phytochemicals followed by assessing antimicrobial, anti-oxidant and anti-cancer activities. The efficient methanolic crude extract of Rhizospora mucornata was further purified and characterized for the presence of the bioactive compound. Based on UV-visible spectroscopy, FTIR, NMR and HRMS analysis, the bioactive compound was 1,4-dihydroanthraquinone; also termed as Quinizarin. This identified compound was potential in exhibiting antimicrobial, antioxidant, and cytotoxic activity. Quinizarin inhibited the growth of Bacillus cereus and Klebsiella aerogenes with minimum inhibitory concentration (MIC) of 0.78 and 1.5 mg/ml. The DPPH free radical scavenging assay revealed the maximum activity of 99.8% at the concentration of 200 µg/ml with an IC50 value of 12.67 ± 0.41 µg/ml. Cytotoxic assay against HeLa (cervical) and MDA-MB231(breast) cancer cell lines revealed IC50 values to be 4.60 ± 0.26 and 3.89 ± 0.15 µg/ml. Together the results of molecular docking and molecular dynamics simulation studies explained that Quinizarin molecule showed stronger binding affinity (-6.2 kcal/mol) and significant structural stability towards anti-apoptotic Bcl-2 protein. Thus, the study put forth the promising role of the natural molecule - Quinizarin isolated from R. mucornata in the formulation of therapeutic drugs against bacterial infections and cancer. Communicated by Ramaswamy H. Sarma.
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Affiliation(s)
- V Sachithanandam
- National Centre for Sustainable Coastal Management, Ministry of Environment, Forest and Climate Change, Anna University Campus, Chennai, India
| | - P Lalitha
- National Centre for Sustainable Coastal Management, Ministry of Environment, Forest and Climate Change, Anna University Campus, Chennai, India
| | - A Parthiban
- National Centre for Sustainable Coastal Management, Ministry of Environment, Forest and Climate Change, Anna University Campus, Chennai, India
| | - Jayaraman Muthukumaran
- Department of Biotechnology, School of Engineering and Technology, Sharda University, Greater Noida, U.P, India
| | - Monika Jain
- Department of Biotechnology, School of Engineering and Technology, Sharda University, Greater Noida, U.P, India
| | - Ranjita Misra
- Centre for Molecular and Nanomedical Sciences, International Research Centre, Sathyabama Institute of Science and Technology, Chennai, Tamil Nadu, India
| | - T Mageswaran
- National Centre for Sustainable Coastal Management, Ministry of Environment, Forest and Climate Change, Anna University Campus, Chennai, India
| | - R Sridhar
- National Centre for Sustainable Coastal Management, Ministry of Environment, Forest and Climate Change, Anna University Campus, Chennai, India
| | - R Purvaja
- National Centre for Sustainable Coastal Management, Ministry of Environment, Forest and Climate Change, Anna University Campus, Chennai, India
| | - R Ramesh
- National Centre for Sustainable Coastal Management, Ministry of Environment, Forest and Climate Change, Anna University Campus, Chennai, India
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Sridhar R, Narasimhan R, Sundararajan L, Singh R. Clinicoradiopathological features among mediastinal masses. Indian J Respir Care 2021. [DOI: 10.4103/ijrc.ijrc_48_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Kathamuthu GR, Moideen K, Sridhar R, Baskaran D, Babu S. Altered plasma levels of βC and γC chain cytokines and post-treatment modulation in tuberculous lymphadenitis. Cytokine 2020; 138:155405. [PMID: 33341600 DOI: 10.1016/j.cyto.2020.155405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 12/07/2020] [Accepted: 12/08/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Alterations in β common (βC) and γ common (γC) chain cytokines have been described in pulmonary tuberculosis. However, their role in tuberculous lymphadenitis (TBL) disease has not been assessed. METHODS Thus, in the present study, we have examined the systemic levels of βC and γC chain cytokines in TBL, latent tuberculosis (LTB) and healthy control (HC) individuals. We have examined the discriminatory potential of both family of cytokines using ROC analysis. Finally, we measured the pre and post-treatment responses of these cytokines after anti-tuberculosis treatment. RESULTS TBL individuals exhibit significantly increased (IL-3) and diminished systemic levels of (IL-5, GM-CSF) βC cytokines compared to LTB and HC individuals. TBL individuals also exhibit significantly diminished (IL-2, IL-7) and elevated (IL-4, IL-9) levels of γC cytokines compared to LTB and/or HC. ROC analysis shows a clear discriminatory capacity of both βC (IL-5) and γC (IL-2) chain cytokines to distinguish TBL from LTB and HCs. The systemic levels of βC chain cytokines were not significantly altered, but in contrast γC (IL-2 and IL-7) cytokines were significantly modulated after treatment. Finally, no significant correlation was observed for βC and γC chain cytokines with their respective lymphocyte count of TBL individuals. CONCLUSIONS Hence, we conclude that altered plasma levels of βC and γC cytokines are the characteristics of immune alteration in TBL disease and certain cytokines were modulated after treatment.
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Affiliation(s)
- Gokul Raj Kathamuthu
- National Institutes of Health-NIRT-International Center for Excellence in Research, Chennai, India; National Institute for Research in Tuberculosis (NIRT), Chennai, India.
| | - Kadar Moideen
- National Institutes of Health-NIRT-International Center for Excellence in Research, Chennai, India
| | | | - Dhanaraj Baskaran
- National Institute for Research in Tuberculosis (NIRT), Chennai, India
| | - Subash Babu
- National Institutes of Health-NIRT-International Center for Excellence in Research, Chennai, India; Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
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Sachithanandam V, Parthiban A, Lalitha P, Muthukumaran J, Jain M, Elumalai D, Jayabal K, Sridhar R, Ramachandran P, Ramachandran R. Biological evaluation of gallic acid and quercetin derived from Ceriops tagal: insights from extensive in vitro and in silico studies. J Biomol Struct Dyn 2020; 40:1490-1502. [PMID: 32996435 DOI: 10.1080/07391102.2020.1828173] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Gallic acid (PubChem CID: 370) and quercetin (PubChem CID: 5280343) are major phenolic compounds in many mangrove plants that have been related to health cure. In the present study, the active fractions namely gallic acid (1) and quercetin (2) were isolated from the methanolic extract of leaves of Ceriops tagal in a Tropical mangrove ecosystem of Andaman and Nicobar Island (ANI), India. The chemical structures were determined by spectroscopic analysis: Fourier-Transform Infrared spectroscopy (FT-IR), 1H, 13C Nuclear Magnetic Resonance (NMR) spectroscopy, and High-resolution mass spectrometry (HRMS). The anticancer activity of isolated compounds (1) and (2) were evaluated by in vitro assays against two human cancer cell lines namely, HeLa (Cervical) and MDA-MB231 (Breast) cancer cells revealed that IC50 values of gallic acid (HeLa: 4.179197 ± 0.45 µg/ml; MDA-MB231: 80.0427 ± 0.19 µg/ml at 24 h) and quercetin (HeLa: 99.914 ± 0.18 µg/ml; MDA-MB231: 18.288382 ± 0.12 µg/ml at 24 h), respectively. Antioxidant properties of gallic acid (1) and quercetin (2) are found to be IC50 value of 0.77 ± 0.41 µg/ml and 1.897 ± 0.81 µg/ml, respectively. Molecular docking results explained that gallic acid (1) and quercetin (2) showed estimated binding free energy (ΔG) of -5.4 and -6.9 kcal/mol towards drug target Bcl-B protein, respectively. The estimated inhibition constant (Ki) for these two molecules are 110 and 8.75 μM, respectively. The MD simulation additionally supported that quercetin molecule is significantly improved the structural stability of Bcl-B protein. The present study provides key insights about the importance of polyphenols, and thus leads to open the therapeutic route for anti-cancer drug discovery process.Communicated by Ramaswamy H. Sarma.
