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Dave M, Thakrar S, Bagnall H, Kumbang J. Real-time evaluation of a multi-agency TB-screening event for persons experiencing homelessness in a town with a low incidence of TB in England. Epidemiol Infect 2024; 152:e73. [PMID: 38557287 PMCID: PMC11094373 DOI: 10.1017/s0950268824000402] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 01/28/2024] [Accepted: 02/22/2024] [Indexed: 04/04/2024] Open
Abstract
Real-time evaluation (RTE) supports populations (e.g., persons experiencing homelessness (PEH) to engage in evaluation of health interventions who may otherwise be overlooked. The aim of this RTE was to explore the understanding of TB amongst PEH, identify barriers/facilitators to attending screening for PEH alongside suggestions for improving TB-screening events targeting PEH, who have high and complex health needs. This RTE composed of free-text structured one-to-one interviews performed immediately after screening at a single tuberculosis (TB) screening event. Handwritten forms were transcribed for thematic analysis, with codes ascribed to answers that were developed into core themes. All RTE participants (n=15) learned about the screening event on the day it was held. Key concerns amongst screening attendees included: stigma around drug use, not understanding the purpose of TB screening, lack of trusted individuals/services present, too many partner organizations involved, and language barriers. Facilitators to screening included a positive welcome to the event, a satisfactory explanation of screening tests, and sharing of results. A need for improved event promotion alongside communication of the purpose of TB screening amongst PEH was also identified. A lack of trust identified by some participants suggests the range of services present should be reconsidered for future screening events.
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Affiliation(s)
- Mona Dave
- UK Field Epidemiology Training Program (UK FETP), UK Health Security Agency, London, United Kingdom
- Field Service Midlands Regions Directorate, UK Health Security Agency, Birmingham, UK
| | - Shivan Thakrar
- East Midlands Health Protection Team, UK Health Security Agency, Nottingham, UK
| | - Helen Bagnall
- Field Service Midlands Regions Directorate, UK Health Security Agency, Birmingham, UK
| | - Jharna Kumbang
- East Midlands Health Protection Team, UK Health Security Agency, Nottingham, UK
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2
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Vaddi A, Hulsebus HJ, O’Neill EL, Knight V, Chan ED. A narrative review of the controversy on the risk of mycobacterial infections with immune checkpoint inhibitor use: does Goldilocks have the answer? J Thorac Dis 2024; 16:1601-1624. [PMID: 38505086 PMCID: PMC10944775 DOI: 10.21037/jtd-23-1395] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 01/11/2024] [Indexed: 03/21/2024]
Abstract
Background and Objective Immune checkpoint inhibitors (ICIs) have revolutionized oncologic treatment. Whether ICIs increase susceptibility to or provide protection against mycobacterial infections remains controversial. The objective of this narrative review is to summarize the literature on the link between ICI use and mycobacterial infections-tuberculosis and non-tuberculous mycobacterial (NTM) infections-and to critically discuss evidence linking ICIs with mycobacterial infections, the possible confounders, and, if indeed the ICIs predispose to such infections, the potential mechanisms of how this may occur. Methods We conducted a literature search on PubMed for relevant articles published from 2011 to current time [2024] utilizing specific keywords of "immune checkpoint inhibitors", "programmed cell death protein-1", "PD-1", "programmed death-ligand 1", "PD-L1", "cytotoxic T-lymphocyte-associated protein-4", or "CTLA-4" with that of "non-tuberculous mycobacterial lung disease", "tuberculosis", or "mycobacteria". The bibliographies of identified papers were perused for additional relevant articles. Key Content and Findings Ex vivo studies using human cells indicate that ICIs would be salubrious for the host against mycobacteria. Yet, many case reports associate ICI use with mycobacterial infections, mostly tuberculosis. Potential confounders include immunosuppression from the cancer, concomitant use of immunosuppressive drugs, lung injury and distortion from chemotherapeutics or radiation, and reporting bias. Mice with genetic disruption of the programmed cell death protein-1 (PD-1) gene are paradoxically more susceptible to Mycobacterium tuberculosis (M. tuberculosis). In contrast, mice administered neutralizing antibody to T cell immunoglobulin and mucin domain-containing protein 3 (TIM3) or knocked out for TIM3 gene have greater capacity to control an M. tuberculosis infection. We posit that hosts with greater baseline immunodeficiency are more likely to derive benefit from ICIs against mycobacterial infections than those with more intact immunity, where ICIs are more likely to be detrimental. Conclusions Studies are needed to test the hypothesis that ICIs may either protect or predispose to mycobacterial infections, depending on the baseline host immune status. Prospective studies are required of patients on ICIs that control for potential confounders as anecdotal case reports are insufficient to provide a causal link. Murine studies with ICIs are also required to corroborate or refute studies of mice with genetic disruption of an immune checkpoint.
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Affiliation(s)
- Akshara Vaddi
- Department of Biology, University of Wisconsin, Madison, WI, USA
| | - Holly J. Hulsebus
- Complement Laboratory, Advance Diagnostics, National Jewish Health, Denver, CO, USA
| | - Emily L. O’Neill
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Vijaya Knight
- Clinical and Translational Allergy and Immunology Laboratory, Children’s Hospital Colorado, Aurora, CO, USA
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA
| | - Edward D. Chan
- Department of Medicine, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, CO, USA
- Department of Academic Affairs, National Jewish Health, Denver, CO, USA
- Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado School of Medicine, Aurora, CO, USA
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Diedericks B, Kok AM, Mandiwana V, Lall N. A Review of the Potential of Poly-(lactide-co-glycolide) Nanoparticles as a Delivery System for an Active Antimycobacterial Compound, 7-Methyljuglone. Pharmaceutics 2024; 16:216. [PMID: 38399270 PMCID: PMC10893214 DOI: 10.3390/pharmaceutics16020216] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/15/2024] [Accepted: 01/30/2024] [Indexed: 02/25/2024] Open
Abstract
7-Methyljuglone (7-MJ) is a pure compound isolated from the roots of Euclea natalensis A. DC., a shrub indigenous to South Africa. It exhibits significant promise as a potential treatment for the highly communicable disease tuberculosis (TB), owing to its effective antimycobacterial activity against Mycobacterium tuberculosis. Despite its potential therapeutic benefits, 7-MJ has demonstrated in vitro cytotoxicity against various cancerous and non-cancerous cell lines, raising concerns about its safety for consumption by TB patients. Therefore, this review focuses on exploring the potential of poly-(lactide-co-glycolic) acid (PLGA) nanoparticles as a delivery system, which has been shown to decrease in vitro cytotoxicity, and 7-MJ as an effective antimycobacterial compound.
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Affiliation(s)
- Bianca Diedericks
- Department of Plant and Soil Sciences, University of Pretoria, Pretoria 0002, South Africa; (B.D.); (A.-M.K.)
| | - Anna-Mari Kok
- Department of Plant and Soil Sciences, University of Pretoria, Pretoria 0002, South Africa; (B.D.); (A.-M.K.)
- Research Fellow, South African International Maritime Institute (SAIMI), Nelson Mandela University, Gqeberha 6019, South Africa
| | - Vusani Mandiwana
- Chemicals Cluster, Centre for Nanostructures and Advanced Materials, Council for Scientific and Industrial Research, Pretoria 0001, South Africa;
| | - Namrita Lall
- Department of Plant and Soil Sciences, University of Pretoria, Pretoria 0002, South Africa; (B.D.); (A.-M.K.)
- School of Natural Resources, University of Missouri, Columbia, MO 65211, USA
- College of Pharmacy, JSS Academy of Higher Education and Research, Mysuru 643001, India
- Senior Research Fellow, Bio-Tech R&D Institute, University of the West Indies, Kingston IAU-016615, Jamaica
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Wang C, Zou RQ, He GZ. Progress in mechanism-based diagnosis and treatment of tuberculosis comorbid with tumor. Front Immunol 2024; 15:1344821. [PMID: 38298194 PMCID: PMC10827852 DOI: 10.3389/fimmu.2024.1344821] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Accepted: 01/02/2024] [Indexed: 02/02/2024] Open
Abstract
Tuberculosis (TB) and tumor, with similarities in immune response and pathogenesis, are diseases that are prone to produce autoimmune stress response to the host immune system. With a symbiotic relationship between the two, TB can facilitate the occurrence and development of tumors, while tumor causes TB reactivation. In this review, we systematically sorted out the incidence trends and influencing factors of TB and tumor, focusing on the potential pathogenesis of TB and tumor, to provide a pathway for the co-pathogenesis of TB comorbid with tumor (TCWT). Based on this, we summarized the latest progress in the diagnosis and treatment of TCWT, and provided ideas for further exploration of clinical trials and new drug development of TCWT.
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Affiliation(s)
- Chuan Wang
- School of Public Health, Kunming Medical University, Kunming, China
| | - Rong-Qi Zou
- Vice Director of Center of Sports Injury Prevention, Treatment and Rehabilitation China National Institute of Sports Medicine A2 Pangmen, Beijing, China
| | - Guo-Zhong He
- School of Public Health, Kunming Medical University, Kunming, China
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Sao Emani C, Reiling N. Spermine enhances the activity of anti-tuberculosis drugs. Microbiol Spectr 2024; 12:e0356823. [PMID: 38095461 PMCID: PMC10782994 DOI: 10.1128/spectrum.03568-23] [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: 10/04/2023] [Accepted: 11/11/2023] [Indexed: 12/21/2023] Open
Abstract
IMPORTANCE This is the first study that attempted to demonstrate the mechanisms of reactive oxygen species (ROS) generation by spermine (Spm) in Mycobacterium tuberculosis (M.tb). Furthermore, this is the first study to demonstrate that it is able to enhance the activity of currently available and World Health Organization (WHO)-approved tuberculosis (TB) drugs. Spermine can easily be obtained since it is already found in our diet. Moreover, as opposed to conventional antibiotics, it is less toxic to humans since it is found in millimolar concentrations in the body. Finally, with the difficulty of curing TB with conventional antibiotics, this study suggests that less toxic molecules, such as Spm, could in a long-term perspective be incorporated in a TB regimen to boost the treatment.
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Affiliation(s)
- Carine Sao Emani
- Microbial Interface Biology, Research Center Borstel, Leibniz Lung Center, Borstel, Germany
| | - Norbert Reiling
- Microbial Interface Biology, Research Center Borstel, Leibniz Lung Center, Borstel, Germany
- German Center for Infection Research (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, Borstel, Germany
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Banda L, Oladimeji O. A Scoping Review Protocol of Social Determinants of HIV/TB Coinfections in Sub-Saharan Africa. Methods Protoc 2024; 7:4. [PMID: 38251197 PMCID: PMC10801473 DOI: 10.3390/mps7010004] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 12/03/2023] [Accepted: 12/06/2023] [Indexed: 01/23/2024] Open
Abstract
Introduction: Tuberculosis (TB) and Human Immunodeficiency Virus (HIV) remain major public health issues in sub-Saharan Africa. The co-occurrence of these diseases is a growing concern in the region, and social determinants, the circumstances under which people are born, live, work, and age, are known to influence the risk of disease transmission, diagnosis, treatment, and outcomes. Here, we present a protocol for the evidence synthesis on the social determinants of HIV/TB coinfections in sub-Saharan Africa. The high prevalence of Tuberculosis (TB) and Human Immunodeficiency Virus (HIV) in sub-Saharan Africa presents significant public health challenges. TB/HIV comorbidity is influenced by various social determinants, including social, economic, cultural, and environmental factors, impacting disease transmission risk, accurate diagnosis, and treatment outcomes. This study protocol aims to provide an evidence synthesis on the social determinants of HIV/TB coinfection in sub-Saharan Africa. Methods and analysis: The researchers will use the Arksey and O'Malley's (2005) methodological framework to guide the scoping review. First, databases such as PubMed, MEDLINE, Web of Science, and PsychInfo will be searched. The researchers will then proceed in two steps. Before finalising the study selection, two independent reviewers will examine the article titles and abstracts for eligibility and inclusion. The researchers will then conduct a full-text screening of the articles based on the selected titles and abstracts. The authors' tool will be used to extract data, ensuring that the articles are properly screened and that the risk of bias is minimized. The chosen studies will be examined using a standardized tool to examine all bibliographic data and study characteristics. Ethics and dissemination: The review will provide an overview of the social determinants influencing the prevalence and outcomes of TB/HIV comorbidity in the region, as well as identify any research gaps. Policymakers, researchers, and healthcare professionals will benefit from the findings in developing targeted interventions to address the social determinants of TB/HIV comorbidity in sub-Saharan Africa.
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Affiliation(s)
- Lucas Banda
- Department of Public Health, Faculty of Medicine and Health Sciences, Walter Sisulu University, Mthatha 5099, South Africa;
| | - Olanrewaju Oladimeji
- Department of Public Health, Faculty of Medicine and Health Sciences, Walter Sisulu University, Mthatha 5099, South Africa;
- Department of Epidemiology and Biostatistics, School of Public Health, Sefako Makgatho Health Sciences University, Pretoria 0208, South Africa
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Fang WJ, Tang SN, Liang RY, Zheng QT, Yao DQ, Hu JX, Song M, Zheng GP, Rosenthal A, Tartakovsky M, Lu PX, Wáng YXJ. Differences in pulmonary nodular consolidation and pulmonary cavity among drug-sensitive, rifampicin-resistant and multi-drug resistant tuberculosis patients: the Guangzhou computerized tomography study. Quant Imaging Med Surg 2024; 14:1010-1021. [PMID: 38223080 PMCID: PMC10783999 DOI: 10.21037/qims-23-694] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 10/28/2023] [Indexed: 01/16/2024]
Abstract
Background Pulmonary nodular consolidation (PN) and pulmonary cavity (PC) may represent the two most promising imaging signs in differentiating multidrug-resistant (MDR)-pulmonary tuberculosis (PTB) from drug-sensitive (DS)-PTB. However, there have been concerns that literature described radiological feature differences between DS-PTB and MDR-PTB were confounded by that MDR-PTB cases tend to have a longer history. This study seeks to further clarify this point. Methods All cases were from the Guangzhou Chest Hospital, Guangzhou, China. We retrieved data of consecutive new MDR cases [n=46, inclusive of rifampicin-resistant (RR) cases] treated during the period of July 2020 and December 2021, and according to the electronic case archiving system records, the main PTB-related symptoms/signs history was ≤3 months till the first computed tomography (CT) scan in Guangzhou Chest Hospital was taken. To pair the MDR-PTB cases with assumed equal disease history length, we additionally retrieved data of 46 cases of DS-PTB patients. Twenty-two of the DS patients and 30 of the MDR patients were from rural communities. The first CT in Guangzhou Chest Hospital was analysed in this study. When the CT was taken, most cases had anti-TB drug treatment for less than 2 weeks, and none had been treated for more than 3 weeks. Results Apparent CT signs associated with chronicity were noted in 10 cases in the DS group (10/46) and 9 cases in the MDR group (10/46). Thus, the overall disease history would have been longer than the assumed <3 months. Still, the history length difference between DS patients and MDR patients in the current study might not be substantial. The lung volume involvement was 11.3%±8.3% for DS cases and 8.4%±6.6% for MDR cases (P=0.022). There was no statistical difference between DS cases and MDR cases both in PN prevalence and in PC prevalence. For positive cases, MDR cases had more PN number (mean of positive cases: 2.63 vs. 2.28, P=0.38) and PC number (mean of positive cases: 2.14 vs. 1.38, P=0.001) than DS cases. Receiver operating characteristic curve analysis shows, PN ≥4 and PC ≥3 had a specificity of 86% (sensitivity 25%) and 93% (sensitivity 36%), respectively, in suggesting the patient being a MDR cases. Conclusions A combination of PN and PC features allows statistical separation of DS and MDR cases.
