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Gunasekaran H, Sampath P, Thiruvengadam K, Malaisamy M, Ramasamy R, Ranganathan UD, Bethunaickan R. A systematic review and meta-analysis of circulating serum and plasma microRNAs in TB diagnosis. BMC Infect Dis 2024; 24:402. [PMID: 38622570 PMCID: PMC11017603 DOI: 10.1186/s12879-024-09232-0] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 03/18/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND Tuberculosis (TB) ranks as the second leading cause of death globally among all infectious diseases. This problem is likely due to the lack of biomarkers to differentiate the heterogeneous spectrum of infection. Therefore, the first step in solving this problem is to identify biomarkers to distinguish the different disease states of an individual and treat them accordingly. Circulating microRNA (miRNA) biomarkers are promising candidates for various diseases. In fact, we are yet to conceptualize how miRNA expression influences and predicts TB disease outcomes. Thus, this systematic review and meta-analysis aimed to assess the diagnostic efficacy of circulating miRNAs in Latent TB (LTB) and Active Pulmonary TB (PTB). METHODS Literature published between 2012 and 2021 was retrieved from PubMed, Web of Science, Cochrane, Scopus, Embase, and Google Scholar. Articles were screened based on inclusion and exclusion criteria, and their quality was assessed using the QUADAS-2 tool. Funnel plots and forest plots were generated to assess the likelihood of study bias and heterogeneity, respectively. RESULTS After the screening process, seven articles were selected for qualitative analysis. The study groups, which consisted of Healthy Control (HC) vs. TB and LTB vs. TB, exhibited an overall sensitivity of 81.9% (95% CI: 74.2, 87.7) and specificity of 68.3% (95% CI: 57.8, 77.2), respectively. However, our meta-analysis results highlighted two potentially valuable miRNA candidates, miR-197 and miR-144, for discriminating TB from HC. The miRNA signature model (miR197-3p, miR-let-7e-5p, and miR-223-3p) has also been shown to diagnose DR-TB with a sensitivity of 100%, but with a compromised specificity of only 75%. CONCLUSION miRNA biomarkers show a promising future for TB diagnostics. Further multicentre studies without biases are required to identify clinically valid biomarkers for different states of the TB disease spectrum. SYSTEMATIC REVIEW REGISTRATION PROSPERO (CRD42022302729).
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Affiliation(s)
- Harinisri Gunasekaran
- Department of Immunology, ICMR-National Institute for Research in Tuberculosis, No.1. Mayor Sathyamoorthy Road, 600 031, Chetpet, Chennai, India
- University of Madras, Chennai, India
| | - Pavithra Sampath
- Department of Immunology, ICMR-National Institute for Research in Tuberculosis, No.1. Mayor Sathyamoorthy Road, 600 031, Chetpet, Chennai, India
- University of Madras, Chennai, India
| | - Kannan Thiruvengadam
- Department of Epidemiology Statistics, ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - Muniyandi Malaisamy
- Department of Health Economics, ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - Rathinasabapati Ramasamy
- Library and Information Center, ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - Uma Devi Ranganathan
- Department of Immunology, ICMR-National Institute for Research in Tuberculosis, No.1. Mayor Sathyamoorthy Road, 600 031, Chetpet, Chennai, India
| | - Ramalingam Bethunaickan
- Department of Immunology, ICMR-National Institute for Research in Tuberculosis, No.1. Mayor Sathyamoorthy Road, 600 031, Chetpet, Chennai, India.
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Rajamanickam A, Kumar NP, Venkataraman A, Varadarjan P, Selladurai E, Sankaralingam T, Thiruvengadam K, Selvam R, Thimmaiah A, Natarajan S, Ramaswamy G, Putlibai S, Sadasivam K, Sundaram B, Hissar S, Ranganathan UD, Babu S. Sex-specific differences in systemic immune responses in MIS-C children. Sci Rep 2024; 14:1720. [PMID: 38243064 PMCID: PMC10799056 DOI: 10.1038/s41598-024-52116-1] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 01/14/2024] [Indexed: 01/21/2024] Open
Abstract
Multisystem Inflammatory Syndrome in Children (MIS-C) is a rare manifestation of Severe Acute Respiratory Syndrome-CoronaVirus-2 (SARS-CoV-2) infection that can result in increased morbidity and mortality. Mounting evidence describes sex disparities in the clinical outcomes of coronavirus disease 2019 (COVID-19). However, there is a lack of information on sex-specific differences in immune responses in MIS-C. This study is an observational and cross-sectional study and we wanted to examine immune parameters such as cytokines, chemokines, acute phase proteins (APPs), growth factors, microbial translocation markers (MTMs), complement components and matrix metalloproteinases (MMPs) in MIS-C children, based on sex. Male children were associated with heightened levels of pro-inflammatory cytokines-IFNγ, IL-2, TNFα, IL-1α, IL-1β, IL-6, IL-12, G-CSF and GM-CSF, chemokines-CCL2, CCL11, CXCL1, CXCL8 and CXCL10, acute phase proteins-α-2M, CRP, growth factors VEGF and TGFα, microbial translocation markers- iFABP, LBP, EndoCAb, complement components-C1q, MBL and C3 and matrix metalloproteinases MMP-8 and MMP-9 compared to female children with MIS-C. These results indicate that the heightened immune response in males is a characteristic feature of MIS-C. These findings might explain the differential disease pathogenesis in males compared to females with MIS-C and facilitate a deeper understanding of this disease.
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Affiliation(s)
- Anuradha Rajamanickam
- National Institutes of Health-National Institute for Research in Tuberculosis - International Center for Excellence in Research, Chennai, India.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Syed Hissar
- National Institute for Research in Tuberculosis, Chennai, India
| | | | - Subash Babu
- National Institutes of Health-National Institute for Research in Tuberculosis - 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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3
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Pavan Kumar N, Abbas KM, Renji RM, Venkataraman A, Nancy A, Varadarjan P, Selladurai E, Sangaralingam T, Selvam R, Thimmaiah A, Natarajan S, Ramasamy G, Hissar S, Ranganathan UD, Nutman TB, Babu S. Multisystem inflammatory syndrome in children characterized by enhanced antigen-specific T-cell expression of cytokines and its reversal following recovery. Front Pediatr 2023; 11:1235342. [PMID: 38116577 PMCID: PMC10728284 DOI: 10.3389/fped.2023.1235342] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 11/13/2023] [Indexed: 12/21/2023] Open
Abstract
Background Multisystem inflammatory syndrome (MIS) in children is considered to be a post-infectious complication of COVID-19. T-cell responses in children with this condition have not been well-studied. Methods We aimed to study the immune responses in children with MIS in comparison to children with acute COVID-19 and children with other infections. Whole blood was stimulated with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)-specific antigens and flow cytometry was performed to examine CD4+ and CD8+ T-cell responses. Results Children with MIS had higher frequencies of CD4+ and CD8+ T cells expressing cytokines at baseline and upon SARS-CoV-2 antigen-specific stimulation in comparison to children with COVID-19 and/or other infections. Children with COVID-19 also exhibited higher frequencies of CD4+ and CD8+ T cells expressing cytokines at baseline and upon SARS-CoV-2 antigen-specific stimulation in comparison to children with other infections. At 6-9 months following treatment and recovery, this enhanced response against SARS-CoV-2 antigens was down modulated in children with MIS. Conclusion Our study, therefore, provides evidence of enhanced activation of CD4+ and CD8+ T-cell responses in children with MIS and reversal following recovery.
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Affiliation(s)
- Nathella Pavan Kumar
- Department of Immunology, ICMR—National Institute for Research in Tuberculosis, Chennai, India
| | - Kadar M. Abbas
- National Institutes of Health—International Center for Excellence in Research, Chennai, India
| | - Rachel M. Renji
- National Institutes of Health—International Center for Excellence in Research, Chennai, India
| | - Aishwarya Venkataraman
- Department of Clinical Research, ICMR—National Institute for Research in Tuberculosis, Chennai, India
| | - Arul Nancy
- National Institutes of Health—International Center for Excellence in Research, Chennai, India
| | - Poovazhagi Varadarjan
- Department of Pulmonology, Institute of Child Health and Hospital for Children, Chennai, India
| | - Elilarasi Selladurai
- Department of Pulmonology, Institute of Child Health and Hospital for Children, Chennai, India
| | | | - Ramya Selvam
- General Pediatrics, Dr. Mehta’s Children’s Hospital, Chennai, India
| | | | | | - Ganesh Ramasamy
- General Pediatrics, Rainbow Children’s Hospital, Chennai, India
| | - Syed Hissar
- Department of Clinical Research, ICMR—National Institute for Research in Tuberculosis, Chennai, India
| | - Uma Devi Ranganathan
- Department of Immunology, ICMR—National Institute for Research in Tuberculosis, Chennai, India
| | - Thomas B. Nutman
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States
| | - Subash Babu
- National Institutes 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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Sampath P, Moorthy M, Menon A, Madhav L, Janaki A, Dhanapal M, Natarajan AP, Hissar S, Ranganathan UD, Ramaswamy G, Bethunaickan R. Downregulation of monocyte miRNAs: implications for immune dysfunction and disease severity in drug-resistant tuberculosis. Front Immunol 2023; 14:1197805. [PMID: 37457712 PMCID: PMC10345223 DOI: 10.3389/fimmu.2023.1197805] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 06/02/2023] [Indexed: 07/18/2023] Open
Abstract
Background Monocyte miRNAs govern both protective and pathological responses during tuberculosis (TB) through their differential expression and emerged as potent targets for biomarker discovery and host-directed therapeutics. Thus, this study examined the miRNA profile of sorted monocytes across the TB disease spectrum [drug-resistant TB (DR-TB), drug-sensitive TB (DS-TB), and latent TB] and in healthy individuals (HC) to understand the underlying pathophysiology and their regulatory mechanism. Methods We sorted total monocytes including three subsets (HLA-DR+CD14+, HLA-DR+CD14+CD16+, and HLA-DR+CD16+cells) from peripheral blood mononuclear cells (PBMCs) of healthy and TB-infected individuals through flow cytometry and subjected them to NanoString-based miRNA profiling. Results The outcome was the differential expression of 107 miRNAs particularly the downregulation of miRNAs in the active TB groups (both drug-resistant and drug-sensitive). The miRNA profile revealed differential expression signatures: i) decline of miR-548m in DR-TB alone, ii) decline of miR-486-3p in active TB but significant elevation only in LTB iii) elevation of miR-132-3p only in active TB (DR-TB and DS-TB) and iv) elevation of miR-150-5p in DR-TB alone. The directionality of functions mediated by monocyte miRNAs from Gene Set Enrichment Analysis (GSEA) facilitated two phenomenal findings: i) a bidirectional response between active disease (activation profile in DR-TB and DS-TB compared to LTB and HC) and latent infection (suppression profile in LTB vs HC) and ii) hyper immune activation in the DR-TB group compared to DS-TB. Conclusion Thus, monocyte miRNA signatures provide pathological clues for altered monocyte function, drug resistance, and disease severity. Further studies on monocyte miRNAs may shed light on the immune regulatory mechanism for tuberculosis.