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Affiliation(s)
- V Sachithanandam
- National Centre for Sustainable Coastal Management, Ministry of Environment, Forest and Climate Change, Anna University Campus, Chennai, India
| | - A Parthiban
- National Centre for Sustainable Coastal Management, Ministry of Environment, Forest and Climate Change, Anna University Campus, Chennai, India
| | - P Lalitha
- National Centre for Sustainable Coastal Management, Ministry of Environment, Forest and Climate Change, Anna University Campus, Chennai, India
| | - Jayaraman Muthukumaran
- Department of Biotechnology, School of Engineering and Technology, Sharda University, Greater Noida, India
| | - Monika Jain
- Department of Biotechnology, School of Engineering and Technology, Sharda University, Greater Noida, India
| | | | | | - R Sridhar
- National Centre for Sustainable Coastal Management, Ministry of Environment, Forest and Climate Change, Anna University Campus, Chennai, India
| | - Purvaja Ramachandran
- National Centre for Sustainable Coastal Management, Ministry of Environment, Forest and Climate Change, Anna University Campus, Chennai, India
| | - Ramesh Ramachandran
- National Centre for Sustainable Coastal Management, Ministry of Environment, Forest and Climate Change, Anna University Campus, Chennai, India
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Kathamuthu GR, Moideen K, Sridhar R, Baskaran D, Babu S. Diminished Frequencies of Cytotoxic Marker Expressing T- and NK Cells at the Site of Mycobacterium tuberculosis Infection. Front Immunol 2020; 11:585293. [PMID: 33101317 PMCID: PMC7546427 DOI: 10.3389/fimmu.2020.585293] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 09/07/2020] [Indexed: 11/25/2022] Open
Abstract
Tuberculous lymphadenitis (TBL) individuals exhibit reduced frequencies of CD8+ T cells expressing cytotoxic markers in peripheral blood. However, the frequencies of cytotoxic marker expressing CD4+, CD8+ T cells, and NK cells at the site of infection is not known. Therefore, we measured the baseline and mycobacterial antigen specific frequencies of cytotoxic markers expressing CD4+, CD8+ T cells, and NK cells in the LN (n = 18) and whole blood (n = 10) of TBL individuals. TBL LN is associated with lower frequencies of CD4+ T cells expressing cytotoxic markers (Granzyme B, CD107a) compared to peripheral blood at baseline and in response to PPD, ESAT-6, and CFP-10 antigen stimulation. Similarly, lower frequencies of CD8+ T cells expressing cytotoxic markers (Perforin, Granzyme B, and CD107a) were also present in the TBL LN at baseline and following (except perforin) antigen stimulation. Finally, at baseline and after antigen (PPD, ESAT-6, and CFP-10) stimulation, frequencies of NK cells expressing cytotoxic markers were also significantly lower in TBL LN compared to whole blood. Hence, TBL is characterized by diminished frequencies of cytotoxic marker expressing CD4+, CD8+ T cells, and NK cells at the site of infection, which might reflect the lack of protective immune responses at the site of Mycobacterium tuberculosis infection.
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Affiliation(s)
- Gokul Raj Kathamuthu
- International Center for Excellence in Research, National Institutes of Health, National Institute for Research in Tuberculosis, Chennai, India.,National Institute for Research in Tuberculosis (NIRT), Chennai, India
| | - Kadar Moideen
- International Center for Excellence in Research, National Institutes of Health, National Institute for Research in Tuberculosis, Chennai, India
| | | | - Dhanaraj Baskaran
- National Institute for Research in Tuberculosis (NIRT), Chennai, India
| | - Subash Babu
- International Center for Excellence in Research, National Institutes of Health, National Institute for Research in Tuberculosis, Chennai, India.,Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States
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Angadi G, Murthy HNN, Sridhar R, Firdosh S, Roopa TS. Study of Mechanical and Moisture Absorption Behavior of Epoxy/Cloisite-15A Nanocomposites Processed Using Twin Screw Extruder. INT POLYM PROC 2020. [DOI: 10.3139/217.3875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Abstract
This paper presents the effect of process parameters of twin screw extruder and addition of Cloisite-15A on mechanical, thermal and moisture barrier properties of epoxy/Cloisite-15A nanocomposites. Four lobed kneading blocks were used the in shearing zone of the extruder, based on their effectiveness in dispersing nanofillers in epoxy. Screw speeds from 100 min−1 to 400 min−1, number of passes up to 15, temperature from 5°C to 80°C and Cloisite-15A contents from 1 wt.% to 2.5 wt.% were considered for designing the L12 Orthogonal Array. Improvements in tensile strength, compression strength, flexural strength, impact strength, hardness and moisture diffusivity in the nanocomposites were 11.89%, 20.06%, 27.73%, 37.26%, 25.48% and 56.22% respectively, when compared to neat epoxy. The improvements were achieved for screw speed of 400 min–1, 5 passes through the extruder, processing temperature of 5°C and 2 wt.% of Cloisite-15A. Dispersion of Cloisite-15A in epoxy was studied by XRD, SEM and TEM. Thermal stability and moisture barrier properties were superior in the nanocomposites.
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Affiliation(s)
- G. Angadi
- Department of Mechanical Engineering , RV College of Engineering, Bangalore, Karnataka , India
| | - H. N. N. Murthy
- Department of Mechanical Engineering , RV College of Engineering, Bangalore, Karnataka , India
| | - R. Sridhar
- Department of Mechanical Engineering , RV College of Engineering, Bangalore, Karnataka , India
| | - S. Firdosh
- Department of Mechanical Engineering , RV College of Engineering, Bangalore, Karnataka , India
| | - T. S. Roopa
- Department of Mechanical Engineering , RV College of Engineering, Bangalore, Karnataka , India
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Kathamuthu GR, Moideen K, Kumar NP, Sridhar R, Baskaran D, Babu S. Altered systemic levels of acute phase proteins in tuberculous lymphadenitis and modulation after treatment. PLoS One 2020; 15:e0233426. [PMID: 32470023 PMCID: PMC7259661 DOI: 10.1371/journal.pone.0233426] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 04/28/2020] [Indexed: 12/18/2022] Open
Abstract
Background Pulmonary tuberculosis (PTB) is characterized by elevated levels of acute phase proteins (APPs), but their association with tuberculous lymphadenitis (TBL) is poorly studied. Methods We examined the systemic levels of APPs (alpha-2-macroglobulin [⍺-2MG], serum amyloid A [SAA], C-reactive protein [CRP] and haptoglobin [Hp]) in TBL, PTB, latent tuberculosis (LTB) and healthy controls (HC) at baseline and in TBL after the completion of anti-tuberculosis treatment (ATT). We have also examined the association of these proteins with lymph node (LN) size, culture grade and multiple versus single LN involvement. Results TBL individuals exhibited increased systemic levels of ⍺-2MG, SAA, CRP and Hp in comparison to HCs and increased CRP levels in comparison to LTB individuals. TBL individuals also exhibited decreased systemic levels of Hp compared to PTB individuals. APPs were not significantly associated with LN size, LN involvement and culture grade, indicating a lack of association with disease severity. Following ATT, post-treatment levels of ⍺-2MG, CRP and Hp were significantly diminished compared to pre-treatment levels. Conclusion TBL disease is characterized by altered levels of APPs at baseline and modulated following treatment, indicating the presence of systemic inflammation.
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Affiliation(s)
- Gokul Raj Kathamuthu
- National Institutes of Health-NIRT-International Center for Excellence in Research, Chennai, India
- National Institute for Research in Tuberculosis (NIRT), Chennai, India
- * E-mail:
| | - Kadar Moideen
- National Institutes of Health-NIRT-International Center for Excellence in Research, Chennai, India
| | - Nathella Pavan Kumar
- National Institutes of Health-NIRT-International Center for Excellence in Research, Chennai, India
| | | | - Dhanaraj Baskaran
- National Institute for Research in Tuberculosis (NIRT), Chennai, India
| | - Subash Babu
- National Institutes of Health-NIRT-International Center for Excellence in Research, Chennai, India
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
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Kathamuthu GR, Sridhar R, Baskaran D, Babu S. Low body mass index has minimal impact on plasma levels of cytokines and chemokines in tuberculous lymphadenitis. J Clin Tuberc Other Mycobact Dis 2020; 20:100163. [PMID: 32420460 PMCID: PMC7218292 DOI: 10.1016/j.jctube.2020.100163] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Malnutrition, due to low body mass index (LBMI), is considered to be one of the key risk factors for tuberculosis (TB) development. The link between pro and anti-inflammatory cytokines and BMI has been studied in active pulmonary TB. However, the association of BMI with cytokines and chemokines in TB lymphadenitis (TBL) has not been examined. Hence, we wanted to examine the plasma levels of different cytokines and chemokines in TBL individuals with LBMI, normal BMI (NBMI) and high BMI (HBMI). LBMI with TBL disease is associated with enhanced systemic levels of type 1 (tumor necrosis factor alpha [TNFα], interleukin-2 [IL-2]) and type 2 (IL-4, IL-13) cytokines in comparison with NBMI and/or HBMI. However, other pro-inflammatory (IFNγ, IL-1β, IL-17A, IL-6, IL-7, IL-12, G-CSF, and GM-CSF) and anti-inflammatory (IL-5 and IL-10) cytokines were not significantly different among the TBL individuals with different BMI status. Likewise, no significant differences were observed in the CC (CCL-1, CCL-2/MCP-1, CCL3/MIP1α, CCL4/MIP-1β, CCL11/eotaxin) and CXC (CXCL-1/GRO-⍺, CXCL2/GRO-β, CXCL9/MIG, CXCL10/IP-10, CXCL11/ITAC 1) chemokine profile among the TBL individuals with different BMI. Hence, our data implies that TBL individuals with LBMI are characterized by minimal effects on plasma cytokines and chemokines in TBL.