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Affiliation(s)
- Wei-Jun Fang
- Department of Radiology, Guangzhou Chest Hospital, State Key Laboratory of Respiratory Disease, Guangzhou, China
| | - Sheng-Nan Tang
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
| | - Rui-Yun Liang
- Department of Radiology, Guangzhou Chest Hospital, State Key Laboratory of Respiratory Disease, Guangzhou, China
| | - Qiu-Ting Zheng
- Department of Medical Imaging, Shenzhen Center for Chronic Disease Control, Shenzhen, China
| | - Dian-Qi Yao
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
| | - Jin-Xing Hu
- Department of Tuberculosis, Guangzhou Chest Hospital, State Key Laboratory of Respiratory Disease, Guangzhou, China
| | - Min Song
- Department of Radiology, Guangzhou Chest Hospital, State Key Laboratory of Respiratory Disease, Guangzhou, China
| | - Guang-Ping Zheng
- Department of Radiology, The Third People’s Hospital of Shenzhen, Shenzhen, China
| | - Alex Rosenthal
- Office of Cyber Infrastructure and Computational Biology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Michael Tartakovsky
- Office of Cyber Infrastructure and Computational Biology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Pu-Xuan Lu
- Department of Medical Imaging, Shenzhen Center for Chronic Disease Control, Shenzhen, China
| | - Yì Xiáng J. Wáng
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
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8
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Zhuang L, Yang L, Li L, Ye Z, Gong W. Mycobacterium tuberculosis: immune response, biomarkers, and therapeutic intervention. MedComm (Beijing) 2024; 5:e419. [PMID: 38188605 PMCID: PMC10771061 DOI: 10.1002/mco2.419] [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: 05/28/2023] [Revised: 10/03/2023] [Accepted: 10/12/2023] [Indexed: 01/09/2024] Open
Abstract
Although tuberculosis (TB) is an infectious disease, the progression of the disease following Mycobacterium tuberculosis (MTB) infection is closely associated with the host's immune response. In this review, a comprehensive analysis of TB prevention, diagnosis, and treatment was conducted from an immunological perspective. First, we delved into the host's immune response mechanisms against MTB infection as well as the immune evasion mechanisms of the bacteria. Addressing the challenges currently faced in TB diagnosis and treatment, we also emphasized the importance of protein, genetic, and immunological biomarkers, aiming to provide new insights for early and personalized diagnosis and treatment of TB. Building upon this foundation, we further discussed intervention strategies involving chemical and immunological treatments for the increasingly critical issue of drug-resistant TB and other forms of TB. Finally, we summarized TB prevention, diagnosis, and treatment challenges and put forward future perspectives. Overall, these findings provide valuable insights into the immunological aspects of TB and offer new directions toward achieving the WHO's goal of eradicating TB by 2035.
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Affiliation(s)
- Li Zhuang
- Beijing Key Laboratory of New Techniques of Tuberculosis Diagnosis and TreatmentSenior Department of Tuberculosis, the Eighth Medical Center of PLA General HospitalBeijingChina
- Senior Department of TuberculosisHebei North UniversityZhangjiakouHebeiChina
| | - Ling Yang
- Senior Department of TuberculosisHebei North UniversityZhangjiakouHebeiChina
| | - Linsheng Li
- Senior Department of TuberculosisHebei North UniversityZhangjiakouHebeiChina
| | - Zhaoyang Ye
- Senior Department of TuberculosisHebei North UniversityZhangjiakouHebeiChina
| | - Wenping Gong
- Beijing Key Laboratory of New Techniques of Tuberculosis Diagnosis and TreatmentSenior Department of Tuberculosis, the Eighth Medical Center of PLA General HospitalBeijingChina
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Diab R, Shahidi Dadras M, Rakhshan A, Kaddah A, Abdollahimajd F. Progressive mucinous histiocytosis treated successfully with thalidomide: a rare case report. J DERMATOL TREAT 2023; 34:2117538. [PMID: 36036585 DOI: 10.1080/09546634.2022.2117538] [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] [Indexed: 10/24/2022]
Abstract
Hereditary progressive mucinous histiocytosis (HPMH) is an extremely rare progressive non-Langerhans cell histiocytic disorder presenting with only cutaneous manifestations. Patients typically present with multiple asymptomatic dome-shaped erythematous papules, usually involving the face and upper extremities. Twenty-six cases have been reported worldwide, with no spontaneous regression. Treatment with thalidomide stopped the progression of the disease in two cases. We report a case of progressive mucinous histiocytosis in a 31-year-old female patient with a history of tuberculosis who presented papular lesions on the face that later extended to the hands. She was treated with isoniazid for tuberculosis and isotretinoin for the skin lesions; the improvement was minimal during the next two months, with new lesions appearing on both hands. Thalidomide stopped the progression of the disease. The cause and pathogenesis of HPMH are undetermined. The pathogenesis of HPMH may be similar to that of lysosomal storage disease, considering the intra-cytoplasmic phospholipid deposition in both diseases, in addition to the likelihood of a role of macrophages in triggering the disease. In our patient, tuberculosis may have contributed.
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Affiliation(s)
- Reem Diab
- Department of Dermatology, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Shahidi Dadras
- Department of Dermatology, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Azadeh Rakhshan
- Department of Pathology, Shohada-e Tajrish Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Kaddah
- Department of Surgery, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fahimeh Abdollahimajd
- Department of Dermatology, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Clinical Research Development Unit, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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10
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Jiang F, Han Y, Liu Y, Xue Y, Cheng P, Xiao L, Gong W. A comprehensive approach to developing a multi-epitope vaccine against Mycobacterium tuberculosis: from in silico design to in vitro immunization evaluation. Front Immunol 2023; 14:1280299. [PMID: 38022558 PMCID: PMC10652892 DOI: 10.3389/fimmu.2023.1280299] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 10/20/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction The Bacillus Calmette-Guérin (BCG) vaccine, currently used against tuberculosis (TB), exhibits inconsistent efficacy, highlighting the need for more potent TB vaccines. Materials and methods In this study, we employed reverse vaccinology techniques to develop a promising multi-epitope vaccine (MEV) candidate, called PP13138R, for TB prevention. PP13138R comprises 34 epitopes, including B-cell, cytotoxic T lymphocyte, and helper T lymphocyte epitopes. Using bioinformatics and immunoinformatics tools, we assessed the physicochemical properties, structural features, and immunological characteristics of PP13138R. Results The vaccine candidate demonstrated excellent antigenicity, immunogenicity, and solubility without any signs of toxicity or sensitization. In silico analyses revealed that PP13138R interacts strongly with Toll-like receptor 2 and 4, stimulating innate and adaptive immune cells to produce abundant antigen-specific antibodies and cytokines. In vitro experiments further supported the efficacy of PP13138R by significantly increasing the population of IFN-γ+ T lymphocytes and the production of IFN-γ, TNF-α, IL-6, and IL-10 cytokines in active tuberculosis patients, latent tuberculosis infection individuals, and healthy controls, revealing the immunological characteristics and compare the immune responses elicited by the PP13138R vaccine across different stages of Mycobacterium tuberculosis infection. Conclusion These findings highlight the potential of PP13138R as a promising MEV candidate, characterized by favorable antigenicity, immunogenicity, and solubility, without any toxicity or sensitization.
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Affiliation(s)
- Fan Jiang
- Beijing Key Laboratory of New Techniques of Tuberculosis Diagnosis and Treatment, Senior Department of Tuberculosis, The Eighth Medical Center of PLA General Hospital, Beijing, China
- Respiratory Research Institute, Senior Department of Pulmonary & Critical Care Medicine, The Eighth Medical Center of PLA General Hospital, Beijing, China
- Section of Health, No. 94804 Unit of the Chinese People’s Liberation Army, Shanghai, China
- Resident standardization training cadet corps, Air Force Hospital of Eastern Theater, Nanjing, China
| | - Yong Han
- Respiratory Research Institute, Senior Department of Pulmonary & Critical Care Medicine, The Eighth Medical Center of PLA General Hospital, Beijing, China
| | - Yinping Liu
- Beijing Key Laboratory of New Techniques of Tuberculosis Diagnosis and Treatment, Senior Department of Tuberculosis, The Eighth Medical Center of PLA General Hospital, Beijing, China
| | - Yong Xue
- Beijing Key Laboratory of New Techniques of Tuberculosis Diagnosis and Treatment, Senior Department of Tuberculosis, The Eighth Medical Center of PLA General Hospital, Beijing, China
| | - Peng Cheng
- Beijing Key Laboratory of New Techniques of Tuberculosis Diagnosis and Treatment, Senior Department of Tuberculosis, The Eighth Medical Center of PLA General Hospital, Beijing, China
| | - Li Xiao
- Respiratory Research Institute, Senior Department of Pulmonary & Critical Care Medicine, The Eighth Medical Center of PLA General Hospital, Beijing, China
| | - Wenping Gong
- Beijing Key Laboratory of New Techniques of Tuberculosis Diagnosis and Treatment, Senior Department of Tuberculosis, The Eighth Medical Center of PLA General Hospital, Beijing, China
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11
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Sodsri T, Baughman RP, Sriprasart T. Diagnosis of pulmonary sarcoidosis in tuberculosis endemic area-a narrative review. J Thorac Dis 2023; 15:5760-5772. [PMID: 37969315 PMCID: PMC10636435 DOI: 10.21037/jtd-23-192] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 08/18/2023] [Indexed: 11/17/2023]
Abstract
Background and Objective Pulmonary sarcoidosis and tuberculosis (TB) are the most frequent tissue-confirmed granulomatous diseases. Due to its unknown etiology, pulmonary sarcoidosis is diagnosed by ruling out other granulomatous diseases and necessitating clinical, radiological, and pathological evidence. There are many factors that contribute to the diagnostic dilemma between these two diseases. Even though some aspects of both diseases, such as their pathological evidence and abnormal X-ray findings, are quite similar, the treatment options for each are entirely different. The standard treatment for sarcoidosis is immunosuppressive agents such as glucocorticoids, which can exacerbate TB. Consequently, the overlap between clinical and radiological features constitutes a significant challenge for many physicians in selecting the optimal treatment for each patient. Therefore, the exclusion of pulmonary TB is a mandatory step for the diagnosis of pulmonary sarcoidosis. This article reviews and summarizes basic science and clinical research on distinguishing these two disorders. Methods A systematic search of the MEDLINE and PubMed databases focusing on studies published within the last 35 years was conducted. The last search date is February 4, 2023. The authors used the following combinations of terms: tuberculosis, sarcoidosis, diagnosis, bronchoscopy, biomarkers, and radiography. All studies were reviewed, and 69 references from 1990 to 2023 were found to be relevant. Key Content and Findings Innovative laboratory tests are essential for distinguishing between pulmonary sarcoidosis and TB. The Xpert MTB/RIF assay diagnoses TB with 98% sensitivity and 89% specificity. Loop-mediated isothermal amplification (LAMP) and simultaneous amplification and testing method for Mycobacterium tuberculosis rRNA (SAT-TB) are also highly sensitive and specific for TB diagnosis. Several novel tests, such as the difference of immune complexes for the ESAT-6/SFP-10 antigen in vitro with dynamic light scattering (DLS), lung tissue-based molecular markers, and the blood transcriptome, are promising for differentiating TB from sarcoidosis. Conclusions Recent advancements in laboratory investigations, non-invasive procedures, and invasive procedures play an important role in the diagnosis of sarcoidosis in TB-endemic areas. However, further study is needed to evaluate the diagnostic performance of all tests in terms of their competency in distinguishing between TB and sarcoidosis.
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Affiliation(s)
- Tulaton Sodsri
- Chakri Naruebodindra Medical Institute, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Samut Prakan, Thailand
| | - Robert P. Baughman
- Department of Internal Medicine, University of Cincinnati Medical Center, Cincinnati, OH, USA
| | - Thitiwat Sriprasart
- Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
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12
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Rava A, Mercurio M, Gargiulo G, Fusini F, Boasso G, Galasso O, Gasparini G, Massè A, Girardo M. Conservative treatment of spinal tuberculosis in a retrospective cohort study over 20-year period: high eradication rate and successful health status can be expected. Ann Jt 2023; 8:34. [PMID: 38529251 PMCID: PMC10929317 DOI: 10.21037/aoj-22-54] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 07/19/2023] [Indexed: 03/27/2024]
Abstract
Background Tuberculosis (TB) which mainly cause lung primarily TB, can also affect the musculoskeletal system. Spine involvement occurs in 50% of the cases and neurologic deficit and kyphotic deformity may occur. The choice of conservative or surgical management of spinal TB in the absence of neurologic deficits remains controversial. The aim of the present study was to investigate the outcome and the success rate of conservative treatment and to provide evidence for the timing of treatment for spinal TB in adult patients. Methods Consecutive enrolled adult patients were conservatively treated from January 2000 to January 2020 for spinal TB in a tertiary care Orthopedic and Trauma Center-Spine Surgery Unit in Turin. Patients were conservatively treated with antibiotics and orthoses and followed up for at least 12 months. Clinical, radiological, laboratory and microbiological tests were performed for all the patients and demographic data, risk factors, comorbidity, clinical symptoms such as peripheral neurological deficit, and vertebral level involved were recorded. Treatment success was considered as no disease recurrence after 1 year of follow-up. Patients underwent successful conservative treatment were also evaluated with the self-perceived quality of life [36-Item Short Form (SF-36)] survey. Results A total of 132 patients (59 women and 73 men) suffering from spinal TB with a mean age at presentation of 49 years (range, 32-68 years) were treated. The mean follow-up was 43 months (range, 12-82 months). In 80 cases, there was a single vertebra involvement while multiple levels were involved in 52 cases. Sixty-nine (52%) patients presented spondylitis without involvement of the disk and 63 (48%) patients presented a spondylitis with disk involvement. Conservative treatment was effective in 113 patients (86%) which showed inter-somatic fusion with stability of the spine. The mean period of antibiotic therapy was 12 months (range, 8-15 months). Patients wear spinal orthosis for at least 12 weeks. The physical component summary (PCS)-36 (48.9±10.0) and mental component summary (MCS) (46.5±7.0) summary scores at follow-up were comparable to the normative values (P=0.652 and P=0.862, respectively). Painful deformity occurred in 25 patients (19%). Conclusions Conservative treatment is effective treatment for spinal TB and may avoid surgical intervention in the absence of neurologic deficits.