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Affiliation(s)
- Pavithra Sampath
- Department of Immunology, Indian Council of Medical Research (ICMR)-National Institute for Research in Tuberculosis (NIRT), Chennai, India
| | | | - Athul Menon
- TheraCUES Innovations Pvt. Ltd, Bangalore, India
| | | | - Aishwarya Janaki
- Department of Immunology, Indian Council of Medical Research (ICMR)-National Institute for Research in Tuberculosis (NIRT), Chennai, India
| | - Madhavan Dhanapal
- Department of Immunology, Indian Council of Medical Research (ICMR)-National Institute for Research in Tuberculosis (NIRT), Chennai, India
| | | | - Syed Hissar
- Department of Clinical Research, ICMR-National Institute of Research in Tuberculosis (NIRT), Chennai, India
| | - Uma Devi Ranganathan
- Department of Immunology, Indian Council of Medical Research (ICMR)-National Institute for Research in Tuberculosis (NIRT), Chennai, India
| | | | - Ramalingam Bethunaickan
- Department of Immunology, Indian Council of Medical Research (ICMR)-National Institute for Research in Tuberculosis (NIRT), Chennai, India
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Sampath P, Rajamanickam A, Thiruvengadam K, Natarajan AP, Hissar S, Dhanapal M, Thangavelu B, Jayabal L, Ramesh PM, Ranganathan UD, Babu S, Bethunaickan R. Plasma chemokines CXCL10 and CXCL9 as potential diagnostic markers of drug-sensitive and drug-resistant tuberculosis. Sci Rep 2023; 13:7404. [PMID: 37149713 PMCID: PMC10163852 DOI: 10.1038/s41598-023-34530-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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] [Accepted: 05/03/2023] [Indexed: 05/08/2023] Open
Abstract
Tuberculosis (TB) diagnosis still remains to be a challenge with the currently used immune based diagnostic methods particularly Interferon Gamma Release Assay due to the sensitivity issues and their inability in differentiating stages of TB infection. Immune markers are valuable sources for understanding disease biology and are easily accessible. Chemokines, the stimulant, and the shaper of host immune responses are the vital hub for disease mediated dysregulation and their varied levels in TB disease are considered as an important marker to define the disease status. Hence, we wanted to examine the levels of chemokines among the individuals with drug-resistant, drug-sensitive, and latent TB compared to healthy individuals. Our results demonstrated that the differential levels of chemokines between the study groups and revealed that CXCL10 and CXCL9 as potential markers of drug-resistant and drug-sensitive TB with better stage discriminating abilities.
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Affiliation(s)
- Pavithra Sampath
- Department of Immunology, ICMR-National Institute for Research in Tuberculosis (ICMR-NIRT), No.1. Mayor Sathyamoorthy Road, Chetpet, Chennai, 600 031, India
| | | | - Kannan Thiruvengadam
- Department of Statistics, ICMR-National Institute for Research in Tuberculosis (ICMR-NIRT), Chennai, India
| | | | - Syed Hissar
- Department of Clinical Research, ICMR-National Institute for Research in Tuberculosis (ICMR-NIRT), Chennai, India
| | - Madhavan Dhanapal
- Department of Immunology, ICMR-National Institute for Research in Tuberculosis (ICMR-NIRT), No.1. Mayor Sathyamoorthy Road, Chetpet, Chennai, 600 031, India
| | - Bharathiraja Thangavelu
- Department of Clinical Pharmacology, ICMR-National Institute for Research in Tuberculosis (ICMR-NIRT), Chennai, India
| | | | | | - Uma Devi Ranganathan
- Department of Immunology, ICMR-National Institute for Research in Tuberculosis (ICMR-NIRT), No.1. Mayor Sathyamoorthy Road, Chetpet, Chennai, 600 031, India
| | - Subash Babu
- ICMR-NIRT-NIH-International Center for Excellence in Research, Chennai, India
| | - Ramalingam Bethunaickan
- Department of Immunology, ICMR-National Institute for Research in Tuberculosis (ICMR-NIRT), No.1. Mayor Sathyamoorthy Road, Chetpet, Chennai, 600 031, India.
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Pavan Kumar N, Venkataraman A, Varadarjan P, Nancy A, Rajamanickam A, Selladurai E, Sankaralingam T, Thiruvengadam K, Selvam R, Thimmaiah A, Natarajan S, Ramaswamy G, Putlibai S, Sadasivam K, Sundaram B, Hissar S, Ranganathan UD, Nutman TB, Babu S. Role of matrix metalloproteinases in multi-system inflammatory syndrome and acute COVID-19 in children. Front Med (Lausanne) 2022; 9:1050804. [PMID: 36544496 PMCID: PMC9760695 DOI: 10.3389/fmed.2022.1050804] [Citation(s) in RCA: 4] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 11/15/2022] [Indexed: 12/11/2022] Open
Abstract
Introduction Multisystem Inflammatory Syndrome in children (MIS-C) is a serious inflammatory sequela of SARS-CoV2 infection. The pathogenesis of MIS-C is vague and matrix metalloproteinases (MMPs) may have an important role. Matrix metalloproteinases (MMPs) are known drivers of lung pathology in many diseases. Methods To elucidate the role of MMPs in pathogenesis of pediatric COVID-19, we examined their plasma levels in MIS-C and acute COVID-19 children and compared them to convalescent COVID-19 and children with other common tropical diseases (with overlapping clinical manifestations). Results Children with MIS-C had elevated levels of MMPs (P < 0.005 statistically significant) in comparison to acute COVID-19, other tropical diseases (Dengue fever, typhoid fever, and scrub typhus fever) and convalescent COVID-19 children. PCA and ROC analysis (sensitivity 84-100% and specificity 80-100%) showed that MMP-8, 12, 13 could help distinguish MIS-C from acute COVID-19 and other tropical diseases with high sensitivity and specificity. Among MIS-C children, elevated levels of MMPs were seen in children requiring intensive care unit admission as compared to children not needing intensive care. Similar findings were noted when children with severe/moderate COVID-19 were compared to children with mild COVID-19. Finally, MMP levels exhibited significant correlation with laboratory parameters, including lymphocyte counts, CRP, D-dimer, Ferritin and Sodium levels. Discussion Our findings suggest that MMPs play a pivotal role in the pathogenesis of MIS-C and COVID-19 in children and may help distinguish MIS-C from other conditions with overlapping clinical presentation.
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Affiliation(s)
- Nathella Pavan Kumar
- ICMR – National Institute for Research in Tuberculosis, Chennai, India,*Correspondence: Nathella Pavan Kumar, ,
| | | | | | - Arul Nancy
- National Institutes of Health-National Institute for Research in Tuberculosis – International Center for Excellence in Research, Chennai, India
| | - Anuradha Rajamanickam
- National Institutes of Health-National Institute for Research in Tuberculosis – International Center for Excellence in Research, Chennai, India
| | | | | | | | | | | | | | | | | | | | | | - Syed Hissar
- ICMR – National Institute for Research in Tuberculosis, Chennai, India
| | | | - Thomas B. Nutman
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States
| | - Subash Babu
- National Institutes of Health-National Institute for Research in Tuberculosis – 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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7
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Sampath P, Natarajan AP, Moideen K, Kathamuthu GR, Hissar S, Dhanapal M, Jayabal L, Ramesh PM, Tripathy SP, Ranganathan UD, Babu S, Bethunaickan R. Differential Frequencies of Intermediate Monocyte Subsets Among Individuals Infected With Drug-Sensitive or Drug-Resistant Mycobacterium tuberculosis. Front Immunol 2022; 13:892701. [PMID: 35911760 PMCID: PMC9336531 DOI: 10.3389/fimmu.2022.892701] [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: 03/09/2022] [Accepted: 06/21/2022] [Indexed: 11/13/2022] Open
Abstract
The rampant increase in drug-resistant tuberculosis (TB) remains a major challenge not only for treatment management but also for diagnosis, as well as drug design and development. Drug-resistant mycobacteria affect the quality of life owing to the delayed diagnosis and require prolonged treatment with multiple and toxic drugs. The phenotypic modulations defining the immune status of an individual during tuberculosis are well established. The present study aims to explore the phenotypic changes of monocytes & dendritic cells (DC) as well as their subsets across the TB disease spectrum, from latency to drug-sensitive TB (DS-TB) and drug-resistant TB (DR-TB) using traditional immunophenotypic analysis and by uniform manifold approximation and projection (UMAP) analysis. Our results demonstrate changes in frequencies of monocytes (classical, CD14++CD16-, intermediate, CD14++CD16+ and non-classical, CD14+/-CD16++) and dendritic cells (DC) (HLA-DR+CD11c+ myeloid DCs, cross-presenting HLA-DR+CD14-CD141+ myeloid DCs and HLA-DR+CD14-CD16-CD11c-CD123+ plasmacytoid DCs) together with elevated Monocyte to Lymphocyte ratios (MLR)/Neutrophil to Lymphocyte ratios (NLR) and alteration of cytokine levels between DS-TB and DR-TB groups. UMAP analysis revealed significant differential expression of CD14+, CD16+, CD86+ and CD64+ on monocytes and CD123+ on DCs by the DR-TB group. Thus, our study reveals differential monocyte and DC subset frequencies among the various TB disease groups towards modulating the immune responses and will be helpful to understand the pathogenicity driven by Mycobacterium tuberculosis.