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Affiliation(s)
- Gokul Raj Kathamuthu
- National Institutes of Health-NIRT-International Center for Excellence in Research, Chennai, India.,National Institute for Research in Tuberculosis, Chennai, India
| | | | | | - Subash Babu
- National Institutes of Health-NIRT-International Center for Excellence in Research, Chennai, India.,Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
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Kathamuthu GR, Munisankar S, Banurekha VV, Nair D, Sridhar R, Babu S. Filarial Coinfection Is Associated With Higher Bacterial Burdens and Altered Plasma Cytokine and Chemokine Responses in Tuberculous Lymphadenitis. Front Immunol 2020; 11:706. [PMID: 32373129 PMCID: PMC7186434 DOI: 10.3389/fimmu.2020.00706] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 03/30/2020] [Indexed: 11/13/2022] Open
Abstract
Filarial infections are known to modulate cytokine responses in pulmonary tuberculosis by their propensity to induce Type 2 and regulatory cytokines. However, very little is known about the effect of filarial infections on extra-pulmonary forms of tuberculosis. Thus, we have examined the effect of filarial infections on the plasma levels of various families of (IL-1, IL-12, γC, and regulatory) cytokines and (CC and CXC) chemokines in tuberculous lymphadenitis coinfection. We also measured lymph node culture grades in order to assess the burden of Mycobacterium tuberculosis in the two study groups [Fil+ (n = 67) and Fil– (n = 109)]. Our data reveal that bacterial burden was significantly higher in Fil+ compared to Fil– individuals. Plasma levels of IL-1 family (IL-1α, IL-β, IL-18) cytokines were significantly lower with the exception of IL-33 in Fil+ compared to Fil– individuals. Similarly, plasma levels of IL-12 family cytokines -IL-12 and IL-23 were significantly reduced, while IL-35 was significantly elevated in Fil+ compared to Fil– individuals. Filarial infection was also associated with diminished levels of IL-2, IL-9 and enhanced levels of IL-4, IL-10, and IL-1Ra. Similarly, the Fil+ individuals were linked to elevated levels of different CC (CCL-1, CCL-2, CCL-3, CCL-11) and CXC (CXCL-2, CXCL-8, CXCL-9, CXCL-11) chemokines. Therefore, we conclude that filarial infections exert powerful bystander effects on tuberculous lymphadenitis, effects including modulation of protective cytokines and chemokines with a direct impact on bacterial burdens.
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Affiliation(s)
- Gokul Raj Kathamuthu
- National Institutes of Health-NIRT-International Center for Excellence in Research, Chennai, India.,National Institute for Research in Tuberculosis (NIRT), Chennai, India
| | - Saravanan Munisankar
- National Institutes of Health-NIRT-International Center for Excellence in Research, Chennai, India
| | | | - Dina Nair
- National Institute for Research in Tuberculosis (NIRT), Chennai, India
| | | | - Subash Babu
- National Institutes of Health-NIRT-International Center for Excellence in Research, Chennai, India.,Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States.,Frederick National Laboratory for Cancer Research Sponsored by the National Cancer Institute, Frederick, MD, United States
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Kathamuthu GR, Moideen K, Sridhar R, Baskaran D, Subash Babu. Diminished systemic levels of antimicrobial peptides in tuberculous lymphadenitis and their reversal after anti-tuberculosis treatment. Tuberculosis (Edinb) 2020; 122:101934. [PMID: 32275232 DOI: 10.1016/j.tube.2020.101934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 03/09/2020] [Accepted: 03/29/2020] [Indexed: 11/26/2022]
Abstract
Pulmonary tuberculosis is associated with higher plasma levels of antimicrobial peptides (AMPs) and lower granulysin levels. However, the association of AMPs with tuberculous lymphadenitis (TBL) is not well studied. Hence, we measured the plasma levels of human beta defensin-2 (HBD2), granulysin, human neutrophil peptides 1-3 (HNP1-3) and cathelicidin (LL37) in TBL compared to latent tuberculosis (LTB) and healthy controls (HC) and in TBL individuals upon completion of anti-tuberculosis treatment (ATT). We examined the association of AMPs with TBL lymph node culture grade or lymph node involvement. Finally, the discriminatory potential of these proteins was assessed using receiver operating characteristic (ROC) analysis. TBL individuals display significantly diminished circulating levels of AMPs (granulysin and HNP1-3) but not HBD-2 and LL-37 in comparison to LTB and HCs. Similarly, after ATT, both HBD-2 and HNP1-3 were significantly elevated and LL-37 was significantly reduced in TBL individuals. Granulysin and HNP1-3 discriminates TBL from LTB and HC individuals upon ROC analysis. AMPs did not exhibit significant correlation either with lymph node culture grades or lymph node involvement. Overall, TBL individuals show decreased AMPs and their reversal after ATT suggesting their association with underlying immune alteration in this poorly studied form of TB disease.
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Affiliation(s)
- Gokul Raj Kathamuthu
- National Institutes of Health-NIRT-International Center for Excellence in Research, Chennai, India; National Institute for Research in Tuberculosis (NIRT), Chennai, India.
| | - Kadar Moideen
- National Institutes of Health-NIRT-International Center for Excellence in Research, Chennai, India
| | | | - Dhanaraj Baskaran
- National Institute for Research in Tuberculosis (NIRT), Chennai, India
| | - Subash Babu
- National Institutes of Health-NIRT-International Center for Excellence in Research, Chennai, India; Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
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Kathamuthu GR, Kumar NP, Moideen K, Nair D, Banurekha VV, Sridhar R, Baskaran D, Babu S. Matrix Metalloproteinases and Tissue Inhibitors of Metalloproteinases Are Potential Biomarkers of Pulmonary and Extra-Pulmonary Tuberculosis. Front Immunol 2020; 11:419. [PMID: 32218787 PMCID: PMC7078103 DOI: 10.3389/fimmu.2020.00419] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 02/24/2020] [Indexed: 12/20/2022] Open
Abstract
Matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinase (TIMPs) are potential regulators of tuberculosis (TB) pathology. Whether they are candidates for non-sputum-based biomarkers for pulmonary TB (PTB) and extra-pulmonary TB (EPTB) is not fully understood. Hence, to examine the association of MMPs and TIMPs with PTB and EPTB, we have measured the circulating levels of MMPs (MMP-1, 2, 3, 7, 8, 9, 12, and 13) and TIMPs (TIMP-1, 2, 3, and 4) in PTB, EPTB and compared them with latent tuberculosis (LTB) or healthy control (HC) individuals. We have also assessed their circulating levels before and after the completion of anti-tuberculosis treatment (ATT). Our data describes that systemic levels of MMP-1, 8, 9, 12 were significantly increased in PTB compared to EPTB, LTB, and HC individuals. In contrast, MMP-7 was significantly reduced in PTB compared to EPTB individuals. Likewise, the systemic levels of MMP-1, 7, 13 were significantly increased in EPTB in comparison to LTB and HC individuals. In contrast, MMP-8 was significantly reduced in EPTB individuals compared to LTB and HC individuals. In addition, the systemic levels of TIMP-1, 2, 3 were significantly diminished and TIMP-4 levels were significantly enhanced in PTB compared to EPTB, LTB, and HC individuals. The circulating levels of TIMP-2 was significantly reduced and TIMP-3 was significantly elevated in EPTB individuals in comparison with LTB and HCs. Some of the MMPs (7, 8, 9, 12, 13 in PTB and 1, 7, 8, 9 in EPTB) and TIMPs (1, 2, 3, 4 in PTB and 4 in EPTB) were significantly modulated upon treatment completion. ROC analysis showed that MMP-1, 9 and TIMP-2, 4 could clearly discriminate PTB from EPTB, LTB and HCs and MMP-13 and TIMP-2 could clearly discriminate EPTB from LTB and HCs. Additionally, multivariate analysis also indicated that these alterations were independent of age and sex in PTB and EPTB individuals. Therefore, our data demonstrates that MMPs and TIMPs are potential candidates for non-sputum-based biomarkers for differentiating PTB and EPTB from LTB and HC individuals.