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Affiliation(s)
- Alessandro Rava
- Department of Orthopaedic and Traumatology, Spine Surgery Unit, Orthopaedic and Trauma Centre, Città della Salute e della Scienza di Torino, Turin, Italy
| | - Michele Mercurio
- Department of Orthopaedic and Trauma Surgery, “Magna Græcia” University, “Mater Domini” University Hospital, Catanzaro, Italy
| | - Giosuè Gargiulo
- Department of Orthopaedic and Traumatology, Spine Surgery Unit, Orthopaedic and Trauma Centre, Città della Salute e della Scienza di Torino, Turin, Italy
| | - Federico Fusini
- Department of Orthopaedic and Traumatology, Regina Montis Regalis Hospital, Mondovì (CN), Italy
| | - Gabriele Boasso
- Department of Orthopaedic and Traumatology, Orthopaedic and Trauma Centre, Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy
| | - Olimpio Galasso
- Department of Orthopaedic and Trauma Surgery, “Magna Græcia” University, “Mater Domini” University Hospital, Catanzaro, Italy
| | - Giorgio Gasparini
- Department of Orthopaedic and Trauma Surgery, “Magna Græcia” University, “Mater Domini” University Hospital, Catanzaro, Italy
| | - Alessandro Massè
- Department of Orthopaedic and Traumatology, Orthopaedic and Trauma Centre, Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy
| | - Massimo Girardo
- Department of Orthopaedic and Traumatology, Spine Surgery Unit, Orthopaedic and Trauma Centre, Città della Salute e della Scienza di Torino, Turin, Italy
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13
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Zhuang L, Ye Z, Li L, Yang L, Gong W. Next-Generation TB Vaccines: Progress, Challenges, and Prospects. Vaccines (Basel) 2023; 11:1304. [PMID: 37631874 PMCID: PMC10457792 DOI: 10.3390/vaccines11081304] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [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: 07/01/2023] [Revised: 07/28/2023] [Accepted: 07/28/2023] [Indexed: 08/27/2023] Open
Abstract
Tuberculosis (TB), caused by Mycobacterium tuberculosis (MTB), is a prevalent global infectious disease and a leading cause of mortality worldwide. Currently, the only available vaccine for TB prevention is Bacillus Calmette-Guérin (BCG). However, BCG demonstrates limited efficacy, particularly in adults. Efforts to develop effective TB vaccines have been ongoing for nearly a century. In this review, we have examined the current obstacles in TB vaccine research and emphasized the significance of understanding the interaction mechanism between MTB and hosts in order to provide new avenues for research and establish a solid foundation for the development of novel vaccines. We have also assessed various TB vaccine candidates, including inactivated vaccines, attenuated live vaccines, subunit vaccines, viral vector vaccines, DNA vaccines, and the emerging mRNA vaccines as well as virus-like particle (VLP)-based vaccines, which are currently in preclinical stages or clinical trials. Furthermore, we have discussed the challenges and opportunities associated with developing different types of TB vaccines and outlined future directions for TB vaccine research, aiming to expedite the development of effective vaccines. This comprehensive review offers a summary of the progress made in the field of novel TB vaccines.
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Affiliation(s)
- Li Zhuang
- Beijing Key Laboratory of New Techniques of Tuberculosis Diagnosis and Treatment, Senior Department of Tuberculosis, Eighth Medical Center of Chinese PLA General Hospital, Beijing 100091, China
- Hebei North University, Zhangjiakou 075000, China
| | - Zhaoyang Ye
- Hebei North University, Zhangjiakou 075000, China
| | - Linsheng Li
- Hebei North University, Zhangjiakou 075000, China
| | - Ling Yang
- Hebei North University, Zhangjiakou 075000, China
| | - Wenping Gong
- Beijing Key Laboratory of New Techniques of Tuberculosis Diagnosis and Treatment, Senior Department of Tuberculosis, Eighth Medical Center of Chinese PLA General Hospital, Beijing 100091, China
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14
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T Siddeek RA, Gupta A, Singla T, Rajput D, Ahmed SS, Jeladharan R. Pancreatic tuberculosis mimicking as pancreatic malignancy: Surgeon's dilemma. INDIAN J PATHOL MICR 2023; 66:614-617. [PMID: 37530353 DOI: 10.4103/ijpm.ijpm_874_21] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Pancreatic tuberculosis is a rare form of Tuberculosis (TB) which requires a high index of suspicion to diagnose. Here, we report a case of middle-aged gentleman presenting with abdominal pain and constitutional symptoms who was diagnosed with pancreatic tuberculosis on imaging, which was confirmed by Fine Needle Aspiration (FNA) from the lesion. The patient was given Anti-Tubercular Treatment (ATT) as per conventional protocol. Follow-up showed recovery from the entity. A review of patient presentation, patho-physiology, diagnosis, and management of pancreatic tuberculosis is mentioned in this article.
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Affiliation(s)
- Rohik Anjum T Siddeek
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Amit Gupta
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Tanuj Singla
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Deepak Rajput
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Shaik Sameer Ahmed
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Reshma Jeladharan
- Department of Pathology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
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15
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Zhu H, Zhou X, Zhuang Z, Li L, Bi J, Mi K. Advances of new drugs bedaquiline and delamanid in the treatment of multi-drug resistant tuberculosis in children. Front Cell Infect Microbiol 2023; 13:1183597. [PMID: 37384221 PMCID: PMC10293792 DOI: 10.3389/fcimb.2023.1183597] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 05/30/2023] [Indexed: 06/30/2023] Open
Abstract
Tuberculosis (TB) is a major public health problem, with nearly 10 million new cases and millions of deaths each year. Around 10% of these cases are in children, but only a fraction receive proper diagnosis and treatment. The spread of drug-resistant (DR) strain of TB has made it difficult to control, with only 60% of patients responding to treatment. Multi-drug resistant TB (MDR-TB) is often undiagnosed in children due to lack of awareness or under-diagnosis, and the target for children's DR-TB treatment has only been met in 15% of goals. New medications such as bedaquiline and delamanid have been approved for treating DR-TB. However, due to age and weight differences, adults and children require different dosages. The availability of child-friendly formulations is limited by a lack of clinical data in children. This paper reviews the development history of these drugs, their mechanism of action, efficacy, safety potential problems and current use in treating DR-TB in children.
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Affiliation(s)
- Hanzhao Zhu
- Chinese Academy of Science (CAS) Key Laboratory of Pathogen Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing, China
- Savaid Medical School, University of Chinese Academy of Sciences, Beijing, China
| | - Xintong Zhou
- Chinese Academy of Science (CAS) Key Laboratory of Pathogen Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing, China
| | - Zengfang Zhuang
- Chinese Academy of Science (CAS) Key Laboratory of Pathogen Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing, China
- Savaid Medical School, University of Chinese Academy of Sciences, Beijing, China
| | - Lianju Li
- Chinese Academy of Science (CAS) Key Laboratory of Pathogen Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing, China
- School of Basic Medicine, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Jing Bi
- Baoding Hospital of Beijing Children’s Hospital, Capital Medical University, Baoding Key Laboratory for Precision Diagnosis and Treatment of Infectious Diseases in Children, Baoding, China
| | - Kaixia Mi
- Chinese Academy of Science (CAS) Key Laboratory of Pathogen Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing, China
- Savaid Medical School, University of Chinese Academy of Sciences, Beijing, China
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16
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Gong W, Liu Y, Xue Y, Zhuang L. Two issues should be noted when designing a clinical trial to evaluate BCG effects on COVID-19. Front Immunol 2023; 14:1207212. [PMID: 37287961 PMCID: PMC10242049 DOI: 10.3389/fimmu.2023.1207212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 05/12/2023] [Indexed: 06/09/2023] Open
Affiliation(s)
- Wenping Gong
- Beijing Key Laboratory of New Techniques of Tuberculosis Diagnosis and Treatment, Senior Department of Tuberculosis, The 8th Medical Center of PLA General Hospital, Beijing, China
| | - Yinping Liu
- Beijing Key Laboratory of New Techniques of Tuberculosis Diagnosis and Treatment, Senior Department of Tuberculosis, The 8th Medical Center of PLA General Hospital, Beijing, China
| | - Yong Xue
- Beijing Key Laboratory of New Techniques of Tuberculosis Diagnosis and Treatment, Senior Department of Tuberculosis, The 8th Medical Center of PLA General Hospital, Beijing, China
| | - Li Zhuang
- Beijing Key Laboratory of New Techniques of Tuberculosis Diagnosis and Treatment, Senior Department of Tuberculosis, The 8th Medical Center of PLA General Hospital, Beijing, China
- Hebei North University, Zhangjiakou, Hebei, China
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17
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Ketchanji Mougang YC, Endale Mangamba LM, Capuano R, Ciccacci F, Catini A, Paolesse R, Mbatchou Ngahane HB, Palombi L, Di Natale C. On-Field Test of Tuberculosis Diagnosis through Exhaled Breath Analysis with a Gas Sensor Array. Biosensors (Basel) 2023; 13:bios13050570. [PMID: 37232931 DOI: 10.3390/bios13050570] [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: 03/17/2023] [Revised: 04/21/2023] [Accepted: 05/18/2023] [Indexed: 05/27/2023]
Abstract
Tuberculosis (TB) is among the more frequent causes of death in many countries. For pulmonary TB, early diagnosis greatly increases the efficiency of therapies. Although highly sensitive tests based on nucleic acid amplification tests (NAATs) and loop-mediated isothermal amplification (TB-LAMP) are available, smear microscopy is still the most widespread diagnostics method in most low-middle-income countries, and the true positive rate of smear microscopy is lower than 65%. Thus, there is a need to increase the performance of low-cost diagnosis. For many years, the use of sensors to analyze the exhaled volatile organic compounds (VOCs) has been proposed as a promising alternative for the diagnosis of several diseases, including tuberculosis. In this paper, the diagnostic properties of an electronic nose (EN) based on sensor technology previously used to identify tuberculosis have been tested on-field in a Cameroon hospital. The EN analyzed the breath of a cohort of subjects including pulmonary TB patients (46), healthy controls (38), and TB suspects (16). Machine learning analysis of the sensor array data allows for the identification of the pulmonary TB group with respect to healthy controls with 88% accuracy, 90.8% sensitivity, 85.7% specificity, and 0.88 AUC. The model trained with TB and healthy controls maintains its performance when it is applied to symptomatic TB suspects with a negative TB-LAMP. These results encourage the investigation of electronic noses as an effective diagnostic method for future inclusion in clinical practice.
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Affiliation(s)
| | - Laurent-Mireille Endale Mangamba
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Carrefour Ange Raphael, Douala P.O. Box 4035, Cameroon
- Center for Respiratory Diseases, Douala Laquintinie Hospital, Avenue du Jamot, Douala P.O. Box 4035, Cameroon
| | - Rosamaria Capuano
- Department of Electronic Engineering, University of Rome Tor Vergata, via del Politecnico 1, 00133 Roma, Italy
- Interdepartmental Centre for Volatilomics "A D'Amico", University of Rome Tor Vergata, via del Politecnico 1, 00133 Roma, Italy
| | - Fausto Ciccacci
- UniCamillus, Saint Camillus International University of Health and Medical Sciences, 00131 Rome, Italy
| | - Alexandro Catini
- Department of Electronic Engineering, University of Rome Tor Vergata, via del Politecnico 1, 00133 Roma, Italy
- Interdepartmental Centre for Volatilomics "A D'Amico", University of Rome Tor Vergata, via del Politecnico 1, 00133 Roma, Italy
| | - Roberto Paolesse
- Interdepartmental Centre for Volatilomics "A D'Amico", University of Rome Tor Vergata, via del Politecnico 1, 00133 Roma, Italy
- Department of Chemical Science and Technology, University of Rome Tor Vergata, via della Ricerca Scientifica, 00133 Rome, Italy
| | - Hugo Bertrand Mbatchou Ngahane
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Carrefour Ange Raphael, Douala P.O. Box 4035, Cameroon
- Internal Medicine Service, Douala General Hospital, Douala P.O. Box 4856, Cameroon
| | - Leonardo Palombi
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Viale Montpellier 1, 00133 Roma, Italy
| | - Corrado Di Natale
- Department of Electronic Engineering, University of Rome Tor Vergata, via del Politecnico 1, 00133 Roma, Italy
- Interdepartmental Centre for Volatilomics "A D'Amico", University of Rome Tor Vergata, via del Politecnico 1, 00133 Roma, Italy
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18
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Njekwa K, Muyoyeta M, Mulenga B, Chisenga CC, Simuyandi M, Chilengi R. Superimposed Pulmonary Tuberculosis (PTB) in a 26-Year-Old Female with No Underlying Co-Morbidities Recovering from COVID-19-Case Report. Trop Med Infect Dis 2023; 8:tropicalmed8050268. [PMID: 37235316 DOI: 10.3390/tropicalmed8050268] [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: 03/20/2023] [Revised: 04/16/2023] [Accepted: 04/26/2023] [Indexed: 05/28/2023] Open
Abstract
Tuberculosis before the COVID-19 pandemic is said to have killed more people globally than any other communicable disease and is ranked the 13th cause of death, according to the WHO. Tuberculosis also still remains highly endemic, especially in LIMCs with a high burden of people living with HIV/AIDS, in which it is the leading cause of mortality. Given the risk factors associated with COVID-19, the cross similarities between tuberculosis and COVID-19 symptoms, and the paucity of data on how both diseases impact each other, there is a need to generate more information on COVID-19-TB co-infection. In this case report, we present a young female patient of reproductive age with no underlying comorbidities recovering from COVID-19, who later presented with pulmonary tuberculosis. It describes the series of investigations performed and treatments given during the follow-up. There is a need for more surveillance for possible COVID-19-TB co-infection cases and further research to understand the impact of COVID-19 on tuberculosis and vice versa, especially in LMICs.
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Affiliation(s)
- Katanekwa Njekwa
- Center for Infectious Disease Research in Zambia (CIDRZ), P.O. Box 34681, Lusaka 10101, Zambia
| | - Monde Muyoyeta
- Center for Infectious Disease Research in Zambia (CIDRZ), P.O. Box 34681, Lusaka 10101, Zambia
- Tuberculosis Programs-Director, Centre for Infectious Disease Research, P.O. Box 34681, Lusaka 10101, Zambia
| | - Bavin Mulenga
- Center for Infectious Disease Research in Zambia (CIDRZ), P.O. Box 34681, Lusaka 10101, Zambia
| | | | - Michelo Simuyandi
- Center for Infectious Disease Research in Zambia (CIDRZ), P.O. Box 34681, Lusaka 10101, Zambia
- Enteric Diseases and Vaccine Research Unit (EDVRU)-Director, P.O. Box 34681, Lusaka 10101, Zambia
| | - Roma Chilengi
- Center for Infectious Disease Research in Zambia (CIDRZ), P.O. Box 34681, Lusaka 10101, Zambia
- Zambia National Public Health Institute (ZNPHI)-Director, H9M2+WGX, Lusaka 10101, Zambia
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19
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Jiang F, Peng C, Cheng P, Wang J, Lian J, Gong W. PP19128R, a Multiepitope Vaccine Designed to Prevent Latent Tuberculosis Infection, Induced Immune Responses In Silico and In Vitro Assays. Vaccines (Basel) 2023; 11:vaccines11040856. [PMID: 37112768 PMCID: PMC10145841 DOI: 10.3390/vaccines11040856] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [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: 03/02/2023] [Revised: 04/13/2023] [Accepted: 04/13/2023] [Indexed: 04/29/2023] Open
Abstract
Background: Latent tuberculosis infection (LTBI) is the primary source of active tuberculosis (ATB), but a preventive vaccine against LTBI is lacking. Methods: In this study, dominant helper T lymphocyte (HTL), cytotoxic T lymphocyte (CTL), and B-cell epitopes were identified from nine antigens related to LTBI and regions of difference (RDs). These epitopes were used to construct a novel multiepitope vaccine (MEV) based on their antigenicity, immunogenicity, sensitization, and toxicity. The immunological characteristics of the MEV were analyzed with immunoinformatics technology and verified by enzyme-linked immunospot assay and Th1/Th2/Th17 cytokine assay in vitro. Results: A novel MEV, designated PP19128R, containing 19 HTL epitopes, 12 CTL epitopes, 8 B-cell epitopes, toll-like receptor (TLR) agonists, and helper peptides, was successfully constructed. Bioinformatics analysis showed that the antigenicity, immunogenicity, and solubility of PP19128R were 0.8067, 9.29811, and 0.900675, respectively. The global population coverage of PP19128R in HLA class I and II alleles reached 82.24% and 93.71%, respectively. The binding energies of the PP19128R-TLR2 and PP19128R-TLR4 complexes were -1324.77 kcal/mol and -1278 kcal/mol, respectively. In vitro experiments showed that the PP19128R vaccine significantly increased the number of interferon gamma-positive (IFN-γ+) T lymphocytes and the levels of cytokines, such as IFN-γ, tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and IL-10. Furthermore, positive correlations were observed between PP19128R-specific cytokines in ATB patients and individuals with LTBI. Conclusions: The PP19128R vaccine is a promising MEV with excellent antigenicity and immunogenicity and no toxicity or sensitization that can induce robust immune responses in silico and in vitro. This study provides a vaccine candidate for the prevention of LTBI in the future.