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Affiliation(s)
- Pavithra Sampath
- Department of Immunology, National Institute for Research in Tuberculosis (NIRT), Chennai, India
| | | | - Kadar Moideen
- Indian Council of Medical Research-National Institute for Research in Tuberculosis (ICMR-NIRT)-International Center for Excellence in Research, Chennai, India
| | - Gokul Raj Kathamuthu
- Indian Council of Medical Research-National Institute for Research in Tuberculosis (ICMR-NIRT)-International Center for Excellence in Research, Chennai, India
| | - Syed Hissar
- Department of Clinical Research, National Institute for Research in Tuberculosis (NIRT), Chennai, India
| | - Madhavan Dhanapal
- Department of Immunology, National Institute for Research in Tuberculosis (NIRT), Chennai, India
| | | | | | - Srikanth Prasad Tripathy
- Indian Council of Medical Research-National Institute for Research in Tuberculosis (ICMR-NIRT), Chennai, India
| | - Uma Devi Ranganathan
- Department of Immunology, National Institute for Research in Tuberculosis (NIRT), Chennai, India
| | - Subash Babu
- Indian Council of Medical Research-National Institute for Research in Tuberculosis (ICMR-NIRT)-International Center for Excellence in Research, Chennai, India
| | - Ramalingam Bethunaickan
- Department of Immunology, National Institute for Research in Tuberculosis (NIRT), Chennai, India
- *Correspondence: Ramalingam Bethunaickan, ;
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Mave V, Chen L, Ranganathan UD, Kadam D, Vishwanathan V, Lokhande R, S SK, Kagal A, Pradhan N, Shivakumar SVBY, Paradkar MS, Deshmukh S, Tornheim JA, Kornfeld H, Farhat M, Gupta A, Padmapriyadarsini C, Gupte N, Golub JE, Mathema B, Kreiswirth BN. Whole Genome Sequencing Assessing Impact of Diabetes Mellitus on Tuberculosis Mutations and Type of Recurrence in India. Clin Infect Dis 2022; 75:768-776. [PMID: 34984435 PMCID: PMC9477453 DOI: 10.1093/cid/ciab1067] [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] [Received: 09/29/2021] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Evidence describing the impact of diabetes mellitus (DM) on the recurrence and mutation rate of Mycobacterium tuberculosis (Mtb) is limited. METHODS This study was nested in 3 cohort studies of tuberculosis (TB) patients with and without DM in India. Paired Mtb isolates recovered at baseline and treatment failure/recurrence underwent whole genome sequencing. We compared acquisition of single-nucleotide polymorphisms (SNPs), TB drug resistance mutations, and type of recurrence (endogenous reactivation [<8 SNPs] or exogenous reinfection [≥8 SNPs]) by DM status. RESULTS Of 1633 enrolled in the 3 parent cohorts, 236 (14.5%) had microbiologically confirmed TB treatment failure/recurrence; 76 Mtb isolate pairs were available for sequencing (22 in TB-DM and 54 in TB-only). The SNP acquisition rate was overall was 0.43 (95% confidence interval [CI], .25-.64) per 1 person-year (PY); 0.77 (95% CI, .40-1.35) per 1 PY, and 0.44 (95% CI, .19-.86) per 1 PY at treatment failure and recurrence, respectively. Significant difference in SNP rates by DM status was seen at recurrence (0.21 [95% CI, .04-.61]) per 1 PY for TB-only vs 1.28 (95% CI, .41-2.98) per 1 PY for TB-DM; P = .02). No significant difference in SNP rates by DM status was observed at treatment failure. Acquired TB drug resistance was seen in 4 of 18 (22%) in TB-DM vs 4 of 45 (9%) in TB-only (P = .21). Thirteen (17%) participants had exogenous reinfection; the reinfection rate at recurrence was 25% (3/12) for TB-DM vs 17% (4/24) in TB-only (P = .66). CONCLUSIONS Considerable intrahost Mtb mutation rates were present at recurrence among patients with DM in India. One-fourth of patients with DM had exogenous reinfection at recurrence.
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Affiliation(s)
- Vidya Mave
- Correspondence: V. Mave, Byramjee-Jeejeebhoy Medical College-Johns Hopkins University Clinical Research Site, Jai Prakash Narayan Road, First Floor, Pune, Maharashtra, India 411001 ()
| | - Liang Chen
- Hackensack Meridian Health, Center for Discovery and Innovation, Nutley, New Jersey, USA
| | | | - Dileep Kadam
- Byramjee-Jeejeebhoy Government Medical College, Pune, India
| | | | - Rahul Lokhande
- Byramjee-Jeejeebhoy Government Medical College, Pune, India
| | - Siva Kumar S
- ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - Anju Kagal
- Byramjee-Jeejeebhoy Government Medical College, Pune, India
| | - Neeta N Pradhan
- Byramjee-Jeejeebhoy Medical College–Johns Hopkins University Clinical Research Site, Pune, India,Johns Hopkins India, Pune, India
| | | | - Mandar S Paradkar
- Byramjee-Jeejeebhoy Medical College–Johns Hopkins University Clinical Research Site, Pune, India,Johns Hopkins India, Pune, India
| | - Sona Deshmukh
- Byramjee-Jeejeebhoy Medical College–Johns Hopkins University Clinical Research Site, Pune, India,Johns Hopkins India, Pune, India
| | | | | | - Maha Farhat
- Harvard Medical School, Boston, Massachusetts, USA
| | - Amita Gupta
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | | | - Nikhil Gupte
- Byramjee-Jeejeebhoy Medical College–Johns Hopkins University Clinical Research Site, Pune, India,Johns Hopkins University School of Medicine, Baltimore, Maryland, USA,Johns Hopkins India, Pune, India
| | - Jonathan E Golub
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | | | - Barry N Kreiswirth
- Hackensack Meridian Health, Center for Discovery and Innovation, Nutley, New Jersey, USA
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Tamilzhalagan S, Shanmugam S, Selvaraj A, Suba S, Suganthi C, Moonan PK, Surie D, Sathyanarayanan MK, Gomathi NS, Jayabal L, Sachdeva KS, Selvaraju S, Swaminathan S, Tripathy SP, Hall PJ, Ranganathan UD. Whole-Genome Sequencing to Identify Missed Rifampicin and Isoniazid Resistance Among Tuberculosis Isolates-Chennai, India, 2013-2016. Front Microbiol 2021; 12:720436. [PMID: 34880835 PMCID: PMC8645853 DOI: 10.3389/fmicb.2021.720436] [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: 06/04/2021] [Accepted: 10/12/2021] [Indexed: 11/15/2022] Open
Abstract
India has a high burden of drug-resistant tuberculosis (DR TB) and many cases go undetected by current drug susceptibility tests (DSTs). This study was conducted to identify rifampicin (RIF) and isoniazid (INH) resistance associated genetic mutations undetected by current clinical diagnostics amongst persons with DR TB in Chennai, India. Retrospectively stored 166 DR TB isolates during 2013–2016 were retrieved and cultured in Löwenstein-Jensen medium. Whole genome sequencing (WGS) and MGIT DST for RIF and INH were performed. Discordant genotypic and phenotypic sensitivity results were repeated for confirmation and the discrepant results considered final. Further, drug resistance-conferring mutations identified through WGS were analyzed for their presence as targets in current WHO-recommended molecular diagnostics. WGS detected additional mutations for rifampicin and isoniazid resistance than WHO-endorsed line probe assays. For RIF, WGS was able to identify an additional 10% (15/146) of rpoB mutant isolates associated with borderline rifampicin resistance compared to MGIT DST. WGS could detect additional DR TB cases than commercially available and WHO-endorsed molecular DST tests. WGS results reiterate the importance of the recent WHO revised critical concentrations of current MGIT DST to detect low-level resistance to rifampicin. WGS may help inform effective treatment selection for persons at risk of, or diagnosed with, DR TB.