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Affiliation(s)
- Gokul Raj Kathamuthu
- National Institute for Research in Tuberculosis, National Institute of Health, International Center for Excellence in Research, Chennai, India.,National Institute for Research in Tuberculosis (NIRT), Chennai, India
| | - Nathella Pavan Kumar
- National Institute for Research in Tuberculosis, National Institute of Health, International Center for Excellence in Research, Chennai, India
| | - Kadar Moideen
- National Institute for Research in Tuberculosis, National Institute of Health, International Center for Excellence in Research, Chennai, India
| | - Dina Nair
- National Institute for Research in Tuberculosis (NIRT), Chennai, India
| | | | | | - Dhanaraj Baskaran
- National Institute for Research in Tuberculosis (NIRT), Chennai, India
| | - Subash Babu
- National Institute for Research in Tuberculosis, National Institute of Health, International Center for Excellence in Research, Chennai, India.,Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States
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Affiliation(s)
- R. Sridhar
- Division of Nephrology and Hypertension Department of Internal Medicine University of Cincinnati Medical Center 5502 MSB, 231 Bethesday Avenue Cincinnati, Ohio 45267-0585
| | - D. Thornley-Brown
- Division of Nephrology and Hypertension Department of Internal Medicine University of Cincinnati Medical Center 5502 MSB, 231 Bethesday Avenue Cincinnati, Ohio 45267-0585
| | - R. Shashi Rant
- Division of Nephrology and Hypertension Department of Internal Medicine University of Cincinnati Medical Center 5502 MSB, 231 Bethesday Avenue Cincinnati, Ohio 45267-0585
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Velayutham B, Jawahar MS, Nair D, Navaneethapandian P, Ponnuraja C, Chandrasekaran K, Narayan Sivaramakrishnan G, Makesh Kumar M, Paul Kumaran P, Ramesh Kumar S, Baskaran D, Bella Devaleenal D, Sirasanambati DR, Vasantha M, Palaniyandi P, Ramachandran G, Uma Devi KR, Elizabeth Hannah L, Sekar G, Radhakrishnan A, Kalaiselvi D, Dhanalakshmi A, Thiruvalluvan E, Raja Sakthivel M, Mahilmaran A, Sridhar R, Jayabal L, Rathinam P, Angamuthu P, Soorappa Ponnusamy K, Venkatesan P, Natrajan M, Prasad Tripathy S, Swaminathan S. 4‐month moxifloxacin containing regimens in the treatment of patients with sputum‐positive pulmonary tuberculosis in South India – a randomised clinical trial. Trop Med Int Health 2020; 25:483-495. [DOI: 10.1111/tmi.13371] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | | | - Dina Nair
- ICMR‐ National Institute for Research in Tuberculosis Chennai India
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Gomathi Sekar
- ICMR‐ National Institute for Research in Tuberculosis Chennai India
| | | | | | | | | | | | | | | | | | | | | | | | | | - Mohan Natrajan
- ICMR‐ National Institute for Research in Tuberculosis Chennai India
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Chan H, Ooi G, Sridhar R, Low I, Lim S, Bagdasarian N. Measles in an Open Ward. J Infect Public Health 2020. [DOI: 10.1016/j.jiph.2020.01.127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Kathamuthu GR, Moideen K, Sridhar R, Baskaran D, Babu S. Enhanced Mycobacterial Antigen-Induced Pro-Inflammatory Cytokine Production in Lymph Node Tuberculosis. Am J Trop Med Hyg 2020; 100:1401-1406. [PMID: 30994092 DOI: 10.4269/ajtmh.18-0834] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Lymph node tuberculosis (LNTB) is characterized by the enhanced baseline and antigen-specific production of type 1/17 cytokines and reduced baseline and antigen-specific production of interleukin (IL)-1β and IL-18 at the site of infection when compared with peripheral blood. However, the cytokine profile in the lymph nodes (LNs) of Mycobacterium tuberculosis culture-positive LNTB (LNTB+) and negative LNTB (LNTB-) has not been examined. To address this, we have examined the baseline and mycobacterial antigen-stimulated cytokine levels of type 1 (interferon gamma [IFNγ], tumor necrosis factor alpha [TNFα], IL-2), type 2 (IL-4, IL-5, and IL-13), type 17 (IL-17A, IL-17F, and IL-22), pro-inflammatory (IL-1α, IL-1β, IL-18, and granulocyte macrophage colony-stimulating factor [GM-CSF]), and regulatory cytokines (IL-10, transforming growth factor beta [TGF-β]) cytokines in the LN culture supernatants of LNTB+ and LNTB- individuals. We have observed significantly enhanced baseline levels of IL-13 and IL-10 and significantly reduced baseline levels of IL-4 and GM-CSF in LNTB+ individuals compared with LNTB- individuals. By contrast, we have observed significantly enhanced levels of type 1 (IFNγ, TNFα, and IL-2), type 17 (IL-17F and IL-22), and pro-inflammatory (IL-1α and GM-CSF) cytokines and significantly reduced levels of TGFβ in response to purified protein derivative, early secreted antigen-6, and culture filtrate protein-10 antigens in LNTB+ compared with LNTB- individuals. On phorbol 12-myristate 13-acetate/ionomycin stimulation, no significant difference was observed for any of the cytokines examined. Thus, our study revealed several interesting differences in the cytokine profiles of mycobacterial antigen-stimulated LN cultures in LNTB+ and LNTB- individuals. Therefore, we suggest the presence of mycobacteria plays a significant role in driving the cytokine response at the site of infection in LNTB.
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Affiliation(s)
- Gokul Raj Kathamuthu
- National Institute for Research in Tuberculosis (NIRT), Chennai, India.,National Institutes of Health, National Institute for Research in Tuberculosis (NIRT), International Center for Excellence in Research, Chennai, India
| | - Kadar Moideen
- National Institutes of Health, National Institute for Research in Tuberculosis (NIRT), International Center for Excellence in Research, Chennai, India
| | | | - Dhanaraj Baskaran
- National Institute for Research in Tuberculosis (NIRT), Chennai, India
| | - Subash Babu
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland.,National Institutes of Health, National Institute for Research in Tuberculosis (NIRT), International Center for Excellence in Research, Chennai, India
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Sachithanandam V, Lalitha P, Parthiban A, Mageswaran T, Manmadhan K, Sridhar R. A Review on Antidiabetic Properties of Indian Mangrove Plants with Reference to Island Ecosystem. Evid Based Complement Alternat Med 2019; 2019:4305148. [PMID: 31885647 PMCID: PMC6915161 DOI: 10.1155/2019/4305148] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 07/18/2019] [Accepted: 08/22/2019] [Indexed: 01/19/2023]
Abstract
Mangrove ecosystem has many potential species that are traditionally used by the coastal communities for their traditional cure for health ailments as evidenced by their extensive uses to treat hepatic disorders, diabetes, gastrointestinal disorders, anti-inflammation, anticancer, and skin diseases, etc. In recent times, the diabetes mellitus (DM), a serious physiological disorder all over the world, occur due to the relative or complete deficiency of insulin in the body, characterized by an abnormally high blood glucose level. India has a rich traditional knowledge on plant-based drug formulations that are protective and curative for many health ailments. In this context, we aimed to compile the works done on the antidiabetic activities of mangrove species from Indian coastal regions especially on Andaman and Nicobar Islands as well as some recent works reported from other countries. A total of 126 published articles and 31 mangrove species related pieces of information were gathered with reference to antidiabetic properties of mangroves. This review summarizes the chemical structures, molecular formula, molecular weight, and their biological activities with an aspiration that it might be helpful for the future bioprospecting industries who are interested in develop the natural drugs for DM.