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Affiliation(s)
- Fan Jiang
- Tuberculosis Prevention and Control Key Laboratory/Beijing Key Laboratory of New Techniques of Tuberculosis Diagnosis and Treatment, Senior Department of Tuberculosis, The 8th Medical Center of PLA General Hospital, Beijing 100091, China
- The Second Brigade of Cadet, Basic Medical Science Academy of Air Force Medical University, Xi'an 710032, China
- Department of Infectious Diseases, Tangdu Hospital, Air Force Medical University, Xi'an 710032, China
| | - Cong Peng
- Tuberculosis Prevention and Control Key Laboratory/Beijing Key Laboratory of New Techniques of Tuberculosis Diagnosis and Treatment, Senior Department of Tuberculosis, The 8th Medical Center of PLA General Hospital, Beijing 100091, China
| | - Peng Cheng
- Tuberculosis Prevention and Control Key Laboratory/Beijing Key Laboratory of New Techniques of Tuberculosis Diagnosis and Treatment, Senior Department of Tuberculosis, The 8th Medical Center of PLA General Hospital, Beijing 100091, China
| | - Jie Wang
- Tuberculosis Prevention and Control Key Laboratory/Beijing Key Laboratory of New Techniques of Tuberculosis Diagnosis and Treatment, Senior Department of Tuberculosis, The 8th Medical Center of PLA General Hospital, Beijing 100091, China
| | - Jianqi Lian
- Department of Infectious Diseases, Tangdu Hospital, Air Force Medical University, Xi'an 710032, China
| | - Wenping Gong
- Tuberculosis Prevention and Control Key Laboratory/Beijing Key Laboratory of New Techniques of Tuberculosis Diagnosis and Treatment, Senior Department of Tuberculosis, The 8th Medical Center of PLA General Hospital, Beijing 100091, China
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20
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Bohlbro AS, Hønge BL, Engell-Sørensen T, Mendes AM, Sifna A, Gomes V, Rudolf F, Wejse C. Life expectancy among patients with pulmonary tuberculosis is less than one-third of life expectancy in the background population in Guinea-Bissau-an observational study. Int J Epidemiol 2023:7104036. [PMID: 37015100 DOI: 10.1093/ije/dyad039] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 03/15/2023] [Indexed: 04/06/2023] Open
Abstract
BACKGROUND Few studies have assessed life expectancy of patients with tuberculosis (TB) against a comparable background population, particularly in low-income, high-incidence settings. This study aimed to estimate the life expectancy (LE) of patients with TB in the West African country of Guinea-Bissau and compare it with the LE of the background population. METHODS This study used data from the Bandim TB cohort from 2004-20 as well as census data from the capital of Guinea-Bissau. LE was estimated using a bootstrapped Kaplan-Meier survival analysis for patients with TB and the background population, stratifying by age of entry and various patient subgroups. The analysis was further stratified by diagnosis period and length of schooling (an indicator of socioeconomic status), to assess their influence on LE. A sensitivity analysis was performed assuming death at loss to follow-up. RESULTS The analysis included 2278 patients and a background population of 169 760 individuals. Overall median LE among 30-year-old patients with TB was 10.7 years (95% CI: 8.7-12.6), compared with 35.8 (95% CI: 35.1-36.5) in the background population. LE was shorter in HIV-infected patients and those who had unsuccessful treatment outcome; however, even among those who were both uninfected with HIV and experienced successful treatment outcome, LE was 20% shorter than in the background population. Longer schooling appeared to decrease mortality. CONCLUSIONS TB substantially shortens LE. This effect is present even in patients who are uninfected with HIV and who have successful treatment outcome.
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Affiliation(s)
- Anders Solitander Bohlbro
- Bandim Health Project, INDEPTH Network, Apartado 861, Bissau, Guinea-Bissau
- Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark
- Center for Global Health, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Bo Langhoff Hønge
- Bandim Health Project, INDEPTH Network, Apartado 861, Bissau, Guinea-Bissau
- Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark
| | | | | | - Armando Sifna
- Bandim Health Project, INDEPTH Network, Apartado 861, Bissau, Guinea-Bissau
| | - Victor Gomes
- Bandim Health Project, INDEPTH Network, Apartado 861, Bissau, Guinea-Bissau
| | - Frauke Rudolf
- Bandim Health Project, INDEPTH Network, Apartado 861, Bissau, Guinea-Bissau
- Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark
| | - Christian Wejse
- Bandim Health Project, INDEPTH Network, Apartado 861, Bissau, Guinea-Bissau
- Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark
- Center for Global Health, Department of Public Health, Aarhus University, Aarhus, Denmark
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21
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Dania E, Stiegler N, Bouchard JP. [Tuberculosis remains a public health issue in South Africa]. Rev Infirm 2023; 72:39-40. [PMID: 37088495 DOI: 10.1016/j.revinf.2023.03.010] [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] [Indexed: 04/25/2023]
Abstract
Tuberculosis is an airborne infectious disease that can damage the lungs and other body organs. Early detection of people infected with Koch's bacillus is important because tuberculosis is a contagious disease. It can be cured. It is still a very common disease in South Africa and is fatal for sixty thousand people per year. Tuberculosis remains a major health problem for which the public authorities must put in place more effective prevention and management policies, particularly by improving the training of nurses and doctors.
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Affiliation(s)
- Elizabeth Dania
- Statistics and Population Studies Department, Faculty of Natural Sciences, University of the Western Cape, RobertSobukwe road, Bellville, 7535 Cape Town, South Africa
| | - Nancy Stiegler
- Statistics and Population Studies Department, Faculty of Natural Sciences, University of the Western Cape, RobertSobukwe road, Bellville, 7535 Cape Town, South Africa
| | - Jean-Pierre Bouchard
- Statistics and Population Studies Department, Faculty of Natural Sciences, University of the Western Cape, RobertSobukwe road, Bellville, 7535 Cape Town, South Africa; Psychologie-Criminologie-Victimologie (PCV), 33000 Bordeaux, France; Centre hospitalier de Cadillac, 33410 Cadillac, France.
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Druszczynska M, Seweryn M, Wawrocki S, Pankowska A, Godkowicz M, Kowalewska-Pietrzak M. The Interferon-Gamma Release Assay versus the Tuberculin Skin Test in the Diagnosis of Mycobacterium tuberculosis Infection in BCG-Vaccinated Children and Adolescents Exposed or Not Exposed to Contagious TB. Vaccines (Basel) 2023; 11. [PMID: 36851265 DOI: 10.3390/vaccines11020387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/02/2023] [Accepted: 02/05/2023] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND Children have an increased risk of developing active tuberculosis (TB) after exposure to Mycobacterium tuberculosis (M.tb), and they are more likely to develop the most severe forms of TB. Rapid diagnosis and treatment of latent M.tb infection (LTBI) is essential to lessen the devastating consequences of TB in children. OBJECTIVE The aim of the study was to evaluate TST (tuberculin skin test) and IGRA (interferon-gamma release assay) utility in identifying LTBI in a cohort of Bacille Calmette-Guérin (BCG)-vaccinated Polish children and adolescents exposed or not exposed to contagious TB. In addition, we asked whether quantitative assessment of IGRA results could be valuable in predicting active TB disease. RESULTS Of the 235 recruited volunteers, 89 (38%) were TST-positive (TST+), 74 (32%) were IGRA-positive (IGRA+), and 62 (26%) were both TST+ and IGRA+. The frequency of TST positivity was significantly higher in the group with (59%) than without TB contact (18%). The percentage of TST+ subjects increased with age from 36% in the youngest children (<2 years) to 47% in the oldest group (>10 years). All positive IGRA results were found solely in the group of children with TB contact. There was a significant increase in the rate of positive IGRA results with age, from 9% in the youngest to 48% in the oldest group. The 10 mm TST cutoff showed good sensitivity and specificity in both TB exposed and nonexposed children and was associated with excellent negative predictive value, especially among nonexposed volunteers. Mean IFN-γ concentrations in IGRA cultures were significantly higher in the group of LTBI compared to the children with active TB disease, both TST+ and TST-. CONCLUSIONS Both TST and IGRA can be used as screening tests for BCG-vaccinated children and adolescents exposed to contagious TB.
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Du J, Su Y, Wang R, Dong E, Cao Y, Zhao W, Gong W. Research progress on specific and non-specific immune effects of BCG and the possibility of BCG protection against COVID-19. Front Immunol 2023; 14:1118378. [PMID: 36798128 PMCID: PMC9927227 DOI: 10.3389/fimmu.2023.1118378] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 01/20/2023] [Indexed: 02/04/2023] Open
Abstract
Bacille Calmette-Guérin (BCG) is the only approved vaccine for tuberculosis (TB) prevention worldwide. BCG has an excellent protective effect on miliary tuberculosis and tuberculous meningitis in children or infants. Interestingly, a growing number of studies have shown that BCG vaccination can induce nonspecific and specific immunity to fight against other respiratory disease pathogens, including SARS-CoV-2. The continuous emergence of variants of SARS-CoV-2 makes the protective efficiency of COVID-19-specific vaccines an unprecedented challenge. Therefore, it has been hypothesized that BCG-induced trained immunity might protect against COVID-19 infection. This study comprehensively described BCG-induced nonspecific and specific immunity and the mechanism of trained immunity. In addition, this study also reviewed the research on BCG revaccination to prevent TB, the impact of BCG on other non-tuberculous diseases, and the clinical trials of BCG to prevent COVID-19 infection. These data will provide new evidence to confirm the hypotheses mentioned above.
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Affiliation(s)
- Jingli Du
- Tuberculosis Prevention and Control Key Laboratory/Beijing Key Laboratory of New Techniques of Tuberculosis Diagnosis and Treatment, Senior Department of Tuberculosis, The 8th Medical Center of PLA General Hospital, Beijing, China
| | - Yue Su
- Tuberculosis Prevention and Control Key Laboratory/Beijing Key Laboratory of New Techniques of Tuberculosis Diagnosis and Treatment, Senior Department of Tuberculosis, The 8th Medical Center of PLA General Hospital, Beijing, China
| | - Ruilan Wang
- Tuberculosis Prevention and Control Key Laboratory/Beijing Key Laboratory of New Techniques of Tuberculosis Diagnosis and Treatment, Senior Department of Tuberculosis, The 8th Medical Center of PLA General Hospital, Beijing, China
| | - Enjun Dong
- Tuberculosis Prevention and Control Key Laboratory/Beijing Key Laboratory of New Techniques of Tuberculosis Diagnosis and Treatment, Senior Department of Tuberculosis, The 8th Medical Center of PLA General Hospital, Beijing, China
| | - Yan Cao
- Tuberculosis Prevention and Control Key Laboratory/Beijing Key Laboratory of New Techniques of Tuberculosis Diagnosis and Treatment, Senior Department of Tuberculosis, The 8th Medical Center of PLA General Hospital, Beijing, China
| | - Wenjuan Zhao
- Tuberculosis Prevention and Control Key Laboratory/Beijing Key Laboratory of New Techniques of Tuberculosis Diagnosis and Treatment, Senior Department of Tuberculosis, The 8th Medical Center of PLA General Hospital, Beijing, China
| | - Wenping Gong
- Tuberculosis Prevention and Control Key Laboratory/Beijing Key Laboratory of New Techniques of Tuberculosis Diagnosis and Treatment, Senior Department of Tuberculosis, The 8th Medical Center of PLA General Hospital, Beijing, China
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Reddy DS, Sinha A, Kurjogi MM, Shanavaz H, Kumar A. Design, synthesis, molecular docking, and biological evaluation of coumarin-thymidine analogs as potent anti-TB agents. Arch Pharm (Weinheim) 2023; 356:e2200633. [PMID: 36634969 DOI: 10.1002/ardp.202200633] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 12/21/2022] [Accepted: 12/23/2022] [Indexed: 01/14/2023]
Abstract
With the intent to discover new antituberculosis (TB) compounds, coumarin-thymidine analogs were synthesized using second-order nucleophilic substitution reactions of bromomethyl coumarin with thymidine. The newly synthesized coumarin-thymidine conjugates (1a-l) were characterized using IR, NMR, GC-MS, and CHN elemental analysis. The novel conjugates were found to exhibit potent anti-TB activity against the Mycobacterium tuberculosis H37 Rv strain, with minimum inhibitory concentrations (MIC) of the active compounds ranging between 0.012 and 0.482 µM. Compound 1k was established as the most active candidate with a MIC of 0.012 µM. The toxicity study on HEK cells confirmed the nontoxic nature of compounds 1e, 1h, 1i, 1j, and 1k. Also, the most active compounds (1k, 1j, and 1e) were stable in the pH range from 2.5 to 10, indicating compatibility with the biophysical environment. Based on the pKa studies, compounds 1k, 1j, and 1e are capable of crossing lipid-membrane barriers and acting on target cells. Molecular docking studies on the M. tuberculosis β-oxidation trifunctional enzyme (PDB ID: 7O4V) were conducted to investigate the mechanisms of anti-TB activity. All compounds showed excellent hydrogen binding interactions and exceptional docking scores against M. tuberculosis, which was in accordance with the results. Compounds 1a-l possessed excellent affinity to proteins, with binding energies ranging from -7.4 to -8.7 kcal/mol.