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Affiliation(s)
| | | | - Ashok Selvaraj
- ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - Sakthi Suba
- ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | | | - Patrick K Moonan
- U.S. Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Diya Surie
- U.S. Centers for Disease Control and Prevention, Atlanta, GA, United States
| | | | | | | | | | - Sriram Selvaraju
- ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - Soumya Swaminathan
- ICMR-National Institute for Research in Tuberculosis, Chennai, India.,World Health Organization, Geneva, Switzerland
| | | | - Patricia J Hall
- U.S. Centers for Disease Control and Prevention, Atlanta, GA, United States
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Sampath P, Periyasamy KM, Ranganathan UD, Bethunaickan R. Monocyte and Macrophage miRNA: Potent Biomarker and Target for Host-Directed Therapy for Tuberculosis. Front Immunol 2021; 12:667206. [PMID: 34248945 PMCID: PMC8267585 DOI: 10.3389/fimmu.2021.667206] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [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: 02/12/2021] [Accepted: 05/11/2021] [Indexed: 12/13/2022] Open
Abstract
The end TB strategy reinforces the essentiality of readily accessible biomarkers for early tuberculosis diagnosis. Exploration of microRNA (miRNA) and pathway analysis opens an avenue for the discovery of possible therapeutic targets. miRNA is a small, non-coding oligonucleotide characterized by the mechanism of gene regulation, transcription, and immunomodulation. Studies on miRNA define their importance as an immune marker for active disease progression and as an immunomodulator for innate mechanisms, such as apoptosis and autophagy. Monocyte research is highly advancing toward TB pathogenesis and biomarker efficiency because of its innate and adaptive response connectivity. The combination of monocytes/macrophages and their relative miRNA expression furnish newer insight on the unresolved mechanism for Mycobacterium survival, exploitation of host defense, latent infection, and disease resistance. This review deals with miRNA from monocytes, their relative expression in different disease stages of TB, multiple gene regulating mechanisms in shaping immunity against tuberculosis, and their functionality as biomarker and host-mediated therapeutics. Future collaborative efforts involving multidisciplinary approach in various ethnic population with multiple factors (age, gender, mycobacterial strain, disease stage, other chronic lung infections, and inflammatory disease criteria) on these short miRNAs from body fluids and cells could predict the valuable miRNA biosignature network as a potent tool for biomarkers and host-directed therapy.
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Affiliation(s)
- Pavithra Sampath
- Department of Immunology, National Institute for Research in Tuberculosis, Chennai, India
| | | | - Uma Devi Ranganathan
- Department of Immunology, National Institute for Research in Tuberculosis, Chennai, India
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Adikesavalu H, Gopalaswamy R, Kumar A, Ranganathan UD, Shanmugam S. Autophagy Induction as a Host-Directed Therapeutic Strategy against Mycobacterium tuberculosis Infection. Medicina (Kaunas) 2021; 57:522. [PMID: 34070995 PMCID: PMC8224563 DOI: 10.3390/medicina57060522] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 05/15/2021] [Accepted: 05/21/2021] [Indexed: 12/11/2022]
Abstract
Tuberculosis (TB), a bacterialinfectious disease caused by Mycobacterium tuberculosis (M.tb), which causes significant mortality in humans worldwide. Current treatment regimen involve the administration of multiple antibiotics over the course of several months that contributes to patient non-compliance leading to relapse and the development of drug-resistant M.tb (MDR and XDR) strains. Together, these facts highlight the need for the development of shorter TB treatment regimens. Host-directed therapy (HDT) is a new and emerging concept that aims to augment host immune response using drugs/compounds with or without adjunct antibiotics against M.tb infection. Autophagy is a natural catabolic mechanism of the cell that involves delivering the cytosolic constituents to the lysosomes for degradation and recycling the components; thereby maintaining the cellular and energy homoeostasis of a cell. However, over the past decade, an improved understanding of the role of autophagy in immunity has led to autophagy activation by using drugs or agents. This autophagy manipulation may represent a promising host-directed therapeutic strategy for human TB. However, current clinical knowledge on implementing autophagy activation by drugs or agents, as a stand-alone HDT or as an adjunct with antibiotics to treat human TB is insufficient. In recent years, many reports on high-throughput drug screening and measurement of autophagic flux by fluorescence, high-content microscopy, flow cytometry, microplate reader and immunoblotting have been published for the discovery of drugs that modulate autophagy. In this review, we discuss the commonly used chemical screening approaches in mammalian cells for the discovery of autophagy activating drugs against M.tbinfection. We also summarize the various autophagy-activating agents, both pre-clinical candidates and compounds approved for advanced clinical investigation during mycobacterial infection. Finally, we discuss the opportunities and challenges in using autophagy activation as HDT strategy to improve TB outcome and shorten treatment regimen.
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Affiliation(s)
- Harresh Adikesavalu
- Department of Bacteriology, ICMR-National Institute for Research in Tuberculosis, Chetpet, Chennai 600031, India; (H.A.); (R.G.); (A.K.)
| | - Radha Gopalaswamy
- Department of Bacteriology, ICMR-National Institute for Research in Tuberculosis, Chetpet, Chennai 600031, India; (H.A.); (R.G.); (A.K.)
| | - Ashok Kumar
- Department of Bacteriology, ICMR-National Institute for Research in Tuberculosis, Chetpet, Chennai 600031, India; (H.A.); (R.G.); (A.K.)
| | - Uma Devi Ranganathan
- Department of Immunology, ICMR-National Institute for Research in Tuberculosis, Chetpet, Chennai 600031, India;
| | - Sivakumar Shanmugam
- Department of Bacteriology, ICMR-National Institute for Research in Tuberculosis, Chetpet, Chennai 600031, India; (H.A.); (R.G.); (A.K.)
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Shanmugam S, Bachmann NL, Martinez E, Menon R, Narendran G, Narayanan S, Tripathy SP, Ranganathan UD, Sawleshwarkar S, Marais BJ, Sintchenko V. Whole genome sequencing based differentiation between re-infection and relapse in Indian patients with tuberculosis recurrence, with and without HIV co-infection. Int J Infect Dis 2021; 113 Suppl 1:S43-S47. [PMID: 33741489 DOI: 10.1016/j.ijid.2021.03.020] [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] [Received: 11/10/2020] [Revised: 03/09/2021] [Accepted: 03/09/2021] [Indexed: 10/21/2022] Open
Abstract
INTRODUCTION Differentiation between relapse and reinfection in cases with tuberculosis (TB) recurrence has important implications for public health, especially in patients with human immunodeficiency virus (HIV) co-infection. We compared Mycobacterial Interspersed Repeat Unit (MIRU) typing and spoligotyping with whole genome sequencing (WGS) to differentiate between relapse and reinfection in patients (HIV-positive and HIV-negative) with TB recurrence. We also assessed the value of WGS to track acquired drug resistance in those with relapse after successful treatment. METHOD Forty-one paired M. tuberculosis isolates collected from 20 HIV-positive and 21 HIV-negative patients were subjected to WGS in addition to spoligotyping and MIRU typing. Phylogenetic and Single Nucleotide Substitution (SNP) clustering analyses were performed to determine whether recurrences were due to relapse or re-infection. RESULTS Comparison of M. tuberculosis genomes indicated that 95% of TB recurrences in the HIV-negative cohort were due to relapse, while the majority of TB recurrences (75%) in the HIV-positive cohort was due to reinfection (P = 0.0001). New drug resistance mutations were acquired in 5/24 cases (20.8%) that experienced relapse. CONCLUSIONS WGS provided increased resolution, but differentiation between relapse and reinfection was broadly consistent with MIRU and spoligotyping. The high contribution of reinfection among HIV infected patients experiencing TB recurrence warrants further study to explore risk factors for TB exposure.
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Affiliation(s)
- Sivakumar Shanmugam
- ICMR-National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India
| | - Nathan L Bachmann
- Centre for Infectious Diseases and Microbiology - Public Health, Westmead Hospital, Sydney, New South Wales, Australia.
| | - Elena Martinez
- Centre for Infectious Diseases and Microbiology - Public Health, Westmead Hospital, Sydney, New South Wales, Australia
| | - Ranjeeta Menon
- Centre for Infectious Diseases and Microbiology - Public Health, Westmead Hospital, Sydney, New South Wales, Australia; Sydney Medical School, Faculty of Medicine and Health, University of Sydney, New South Wales, Australia
| | - G Narendran
- ICMR-National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India
| | - Sujatha Narayanan
- ICMR-National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India
| | - Srikanth P Tripathy
- ICMR-National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India
| | - Uma Devi Ranganathan
- ICMR-National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India
| | - Shailendra Sawleshwarkar
- Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, New South Wales, Australia; Sydney Medical School, Faculty of Medicine and Health, University of Sydney, New South Wales, Australia
| | - Ben J Marais
- Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, New South Wales, Australia
| | - Vitali Sintchenko
- Centre for Infectious Diseases and Microbiology - Public Health, Westmead Hospital, Sydney, New South Wales, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, New South Wales, Australia; Sydney Medical School, Faculty of Medicine and Health, University of Sydney, New South Wales, Australia
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13
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Harishankar M, Sampath P, Athikesavan V, Chinnaiyan P, Velayutham B, Putcha UK, Tripathy SP, Ranganathan UD, Selvaraj P, Bethunaickan R. Association of rs7041 and rs4588 polymorphisms of vitamin D binding protein gene in pulmonary tuberculosis. Meta Gene 2020. [DOI: 10.1016/j.mgene.2020.100822] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
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Sivakumar S, Chandramohan Y, Kathamuthu GR, Sekar G, Kandhasamy D, Padmanaban V, Hissar S, Tripathy SP, Bethunaickan R, Dhanaraj B, Babu S, Ranganathan UD. The recent trend in mycobacterial strain diversity among extra pulmonary lymph node tuberculosis and their association with drug resistance and the host immunological response in South India. BMC Infect Dis 2020; 20:894. [PMID: 33243148 PMCID: PMC7690019 DOI: 10.1186/s12879-020-05597-0] [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: 05/19/2020] [Accepted: 11/08/2020] [Indexed: 11/11/2022] Open
Abstract
Background Tuberculosis (TB) though primarily affects the lungs it may also affect the other parts of the body and referred as extra pulmonary (EPTB). This study is focused on understanding the genetic diversity and molecular epidemiology of Mycobacterium tuberculosis (M.tb) among tuberculous lymphadenitis (TBL), a form of EPTB patients identified in Chennai, Tamil Nadu. Methods The genetic diversity was identified by performing spoligotyping on the M.tb clinical isolates that were recovered from lymph node samples. A total of 71 M.tb isolates were recovered from extra pulmonary lymph node samples and subjected to Drug susceptibility testing and spoligotyping was carried out. In addition, immunological characterization from blood of same individuals from whom M.tb was isolated was carried out between the two major lineages groups East African Indian 3 (EAI3) and non-EAI3 strains by ELISA. The results of spoligotyping patterns were compared with the world Spoligotyping Database of Institute Pasteur de Guadeloupe (SpolDB4). Results We found 41 spoligotype patterns and their associated lineages. Out of 41 spoligotype pattern, only 22 patterns are available in the spoldB4 database with Spoligotype international Type (SIT) number and remaining patterns were orphan strains without SIT number. The most predominant spoligotype lineage that was found in lymph node sample in this region of India was EAI (36), followed by central Asian strain (CAS) (6), T1 (5), Beijing (3), Latin American & Mediterranean (LAM) (2), U (1), X2 (1) and orphan (22). In addition to EAI, CAS and Beijing, our study identified the presence of orphan and unique spoligotyping patterns in Chennai region. We observed six drug resistant isolates. Out of six drug resistant isolates, four were resistant to isoniazid drug and associated with EAI family. Moreover, we observed increased levels of type 2 and type 17 cytokine profiles between EAI3 and non-EAI family, infected individuals. Conclusions The study confirms that EAI lineage to be the most predominant lineages in EPTB patients with lymphadenitis and were found to have increased type 1 and type 17 proinflammatory cytokine profiles. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-020-05597-0.