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Affiliation(s)
- V. Sachithanandam
- Integrated Island Management Unit, Futuristic Research Division, National Centre for Sustainable Coastal Management, Ministry of Environment, Forests & Climate Change, Government of India, Chennai, Tamil Nadu 600025, India
| | - P. Lalitha
- Integrated Island Management Unit, Futuristic Research Division, National Centre for Sustainable Coastal Management, Ministry of Environment, Forests & Climate Change, Government of India, Chennai, Tamil Nadu 600025, India
| | - A. Parthiban
- Integrated Island Management Unit, Futuristic Research Division, National Centre for Sustainable Coastal Management, Ministry of Environment, Forests & Climate Change, Government of India, Chennai, Tamil Nadu 600025, India
| | - T. Mageswaran
- Integrated Island Management Unit, Futuristic Research Division, National Centre for Sustainable Coastal Management, Ministry of Environment, Forests & Climate Change, Government of India, Chennai, Tamil Nadu 600025, India
| | - K. Manmadhan
- Integrated Island Management Unit, Futuristic Research Division, National Centre for Sustainable Coastal Management, Ministry of Environment, Forests & Climate Change, Government of India, Chennai, Tamil Nadu 600025, India
| | - R. Sridhar
- Integrated Island Management Unit, Futuristic Research Division, National Centre for Sustainable Coastal Management, Ministry of Environment, Forests & Climate Change, Government of India, Chennai, Tamil Nadu 600025, India
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Hariharan NC, Muthukumar R, Sridhar R, Shankari B, Valarmathy VS. Ideal Flap Cover for the Salvage of Exposed/Infected Cochlear Implants: A Case Series and Literature Review. Indian J Otolaryngol Head Neck Surg 2019; 72:292-296. [PMID: 32728537 DOI: 10.1007/s12070-019-01764-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 11/08/2019] [Indexed: 12/01/2022] Open
Abstract
With an increase in the number of cochlear implant surgeries there is bound to be an increase in the number of complications. A dreaded problem in any implant procedure is the implant exposure and infection. Explantation of the implant leads to an unpleasant situation to the patient and the surgeon owing to the high cost of the device. There are reports in the literature favouring the mandatory relocation or removal of the infected implants. On the other hand, there are convincing reports of implant salvage using skin, muscle or fascial flaps. In this paper we have analysed a series of cases referred to us from the departments of E.N.T for the management of implant exposure/infection. We have also reviewed similar case series reported in the literature. From 2014 to 2017 we operated six cases of exposed cochlear implant. We salvaged the implant in five cases, where we could do two layer coverage consisting of the inner temporoparietal fascial flap and outer scalp skin flap. In one case where the temporoparietal fascial flap could not be done as superficial temporal vessels were found to be injured in the previous surgery, the implant was removed due to persistent infection. All these cases were administered appropriate antibiotics for a minimum period of 3 weeks. Early double layer closure with inner temporoparietal fascial flap and outer scalp rotation flap coupled with appropriate antibiotics can salvage an infected, exposed implant.
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Affiliation(s)
- N C Hariharan
- Department of Plastic Surgery, Institute of Non Communicable Diseases and Govt. Royapettah Hospital, V-1, Sri Mahalakshmi Enclave, 24, Gandhi Road, Gill Nagar, Chennai, 600014 India
| | - R Muthukumar
- Upgraded Institute of Otorhinolaryngology, Madras Medical College, Chennai, India
| | - R Sridhar
- Department of Plastic Surgery, Institute of Non Communicable Diseases and Govt. Royapettah Hospital, V-1, Sri Mahalakshmi Enclave, 24, Gandhi Road, Gill Nagar, Chennai, 600014 India
| | - B Shankari
- Department of Plastic Surgery, Institute of Non Communicable Diseases and Govt. Royapettah Hospital, V-1, Sri Mahalakshmi Enclave, 24, Gandhi Road, Gill Nagar, Chennai, 600014 India
| | - V S Valarmathy
- Department of Hand and Reconstructive Micro Surgery, Tamilnadu Govt. Multi Super Specialty Hospital, Anna Salai, Chennai, 600001 India
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Babu H, Ambikan AT, Gabriel EE, Svensson Akusjärvi S, Palaniappan AN, Sundaraj V, Mupanni NR, Sperk M, Cheedarla N, Sridhar R, Tripathy SP, Nowak P, Hanna LE, Neogi U. Systemic Inflammation and the Increased Risk of Inflamm-Aging and Age-Associated Diseases in People Living With HIV on Long Term Suppressive Antiretroviral Therapy. Front Immunol 2019; 10:1965. [PMID: 31507593 PMCID: PMC6718454 DOI: 10.3389/fimmu.2019.01965] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 08/05/2019] [Indexed: 12/19/2022] Open
Abstract
The ART program in low- and middle-income countries (LMIC) like India, follows a public health approach with a standardized regimen for all people living with HIV (PLHIV). Based on the evidence from high-income countries (HIC), the risk of an enhanced, and accentuated onset of premature-aging or age-related diseases has been observed in PLHIV. However, very limited data is available on residual inflammation and immune activation in the populations who are on first-generation anti-HIV drugs like zidovudine and lamivudine that have more toxic side effects. Therefore, the aim of the present study was to evaluate the levels of systemic inflammation and understand the risk of age-associated diseases in PLHIV on long-term suppressive ART using a large number of biomarkers of inflammation and immune activation. Blood samples were obtained from therapy naïve PLHIV (Pre-ART, n = 43), PLHIV on ART for >5 years (ART, n = 53), and HIV-negative healthy controls (HIVNC, n = 41). Samples were analyzed for 92 markers of inflammation, sCD14, sCD163, and telomere length. Several statistical tests were performed to compare the groups under study. Multivariate linear regression was used to investigate the associations. Despite a median duration of 8 years of successful ART, sCD14 (p < 0.001) and sCD163 (p = 0.04) levels continued to be significantly elevated in ART group as compared to HIVNC. Eleven inflammatory markers, including 4E-BP1, ADA, CCL23, CD5, CD8A, CST5, MMP1, NT3, SLAMF1, TRAIL, and TRANCE, were found to be significantly different (p < 0.05) between the groups. Many of these markers are associated with age-related co-morbidities including cardiovascular disease, neurocognitive decline and some of these markers are being reported for the first time in the context of HIV-induced inflammation. Linear regression analysis showed a significant negative association between HIV-1-positivity and telomere length (p < 0.0001). In ART-group CXCL1 (p = 0.048) and TGF-α (p = 0.026) showed a significant association with the increased telomere length and IL-10RA was significantly associated with decreased telomere length (p = 0.042). This observation warrants further mechanistic studies to generate evidence to highlight the need for enhanced treatment monitoring and special interventions in HIV-infected individuals.
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Affiliation(s)
- Hemalatha Babu
- Department of HIV/AIDS, National Institute for Research in Tuberculosis (ICMR), Chennai, India
- Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Anoop T. Ambikan
- Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Erin E. Gabriel
- Department of Medical Epidemiology and Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Sara Svensson Akusjärvi
- Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | | | - Naveen Reddy Mupanni
- Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Maike Sperk
- Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Narayanaiah Cheedarla
- Department of HIV/AIDS, National Institute for Research in Tuberculosis (ICMR), Chennai, India
| | | | - Srikanth P. Tripathy
- Department of HIV/AIDS, National Institute for Research in Tuberculosis (ICMR), Chennai, India
| | - Piotr Nowak
- Unit of Infectious Diseases, Department of Medicine Huddinge, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Luke Elizabeth Hanna
- Department of HIV/AIDS, National Institute for Research in Tuberculosis (ICMR), Chennai, India
| | - Ujjwal Neogi
- Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
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Kathamuthu GR, Kumar NP, Moideen K, Sridhar R, Baskaran D, Babu S. Diminished type 1 and type 17 cytokine expressing - Natural killer cell frequencies in tuberculous lymphadenitis. Tuberculosis (Edinb) 2019; 118:101856. [PMID: 31430696 DOI: 10.1016/j.tube.2019.101856] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 07/29/2019] [Accepted: 08/05/2019] [Indexed: 10/26/2022]
Abstract
Tuberculous lymphadenitis (TBL) is associated with the expansion of CD4+ and CD8+ T cells expressing Type 1 and Type 17 cytokines in the peripheral blood. However, the expression pattern of cytokine producing natural killer (NK) cells in both the peripheral blood and affected lymph nodes i.e. site of infection in TBL have not been examined. Hence, we have analyzed the baseline and mycobacterial antigen specific NK cell cytokine frequencies in whole blood of TBL and pulmonary tuberculosis (PTB) individuals. We have also examined the NK cell frequencies before and after treatment completion and in peripheral blood versus affected lymph nodes (LN) of TBL individuals. TBL is characterized by diminished frequencies of NK cells expressing Type 1 (IFNγ, TNFα), Type 17 (IL-17F) cytokines compared to PTB individuals upon antigen-specific stimulation. In contrast, TBL individuals did not exhibit any significant differences in the frequencies of NK cells expressing Type 1 and Type 17 cytokines upon completion of anti-tuberculosis treatment. LN of TBL is associated with altered frequencies of NK cells expressing Type 17 (increased IL-17F and decreased IL-22) cytokines when compared to peripheral blood. Thus, we conclude that TBL individuals are characterized by diminished frequencies of NK cells expressing Type 1/Type 17 cytokines.