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Affiliation(s)
- Dinesh S Reddy
- Centre for Nano and Material Sciences, Jain (Deemed-to-be-University), Bangalore, Karnataka, India
| | - Anamika Sinha
- Centre for Nano and Material Sciences, Jain (Deemed-to-be-University), Bangalore, Karnataka, India
| | - Mahantesh M Kurjogi
- Multi-Disciplinary Research Unit, Karnataka Institute of Medical Sciences, Hubli, Karnataka, India
| | - H Shanavaz
- Department of Chemistry, Faculty of Engineering and Technology, Jain University, Bangalore, Karnataka, India
| | - Amit Kumar
- Centre for Nano and Material Sciences, Jain (Deemed-to-be-University), Bangalore, Karnataka, India
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Zou S, Xiang Y, Guo W, Zhu Q, Wu S, Tan Y, Yan Y, Shen L, Feng Y, Liang K. Phenotype and function of peripheral blood γδ T cells in HIV infection with tuberculosis. Front Cell Infect Microbiol 2022; 12:1071880. [PMID: 36619740 PMCID: PMC9816428 DOI: 10.3389/fcimb.2022.1071880] [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] [Received: 10/17/2022] [Accepted: 12/12/2022] [Indexed: 12/24/2022] Open
Abstract
Background Although γδ T cells play an essential role in immunity against Human Immunodeficiency Virus (HIV) or Mycobacterium tuberculosis (MTB), they are poorly described in HIV infection with tuberculosis (TB). Methods The phenotypic and functional properties of peripheral blood γδ T cells in patients with HIV/TB co-infection were analyzed compared to healthy controls and patients with HIV mono-infection or TB by direct intracellular cytokine staining (ICS). Results The percentage of Vδ1 subset in HIV/TB group was significantly higher than that in TB group, while the decreased frequency of the Vδ2 and Vγ2Vδ2 subsets were observed in HIV/TB group than in TB group. The percentage of CD4+CD8- Vδ2 subset in HIV/TB group was markedly lower than in TB group. However, the percentage of CD4+CD8+ Vδ2 subset in HIV/TB group was markedly higher than HIV group or TB group. A lower percentage TNF-α and a higher percentage of IL-17A of Vδ2 subset were observed in HIV/TB group than that in HIV mono-infection. The percentage of perforin-producing Vδ2 subset was significantly lower in HIV/TB group than that in HIV group and TB group. Conclusions Our data suggested that HIV/TB co-infection altered the balance of γδ T cell subsets. The influence of HIV/TB co-infection on the function of γδ T cells to produce cytokines was complicated, which will shed light on further investigations on the mechanisms of the immune response against HIV and/or MTB infection.
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Affiliation(s)
- Shi Zou
- Department of Infectious Diseases, Zhongnan Hospital of Wuhan University, Wuhan, China,Wuhan Research Center for Infectious Diseases and Cancer, Chinese Academy of Medical Sciences, Wuhan, China
| | - Yanni Xiang
- Department of Intensive Care Medicine, Yichang Central People's Hospital, Yichang, China
| | - Wei Guo
- Wuhan Research Center for Infectious Diseases and Cancer, Chinese Academy of Medical Sciences, Wuhan, China,Department of Pathology, Zhongnan Hospital of Wuhan University, Wuhan, China,Department of Pathology, School of Basic Medical Sciences, Wuhan University, Wuhan, China
| | - Qi Zhu
- Wuhan Pulmonary Hospital, Wuhan Institute for Tuberculosis Control, Wuhan, China
| | - Songjie Wu
- Wuhan Research Center for Infectious Diseases and Cancer, Chinese Academy of Medical Sciences, Wuhan, China,Department of Nosocomial Infection Management, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Yuting Tan
- Department of Infectious Diseases, Zhongnan Hospital of Wuhan University, Wuhan, China,Wuhan Research Center for Infectious Diseases and Cancer, Chinese Academy of Medical Sciences, Wuhan, China
| | - Yajun Yan
- Department of Infectious Diseases, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Ling Shen
- Department of Microbiology and Immunology, Center for Primate Biomedical Research, University of Illinois College of Medicine, Chicago, United States,*Correspondence: Ling Shen, ; Yong Feng, ; Ke Liang,
| | - Yong Feng
- Department of Medical Microbiology, Wuhan University School of Basic Medical Sciences, Wuhan, China,*Correspondence: Ling Shen, ; Yong Feng, ; Ke Liang,
| | - Ke Liang
- Department of Infectious Diseases, Zhongnan Hospital of Wuhan University, Wuhan, China,Wuhan Research Center for Infectious Diseases and Cancer, Chinese Academy of Medical Sciences, Wuhan, China,Department of Nosocomial Infection Management, Zhongnan Hospital of Wuhan University, Wuhan, China,Hubei Engineering Center for Infectious Disease Prevention, Control and Treatment, Wuhan, China,*Correspondence: Ling Shen, ; Yong Feng, ; Ke Liang,
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26
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Cheng P, Xue Y, Wang J, Jia Z, Wang L, Gong W. Evaluation of the consistence between the results of immunoinformatics predictions and real-world animal experiments of a new tuberculosis vaccine MP3RT. Front Cell Infect Microbiol 2022; 12:1047306. [PMID: 36405961 PMCID: PMC9666678 DOI: 10.3389/fcimb.2022.1047306] [Citation(s) in RCA: 7] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Accepted: 10/17/2022] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Our previous study developed a novel peptide-based vaccine, MP3RT, to fight against tuberculosis (TB) infection in a mouse model. However, the consistency between the immunoinformatics predictions and the results of real-world animal experiments on the MP3RT vaccine remains unclear. METHOD In this study, we predicted the antigenicity, immunogenicity, physicochemical parameters, secondary structure, and tertiary structure of MP3RT using bioinformatics technologies. The immune response properties of the MP3RT vaccine were then predicted using the C-ImmSim server. Finally, humanized mice were used to verify the characteristics of the humoral and cellular immune responses induced by the MP3RT vaccine. RESULTS MP3RT is a non-toxic and non-allergenic vaccine with an antigenicity index of 0.88 and an immunogenicity index of 0.61, respectively. Our results showed that the MP3RT vaccine contained 53.36% α-helix in the secondary structure, and the favored region accounted for 98.22% in the optimized tertiary structure. The binding affinities of the MP3RT vaccine to the human leukocyte antigen (HLA)-DRB1*01:01 allele, toll-like receptor-2 (TLR-2), and TLR-4 receptors were -1234.1 kcal/mol, -1066.4 kcal/mol, and -1250.4 kcal/mol, respectively. The results of the C-ImmSim server showed that the MP3RT vaccine could stimulate T and B cells to produce immune responses, such as high levels of IgM and IgG antibodies, IFN-γ, TNF-α, and IL-2 cytokines. Results from real-world animal experiments showed that the MP3RT vaccine could stimulate the humanized mice to produce high levels of IgG and IgG2a antibodies and IFN-γ+ T lymphocytes. Furthermore, the levels of IFN-γ, IL-2, and IL-6 cytokines in mice immunized with the MP3RT vaccine were significantly higher than those in the control group. CONCLUSION MP3RT is a highly antigenic and immunogenic potential vaccine that can effectively induce Th1-type immune responses in silico analysis and animal experiments. This study lays the foundation for evaluating the value of computational tools and immunoinformatic techniques in reverse vaccinology research.
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Affiliation(s)
- Peng Cheng
- Tuberculosis Prevention and Control Key Laboratory/Beijing Key Laboratory of New Techniques of Tuberculosis Diagnosis and Treatment, Senior Department of Tuberculosis, The 8th Medical Center of PLA General Hospital, Beijing, China,Hebei North University, Zhangjiakou, Hebei, China
| | - Yong Xue
- Tuberculosis Prevention and Control Key Laboratory/Beijing Key Laboratory of New Techniques of Tuberculosis Diagnosis and Treatment, Senior Department of Tuberculosis, The 8th Medical Center of PLA General Hospital, Beijing, China
| | - Jie Wang
- Tuberculosis Prevention and Control Key Laboratory/Beijing Key Laboratory of New Techniques of Tuberculosis Diagnosis and Treatment, Senior Department of Tuberculosis, The 8th Medical Center of PLA General Hospital, Beijing, China
| | - Zaixing Jia
- Tuberculosis Prevention and Control Key Laboratory/Beijing Key Laboratory of New Techniques of Tuberculosis Diagnosis and Treatment, Senior Department of Tuberculosis, The 8th Medical Center of PLA General Hospital, Beijing, China,Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine, Cangzhou, Hebei, China
| | - Liang Wang
- Tuberculosis Prevention and Control Key Laboratory/Beijing Key Laboratory of New Techniques of Tuberculosis Diagnosis and Treatment, Senior Department of Tuberculosis, The 8th Medical Center of PLA General Hospital, Beijing, China,*Correspondence: Wenping Gong, ; Liang Wang,
| | - Wenping Gong
- Tuberculosis Prevention and Control Key Laboratory/Beijing Key Laboratory of New Techniques of Tuberculosis Diagnosis and Treatment, Senior Department of Tuberculosis, The 8th Medical Center of PLA General Hospital, Beijing, China,*Correspondence: Wenping Gong, ; Liang Wang,
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Yadav BK, Shah AK, Karunanand B, Sudan DS, Sharma M. Comparative evaluation of INF-γ as an immunological healing marker based on anti-tubercular treatment among diabetic and non-diabetic pulmonary tuberculosis patients. Horm Mol Biol Clin Investig 2022; 44:33-37. [PMID: 36148507 DOI: 10.1515/hmbci-2022-0031] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 07/20/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Tuberculosis is an infectious airborne disease caused by Mycobacterium tuberculosis. Pulmonary tuberculosis is the ninth most frequent complication of diabetes mellitus. The co-existence of TB and DM in patient causes severe TB symptoms, modify radiological findings, slower response to treatment outcomes and prognosis. IFN-γ is the key cytokine which play role in the protective immune response against mycobacterium infection. The main function of IFN-γ is macrophage activation which is able to exert its microbicidal functions. Estimation and comparison of pre and post treatment serum IFN-γ among pulmonary tuberculosis among diabetic and non-diabetic patients. METHODS The study was conducted in the Departments of Biochemistry and Pulmonary Medicine, FMHS, SGT University, Budhera, Gurugram and District TB Centre, Gurugram, Haryana, India. In this study, 100 newly diagnosed PTB patients without diabetes mellitus and 100 newly diagnosed PTB patients with diabetes mellitus (PTB-DM) above 15 years of age were included after obtaining written consent. 5 mL venous blood was collected from patients of pre and post anti-tubercular treatment. The level of IFN-γ was measured by ELISA method. RESULTS The circulating level of IFN-γ in PTB patients was significantly decreased in post-treatment (25.53 ± 6.12 pg/mL) compared to pre-treatment (58.76 ± 16.02 pg/mL) with t-value 32.03 and p-value <0.001. The circulating level of IFN-γ in PTB-DM patients was significantly decreased in post treatment (29.11 ± 7.41 pg/mL) compared to pre-treatment (44.14 ± 10.85 pg/mL) with t-value 31.35 and p-value <0.001. In the present study, level of IFN-γ in pre-treatment PTB patients (58.76 ± 16.02 pg/mL) was significantly raised compared to PTB-DM patients (44.14 ± 10.85 pg/mL) with t-value 7.55 and p-value <0.001. However, level of IFN-γ in post-treatment PTB patients (25.53 ± 6.12 pg/mL) was significantly low compared to PTB-DM patients (29.11 ± 7.41 pg/mL) with t-value 3.71 and p-value <0.001. CONCLUSIONS The decreased level of IFN-γ in post-treatment compared to pre-treatment in both PTB and PTB-DM patients had shown efficacy of anti-tubercular treatment. However, the post treatment level of IFN-γ was high in PTB-DM patients compared to PTB patients which verified that effect of ATT was low in PTB-DM.
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Affiliation(s)
- Birendra Kumar Yadav
- Department of Biochemistry, Banas Medical College & Research Institute, Palanpur, Gujarat, India
| | - Ashok Kumar Shah
- Department of Biochemistry, Adesh Medical College & Hospital, Shahbad, Haryana, India
| | - Busi Karunanand
- Department of Biochemistry, FMHS, SGT University, Gurugram, Haryana, India
| | | | - Monika Sharma
- Department of Microbiology, FMHS, SGT University, Gurugram, India
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Duan C, Jiang Q, Jiang X, Zeng H, Wu Q, Yu Y, Yang X. Discovery of a Novel Inhibitor Structure of Mycobacterium tuberculosis Isocitrate Lyase. Molecules 2022; 27:molecules27082447. [PMID: 35458645 PMCID: PMC9026967 DOI: 10.3390/molecules27082447] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 03/30/2022] [Accepted: 03/31/2022] [Indexed: 02/06/2023] Open
Abstract
Tuberculosis remains a global threat to public health, and dormant Mycobacterium tuberculosis leads to long-term medication that is harmful to the human body. M. tuberculosis isocitrate lyase (MtICL), which is absent in host cells, is a key rate-limiting enzyme of the glyoxylic acid cycle and is essential for the survival of dormant M. tuberculosis. The aim of this study was to evaluate natural compounds as potential MtICL inhibitors through docking and experimental verification. Screening of the TCMSP database library was done using Discovery Studio 2019 for molecular docking and interaction analysis, with the putative inhibitors of MtICL, 3-BP, and IA as reference ligands. Daphnetin (MOL005118), with a docking score of 94.8 and -CDOCKER interaction energy of 56 kcal/mol, was selected and verified on MtICL in vitro and M. smegmatis; daphnetin gave an IC50 of 4.34 μg/mL for the MtICL enzyme and an MIC value of 128 μg/mL against M. smegmatis, showing enhanced potential in comparison with 3-BP and IA. The interactions and essential amino acid residues of the protein were analyzed. In summary, natural daphnetin may be a promising new skeleton for the design of inhibitors of MtICL to combat dormant M. tuberculosis.
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Affiliation(s)
- Changyuan Duan
- Key Laboratory of Medical Laboratory Diagnostics of the Education Ministry, College of Laboratory Medicine, Chongqing Medical University, No. 1, Yixueyuan Road, Yuzhong Dist, Chongqing 400016, China; (C.D.); (X.J.); (H.Z.); (Q.W.); (Y.Y.)
| | - Qihua Jiang
- College of Pharmacy, Chongqing Medical University, Chongqing 400016, China;
| | - Xue Jiang
- Key Laboratory of Medical Laboratory Diagnostics of the Education Ministry, College of Laboratory Medicine, Chongqing Medical University, No. 1, Yixueyuan Road, Yuzhong Dist, Chongqing 400016, China; (C.D.); (X.J.); (H.Z.); (Q.W.); (Y.Y.)
| | - Hongwei Zeng
- Key Laboratory of Medical Laboratory Diagnostics of the Education Ministry, College of Laboratory Medicine, Chongqing Medical University, No. 1, Yixueyuan Road, Yuzhong Dist, Chongqing 400016, China; (C.D.); (X.J.); (H.Z.); (Q.W.); (Y.Y.)
| | - Qiaomin Wu
- Key Laboratory of Medical Laboratory Diagnostics of the Education Ministry, College of Laboratory Medicine, Chongqing Medical University, No. 1, Yixueyuan Road, Yuzhong Dist, Chongqing 400016, China; (C.D.); (X.J.); (H.Z.); (Q.W.); (Y.Y.)
| | - Yang Yu
- Key Laboratory of Medical Laboratory Diagnostics of the Education Ministry, College of Laboratory Medicine, Chongqing Medical University, No. 1, Yixueyuan Road, Yuzhong Dist, Chongqing 400016, China; (C.D.); (X.J.); (H.Z.); (Q.W.); (Y.Y.)
| | - Xiaolan Yang
- Key Laboratory of Medical Laboratory Diagnostics of the Education Ministry, College of Laboratory Medicine, Chongqing Medical University, No. 1, Yixueyuan Road, Yuzhong Dist, Chongqing 400016, China; (C.D.); (X.J.); (H.Z.); (Q.W.); (Y.Y.)