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Affiliation(s)
- Shanmugam Sivakumar
- Department of Bacteriology, National Institute for Research in Tuberculosis, Chetpet, Chennai, 600 031, India
| | - Yuvaraj Chandramohan
- Department of Immunology, National Institute for Research in Tuberculosis, Chetpet, Chennai, 600 031, India
| | - Gokul Raj Kathamuthu
- National Institute of Health -International Center for Excellence in Research - National Institute for Research in Tuberculosis, Chennai, India
| | - Gomathi Sekar
- Department of Bacteriology, National Institute for Research in Tuberculosis, Chetpet, Chennai, 600 031, India
| | - Devika Kandhasamy
- Department of Bacteriology, National Institute for Research in Tuberculosis, Chetpet, Chennai, 600 031, India
| | - Venkatesan Padmanaban
- Department of Immunology, National Institute for Research in Tuberculosis, Chetpet, Chennai, 600 031, India
| | - Syed Hissar
- Department of Clinical Health Research, National Institute for Research in Tuberculosis, Chetpet, Chennai, 600 031, India
| | - Srikanth P Tripathy
- National Institute for Research in Tuberculosis, Chetpet, Chennai, 600 031, India
| | - Ramalingam Bethunaickan
- Department of Immunology, National Institute for Research in Tuberculosis, Chetpet, Chennai, 600 031, India
| | - Baskaran Dhanaraj
- Department of Clinical Health Research, National Institute for Research in Tuberculosis, Chetpet, Chennai, 600 031, India
| | - Subash Babu
- National Institute of Health -International Center for Excellence in Research - National Institute for Research in Tuberculosis, Chennai, India
| | - Uma Devi Ranganathan
- Department of Immunology, National Institute for Research in Tuberculosis, Chetpet, Chennai, 600 031, India.
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Periyasamy KM, Ranganathan UD, Tripathy SP, Bethunaickan R. Vitamin D - A host directed autophagy mediated therapy for tuberculosis. Mol Immunol 2020; 127:238-244. [PMID: 33039674 DOI: 10.1016/j.molimm.2020.08.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 08/10/2020] [Accepted: 08/13/2020] [Indexed: 12/12/2022]
Abstract
According to the WHO report 2019, Tuberculosis (TB) is an ancient disease of humanity that is curable. TB has caused significant morbidity and mortality even in 2018. The etiological agent of TB, Mycobacterium tuberculosis (MTB) exploits its virulence factors to escape from host immunity and therapeutic drugs. Host Directed Therapy (HDT) is an adjunctive therapy where repurposed drugs, small molecules, vitamins, cytokines, and monoclonal antibodies are used to overcome the pathogen exploited pathways in the host. One of the HDTs, i.e. induction of autophagy is a highly regulated intracellular self-degradative process in which pathogens are sequestered in double-layered autophagosomes and targeted to the lysosome for degradation. Apart from the pathogen clearance, autophagy involves the release of nutrients during starvation, removal of damaged organelles and aggregated proteins, antigen presentation, tumor suppression, and anti-aging mechanisms. Xenophagy is a type of selective autophagy against microbes induced by ubiquitin receptors (p62/SQSTM1, NDP52, NBR1, OPTN, Parkin and Smurf proteins) after pathogen recognition. ULK1/2, Beclin-1, ATG5-ATG12-ATG16 L and LC-II-PE complexes along with two nutrient-sensing protein complexes, mTOR and AMPK activate autophagy mechanisms to limit infection. Pattern Recognition Receptors (PRRs) such as TLR2, recognize lipopolysaccharide (LPS) of MTB and triggers vitamin D3 activating enzymes. Activated vitamin D3 induces the synthesis of antimicrobial peptide, LL-37, which further enhances xenophagy. Apart from vitamin D, few micronutrients such as zinc and iron also regulate autophagy. In this review, we discuss current knowledge, advances and perspectives of autophagy against TB.
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Affiliation(s)
- Krisna Moorthi Periyasamy
- Department of Immunology, ICMR-National Institute for Research in Tuberculosis, Chennai. Affiliated to University of Madras, Chepauk, Chennai, India
| | - Uma Devi Ranganathan
- Department of Immunology, ICMR-National Institute for Research in Tuberculosis, Chennai. Affiliated to University of Madras, Chepauk, Chennai, India
| | | | - Ramalingam Bethunaickan
- Department of Immunology, ICMR-National Institute for Research in Tuberculosis, Chennai. Affiliated to University of Madras, Chepauk, Chennai, India; Department of Pathology and Microbiology, ICMR-National Institute of Nutrition, Hyderabad, India.
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Murhekar MV, Bhatnagar T, Selvaraju S, Rade K, Saravanakumar V, Vivian Thangaraj JW, Kumar MS, Shah N, Sabarinathan R, Turuk A, Anand PK, Asthana S, Balachandar R, Bangar SD, Bansal AK, Bhat J, Chakraborty D, Rangaraju C, Chopra V, Das D, Deb AK, Devi KR, Dwivedi GR, Salim Khan SM, Haq I, Kumar MS, Laxmaiah A, (Major) Madhukar, Mahapatra A, Mitra A, Nirmala A, Pagdhune A, Qurieshi MA, Ramarao T, Sahay S, Sharma Y, Shrinivasa MB, Shukla VK, Singh PK, Viramgami A, Wilson VC, Yadav R, Girish Kumar C, Luke HE, Ranganathan UD, Babu S, Sekar K, Yadav PD, Sapkal GN, Das A, Das P, Dutta S, Hemalatha R, Kumar A, Narain K, Narasimhaiah S, Panda S, Pati S, Patil S, Sarkar K, Singh S, Kant R, Tripathy S, Toteja G, Babu GR, Kant S, Muliyil J, Pandey RM, Sarkar S, Singh SK, Zodpey S, Gangakhedkar RR, Reddy D, Bhargava B. Prevalence of SARS-CoV-2 infection in India: Findings from the national serosurvey, May-June 2020. Indian J Med Res 2020; 152:48-60. [PMID: 32952144 PMCID: PMC7853249 DOI: 10.4103/ijmr.ijmr_3290_20] [Citation(s) in RCA: 129] [Impact Index Per Article: 32.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND & OBJECTIVES Population-based seroepidemiological studies measure the extent of SARS-CoV-2 infection in a country. We report the findings of the first round of a national serosurvey, conducted to estimate the seroprevalence of SARS-CoV-2 infection among adult population of India. METHODS From May 11 to June 4, 2020, a randomly sampled, community-based survey was conducted in 700 villages/wards, selected from the 70 districts of the 21 States of India, categorized into four strata based on the incidence of reported COVID-19 cases. Four hundred adults per district were enrolled from 10 clusters with one adult per household. Serum samples were tested for IgG antibodies using COVID Kavach ELISA kit. All positive serum samples were re-tested using Euroimmun SARS-CoV-2 ELISA. Adjusting for survey design and serial test performance, weighted seroprevalence, number of infections, infection to case ratio (ICR) and infection fatality ratio (IFR) were calculated. Logistic regression was used to determine the factors associated with IgG positivity. RESULTS Total of 30,283 households were visited and 28,000 individuals were enrolled. Population-weighted seroprevalence after adjusting for test performance was 0.73 per cent [95% confidence interval (CI): 0.34-1.13]. Males, living in urban slums and occupation with high risk of exposure to potentially infected persons were associated with seropositivity. A cumulative 6,468,388 adult infections (95% CI: 3,829,029-11,199,423) were estimated in India by the early May. The overall ICR was between 81.6 (95% CI: 48.3-141.4) and 130.1 (95% CI: 77.0-225.2) with May 11 and May 3, 2020 as plausible reference points for reported cases. The IFR in the surveyed districts from high stratum, where death reporting was more robust, was 11.72 (95% CI: 7.21-19.19) to 15.04 (9.26-24.62) per 10,000 adults, using May 24 and June 1, 2020 as plausible reference points for reported deaths. INTERPRETATION & CONCLUSIONS Seroprevalence of SARS-CoV-2 was low among the adult population in India around the beginning of May 2020. Further national and local serosurveys are recommended to better inform the public health strategy for containment and mitigation of the epidemic in various parts of the country.