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Affiliation(s)
- Gokul Raj Kathamuthu
- National Institutes of Health-NIRT-International Center for Excellence in Research, Chennai, India; National Institute for Research in Tuberculosis (NIRT), Chennai, India.
| | - Nathella Pavan Kumar
- National Institutes of Health-NIRT-International Center for Excellence in Research, Chennai, India
| | - Kadar Moideen
- National Institutes of Health-NIRT-International Center for Excellence in Research, Chennai, India
| | | | - Dhanaraj Baskaran
- National Institute for Research in Tuberculosis (NIRT), Chennai, India
| | - Subash Babu
- National Institutes of Health-NIRT-International Center for Excellence in Research, Chennai, India; Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
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Natrajan M, Sridhar R, Narendran G, Ramachandran G, Kumar VV, Tripathy S. Crusade for TB: Bringing Treatment to Masses at their Doorsteps. Indian J Med Res 2019; 149:S89-S93. [PMID: 31070184 PMCID: PMC6515743 DOI: 10.4103/0971-5916.251664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Mohan Natrajan
- ICMR - National Institute For Research in Tuberculosis (ICMR - NIRT), Chennai, India
| | | | - Gopalan Narendran
- ICMR - National Institute For Research in Tuberculosis (ICMR - NIRT), Chennai, India
| | - Geetha Ramachandran
- ICMR - National Institute For Research in Tuberculosis (ICMR - NIRT), Chennai, India
| | | | - Srikanth Tripathy
- ICMR - National Institute For Research in Tuberculosis (ICMR - NIRT), Chennai, India
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Kathamuthu GR, Munisankar S, Sridhar R, Baskaran D, Babu S. Helminth mediated modulation of the systemic and mycobacterial antigen - stimulated cytokine profiles in extra-pulmonary tuberculosis. PLoS Negl Trop Dis 2019; 13:e0007265. [PMID: 30897083 PMCID: PMC6445485 DOI: 10.1371/journal.pntd.0007265] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 04/02/2019] [Accepted: 02/26/2019] [Indexed: 11/18/2022] Open
Abstract
Background Helminth infections are known to regulate cytokine responses in both pulmonary and latent tuberculosis infection. Whether helminth infections also modulate cytokine responses in extra-pulmonary tuberculosis, specifically tuberculous lymphadenitis (TBL), has not been examined thus far. Methodology Hence, to determine the cytokine profile in helminth-TBL coinfection, we measured the systemic and mycobacterial (TB)–antigen stimulated levels of Type 1, Type 2, Type 17, regulatory and pro-inflammatory cytokines in TBL individuals coinfected with or without Strongyloides stercoralis (Ss) infection. Significant findings TBL-Ss+ individuals have significantly higher bacterial burdens in the affected lymph nodes in comparison to TBL-Ss- individuals. TBL-Ss+ individuals exhibit significantly enhanced plasma levels of Type 2 (IL-5 and IL-13), Type 17 (IL-17 and IL-22) and regulatory (IL-10) cytokines in comparison to TBL-Ss- individuals. In contrast, TBL-Ss+ individuals exhibit significantly diminished plasma levels of pro-inflammatory cytokines (IL-1α and GM-CSF) in comparison to TBL-Ss- individuals. TBL-Ss+ individuals also exhibit significantly diminished unstimulated or mycobacterial—antigen stimulated levels of Type 1, Type 17 or IL-1 family cytokines in comparison to TBL-Ss- individuals but no differences in mitogen stimulated cytokine levels. Conclusion Therefore, our data reveal a profound influence of Ss infection on the bacteriological profile of TBL and suggesting that the underlying modulation of cytokine responses might be a mechanism by which this helminth infection could impart a detrimental effect on the pathogenesis of TBL disease. Strongyloides stercoralis (Ss) infects about 30–100 million people worldwide and it is the main causative agent of strongyloidiasis, a chronic parasitic infection. Similarly, tuberculosis (TB) affects nearly 2 billion people and both Ss and TB are co-endemic as well as share a major global disease burden. Earlier studies have revealed that helminth co-infection can modify the effect produced by the host immunity against Mycobacterium tuberculosis. However, no studies have examined the association of helminth co-infection with extra-pulmonary TB, especially in tuberculous lymphadenitis (TBL). In the present study, we have addressed this gap by measuring the cytokine profile in co-infected helminth-TBL individuals. Our study first shows that TBL-Ss+ co-infection is associated with “higher bacterial burden” in the affected lymph nodes. Our study also shows that co-infection is associated with alterations in plasma cytokines, specifically Type 2, regulatory and Type 17 cytokines were elevated and pro-inflammatory cytokines were reduced. Our study demonstrates significantly diminished unstimulated or TB—antigen stimulated levels of Type 1, Type 17 or IL-1 family of cytokines in TBL-Ss+ coinfected individuals. Hence, we conclude that helminth coinfection can possibly skew the protective immunity in TBL disease or infection.
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Affiliation(s)
- Gokul Raj Kathamuthu
- National Institutes of Health-NIRT-International Center for Excellence in Research, Chennai, India
- National Institute for Research in Tuberculosis (NIRT), Chennai, India
- * E-mail:
| | - Saravanan Munisankar
- National Institutes of Health-NIRT-International Center for Excellence in Research, Chennai, India
| | | | - Dhanaraj Baskaran
- National Institute for Research in Tuberculosis (NIRT), Chennai, India
| | - Subash Babu
- National Institutes of Health-NIRT-International Center for Excellence in Research, Chennai, India
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
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Kathamuthu GR, Moideen K, Banurekha VV, Nair D, Sridhar R, Baskaran D, Babu S. Altered circulating levels of B cell growth factors and their modulation upon anti-tuberculosis treatment in pulmonary tuberculosis and tuberculous lymphadenitis. PLoS One 2018; 13:e0207404. [PMID: 30427928 PMCID: PMC6235371 DOI: 10.1371/journal.pone.0207404] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 10/30/2018] [Indexed: 11/23/2022] Open
Abstract
B cell activating factor/a proliferation-inducing ligand (BAFF/APRIL) are members of the tumor necrosis factor alpha (TNF) α family of ligands, which are essential for B cell survival, development, and modulation of the immune system. To examine the association of circulating levels of BAFF and APRIL with pulmonary tuberculosis (PTB) and tuberculous lymphadenitis (TBL), we measured the systemic levels of APRIL and BAFF in individuals with PTB, TBL, latent tuberculosis (LTB) and healthy controls (HC). Further, we also examined the pre and post-treatment plasma levels of above-mentioned parameters in PTB and TBL individuals upon completion of anti-TB chemotherapy. Next, the association of these cytokines either with extent of disease, disease severity, bacterial burden in PTB and lymph node culture grade or the lymph node size in TBL was also assessed. Finally, ROC analysis was performed to examine the discrimination capacity of APRIL and BAFF between PTB or TBL with LTB. Our study revealed significantly diminished plasma levels of APRIL in PTB and higher plasma levels of BAFF in both PTB and TBL individuals compared to LTB and HC. Furthermore, we observed a significant increase in APRIL levels in TBL and significantly decreased plasma levels of BAFF in both PTB and TBL after the completion of successful anti-TB treatment. There was no statistically positive relationship between BAFF and APRIL levels and the extent of disease, disease severity and bacterial burden in PTB. In TBL, there was a significant correlation between APRIL (but not BAFF) levels with lymph node culture grades. In contrast, APRIL in PTB and BAFF in TBL were able to clearly discriminate from LTB in ROC analysis. In summary, our results showed altered levels of BAFF/APRIL and their modulation upon chemotherapy, suggesting that these cytokines might be involved in the immune-modulation of TB infection.
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Affiliation(s)
- Gokul Raj Kathamuthu
- National Institutes of Health-NIRT-International Center for Excellence in Research, Chennai, India
- National Institute for Research in Tuberculosis (NIRT), Chennai, India
- * E-mail:
| | - Kadar Moideen
- National Institutes of Health-NIRT-International Center for Excellence in Research, Chennai, India
| | | | - Dina Nair
- National Institute for Research in Tuberculosis (NIRT), Chennai, India
| | - R. Sridhar
- Government Stanley Medical Hospital, Chennai, India
| | - Dhanaraj Baskaran
- National Institute for Research in Tuberculosis (NIRT), Chennai, India
| | - Subash Babu
- National Institutes of Health-NIRT-International Center for Excellence in Research, Chennai, India
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
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Sridhar R. Annual Review of Phytopathology, 2016. CURR SCI INDIA 2018. [DOI: 10.18520/cs/v114/i07/1557-1559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Amith V, Sridhar R, Angadi G, Prajwal D, Mamatha V, Narasimha Murthy H. Development of Electrospinning System for Synthesis of Polyvinylpyrrolidone Thin Films for Sensor Applications. ACTA ACUST UNITED AC 2018. [DOI: 10.1016/j.matpr.2018.06.480] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Thangapandiyan M, Balachandran C, Preetha SP, Mohanapriya T, Nivethitha R, Pavithra S, Sridhar R. Gross, histopathological and immunohistochemical study on strobilocercus of Taenia taeniaeformis infection in the liver of laboratory rats (Rattus norvegicus) in India. Vet Parasitol Reg Stud Reports 2017; 10:35-38. [PMID: 31014595 DOI: 10.1016/j.vprsr.2017.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 01/27/2017] [Accepted: 07/14/2017] [Indexed: 11/15/2022]
Abstract
We report the detailed gross, histopathological and immunohistochemical study of Strobilocercus fasciolaris infection, the metacestodal stage of Taenia taeniaeformis, in the liver of laboratory Wistar rats. Necropsy examination of seventeen rats revealed transparent or white or cream to clear, thick walled cysts, 1 to 97 in number, measuring about 2mm to 12mm on one or many of the liver lobes and containing strobilocercus of Taenia taeniaeformis. Histopathological examination revealed the presence of the cross-section of larva surrounded by a thick fibrous capsule and moderate infiltration of lymphocytes, plasma cells and a few eosinophils. Fatty degeneration of hepatocytes, gastric mucosal hyperplasia, distended gastric glands and marked increase in the mucosal epithelial cells and goblet cells in the duodenum were also observed. Contamination of feed and bedding materials seems to be the probable source in these naturally infected rats.