- Correspondence: ; Tel.: +86-23-6848-5240
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Getachew E, Woldeamanuel Y, Manyazewal T. Capacity and Readiness Assessment of Healthcare Facilities for Digital Health Interventions Against Tuberculosis and HIV in Addis Ababa, Ethiopia. Front Digit Health 2022; 4:821390. [PMID: 35295619 PMCID: PMC8918491 DOI: 10.3389/fdgth.2022.821390] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [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: 11/24/2021] [Accepted: 02/03/2022] [Indexed: 01/12/2023] Open
Abstract
Background There is a high level of concern that low-income countries lack the capacity and readiness to effectively adopt, implement, and scale up digital health interventions (DHIs). We aimed to assess the infrastructure and human resource capacity and readiness of healthcare facilities to adopt and implement any new DHI for tuberculosis (TB) and HIV care and treatment in Addis Ababa, Ethiopia. Method We carried out a cross-sectional, mixed-methods study in 14 public healthcare facilities that provide TB and HIV care and treatment services. Providers' perceived readiness to adopt and implement digital health was assessed using a self-administered questionnaire designed based on an adapted eHealth readiness assessment model that covers six domains: core readiness, organizational cultural readiness, value proposition readiness, technological readiness, regulatory policy readiness, and operational resource readiness. The infrastructure and human resource capacity were assessed on-site using a tool adapted from the Technology Infrastructure Checklist. Internal consistency was assessed using Cronbach's alpha, and the significant relationship between the composite variables was assessed using Pearson's correlation coefficients (r). Result We assessed 14 facilities on-site and surveyed 60 TB and HIV healthcare providers. According to Cronbach's alpha test, all the six technology acceptance domains had a value of >0.8, suggesting a strong interrelatedness between the measuring items. The correlation between technological readiness and operational resource readiness was significant (r = 0.8). The providers perceived their work environment as good enough in electronic data protection, while more efforts are needed in planning, training, adapting, and implementing digital health. Of the 14 facilities, 64.3% lack the plan to establish a functional local area network, and 43% lack skilled staff on payroll to provide maintenance of computers and other digital technologies. Conclusion Like many developing countries, there was a modest infrastructure and human resource capacity and readiness of public healthcare facilities in Addis Ababa, Ethiopia, to nurture and strengthen DHIs across the TB and HIV cascades of care. Technological and operational resource readiness, including funding and a Well-trained workforce, are essential for successful implementation and use of digital health against the two infectious diseases of global importance in such settings.
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Affiliation(s)
- Emnet Getachew
- Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Public Health, College of Health Science, Arsi University, Asella, Ethiopia
| | - Yimtubezinash Woldeamanuel
- Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tsegahun Manyazewal
- Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Yang F, Yu H, Kantipudi K, Karki M, Kassim YM, Rosenthal A, Hurt DE, Yaniv Z, Jaeger S. Differentiating between drug-sensitive and drug-resistant tuberculosis with machine learning for clinical and radiological features. Quant Imaging Med Surg 2022; 12:675-687. [PMID: 34993110 DOI: 10.21037/qims-21-290] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [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: 03/16/2021] [Accepted: 07/23/2021] [Indexed: 12/12/2022]
Abstract
Background Tuberculosis (TB) drug resistance is a worldwide public health problem that threatens progress made in TB care and control. Early detection of drug resistance is important for disease control, with discrimination between drug-resistant TB (DR-TB) and drug-sensitive TB (DS-TB) still being an open problem. The objective of this work is to investigate the relevance of readily available clinical data and data derived from chest X-rays (CXRs) in DR-TB prediction and to investigate the possibility of applying machine learning techniques to selected clinical and radiological features for discrimination between DR-TB and DS-TB. We hypothesize that the number of sextants affected by abnormalities such as nodule, cavity, collapse and infiltrate may serve as a radiological feature for DR-TB identification, and that both clinical and radiological features are important factors for machine classification of DR-TB and DS-TB. Methods We use data from the NIAID TB Portals program (https://tbportals.niaid.nih.gov), 1,455 DR-TB cases and 782 DS-TB cases from 11 countries. We first select three clinical features and 26 radiological features from the dataset. Then, we perform Pearson's chi-squared test to analyze the significance of the selected clinical and radiological features. Finally, we train machine classifiers based on different features and evaluate their ability to differentiate between DR-TB and DS-TB. Results Pearson's chi-squared test shows that two clinical features and 23 radiological features are statistically significant regarding DR-TB vs. DS-TB. A ten-fold cross-validation using a support vector machine shows that automatic discrimination between DR-TB and DS-TB achieves an average accuracy of 72.34% and an average AUC value of 78.42%, when combing all 25 statistically significant features. Conclusions Our study suggests that the number of affected lung sextants can be used for predicting DR-TB, and that automatic discrimination between DR-TB and DS-TB is possible, with a combination of clinical features and radiological features providing the best performance.
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Affiliation(s)
- Feng Yang
- Lister Hill National Center for Biomedical Communications, National Library of Medicine, National Institutes of Health, Bethesda, MD, USA
| | - Hang Yu
- Lister Hill National Center for Biomedical Communications, National Library of Medicine, National Institutes of Health, Bethesda, MD, USA
| | - Karthik Kantipudi
- Office of Cyber Infrastructure and Computational Biology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Manohar Karki
- Lister Hill National Center for Biomedical Communications, National Library of Medicine, National Institutes of Health, Bethesda, MD, USA
| | - Yasmin M Kassim
- Lister Hill National Center for Biomedical Communications, National Library of Medicine, National Institutes of Health, Bethesda, MD, USA
| | - Alex Rosenthal
- Office of Cyber Infrastructure and Computational Biology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Darrell E Hurt
- Office of Cyber Infrastructure and Computational Biology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Ziv Yaniv
- Office of Cyber Infrastructure and Computational Biology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Stefan Jaeger
- Lister Hill National Center for Biomedical Communications, National Library of Medicine, National Institutes of Health, Bethesda, MD, USA
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Korzeniewska-Koseła M, Wesołowski S. Tuberculosis in Poland in 2020. Przegl Epidemiol 2022; 76:528-546. [PMID: 37017237 DOI: 10.32394/pe.76.48] [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] [Subscribe] [Scholar Register] [Indexed: 04/06/2023]
Abstract
AIM OF THE STUDY To evaluate the main features of epidemiology of tuberculosis (TB) in 2020 in Poland and to compare with the situation in the European Union and European Economic Area (EU/EEA) countries. MATERIAL AND METHODS Analysis of case-based data on TB patients from National TB Register, data on anti-TB drug susceptibility in cases notified in 2020, data from Statistics Poland on deaths from tuberculosis in 2019, data from National Institute of Public Health NIH - National Research Institute (NIPH NIH - NRI) on HIV-positive subjects for whom TB was an AIDS-defining disease, data from the report "European Centre for Disease Prevention and Control, WHO Regional Office for Europe. Tuberculosis surveillance and monitoring in Europe 2022 - 2020 data. Copenhagen: WHO Regional Office for Europe and Stockholm: European Centre for Disease Prevention and Control; 2022." RESULTS In 2020, 3,388 TB cases were reported in Poland. The incidence rate was 8.8 cases per 100,000 with large variability between voivodeships from 5.5 to 13.3 per 100,000. A decrease in the incidence was found in 15 voivodeships, the most significant in Śląskie voivodship (63.9%). The number of all pulmonary tuberculosis cases was 3,237 i.e. 8.4 per 100,000. Pulmonary cases represented 95.5% of all TB cases. In 2020, 151 extrapulmonary TB cases were notified (4.5% of all TB cases). Pulmonary tuberculosis was bacteriologically confirmed in 2,573 cases (79.5% of all pulmonary TB cases, the incidence rate 6.7 per 100,000). The number of smear-positive pulmonary TB cases was 1,771 i.e. 4.6 per 100,000 (54.7% of all pulmonary TB cases). In 2020, there were 38 cases (15 of foreign origin) with multidrug resistant TB (MDR-TB) representing 1.6% of cases with known drug sensitivity. The incidence rates of tuberculosis were growing along with increasing age from 0.7 per 100,000 among children (0-14 years) to 15.0 per 100,000 among subjects in the age group 45-64 years, the incidence rate in the age group ≥65 years was 12.1 per 100,000. There were 39 cases in children up to 14 years of age (1.2% of the total) and 49 cases in adolescents between 15 and 19 years of age - rates 0.7 and 2.7 per 100,000 respectively. In 2020, there were 2,506 cases of tuberculosis in men and 882 in women. The TB incidence in men - 13.5 per 100,000 was 3.0 times higher than among women - 4.5. The biggest difference in the TB incidence between the two sex groups occurred in persons aged 50-54 years - 26.8 vs. 4.1 and in age group 55 to 59 years - 28.7 vs. 4.8. In 2020, there were 116 patients of foreign origin among all cases of tuberculosis in Poland (3.4%). In 2019, TB was the cause of death for 456 people (mortality rate - 1.2 per 100,000). CONCLUSIONS TB incidence in Poland in 2020 was 36.7% lower than in 2019. Such significant declines in the incidence have not been observed in the last two decades. As in previous years, there were differences in incidence rates between voivodeships with an unexpectedly sharp decrease in incidence in Silesia (Śląskie voivodeship). The percentage of tuberculosis cases with bacteriological confirmation exceeded 78%, more than in EU/EEA countries (67.3%). The percentage of MDR-TB cases was still lower than the average in EU/EEA countries (1.6% vs. 3.8%). The highest incidence rates were found in Poland in the older age groups (EU/EEAaged 25 to 44). The percentage of children up to 14 years of age among the total number of TB patients was 1.2%, less than the average in EU/EEA countries (3.8%). The incidence of tuberculosis in men was three times higher than in women in Poland, and six times higher in patients aged 50 to 59. The impact of migration on the TB pattern in Poland has not yet become significant in 2020. The percentage of foreigners among TB patients was 3.4% (33% in EU/EEA countries).
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Affiliation(s)
- Maria Korzeniewska-Koseła
- Department of Tuberculosis Epidemiology and Surveillance, National Tuberculosis and Lung Diseases Research Institute
| | - Stefan Wesołowski
- National Tuberculosis and Lung Diseases Research Institute, the Institute Director
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Shi J, Li J, Wang Q, Cheng X, Du H, Han R, Li X, Zhao C, Gao G, He Y, Chen X, Su C, Ren S, Wu F, Zhang Z, Zhou C. The safety and efficacy of immunotherapy with anti-programmed cell death 1 monoclonal antibody for lung cancer complicated with Mycobacterium tuberculosis infection. Transl Lung Cancer Res 2021; 10:3929-3942. [PMID: 34858782 PMCID: PMC8577979 DOI: 10.21037/tlcr-21-524] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 07/15/2021] [Accepted: 09/16/2021] [Indexed: 12/26/2022]
Abstract
Background Anti-programmed cell death 1 (PD-1)/programmed cell death-ligand 1 (PD-L1) immunotherapy has boosted the prognosis in advanced lung cancer. Meanwhile, accumulating cases showed the correlation between tuberculosis (TB) reactivation and anti-PD-1/PD-L1 immunotherapy. However, the safety and efficacy of anti-PD-1/PD-L1 immunotherapy for lung cancer complicated with TB infection could only be learned from real-world data. Methods We retrospectively analyzed 562 patients with advanced lung cancer who received anti-PD-1/PD-L1 immunotherapy at Shanghai Pulmonary Hospital from 2015 to 2019, including 13 patients with TB infection. Besides, relevant literature reviews were performed online to analyze the safety and efficacy of immunotherapy and to explore the appropriate treatment strategies in this specific population. Results In our cohort, the initiation of anti-PD-1/PD-L1 immunotherapy was from June 2015 to December 2019. Among them, 13 patients had TB infection prior to immunotherapy including 11 latent TB and 2 active TB, and all of them were treated with anti-PD-1 immunotherapy. Patients with active TB infection were treated with concurrent anti-TB and anti-PD-1 treatments, and the remaining received either mono-immunotherapy or combined immunotherapy. Neither reactivation of latent TB nor progression of active TB was monitored in our cohort during immunotherapy. Severe immune-related adverse events (irAEs) were diagnosed in two patients. Treatment strategies such as discontinuation of immunotherapy and administration of corticosteroids were provided timely, and one with latent TB infection got gradually improved, but the other one with active TB died quickly. The median progression-free survival (PFS) was 5.5 months for tumor immunotherapy in our cohort. However, the PFS of immunotherapy was merely 2.1 and 2.2 months in lung cancer patients with active TB infection. Conclusions Immunotherapy is relatively safe for lung cancer patients complicated with previously treated latent TB, and the efficacy of immunotherapy in this specified population is not inferior to that in lung cancer patients without TB infection. TB screening before anti-PD-1/PD-L1 immunotherapy is strongly recommended, and irAEs should be monitored more cautiously in lung cancer patients with active TB infection.