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Affiliation(s)
| | - Tarun Bhatnagar
- ICMR-National Institute of Cancer Prevention & Research, Noida, India
| | | | - Kiran Rade
- WHO Country Office for India, New Delhi, India
| | - V. Saravanakumar
- Division of Epidemiology & Bio-Statistics, Chennai, Tamil Nadu, India
| | | | | | | | - R. Sabarinathan
- Division of Epidemiology & Bio-Statistics, Chennai, Tamil Nadu, India
| | - Alka Turuk
- Division of Epidemiology & Communicable Diseases, All India Institute of Medical Sciences, New Delhi, India
| | | | - Smita Asthana
- Division of Epidemiology & Biostatistics, Noida, India
| | | | | | | | - Jyothi Bhat
- Division of Communicable Diseases, ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Debjit Chakraborty
- Division of Epidemiology, ICMR-National Institute of Cholera & Enteric Diseases, Kolkata, West Bengal, India
| | - Chethana Rangaraju
- Division of Advocacy, Communication & Social Mobilisation, Bengaluru, Karnataka, India
| | - Vishal Chopra
- State TB Training & Demonstration Centre, Patiala, Punjab, India
| | - Dasarathi Das
- ICMRRegional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Alok Kumar Deb
- Division of Epidemiology, ICMR-National Institute of Cholera & Enteric Diseases, Kolkata, West Bengal, India
| | - Kangjam Rekha Devi
- Division of Enteric Diseases, ICMR-Regional Medical Research Centre, Northeast Region, Dibrugarh, Assam, India
| | | | - S. Muhammad Salim Khan
- Department of Community Medicine, Government Medical College, Srinagar, Jammu & Kashmir, India
| | - Inaamul Haq
- Department of Community Medicine, Government Medical College, Srinagar, Jammu & Kashmir, India
| | - M. Sunil Kumar
- State TB Training & Demonstration Centre Thiruvananthapuram, Kerala, India
| | - Avula Laxmaiah
- Division of Public Health Nutrition, ICMRNational Institute of Nutrition, Hyderabad, Telangana, India
| | - (Major) Madhukar
- Division of Clinical Medicine, ICMR-Rajendra Memorial Research Institute of Medical Sciences, Patna, Bihar, India
| | | | - Anindya Mitra
- State TB Training & Demonstration Centre Ranchi, Jharkhand, India
| | - A.R. Nirmala
- Lady Willingdon State TB Centre, Government of Karnataka, Bengaluru, Karnataka, India
| | | | - Mariya Amin Qurieshi
- Department of Community Medicine, Government Medical College, Srinagar, Jammu & Kashmir, India
| | | | - Seema Sahay
- Social and Behavioural Research Sciences, Pune, Maharashtra, India
| | - Y.K. Sharma
- Directorate Health Services, Raipur, Chhattisgarh, India
| | | | | | - Prashant Kumar Singh
- Division of Preventive Oncology, ICMR-National Institute of Cancer Prevention & Research, Noida, India
| | - Ankit Viramgami
- Division of Clinical Epidemiology, Ahmedabad, Gujarat, India
| | | | - Rajiv Yadav
- Division of Communicable Diseases, ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - C.P. Girish Kumar
- Laboratory Division, ICMR-National Institute of Epidemiology, Chennai, Tamil Nadu, India
| | | | - Uma Devi Ranganathan
- Immunology, ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - Subash Babu
- NIH-ICER (International Centers for Excellence in Research) Program, Chennai, India
| | | | | | - Gajanan N. Sapkal
- Diagnostic Virology Group, ICMR-National Institute of Virology, Pune, Maharashtra, India
| | - Aparup Das
- ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Pradeep Das
- ICMR-Rajendra Memorial Research Institute of Medical Sciences, Patna, Bihar, India
| | - Shanta Dutta
- ICMR-National Institute of Cholera & Enteric Diseases, Kolkata, West Bengal, India
| | | | - Ashwani Kumar
- ICMR-Vector Control Research Centre, Puducherry, India
| | - Kanwar Narain
- ICMR-Vector Control Research Centre, Puducherry, India
| | | | - Samiran Panda
- ICMR-National AIDS Research Institute, Jabalpur, Madhya Pradesh, India
| | - Sanghamitra Pati
- ICMRRegional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Shripad Patil
- ICMR-Regional Medical Research Centre, Northeast Region, Dibrugarh, Assam, India
| | - Kamalesh Sarkar
- ICMR-National Institute of Occupational Health, Ahmedabad, Gujarat, India
| | - Shalini Singh
- ICMR-National JALMA Institute for Leprosy & Other Mycobacterial Diseases, Agra, India
| | - Rajni Kant
- ICMR-Regional Medical Research Centre, Gorakhpur, India
| | - Srikanth Tripathy
- ICMR-National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India
| | - G.S. Toteja
- ICMR-National Institute for Implementation Research on Non-Communicable Diseases, Jodhpur, Rajasthan, India
| | | | - Shashi Kant
- Centre for Community Medicine, New Delhi, India
| | - J.P. Muliyil
- Independent Consultant, Vellore, Tamil Nadu, India
| | - Ravindra Mohan Pandey
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Swarup Sarkar
- Division of Epidemiology & Communicable Diseases, All India Institute of Medical Sciences, New Delhi, India
| | | | | | - Raman R. Gangakhedkar
- Division of Epidemiology & Communicable Diseases, All India Institute of Medical Sciences, New Delhi, India
| | - D.C.S. Reddy
- Independent Consultant, Lucknow, Uttar Pradesh, India
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17
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Adams KN, Verma AK, Gopalaswamy R, Adikesavalu H, Singhal DK, Tripathy S, Ranganathan UD, Sherman DR, Urdahl KB, Ramakrishnan L, Hernandez RE. Diverse Clinical Isolates of Mycobacterium tuberculosis Develop Macrophage-Induced Rifampin Tolerance. J Infect Dis 2020; 219:1554-1558. [PMID: 30753612 PMCID: PMC6473171 DOI: 10.1093/infdis/jiy710] [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: 08/01/2018] [Accepted: 01/29/2019] [Indexed: 12/28/2022] Open
Abstract
The Mycobacterium tuberculosis lineage 4 strains CDC1551 and H37Rv develop tolerance to multiple antibiotics upon macrophage residence. To determine whether macrophage-induced tolerance is a general feature of clinical M. tuberculosis isolates, we assessed macrophage-induced drug tolerance in strains from lineages 1–3, representing the other predominant M. tuberculosis strains responsible for tuberculosis globally. All 3 lineages developed isoniazid tolerance. While lineage 1, 3, and 4 strains developed rifampin tolerance, lineage 2 Beijing strains did not. Their failure to develop tolerance may be explained by their harboring of a loss-of-function mutation in the Rv1258c efflux pump that is linked to macrophage-induced rifampicin tolerance.
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Affiliation(s)
- Kristin N Adams
- Center for Global Infectious Diseases Research, Seattle Children's Research Institute, Center for Infectious Diseases Research, Seattle, Washington
| | - Amit Kumar Verma
- Molecular Immunity Unit, Department of Medicine, University of Cambridge, United Kingdom
| | | | | | | | | | | | - David R Sherman
- Center for Global Infectious Diseases Research, Seattle Children's Research Institute, Center for Infectious Diseases Research, Seattle, Washington
| | - Kevin B Urdahl
- Center for Global Infectious Diseases Research, Seattle Children's Research Institute, Center for Infectious Diseases Research, Seattle, Washington
| | - Lalita Ramakrishnan
- Molecular Immunity Unit, Department of Medicine, University of Cambridge, United Kingdom
| | - Rafael E Hernandez
- Center for Global Infectious Diseases Research, Seattle Children's Research Institute, Center for Infectious Diseases Research, Seattle, Washington.,Department of Pediatrics, University of Washington, Seattle, Washington
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18
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Munir A, Kumar N, Ramalingam SB, Tamilzhalagan S, Shanmugam SK, Palaniappan AN, Nair D, Priyadarshini P, Natarajan M, Tripathy S, Ranganathan UD, Peacock SJ, Parkhill J, Blundell TL, Malhotra S. Identification and Characterization of Genetic Determinants of Isoniazid and Rifampicin Resistance in Mycobacterium tuberculosis in Southern India. Sci Rep 2019; 9:10283. [PMID: 31311987 PMCID: PMC6635374 DOI: 10.1038/s41598-019-46756-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [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: 03/18/2019] [Accepted: 06/28/2019] [Indexed: 02/02/2023] Open
Abstract
Drug-resistant tuberculosis (TB), one of the leading causes of death worldwide, arises mainly from spontaneous mutations in the genome of Mycobacterium tuberculosis. There is an urgent need to understand the mechanisms by which the mutations confer resistance in order to identify new drug targets and to design new drugs. Previous studies have reported numerous mutations that confer resistance to anti-TB drugs, but there has been little systematic analysis to understand their genetic background and the potential impacts on the drug target stability and/or interactions. Here, we report the analysis of whole-genome sequence data for 98 clinical M. tuberculosis isolates from a city in southern India. The collection was screened for phenotypic resistance and sequenced to mine the genetic mutations conferring resistance to isoniazid and rifampicin. The most frequent mutation among isoniazid and rifampicin isolates was S315T in katG and S450L in rpoB respectively. The impacts of mutations on protein stability, protein-protein interactions and protein-ligand interactions were analysed using both statistical and machine-learning approaches. Drug-resistant mutations were predicted not only to target active sites in an orthosteric manner, but also to act through allosteric mechanisms arising from distant sites, sometimes at the protein-protein interface.