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Affiliation(s)
- M Thangapandiyan
- Department of Veterinary Pathology, Madras Veterinary College, TANUVAS, Chennai 600 007, India.
| | - C Balachandran
- Department of Veterinary Pathology, Madras Veterinary College, TANUVAS, Chennai 600 007, India
| | - S P Preetha
- Department of Veterinary Pharmacology and Toxicology, Madras Veterinary College, TANUVAS, Chennai 600 007, India
| | - T Mohanapriya
- Department of Veterinary Pathology, Madras Veterinary College, TANUVAS, Chennai 600 007, India
| | - R Nivethitha
- Department of Veterinary Pathology, Madras Veterinary College, TANUVAS, Chennai 600 007, India
| | - S Pavithra
- Department of Veterinary Pharmacology and Toxicology, Madras Veterinary College, TANUVAS, Chennai 600 007, India
| | - R Sridhar
- Department of Veterinary Pathology, Madras Veterinary College, TANUVAS, Chennai 600 007, India
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Ananda Raja R, Sridhar R, Balachandran C, Palanisammi A, Ramesh S, Nagarajan K. Pathogenicity profile of Vibrio parahaemolyticus in farmed Pacific white shrimp, Penaeus vannamei. Fish Shellfish Immunol 2017; 67:368-381. [PMID: 28606862 DOI: 10.1016/j.fsi.2017.06.020] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Revised: 05/31/2017] [Accepted: 06/05/2017] [Indexed: 06/07/2023]
Abstract
A pathobiological study was conducted using Vibrio parahaemolyticus (VP) strain isolated from vibriosis affected shrimp (Penaeus vannamei) farms in Kancheepuram and Thiruvallur districts of Tamil Nadu during August 2014 to February 2015. The isolate was identified based on the morphological, physiological, biochemical and molecular characters. LD50 value with intramuscular injection was determined as 2.6 × 104 cfu/shrimp and sequential pathology was studied giving 6.1 × 103 cfu/shrimp (LD25). Total plate count (TPC) and total Vibrio count (TVC) in water, pond sediment, haemolymph, muscle, HP and gut were found significantly (P < 0.01) higher in natural cases than the experimental set up. Clinical signs and lesions observed in the natural and experimental cases were anorexia, lethargy, cuticle softening, loose shells, abdominal muscle cramp, red discoloration, opaque and whitish abdominal and tail musculature, necrosis of exoskeleton or splinter burns, reddish pleural borders of antennae, uropods and telson, swollen tail fan, ulcers, moribund shrimp sinking to bottom, and mortalities with shrunken discoloured HP with empty gut. Total haemocyte count (THC), small nongranular haemocyte (SNGH), large nongranular haemocyte (LNGH), small granular haemocyte (SGH) and large granular haemocyte (LGH) counts lowered significantly (P < 0.01) at 3, 6, 12, 24, 48, 96 and 192 h post injection (p.i). No LGH were found after 96 h of challenge. The post injection qPCR analyses of haemocytes showed up-regulations of penaeidin-3a, lysozyme, prophenoloxidase I, prophenoloxidase II and serine protein at 3 and 6 h of infection. There was total down-regulation of crustin from 3 to 192 h p.i. There was a remarkable elevation in the level of proPO I with concomitant depletion of proPO II. The pattern of up- and down-regulations in proPO I and SP were similar. The post infection qPCR analyses showed that these immune related genes could be used as markers for assessing the immune status of P. vannamei. Major histopathological manifestations observed were haemocyte infiltration/nodule in the epidermis, skeletal and cardiac muscles, atrophy of the excretory organ, and disrupted HP tubules with diffuse interstitial edema and haemocytic infiltration. Further HP showed that there was thickening of intertubular space, karyomegaly with prominent nucleoli, rounding and sloughing of HP tubular epithelium, many mitotic figures with bacterial colonies and apoptotic bodies, separation of shrunken tubule epithelium from myoepithelial fibers, regeneration of tubules, cystic, dilated and vacuolated appearance of HP tubules, hypoplastic changes in the tubules with no B, R and F cells, granuloma formation, concretions in tubules, calcification, necrosis, and washed out appearance with complete loss of architecture. The progression of the degenerative changes in the HP tubular epithelial cells was from proximal to distal end. In haematopoietic organ, increased mitotic activities with focal to extensive depletion and degeneration were observed. Degeneration of the stromal matrix with spheroid formation in lymphoid organ was observed among the Vp infected natural and experimental animals. Degeneration of glandular structures in the prehensile appendages with bacterial colonies, melanization and loss of epithelial layer in oesophagus, swelling and loss of architecture with mucinous secretion in the stomach, degeneration of peritrophic membrane in the lumen of intestine were observed in field cases but not in the experimental studies. Further, this study established the pathobiology of the Vp isolate to P. vannamei.
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Affiliation(s)
- R Ananda Raja
- Department of Veterinary Pathology, Madras Veterinary College, Chennai, 600 007, India; Aquatic Animal Health and Environment Division, ICAR-Central Institute of Brackishwater Aquaculture, Chennai, 600 028, India.
| | - R Sridhar
- Department of Veterinary Pathology, Madras Veterinary College, Chennai, 600 007, India
| | - C Balachandran
- Department of Veterinary Pathology, Madras Veterinary College, Chennai, 600 007, India
| | - A Palanisammi
- Department of Animal Biotechnology, Madras Veterinary College, Chennai, 600 007, India
| | - S Ramesh
- Laboratory Animal Medicine, Centre for Animal Health Studies, TANUVAS, Madhavaram Milk Colony, Chennai, 600 051, India
| | - K Nagarajan
- Department of Veterinary Pathology, Madras Veterinary College, Chennai, 600 007, India
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Hou Y, Sridhar R, Chan H, Chiu L, Lee C, Tambyah P, Fisher D, Bagdasarian N. The Zika outbreak: An overview of suspected Zika cases presenting at a tertiary hospital in Singapore. Int J Infect Dis 2016. [DOI: 10.1016/j.ijid.2016.11.305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Sridhar R, Jeevananthan S, Dash SS, Vishnuram P. A new maximum power tracking in PV system during partially shaded conditions based on shuffled frog leap algorithm. J EXP THEOR ARTIF IN 2016. [DOI: 10.1080/0952813x.2016.1186750] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Pavan Kumar N, Nair D, Banurekha VV, Dolla C, Kumaran P, Sridhar R, Babu S. Type 2 diabetes mellitus coincident with pulmonary or latent tuberculosis results in modulation of adipocytokines. Cytokine 2016; 79:74-81. [PMID: 26771473 PMCID: PMC4729624 DOI: 10.1016/j.cyto.2015.12.026] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Revised: 12/28/2015] [Accepted: 12/29/2015] [Indexed: 12/15/2022]
Abstract
Type 2 diabetes mellitus (T2DM) is recognized as major risk factor for the progress of active pulmonary tuberculosis (PTB), although the mechanistic link between diabetes and tuberculosis remains poorly characterized. Moreover, the influence of poorly controlled diabetes on the baseline levels of adipocytokines in the context of tuberculosis has not been explored in detail. To characterize the influence of coexistent DM on adipocytokine levels in pulmonary or latent TB (LTB), we examined circulating levels of adipocytokines in the plasma of individuals with PTB-DM or LTB-DM and compared them with those without DM (PTB or LTB). PTB-DM or LTB-DM is characterized by diminished circulating levels of adiponectin and adipsin and/or heightened circulating levels of leptin, visfatin and PAI-1. In addition, adiponectin and adipsin exhibit a significant negative correlation, whereas leptin, visfatin and PAI-1 display a significant positive correlation with HbA1C levels and random blood glucose levels. Therefore, our data reveal that PTB-DM or LTB-DM is characterized by alterations in the systemic levels of adipocytokines, indicating that altered adipose tissue inflammation underlying Type 2 diabetes potentially contributes to pathogenesis of TB disease.