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Affiliation(s)
- Jinpeng Shi
- Department of Medical Oncology, Shanghai Pulmonary Hospital & Thoracic Cancer Institute, School of Medicine, Tongji University, Shanghai, China.,Department of Pulmonary & Critical Care Medicine, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China.,School of Medicine, Tongji University, Shanghai, China
| | - Jiayu Li
- Department of Medical Oncology, Shanghai Pulmonary Hospital & Thoracic Cancer Institute, School of Medicine, Tongji University, Shanghai, China
| | - Qi Wang
- Department of Medical Oncology, Shanghai Pulmonary Hospital & Thoracic Cancer Institute, School of Medicine, Tongji University, Shanghai, China.,Department of Pulmonary & Critical Care Medicine, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China.,School of Medicine, Tongji University, Shanghai, China
| | - Xiaomin Cheng
- Department of Medical Oncology, Shanghai Pulmonary Hospital & Thoracic Cancer Institute, School of Medicine, Tongji University, Shanghai, China.,Department of Pulmonary & Critical Care Medicine, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China.,School of Medicine, Tongji University, Shanghai, China
| | - He Du
- Department of Medical Oncology, Shanghai Pulmonary Hospital & Thoracic Cancer Institute, School of Medicine, Tongji University, Shanghai, China
| | - Ruoshuang Han
- Department of Medical Oncology, Shanghai Pulmonary Hospital & Thoracic Cancer Institute, School of Medicine, Tongji University, Shanghai, China.,School of Medicine, Tongji University, Shanghai, China
| | - Xuefei Li
- Department of Lung Cancer and Immunology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Chao Zhao
- Department of Lung Cancer and Immunology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Guanghui Gao
- Department of Medical Oncology, Shanghai Pulmonary Hospital & Thoracic Cancer Institute, School of Medicine, Tongji University, Shanghai, China
| | - Yayi He
- Department of Medical Oncology, Shanghai Pulmonary Hospital & Thoracic Cancer Institute, School of Medicine, Tongji University, Shanghai, China
| | - Xiaoxia Chen
- Department of Medical Oncology, Shanghai Pulmonary Hospital & Thoracic Cancer Institute, School of Medicine, Tongji University, Shanghai, China
| | - Chunxia Su
- Department of Medical Oncology, Shanghai Pulmonary Hospital & Thoracic Cancer Institute, School of Medicine, Tongji University, Shanghai, China
| | - Shengxiang Ren
- Department of Medical Oncology, Shanghai Pulmonary Hospital & Thoracic Cancer Institute, School of Medicine, Tongji University, Shanghai, China
| | - Fengying Wu
- Department of Medical Oncology, Shanghai Pulmonary Hospital & Thoracic Cancer Institute, School of Medicine, Tongji University, Shanghai, China
| | - Zhemin Zhang
- Department of Pulmonary & Critical Care Medicine, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Caicun Zhou
- Department of Medical Oncology, Shanghai Pulmonary Hospital & Thoracic Cancer Institute, School of Medicine, Tongji University, Shanghai, China
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Zhang B, Xiao L, Qiu Q, Miao L, Yan S, Zhou S. Association between IL-18, IFN-γ and TB susceptibility: a systematic review and meta-analysis. Ann Palliat Med 2021; 10:10878-10886. [PMID: 34763449 DOI: 10.21037/apm-21-2582] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 10/02/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND This study sought to evaluate the relationship between interleukin 18 (IL-18), interferon-gamma (IFN-γ), and susceptibility to tuberculosis (TB). METHODS We searched multiple databases, such as PubMed, Embase, Cochrane and China National Knowledge Database, for full-text articles on IL-18, IFN-γ, and TB. Bias risk tool in Review Manager 5.2 was used to evaluate the seven kinds of bias. We used Review Manager 5.2 to evaluate the effects of the results in the selected articles, analyzed the heterogeneity of the included articles to make a forest map, and undertook a sensitivity analysis and publication bias analysis. RESULTS Ultimately, 10 studies met the inclusion criteria, and were subjected to a data analysis. IL-18 was higher in the TB group than the health control (HC) group [mean difference (MD) =248.11, 95% confidence interval CI: 197.25, 298.98, P<0.0001; I2=63%]. The meta-analysis also showed that IFN-γ was higher in the TB group than the HC group (MD =38.74, 95% CI: 14.84, 62.64, P=0.001; I2=100%). Sensitivity analysis proved the robustness of this research and limited publication bias was observed in this study. DISCUSSION This study showed that IL-18 and IF-γ had a relationship with TB and might be used to help diagnose TB, which might be helpful in the clinical diagnosis about TB.
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Affiliation(s)
- Bingbing Zhang
- Department of Community Health Service, People's Hospital of Longhua, Shenzhen, China
| | - Liubin Xiao
- Department of Community Health Service, People's Hospital of Longhua, Shenzhen, China
| | - Qunfang Qiu
- Department of Community Health Service, People's Hospital of Longhua, Shenzhen, China
| | - Lei Miao
- Department of Community Health Service, People's Hospital of Longhua, Shenzhen, China
| | - Shan Yan
- Department of Community Health Service, People's Hospital of Longhua, Shenzhen, China
| | - Shiquan Zhou
- Department of Disease Control, Center for Disease Control and Prevention of Longhua, Shenzhen, China
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Korzeniewska-Koseła M, Wesołowski S. Tuberculosis in Poland in 2019. Przegl Epidemiol 2021; 75:192-209. [PMID: 34696557 DOI: 10.32394/pe.75.18] [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] [Indexed: 11/19/2022]
Abstract
AIM OF THE STUDY To evaluate the main features of epidemiology of tuberculosis (TB) in 2019 in Poland and to compare with the situation in the European Union and European Economic Area (EU/EEA) countries. MATERIAL AND METHODS Analysis of case-based data on TB patients from National TB Register, data on anti-TB drug susceptibility in cases notified in 2019, data from Central Statistical Office on deaths from tuberculosis in 2018, data from National Institute of Public Health - National Institute of Hygiene on HIV-positive subjects for whom TB was an AIDS-defining disease, data from the report "European Centre for Disease Prevention and Control/WHO Regional Office for Europe. Tuberculosis surveillance and monitoring in Europe 2021 - 2019 data". RESULTS In 2019, 5321 TB cases were reported in Poland. The incidence rate was 13.9 cases per 100,000 with large variability between voivodeships from 8.0 to 20.0 per 100,000. The number of all pulmonary tuberculosis cases was 5075 i.e. 13.2 per 100,000. Pulmonary cases represented 95.4% of all TB cases. In 2019, 246 extrapulmonary TB cases were notified (4.6% of all TB cases). Pulmonary tuberculosis was bacteriologically confirmed in 3926 cases (77.4% of all pulmonary TB cases, the incidence rate 10.2 per 100,000). The number of smear-positive pulmonary TB cases was 2565 i.e. 6.7 per 100,000 ( 48.2% of all pulmonary TB cases). In 2019, there were 41 cases (18 of foreign origin) with multidrug resistant TB (MDR-TB) representing 1.1% of cases with known drug sensitivity. The incidence rates of tuberculosis were growing along with the age group from 1.4 per 100,000 among children (0-14 years) to 23.9 per 100,000 among subjects in the age group 45-64 years, the incidence rate in the age group ≥65 years was 19.8 per 100,000. There were 81 cases in children up to 14 years of age (1.5% of the total) and 48 cases in adolescents between 15 and 19 years of age - rates 1.4 and 2.6 per 100,000 respectively. In 2019, there were 3897 cases of tuberculosis in men and 1424 in women. The TB incidence in men - 21.0 per 100,000 was 2.9 times higher than among women - 7.2. The biggest difference in the TB incidence between the two sex groups occurred in persons aged 50-54 years - 40.2 vs. 8.1 and in age group 55 to 59 years - 45.1 vs. 9.0. In 2019, there were 121 patients of foreign origin among all cases of tuberculosis in Poland (2.3%). In 2018, TB was the cause of death for 519 people (mortality rate - 1.4 per 100,000). CONCLUSIONS TB incidence in Poland in 2019 was lower than in the previous year. Differences in incidence between voivodships persist. The percentage of TB cases with bacteriological confirmation exceeded 75%, more than in EU/EEA countries (67.1%). In Poland, MDR-TB is less common than the average in the EU/EEA countries. In Poland, the highest incidence rates are found in older age groups. The percentage of children up to 14 years of age among all TB patients was 1.5%, lower than the average in EU/EEA countries (3.9%). The incidence of tuberculosis in men is nearly three times as high as in women. The impact of migration on the characteristics of tuberculosis in Poland is not substantial. The percentage of foreign-born persons among TB patients is low.
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Affiliation(s)
- Maria Korzeniewska-Koseła
- National Tuberculosis and Lung Diseases Research Institute, Warsaw, Poland Department of Tuberculosis Epidemiology and Surveillance
| | - Stefan Wesołowski
- National Tuberculosis and Lung Diseases Research Institute, Warsaw, Poland, the Institute Director
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Hult C, Mattila JT, Gideon HP, Linderman JJ, Kirschner DE. Neutrophil Dynamics Affect Mycobacterium tuberculosis Granuloma Outcomes and Dissemination. Front Immunol 2021; 12:712457. [PMID: 34675916 PMCID: PMC8525425 DOI: 10.3389/fimmu.2021.712457] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 05/20/2021] [Accepted: 08/18/2021] [Indexed: 01/01/2023] Open
Abstract
Neutrophil infiltration into tuberculous granulomas is often associated with higher bacteria loads and severe disease but the basis for this relationship is not well understood. To better elucidate the connection between neutrophils and pathology in primate systems, we paired data from experimental studies with our next generation computational model GranSim to identify neutrophil-related factors, including neutrophil recruitment, lifespan, and intracellular bacteria numbers, that drive granuloma-level outcomes. We predict mechanisms underlying spatial organization of neutrophils within granulomas and identify how neutrophils contribute to granuloma dissemination. We also performed virtual deletion and depletion of neutrophils within granulomas and found that neutrophils play a nuanced role in determining granuloma outcome, promoting uncontrolled bacterial growth in some and working to contain bacterial growth in others. Here, we present three key results: We show that neutrophils can facilitate local dissemination of granulomas and thereby enable the spread of infection. We suggest that neutrophils influence CFU burden during both innate and adaptive immune responses, implying that they may be targets for therapeutic interventions during later stages of infection. Further, through the use of uncertainty and sensitivity analyses, we predict which neutrophil processes drive granuloma severity and structure.
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Affiliation(s)
- Caitlin Hult
- Department of Mathematics, Gettysburg College, Gettysburg, PA, United States
| | - Joshua T Mattila
- Department of Infectious Diseases and Microbiology, University of Pittsburgh School of Public Health, Pittsburgh, PA, United States.,Center for Vaccine Research, University of Pittsburgh, Pittsburgh, PA, United States
| | - Hannah P Gideon
- Center for Vaccine Research, University of Pittsburgh, Pittsburgh, PA, United States.,Department of Microbiology and Molecular Genetics, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Jennifer J Linderman
- Department of Chemical Engineering, University of Michigan, Ann Arbor, MI, United States
| | - Denise E Kirschner
- Department of Microbiology and Immunology, University of Michigan Medical School, Ann Arbor, MI, United States
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Kalra R, Tiwari D, Dkhar HK, Bhagyaraj E, Kumar R, Bhardwaj A, Gupta P. Host factors subverted by Mycobacterium tuberculosis: Potential targets for host directed therapy. Int Rev Immunol 2021; 42:43-70. [PMID: 34678117 DOI: 10.1080/08830185.2021.1990277] [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] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Despite new approaches in the diagnosis and treatment of tuberculosis (TB), it continues to be a major health burden. Several immunotherapies that potentiate the immune response have come up as adjuncts to drug therapies against drug resistant TB strains; however, there needs to be an urgent appraisal of host specific drug targets for improving their clinical management and to curtail disease progression. Presently, various host directed therapies (HDTs) exist (repurposed drugs, nutraceuticals, monoclonal antibodies and immunomodulatory agents), but these mostly address molecules that combat disease progression. AREAS COVERED The current review discusses major Mycobacterium tuberculosis (M. tuberculosis) survival paradigms inside the host and presents a plethora of host targets subverted by M. tuberculosis which can be further explored for future HDTs. The host factors unique to M. tuberculosis infection (in humans) have also been identified through an in-silico interaction mapping. EXPERT OPINION HDTs could become the next-generation adjunct therapies in order to counter antimicrobial resistance and virulence, as well as to reduce the duration of existing TB treatments. However, current scientific efforts are largely directed toward combatants rather than host molecules co-opted by M. tuberculosis for its survival. This might drive the immune system to a hyper-inflammatory condition; therefore, we emphasize that host factors subverted by M. tuberculosis, and their subsequent neutralization, must be considered for development of better HDTs.
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Affiliation(s)
- Rashi Kalra
- Department of Molecular Biology, CSIR-Institute of Microbial Technology, Chandigarh-160036, India
| | - Drishti Tiwari
- Department of Molecular Biology, CSIR-Institute of Microbial Technology, Chandigarh-160036, India
| | - Hedwin Kitdorlang Dkhar
- Department of Molecular Biology, CSIR-Institute of Microbial Technology, Chandigarh-160036, India
| | - Ella Bhagyaraj
- Department of Molecular Biology, CSIR-Institute of Microbial Technology, Chandigarh-160036, India
| | - Rakesh Kumar
- Bioinformatics Center, CSIR-Institute of Microbial Technology, Chandigarh-160036, India.,Academy of Scientific and Innovative Research (AcSIR), Ghaziabad-201002, India
| | - Anshu Bhardwaj
- Bioinformatics Center, CSIR-Institute of Microbial Technology, Chandigarh-160036, India.,Academy of Scientific and Innovative Research (AcSIR), Ghaziabad-201002, India
| | - Pawan Gupta
- Department of Molecular Biology, CSIR-Institute of Microbial Technology, Chandigarh-160036, India.,Academy of Scientific and Innovative Research (AcSIR), Ghaziabad-201002, India
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Fursov MV, Shitikov EA, Lagutkin DA, Fursova AD, Ganina EA, Kombarova TI, Grishenko NS, Rudnitskaya TI, Bespiatykh DA, Kolupaeva NV, Firstova VV, Domotenko LV, Panova AE, Vinokurov AS, Gushchin VA, Tkachuk AP, Vasilyeva IA, Potapov VD, Dyatlov IA. MDR and Pre-XDR Clinical Mycobacterium tuberculosis Beijing Strains: Assessment of Virulence and Host Cytokine Response in Mice Infectious Model. Microorganisms 2021; 9:1792. [PMID: 34442871 PMCID: PMC8400193 DOI: 10.3390/microorganisms9081792] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 06/08/2021] [Revised: 08/05/2021] [Accepted: 08/18/2021] [Indexed: 11/16/2022] Open
Abstract
Mycobacterium tuberculosis Beijing genotype associated with drug resistance is a growing public health problem worldwide. The aim of this study was the assessment of virulence for C57BL/6 mice after infection by clinical M. tuberculosis strains 267/47 and 120/26, which belong to the modern sublineages B0/W148 and Central Asia outbreak of the Beijing genotype, respectively. The sublineages were identified by the analysis of the strains' whole-genomes. The strains 267/47 and 120/26 were characterized as agents of pre-extensively drug-resistant (pre-XDR) and multidrug-resistant (MDR) tuberculosis, respectively. Both clinical strains were slow-growing in 7H9 broth compared to the M. tuberculosis H37Rv strain. The survival rates of C57BL/6 mice infected by 267/47, 120/26, and H37Rv on the 150th day postinfection were 10%, 40%, and 70%, respectively. Mycobacterial load in the lungs, spleen, and liver was higher and histopathological changes were more expressed for mice infected by the 267/47 strain compared to those infected by the 120/26 and H37Rv strains. The cytokine response in the lungs of C57BL/6 mice after infection with the 267/47, 120/26, and H37Rv strains was different. Notably, proinflammatory cytokine genes Il-1α, Il-6, Il-7, and Il-17, as well as anti-inflammatory genes Il-6 and Il-13, were downregulated after an infection caused by the 267/47 strain compared to those after infection with the H37Rv strain.