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Affiliation(s)
- Asma Munir
- 0000000121885934grid.5335.0Department of Biochemistry, University of Cambridge, Tennis Court. Rd., Cambridge, CB2 1GA UK
| | - Narender Kumar
- 0000000121885934grid.5335.0Department of Medicine, University of Cambridge, Hills Rd., Cambridge, CB2 0QQ UK
| | - Suresh Babu Ramalingam
- 0000 0004 1767 6138grid.417330.2ICMR-National Institute for Research in Tuberculosis, Chennai, 600031 India
| | - Sembulingam Tamilzhalagan
- 0000 0004 1767 6138grid.417330.2ICMR-National Institute for Research in Tuberculosis, Chennai, 600031 India
| | - Siva Kumar Shanmugam
- 0000 0004 1767 6138grid.417330.2ICMR-National Institute for Research in Tuberculosis, Chennai, 600031 India
| | | | - Dina Nair
- 0000 0004 1767 6138grid.417330.2ICMR-National Institute for Research in Tuberculosis, Chennai, 600031 India
| | - Padma Priyadarshini
- 0000 0004 1767 6138grid.417330.2ICMR-National Institute for Research in Tuberculosis, Chennai, 600031 India
| | - Mohan Natarajan
- 0000 0004 1767 6138grid.417330.2ICMR-National Institute for Research in Tuberculosis, Chennai, 600031 India
| | - Srikanth Tripathy
- 0000 0004 1767 6138grid.417330.2ICMR-National Institute for Research in Tuberculosis, Chennai, 600031 India
| | - Uma Devi Ranganathan
- 0000 0004 1767 6138grid.417330.2ICMR-National Institute for Research in Tuberculosis, Chennai, 600031 India
| | - Sharon J. Peacock
- 0000000121885934grid.5335.0Department of Medicine, University of Cambridge, Hills Rd., Cambridge, CB2 0QQ UK ,0000 0004 0425 469Xgrid.8991.9London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT UK
| | - Julian Parkhill
- 0000 0004 0606 5382grid.10306.34Wellcome Trust Sanger Institute, Hinxton, Cambridgeshire CB10 1SA UK
| | - Tom L. Blundell
- 0000000121885934grid.5335.0Department of Biochemistry, University of Cambridge, Tennis Court. Rd., Cambridge, CB2 1GA UK
| | - Sony Malhotra
- 0000000121885934grid.5335.0Department of Biochemistry, University of Cambridge, Tennis Court. Rd., Cambridge, CB2 1GA UK ,0000 0001 2161 2573grid.4464.2Present Address: Birkbeck College, University of London, Malet Street, WC1E7HX London, UK
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19
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Chandramohan Y, Padmanaban V, Bethunaickan R, Tripathy S, Swaminathan S, Ranganathan UD. In vitro interaction profiles of the new antitubercular drugs bedaquiline and delamanid with moxifloxacin against clinical Mycobacterium tuberculosis isolates. J Glob Antimicrob Resist 2019; 19:348-353. [PMID: 31226332 DOI: 10.1016/j.jgar.2019.06.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 08/14/2018] [Revised: 01/17/2019] [Accepted: 06/08/2019] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES The emergence of drug-resistant tuberculosis (TB) poses a serious challenge to existing anti-TB therapies. Hence, there is a direct need for identification of new drugs and effective combination regimens. METHODS In this study, minimum inhibitory concentrations (MICs) of the anti-TB drugs bedaquiline (BDQ), delamanid (DEL) and moxifloxacin (MFX) were evaluated using a resazurin microtiter assay (REMA) against five drug-resistant clinicalMycobacterium tuberculosis (MTB) isolates as well as the drug-susceptible reference strain H37Rv. In addition, their fractional inhibitory concentration indices (FICIs) were evaluated using a REMA-based calorimetric chequerboard assay to assess their interaction profiles against the MTB isolates. RESULTS The FICI indicated that BDQ acted synergistically with DEL against isoniazid (INH)-monoresistant, rifampicin (RIF)-monoresistant and extensively drug-resistant (XDR) clinical MTB isolates. In addition, the combination of DEL acted synergistically with MFX against INH-monoresistant, RIF-monoresistant and XDR clinical MTB isolates. Moreover, the combination of BDQ and MFX showed a synergistic effect against RIF-monoresistant and pre-XDR clinical MTB isolates. DEL at 0.125×MIC (i.e. 0.015μg/mL) used in combination with BDQ at 0.25×MIC (i.e. 0.015μg/mL) had a stronger bactericidal effect against the XDR-TB clinical isolate than DEL alone at 1×MIC (i.e. 0.125μg/mL). CONCLUSION Synergistic and additive effects between these two-drug combinations offer an attractive chemotherapeutic regimen against drug-resistant clinical MTB isolates.
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Affiliation(s)
- Yuvaraj Chandramohan
- Department of Immunology, National Institute for Research in Tuberculosis, No. 1 Mayor Sathyamoorthy Road, Chetpet, Chennai 600 031, India
| | - Venkatesan Padmanaban
- Department of Immunology, National Institute for Research in Tuberculosis, No. 1 Mayor Sathyamoorthy Road, Chetpet, Chennai 600 031, India
| | - Ramalingam Bethunaickan
- Department of Immunology, National Institute for Research in Tuberculosis, No. 1 Mayor Sathyamoorthy Road, Chetpet, Chennai 600 031, India; Pathology and Microbiology Division, ICMR-National Institute of Nutrition, Hyderabad, India
| | - Srikanth Tripathy
- National Institute for Research in Tuberculosis, Chetpet, Chennai 600 031, India
| | - Soumya Swaminathan
- Indian Council of Medical Research, Ansari Nagar East, New Delhi 110029, India
| | - Uma Devi Ranganathan
- Department of Immunology, National Institute for Research in Tuberculosis, No. 1 Mayor Sathyamoorthy Road, Chetpet, Chennai 600 031, India.
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20
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Abstract
Despite the global efforts made to control tuberculosis (TB) and the large number of available new anti-TB drugs, TB still affects one-third of the world population. The conventional vaccine bacille Calmette-Guérin (BCG) shows varying efficacy in different populations, and there are safety issues in immunocompromised patients. Hence, there is an urgent requirement for a new and better TB vaccine candidate than BCG. There are several alternate vaccines available for TB such as DNA, subunit, adjuvant, and live-attenuated vaccines. Use of auxotrophic vaccine is an emerging technology. Newer vaccine technologies include vaccine delivery methods such as adenovirus- and cytomegalovirus (CMV)-based vector delivery, chimeric monoclonal antibody, single-chain fragment variable, RNA-lipoplexes, and nanoparticle-based technology. Based on its application, TB vaccines are classified as conventional, prophylactic, booster, therapeutic, and reinfection preventive vaccines. Currently, there are 12 vaccine candidates in clinical trials. In this review, we have briefly discussed about each of these vaccines in different phases of clinical trials. These vaccines should be analyzed further for developing a safe and more efficacious vaccine for TB.
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Affiliation(s)
- J S V Soundarya
- PhD Research Scholar, Department of Immunology, National Institute for Research in Tuberculosis, Chennai 600031, India
| | - Uma Devi Ranganathan
- Scientist 'D', Department of Immunology, National Institute for Research in Tuberculosis, Chennai 600031, India
| | - Srikanth P Tripathy
- Scientist 'G' & Director-in-charge, National Institute for Research in Tuberculosis, Chennai 600031, India
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21
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Sampath P, Moideen K, Ranganathan UD, Bethunaickan R. Monocyte Subsets: Phenotypes and Function in Tuberculosis Infection. Front Immunol 2018; 9:1726. [PMID: 30105020 PMCID: PMC6077267 DOI: 10.3389/fimmu.2018.01726] [Citation(s) in RCA: 133] [Impact Index Per Article: 22.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 07/12/2018] [Indexed: 12/22/2022] Open
Abstract
Monocytes are critical defense components that play an important role in the primary innate immune response. The heterogeneous nature of monocytes and their ability to differentiate into either monocyte-derived macrophages or monocyte-derived dendritic cells allows them to serve as a bridge between the innate and adaptive immune responses. Current studies of monocytes based on immunofluorescence, single-cell RNA sequencing and whole mass spectrometry finger printing reveals different classification systems for monocyte subsets. In humans, three circulating monocyte subsets are classified based on relative expression levels of CD14 and CD16 surface proteins, namely classical, intermediate and non-classical subsets. Transcriptomic analyses of these subsets help to define their distinct functional properties. Tuberculosis (TB) is a disease instigated by the deadly pathogen Mycobacterium tuberculosis. Current research on monocytes in TB has indicated that there are alterations in the frequency of intermediate and non-classical subsets suggesting their impact in bacterial persistence. In this review, we will focus on these monocyte subsets, including their classification, frequency distribution, cytokine profiles, role as a biomarker and will comment on future directions for understanding the salient phenotypic and functional properties relevant to TB pathogenesis.
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Affiliation(s)
- Pavithra Sampath
- Department of Immunology, National Institute for Research in Tuberculosis, Chennai, India
| | - Kadar Moideen
- International Center of Excellence in Research, National Institute for Research in Tuberculosis, National Institutes for Health, Chennai, India
| | - Uma Devi Ranganathan
- Department of Immunology, National Institute for Research in Tuberculosis, Chennai, India
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22
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Saadhali SA, Hassan S, Hanna LE, Ranganathan UD, Kumar V. Homology modeling, substrate docking, and molecular simulation studies of mycobacteriophage Che12 lysin A. J Mol Model 2016; 22:180. [PMID: 27411553 DOI: 10.1007/s00894-016-3056-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 06/28/2016] [Indexed: 11/26/2022]
Abstract
Mycobacteriophages produce lysins that break down the host cell wall at the end of lytic cycle to release their progenies. The ability to lyse mycobacterial cells makes the lysins significant. Mycobacteriophage Che12 is the first reported temperate phage capable of infecting and lysogenising Mycobacterium tuberculosis. Gp11 of Che12 was found to have Chitinase domain that serves as endolysin (lysin A) for Che12. Structure of gp11 was modeled and evaluated using Ramachandran plot in which 98 % of the residues are in the favored and allowed regions. Che12 lysin A was predicted to act on NAG-NAM-NAG molecules in the peptidoglycan of cell wall. The tautomers of NAG-NAM-NAG molecule were generated and docked with lysin A. The stability and binding affinity of lysin A - NAG-NAM-NAG tautomers were studied using molecular dynamics simulations.