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Affiliation(s)
- Nathella Pavan Kumar
- National Institutes of Health-International Center for Excellence in Research, Chennai, India; National Institute for Research in Tuberculosis, Chennai, India.
| | - Dina Nair
- National Institute for Research in Tuberculosis, Chennai, India
| | - V V Banurekha
- National Institute for Research in Tuberculosis, Chennai, India
| | | | - Paul Kumaran
- National Institute for Research in Tuberculosis, Chennai, India
| | | | - Subash Babu
- National Institutes of Health-International Center for Excellence in Research, Chennai, India
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Arunachalam A, Dhanapandian S, Manoharan C, Sridhar R. Characterization of sprayed TiO2 on ITO substrates for solar cell applications. Spectrochim Acta A Mol Biomol Spectrosc 2015; 149:904-912. [PMID: 26004100 DOI: 10.1016/j.saa.2015.05.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Revised: 04/28/2015] [Accepted: 05/04/2015] [Indexed: 06/04/2023]
Abstract
Titanium dioxide (TiO2) thin films had been deposited with various substrate temperatures by spray pyrolysis technique onto ITO substrates. All films exhibited polycrystalline nature with the preferred orientation along (101) plane. At the substrate temperature 450 °C, the film favored the formation of anatase phase. The higher substrate temperature (475 °C) favored the appearance of rutile structure. The SEM image of the film at substrate temperature (Ts=450 °C) showed high structural quality with the porous nature. The typical AFM image of TiO2 film deposited at the substrate temperature, 450 °C depicted the regular arrangement of fine closely packed tetragonal structured grains. The transmittance of the spectra exhibited above 85% with energy band gap of 3.6 eV. From the study of photoluminescence, the emission at 417 nm, 437 nm and with weak emission at 551 nm was observed, which confirmed the lesser defects in the samples. The electrical resistivity was found to be 6.856×10(1) Ω cm for the substrate temperature 450 °C. The efficiency of anatase TiO2 photoelectrode deposited at the substrate temperature 450 °C based cell was much higher than the efficiency of TiO2 photoelectrode deposited at the substrate temperature 475 °C based cell.
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Affiliation(s)
- A Arunachalam
- Department of Physics, Annamalai University, Annamalai Nagar 608 002, Tamilnadu, India
| | - S Dhanapandian
- Department of Physics, Annamalai University, Annamalai Nagar 608 002, Tamilnadu, India.
| | - C Manoharan
- Department of Physics, Annamalai University, Annamalai Nagar 608 002, Tamilnadu, India
| | - R Sridhar
- Department of Physics, Annamalai University, Annamalai Nagar 608 002, Tamilnadu, India
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Andrade BB, Pavan Kumar N, Amaral EP, Riteau N, Mayer-Barber KD, Tosh KW, Maier N, Conceição EL, Kubler A, Sridhar R, Banurekha VV, Jawahar MS, Barbosa T, Manganiello VC, Moss J, Fontana JR, Marciano BE, Sampaio EP, Olivier KN, Holland SM, Jackson SH, Moayeri M, Leppla S, Sereti I, Barber DL, Nutman TB, Babu S, Sher A. Heme Oxygenase-1 Regulation of Matrix Metalloproteinase-1 Expression Underlies Distinct Disease Profiles in Tuberculosis. J Immunol 2015; 195:2763-73. [PMID: 26268658 DOI: 10.4049/jimmunol.1500942] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 07/15/2015] [Indexed: 01/19/2023]
Abstract
Pulmonary tuberculosis (TB) is characterized by oxidative stress and lung tissue destruction by matrix metalloproteinases (MMPs). The interplay between these distinct pathological processes and the implications for TB diagnosis and disease staging are poorly understood. Heme oxygenase-1 (HO-1) levels were previously shown to distinguish active from latent TB, as well as successfully treated Mycobacterium tuberculosis infection. MMP-1 expression is also associated with active TB. In this study, we measured plasma levels of these two important biomarkers in distinct TB cohorts from India and Brazil. Patients with active TB expressed either very high levels of HO-1 and low levels of MMP-1 or the converse. Moreover, TB patients with either high HO-1 or MMP-1 levels displayed distinct clinical presentations, as well as plasma inflammatory marker profiles. In contrast, in an exploratory North American study, inversely correlated expression of HO-1 and MMP-1 was not observed in patients with other nontuberculous lung diseases. To assess possible regulatory interactions in the biosynthesis of these two enzymes at the cellular level, we studied the expression of HO-1 and MMP-1 in M. tuberculosis-infected human and murine macrophages. We found that infection of macrophages with live virulent M. tuberculosis is required for robust induction of high levels of HO-1 but not MMP-1. In addition, we observed that CO, a product of M. tuberculosis-induced HO-1 activity, inhibits MMP-1 expression by suppressing c-Jun/AP-1 activation. These findings reveal a mechanistic link between oxidative stress and tissue remodeling that may find applicability in the clinical staging of TB patients.
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Affiliation(s)
- Bruno B Andrade
- Immunobiology Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892; Unidade de Medicina Investigativa, Laboratório Integrado de Microbiologia e Imunorregulação, Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador 40296-710, Brazil;
| | - Nathella Pavan Kumar
- National Institutes of Health, International Center for Excellence in Research, Chennai 600031, India; National Institute for Research in Tuberculosis, Chennai 600031, India
| | - Eduardo P Amaral
- Immunobiology Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892
| | - Nicolas Riteau
- Immunobiology Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892
| | - Katrin D Mayer-Barber
- Immunobiology Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892
| | - Kevin W Tosh
- Immunobiology Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892
| | - Nolan Maier
- Microbial Pathogenesis Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892
| | - Elisabete L Conceição
- Unidade de Medicina Investigativa, Laboratório Integrado de Microbiologia e Imunorregulação, Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador 40296-710, Brazil
| | - Andre Kubler
- Department of Medicine, Imperial College London, London SW7 2AZ, United Kingdom
| | | | | | | | - Theolis Barbosa
- Unidade de Medicina Investigativa, Laboratório Integrado de Microbiologia e Imunorregulação, Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador 40296-710, Brazil
| | - Vincent C Manganiello
- Cardiovascular and Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20892
| | - Joel Moss
- Cardiovascular and Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20892
| | - Joseph R Fontana
- Cardiovascular and Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20892
| | - Beatriz E Marciano
- Immunopathogenesis Section, Laboratory of Clinical Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892
| | - Elizabeth P Sampaio
- Immunopathogenesis Section, Laboratory of Clinical Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892
| | - Kenneth N Olivier
- Immunopathogenesis Section, Laboratory of Clinical Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892
| | - Steven M Holland
- Immunopathogenesis Section, Laboratory of Clinical Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892
| | - Sharon H Jackson
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD 20892
| | - Mahtab Moayeri
- Microbial Pathogenesis Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892
| | - Stephen Leppla
- Microbial Pathogenesis Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892
| | - Irini Sereti
- Clinical and Molecular Retrovirology Section, Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892
| | - Daniel L Barber
- T-Lymphocyte Biology Unit, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892
| | - Thomas B Nutman
- Helminth Immunology Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892
| | - Subash Babu
- National Institutes of Health, International Center for Excellence in Research, Chennai 600031, India; Helminth Immunology Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892
| | - Alan Sher
- Immunobiology Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892
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Manikandan A, Antony SA, Sridhar R, Ramakrishna S, Bououdina M. A Simple Combustion Synthesis and Optical Studies of Magnetic Zn1-xNi(x)Fe2O4 Nanostructures for Photoelectrochemical Applications. J Nanosci Nanotechnol 2015; 15:4948-4960. [PMID: 26373061 DOI: 10.1166/jnn.2015.9814] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Ni-doped ZnFe2O4 (Ni(X)Zn1-x,Fe2O4; x = 0.0 to 0.5) nanoparticles were synthesized by simple microwave combustion method. The X-ray diffraction (XRD) confirms that all compositions crystallize with cubic spinel ZnFe2O4. The lattice parameter decreases with increase in Ni content resulting in the reduction of lattice strain. High resolution scanning electron microscope (HR-SEM) and transmission electron microscope (HR-TEM) images revealed that the as-prepared samples are crystalline with particle size distribution in 42-50 nm range. Optical properties were determined by UV-Visible diffuse reflectance (DRS) and photoluminescence (PL) spectroscopy respectively. The saturation magnetization (Ms) shows the superparamagnetic nature of the sample for x = 0.0-0.2, whereas for x = 0.3-0.5, it shows ferromagnetic nature. The Ms value is 1.638 emu/g for pure ZnFe2O4 sample and it increases with increase in Ni content. Photoelectrochemical (PEC) measurements showed a significant increase of photocurrent density with increase in the Ni-dopant, and 0.5% Ni-doped ZnFe2O4 sample was found to show the better photoresponse than the other doping concentrations.
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