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Affiliation(s)
- Shainaba A Saadhali
- Department of Bacteriology, National Institute for Research in Tuberculosis, Chetpet, Chennai, 600031, India
| | - Sameer Hassan
- Department of Biomedical Informatics, National Institute for Research in Tuberculosis, Chennai, 600031, India
| | - Luke Elizabeth Hanna
- Department of Clinical Research, National Institute for Research in Tuberculosis, Chennai, 600031, India
| | - Uma Devi Ranganathan
- Department of Bacteriology, National Institute for Research in Tuberculosis, Chetpet, Chennai, 600031, India
| | - Vanaja Kumar
- Department of Bacteriology, National Institute for Research in Tuberculosis, Chetpet, Chennai, 600031, India.
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23
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Jensen K, Wilson R, Piatak M, Lifson J, Ranganathan UD, Jacobs W, Fennelly G, Larsen M, Van Rompay K, Kozlowski P, Abel K. Vaccine-induced Intestinal and Salivary IgA Correlates with Reduced Viremia in Orally-challenged Neonatal Macaques. AIDS Res Hum Retroviruses 2014. [DOI: 10.1089/aid.2014.5537.abstract] [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: 11/13/2022] Open
Affiliation(s)
- Kara Jensen
- University of North Carolina at Chapel Hill and Center for AIDS Research, Chapel Hill, NC, United States
| | - Robert Wilson
- Louisiana State University Health Sciences Center, New Orleans, LA, United States
| | | | - Jeff Lifson
- SAIC Frederick, Inc., Frederick, MD, United States
| | | | - William Jacobs
- Albert Einstein College of Medicine, Bronx, NY, United States
| | - Glenn Fennelly
- Albert Einstein College of Medicine, Bronx, NY, United States
| | - Michelle Larsen
- Albert Einstein College of Medicine, Bronx, NY, United States
| | | | - Pamela Kozlowski
- Louisiana State University Health Sciences Center, New Orleans, LA, United States
| | - Kristina Abel
- University of North Carolina at Chapel Hill and Center for AIDS Research, Chapel Hill, NC, United States
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24
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Jensen K, Ranganathan UD, Kozlowski P, Van Rompay K, Canfield D, Ravindran R, Khan I, Luciw P, Fennelly G, Larsen M, Abel K. A recombinant attenuated Mycobacterium tuberculosis-SIV combination vaccine is safe and immunogenic in immunocompromised, SIV-infected infant macaques. Retrovirology 2012. [PMCID: PMC3441880 DOI: 10.1186/1742-4690-9-s2-o4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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25
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Raja A, Ranganathan UD, Bethunaickan R. Improved diagnosis of pulmonary tuberculosis by detection of antibodies against multiple Mycobacterium tuberculosis antigens. Diagn Microbiol Infect Dis 2008; 60:361-8. [PMID: 18206332 DOI: 10.1016/j.diagmicrobio.2007.11.006] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [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: 08/08/2007] [Revised: 11/19/2007] [Accepted: 11/22/2007] [Indexed: 11/19/2022]
Abstract
Two secreted antigens (38 and 30 kDa) and 1 cytosolic antigen (16 kDa) were purified in our laboratory from Mycobacterium tuberculosis culture filtrate and cytosol using chromatographic/electrophoretic methods. One recombinant antigen (27 kDa, MPT51) expressed in Escherichia coli was also isolated. All the 4 antigens were tested individually for detection of serum IgG, IgA, and IgM (a total of 476 sera from 5 groups) by indirect enzyme-linked immunosorbent assay. Keeping the well-reported 38 kDa as the main candidate, the usefulness of the other antigens, which may add to the test positivity in cases not diagnosed by 38 kDa, was analyzed. The individual antigens ranged in their sensitivity from 57% to 67% (IgG). Addition of other antigen results, with that of 38 kDa, offered a sensitivity of 91% in smear- and culture-positive tuberculosis (TB), 78% in smear-negative culture-confirmed TB, and 97% specificity in normal healthy subjects. IgG antibody to multiple antigens (38, 30, and 16 kDa) may be a sensitive, specific, rapid, and cost-effective test to rule-in clinical suspicion of pulmonary TB.
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Affiliation(s)
- Alamelu Raja
- Department of Immunology, Tuberculosis Research Centre (ICMR), Chetput, Chennai 600 031, India.
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26
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Mo Y, Quanquin NM, Vecino WH, Ranganathan UD, Tesfa L, Bourn W, Derbyshire KM, Letvin NL, Jacobs WR, Fennelly GJ. Genetic alteration of Mycobacterium smegmatis to improve mycobacterium-mediated transfer of plasmid DNA into mammalian cells and DNA immunization. Infect Immun 2007; 75:4804-16. [PMID: 17664267 PMCID: PMC2044538 DOI: 10.1128/iai.01877-06] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Mycobacteria target and persist within phagocytic monocytes and are strong adjuvants, making them attractive candidate vectors for DNA vaccines. We characterized the ability of mycobacteria to deliver transgenes to mammalian cells and the effects of various bacterial chromosomal mutations on the efficiency of transfer in vivo and in vitro. First, we observed green fluorescent protein expression via microscopy and fluorescence-activated cell sorting analysis after infection of phagocytic and nonphagocytic cell lines by Mycobacterium smegmatis or M. bovis BCG harboring a plasmid encoding the fluorescence gene under the control of a eukaryotic promoter. Next, we compared the efficiencies of gene transfer using M. smegmatis or BCG containing chromosomal insertions or deletions that cause early lysis, hyperconjugation, or an increased plasmid copy number. We observed a significant-albeit only 1.7-fold-increase in the level of plasmid transfer to eukaryotic cells infected with M. smegmatis hyperconjugation mutants. M. smegmatis strains that overexpressed replication proteins (Rep) of pAL5000, a plasmid whose replicon is incorporated in many mycobacterial constructs, generated a 10-fold increase in plasmid copy number and 3.5-fold and 3-fold increases in gene transfer efficiency to HeLa cells and J774 cells, respectively. Although BCG strains overexpressing Rep could not be recovered, BCG harboring a plasmid with a copy-up mutation in oriM resulted in a threefold increase in gene transfer to J774 cells. Moreover, M. smegmatis strains overexpressing Rep enhanced gene transfer in vivo compared with a wild-type control. Immunization of mice with mycobacteria harboring a plasmid (pgp120(h)(E)) encoding human immunodeficiency virus gp120 elicited gp120-specific CD8 T-cell responses among splenocytes and peripheral blood mononuclear cells that were up to twofold (P < 0.05) and threefold (P < 0.001) higher, respectively, in strains supporting higher copy numbers. The magnitude of these responses was approximately one-half of that observed after intramuscular immunization with pgp120(h)(E). M. smegmatis and other nonpathogenic mycobacteria are promising candidate vectors for DNA vaccine delivery.
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Affiliation(s)
- Yongkai Mo
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, New York, NY 10461, USA
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27
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Raja A, Ranganathan UD, Ramalingam B. Clinical value of specific detection of immune complex-bound antibodies in pulmonary tuberculosis. Diagn Microbiol Infect Dis 2006; 56:281-7. [PMID: 16876372 DOI: 10.1016/j.diagmicrobio.2006.06.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [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: 02/19/2006] [Revised: 05/10/2006] [Accepted: 06/03/2006] [Indexed: 10/24/2022]
Abstract
Two actively secreted (38 and 30 kDa) and 1 cytosolic (16 kDa) antigens were purified from Mycobacterium tuberculosis culture filtrate and cytosol, respectively, using a combination of chromatographic and electrophoretic methods. One recombinant antigen (27 kDa) overexpressed in Escherichia coli was also isolated. The diagnostic test characteristics of circulating immune complex (CIC)-bound antibodies to purified protein antigens, singly and in combination, were evaluated in patients with pulmonary tuberculosis. The individual antigens ranged in their sensitivity from 73% to 88%, while considering the IgG response. Addition of IgA results improved the sensitivity. The combination of IgG results for 38, 30, and 16 kDa offered >95% sensitivity and specificity for the smear- and culture-positive tuberculosis, as well as for the smear-negative, culture-positive group. CIC-bound antibodies promise to be a better diagnostic tool than serum antibodies.
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Affiliation(s)
- Alamelu Raja
- Department of Immunology, Tuberculosis Research Centre (ICMR), Chennai-600 031, India.
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28
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Raja A, Ranganathan UD, Bethunaickan R, Dharmalingam V. Serologic response to a secreted and a cytosolic antigen of Mycobacterium tuberculosis in childhood tuberculosis. Pediatr Infect Dis J 2001; 20:1161-4. [PMID: 11740324 DOI: 10.1097/00006454-200112000-00013] [Citation(s) in RCA: 12] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND AIM Bacteriologic diagnosis of childhood tuberculosis is difficult, and alternate methods are needed. The utility of a serologic test for major secretory antigen (30 kDa) and a cytosolic antigen (16 kDa) of Mycobacterium tuberculosis was evaluated for the diagnosis of tuberculosis in children. METHODS Enzyme-linked immunosorbent assay was used. Specific IgG, IgA and IgM antibodies were measured in the sera from 26 clinically and/or bacteriologically diagnosed cases of childhood tuberculosis and 61 normal children. RESULTS Anti-IgG antibodies alone, against both 30- and 16-kDa antigens, were detected in 65.4% of patients. However, by combination of all three isotypes, increased sensitivities of 84.6 and 73%, with a specificity of 96.7% each, were obtained for 30- and 16-kDa antigens, respectively. CONCLUSIONS We found good specificity and reasonably good sensitivity for detection of antibodies by enzyme-linked immunosorbent assay to 30-kDa antigen alone. The 16-kDa antigen did not perform as well.
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Affiliation(s)
- A Raja
- Department of Immunology, Tuberculosis Research Centre, Chennai, India
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