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Affiliation(s)
- Mikhail V. Fursov
- State Research Center for Applied Microbiology and Biotechnology, Territory “Kvartal A”, 142279 Serpukhov, Russia; (A.D.F.); (E.A.G.); (T.I.K.); (N.S.G.); (T.I.R.); (N.V.K.); (V.V.F.); (L.V.D.); (V.D.P.); (I.A.D.)
| | - Egor A. Shitikov
- Federal Research and Clinical Center of Physical-Chemical Medicine, 119435 Moscow, Russia; (E.A.S.); (D.A.B.)
| | - Denis A. Lagutkin
- National Medical Research Center for Phthisiopulmonology and Infectious Diseases of the Ministry of Health of the Russian Federation, 127473 Moscow, Russia; (D.A.L.); (A.E.P.); (A.S.V.); (I.A.V.)
| | - Anastasiia D. Fursova
- State Research Center for Applied Microbiology and Biotechnology, Territory “Kvartal A”, 142279 Serpukhov, Russia; (A.D.F.); (E.A.G.); (T.I.K.); (N.S.G.); (T.I.R.); (N.V.K.); (V.V.F.); (L.V.D.); (V.D.P.); (I.A.D.)
| | - Elena A. Ganina
- State Research Center for Applied Microbiology and Biotechnology, Territory “Kvartal A”, 142279 Serpukhov, Russia; (A.D.F.); (E.A.G.); (T.I.K.); (N.S.G.); (T.I.R.); (N.V.K.); (V.V.F.); (L.V.D.); (V.D.P.); (I.A.D.)
| | - Tatiana I. Kombarova
- State Research Center for Applied Microbiology and Biotechnology, Territory “Kvartal A”, 142279 Serpukhov, Russia; (A.D.F.); (E.A.G.); (T.I.K.); (N.S.G.); (T.I.R.); (N.V.K.); (V.V.F.); (L.V.D.); (V.D.P.); (I.A.D.)
| | - Natalia S. Grishenko
- State Research Center for Applied Microbiology and Biotechnology, Territory “Kvartal A”, 142279 Serpukhov, Russia; (A.D.F.); (E.A.G.); (T.I.K.); (N.S.G.); (T.I.R.); (N.V.K.); (V.V.F.); (L.V.D.); (V.D.P.); (I.A.D.)
| | - Tatiana I. Rudnitskaya
- State Research Center for Applied Microbiology and Biotechnology, Territory “Kvartal A”, 142279 Serpukhov, Russia; (A.D.F.); (E.A.G.); (T.I.K.); (N.S.G.); (T.I.R.); (N.V.K.); (V.V.F.); (L.V.D.); (V.D.P.); (I.A.D.)
| | - Dmitry A. Bespiatykh
- Federal Research and Clinical Center of Physical-Chemical Medicine, 119435 Moscow, Russia; (E.A.S.); (D.A.B.)
| | - Nadezhda V. Kolupaeva
- State Research Center for Applied Microbiology and Biotechnology, Territory “Kvartal A”, 142279 Serpukhov, Russia; (A.D.F.); (E.A.G.); (T.I.K.); (N.S.G.); (T.I.R.); (N.V.K.); (V.V.F.); (L.V.D.); (V.D.P.); (I.A.D.)
| | - Viktoria V. Firstova
- State Research Center for Applied Microbiology and Biotechnology, Territory “Kvartal A”, 142279 Serpukhov, Russia; (A.D.F.); (E.A.G.); (T.I.K.); (N.S.G.); (T.I.R.); (N.V.K.); (V.V.F.); (L.V.D.); (V.D.P.); (I.A.D.)
| | - Lubov V. Domotenko
- State Research Center for Applied Microbiology and Biotechnology, Territory “Kvartal A”, 142279 Serpukhov, Russia; (A.D.F.); (E.A.G.); (T.I.K.); (N.S.G.); (T.I.R.); (N.V.K.); (V.V.F.); (L.V.D.); (V.D.P.); (I.A.D.)
| | - Anna E. Panova
- National Medical Research Center for Phthisiopulmonology and Infectious Diseases of the Ministry of Health of the Russian Federation, 127473 Moscow, Russia; (D.A.L.); (A.E.P.); (A.S.V.); (I.A.V.)
| | - Anatoliy S. Vinokurov
- National Medical Research Center for Phthisiopulmonology and Infectious Diseases of the Ministry of Health of the Russian Federation, 127473 Moscow, Russia; (D.A.L.); (A.E.P.); (A.S.V.); (I.A.V.)
| | - Vladimir A. Gushchin
- N.F. Gamaleya National Research Centre for Epidemiology and Microbiology of the Ministry of Health of the Russian Federation, 123098 Moscow, Russia; (V.A.G.); (A.P.T.)
| | - Artem P. Tkachuk
- N.F. Gamaleya National Research Centre for Epidemiology and Microbiology of the Ministry of Health of the Russian Federation, 123098 Moscow, Russia; (V.A.G.); (A.P.T.)
| | - Irina A. Vasilyeva
- National Medical Research Center for Phthisiopulmonology and Infectious Diseases of the Ministry of Health of the Russian Federation, 127473 Moscow, Russia; (D.A.L.); (A.E.P.); (A.S.V.); (I.A.V.)
| | - Vasiliy D. Potapov
- State Research Center for Applied Microbiology and Biotechnology, Territory “Kvartal A”, 142279 Serpukhov, Russia; (A.D.F.); (E.A.G.); (T.I.K.); (N.S.G.); (T.I.R.); (N.V.K.); (V.V.F.); (L.V.D.); (V.D.P.); (I.A.D.)
| | - Ivan A. Dyatlov
- State Research Center for Applied Microbiology and Biotechnology, Territory “Kvartal A”, 142279 Serpukhov, Russia; (A.D.F.); (E.A.G.); (T.I.K.); (N.S.G.); (T.I.R.); (N.V.K.); (V.V.F.); (L.V.D.); (V.D.P.); (I.A.D.)
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Korzeniewska-Koseła M. Tuberculosis in Poland in 2018. Przegl Epidemiol 2021; 74:239-257. [PMID: 33112107 DOI: 10.32394/pe.74.19] [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] [Indexed: 11/19/2022]
Abstract
AIM OF THE STUDY To evaluate the main features of tuberculosis (TB) epidemiology in 2018 in Poland and to compare with the situation in the EU/EEA countries. METHODS Analysis of case- based data on TB patients from National TB Register, data on anti-TB drug susceptibility testing results in cases notified in 2018, data from National Institute of Public Health- National Institute of Hygiene on HIV-positive subjects for whom TB was an AIDS-defining disease, data from Central Statistical Office on deaths from tuberculosis based on death certificates, data from the report " European Centre for Disease Prevention and Control/WHO Regional Office for Europe. Tuberculosis surveillance and monitoring in Europe 2020- 2018 data. Stockholm: European Centre for Disease Prevention and Control, 2020". RESULTS In 2018, 5487 TB cases were reported in Poland. The incidence rate was 14.3 cases per 100000, with large variability between voivodeships from 7.3 to 23.4 per 100 000. The mean annual decrease of TB incidence in 2014- 2018 was 3.8%. In 2018, 4852 cases were newly diagnosed with no history of previous treatment i.e. 12.6 per 100 000. 635 cases i.e. 1.7 per 100 000 - 11.6% of all registered subjects were previously treated for tuberculosis. In 2018, the number of all pulmonary tuberculosis cases was 5224 i.e. 13.7 per 100000. Pulmonary cases represented 95.2% of all TB cases. In 2018, 243 extrapulmonary TB cases were found i.e. 0.6 per 100 000. In the whole country there were 52 pediatric cases of tuberculosis. TB in children represented 0.9% of all cases notified in Poland in 2018. The incidence rates of tuberculosis were growing along with the age group from 0.9 per 100 000 among children to 24.7 per 100 000 among subjects in the age group 45-64 years (the highest incidence rate). In 2018, the incidence rate in the age group ≥65 years was 21.3 per 100 000. The TB incidence among men i.e. 21.0 per 100 000 was 2.6 times higher than among women i.e. 8.0 per 100 000. The biggest difference in the TB incidence between the two sex groups occurred in persons aged 55 to 59 years - 44.9 vs. 9.8 and in age group 60- 64 years - 43.7 vs. 10.2. The TB incidence in rural population was lower than in urban, respectively 13.4 per 100 000 and 14.9 per 100 000. The number of all registered culture positive TB cases was 4075. Pulmonary tuberculosis was bacteriologically confirmed in 3935 subjects. Cases confirmed by culture represented 74.3% of all TB cases and 75.3% of all pulmonary TB cases. The number of smear-positive pulmonary TB cases reported in 2018 was 2324 i.e. 6.1 per 100 000 accounting for 44.3% of all pulmonary TB cases and 59.1% of pulmonary TB cases confirmed by culture. In all patients with tuberculosis in Poland in 2018 there were 48 cases with MDR-TB (among them 14 foreigners) and 83 patients with resistance to isoniazid only, representing respectively 1.3% and 2.2% of cases with known DST results (DSTs were available in 90.7% of all culture-confirmed TB cases). In 2018, there were 97 patients of foreign origin among all cases of tuberculosis in Poland. TB was AIDS-indicative disease in 14 subjects with HIV co-infection. There were 490 deaths due to tuberculosis reported in 2017 - 1.3 per 100 000; 468 people died from pulmonary and 22 from extrapulmonary tuberculosis. Mortality among males - 2.1 per 100 000 - was 3.6 X higher than among females - 0.5. 40.2% of all TB deaths were cases 65 years old and older - 3.1 per 100 000. In 2017, there was no death from tuberculosis in children and no deaths in adolescents. In 2017, tuberculosis represented 0.1% of total mortality in Poland and 25.4% of mortality from infectious and parasitic diseases. CONCLUSIONS In 2018, the incidence of tuberculosis in Poland was lower than in 2017. Despite a continuous decline it is still higher than the average in the EU/EEA countries. The highest incidence rates were observed in older age groups. The participation of pediatric cases is smaller than average in the EU/EEA countries. The incidence in males was more than 2 times higher than in females. The impact of migration on the characteristics of tuberculosis in Poland is not substantial. In Poland, MDR-TB is less common than the average in the EU/EEA countries.
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Affiliation(s)
- Maria Korzeniewska-Koseła
- National Tuberculosis and Lung Diseases Research Institute, Department of Tuberculosis Epidemiology and Surveillance
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Wu L, Cheng Q, Wen Z, Song Y, Zhu Y, Wang L. IRF1 as a potential biomarker in Mycobacterium tuberculosis infection. J Cell Mol Med 2021; 25:7270-7279. [PMID: 34213077 PMCID: PMC8335664 DOI: 10.1111/jcmm.16756] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 06/01/2021] [Accepted: 06/08/2021] [Indexed: 12/13/2022] Open
Abstract
Pulmonary tuberculosis (PTB) is a major global public health problem. The purpose of this study was to find biomarkers that can be used to diagnose tuberculosis. We used four NCBI GEO data sets to conduct analysis. Among the four data sets, GSE139825 is lung tissue microarray, and GSE83456, GSE19491 and GSE50834 are blood microarray. The differential genes of GSE139825 and GSE83456 were 68 and 226, and intersection genes were 11. Gene ontology (GO) analyses of 11 intersection genes revealed that the changes were mostly enriched in regulation of leucocyte cell-cell adhesion and regulation of T-cell activation. Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis of DEGs revealed that the host response in TB strongly involves cytokine-cytokine receptor interactions and folate biosynthesis. In order to further narrow the range of biomarkers, we used protein-protein interaction to establish a hub gene network of two data sets and a network of 11 candidate genes. Eventually, IRF1 was selected as a biomarker. As validation, IRF1 levels were shown to be up-regulated in patients with TB relative to healthy controls in data sets GSE19491 and GSE50834. Additionally, IRF1 levels were measured in the new patient samples using ELISA. IRF1 was seen to be significantly up-regulated in patients with TB compared with healthy controls with an AUC of 0.801. These results collectively indicate that IRF1 could serve as a new biomarker for the diagnosis of pulmonary tuberculosis.
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Affiliation(s)
- Liwei Wu
- Department of Thoracic SurgeryShanghai Public Health Clinical CenterFudan UniversityShanghaiChina
| | - Qiliang Cheng
- Department of Thoracic SurgeryTuberculosis Hospital of Shaanxi ProvinceXi’anChina
| | - Zilu Wen
- Department of Scientific ResearchShanghai Public Health Clinical CenterFudan UniversityShanghaiChina
| | - Yanzheng Song
- Department of Thoracic SurgeryShanghai Public Health Clinical CenterFudan UniversityShanghaiChina
- TB CenterShanghai Emerging & Re‐emerging Infectious Diseases InstituteShanghaiChina
| | - Yijun Zhu
- Department of Thoracic SurgeryShanghai Public Health Clinical CenterFudan UniversityShanghaiChina
| | - Lin Wang
- Department of Thoracic SurgeryShanghai Public Health Clinical CenterFudan UniversityShanghaiChina
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Abstract
<b>Background:</b> Genitourinary tuberculosis is one of the most common forms of extra-pulmonary tuberculosis. Owing to a myriad of clinical presentations and discrepancies in the diagnostic modalities, patients usually present late, which results in a high number of them requiring surgical intervention. The present study aims to retrospectively analyze the role of surgery in genitourinary tuberculosis. <br><b>Patients and method:</b> All patients diagnosed with genitourinary tuberculosis at our centre between October 2017 and September 2019 were included in the study. The mode of presentation, duration of symptoms, investigations performed, treatment received, and follow-up were studied. <br><b>Results:</b> Out of 25 patients diagnosed with genitourinary tuberculosis (GUTB), there were 15 (60%) males and 10 (40%) females. The mean age of presentation was 40.84 years. Nineteen (76%) patients underwent surgical intervention, and many patients required more than one surgical procedure. A reconstructive procedure was carried out in seven patients. At a median follow-up of 12 months, all patients did well, showing no relapse. <br><b>Conclusion:</b> Surgery, along with antitubercular treatment, is the key to the management of GUTB presenting with structural damage. However, surgery can be ablative or reconstructive, depending on various factors discussed in the present study. This preserves or restores the optimal function of the genitourinary system affected by the mycobacterium bacilli.
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Salzer HJF, Massango I, Bhatt N, Machonisse E, Reimann M, Heldt S, Lange C, Hoelscher M, Khosa C, Rachow A. Seroprevalence of Aspergillus-Specific IgG Antibody among Mozambican Tuberculosis Patients. J Fungi (Basel) 2021; 7:595. [PMID: 34436134 DOI: 10.3390/jof7080595] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 07/15/2021] [Accepted: 07/22/2021] [Indexed: 12/30/2022] Open
Abstract
Background: Chronic pulmonary aspergillosis (CPA) is a life-threatening sequel in patients with pulmonary tuberculosis (PTB). Aspergillus-specific IgG antibody is a useful diagnostic biomarker supporting CPA diagnosis, especially in countries with limited health recourses. Methods: We conducted a prospective pilot study to assess the seroprevalence of Aspergillus-specific IgG antibodies among 61 Mozambican tuberculosis patients before, during, and after the end of TB treatment. Aspergillus-specific IgG antibody levels were measured using the ImmunoCAP®. Results: In this study, 3 out of 21 HIV-negative PTB patients had a positive Aspergillus-specific IgG antibody level before, during, and after the end of TB treatment. Antibody levels were 41.1, 45.5, and 174 mg/L at end of treatment (EOT), respectively. Additionally, two HIV-negative PTB patients with negative Aspergillus-specific IgG antibody levels at baseline became seropositive at EOT (41.9 and 158 mg/L, respectively). Interestingly, none of the HIV-positive PTB patients (40/61) had a positive Aspergillus-specific IgG antibody level at any time, neither at baseline nor at EOT. Probable CPA was diagnosed in one HIV-negative patient (5%; 1/20). Conclusion: Seroprevalence of Aspergillus-specific IgG antibody may differ between HIV-negative and HIV-positive Mozambican PTB patients. Future studies evaluating post-tuberculosis lung disease should integrate CPA as a life-threatening sequel to PTB.
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Aung ST, Thu A, Aung HL, Thu M. Measuring Catastrophic Costs Due to Tuberculosis in Myanmar. Trop Med Infect Dis 2021; 6:130. [PMID: 34287379 DOI: 10.3390/tropicalmed6030130] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 06/30/2021] [Accepted: 07/12/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND This is the first survey to use the World Health Organization (WHO) methodology to document the magnitude and main drivers of tuberculosis (TB) patient costs in order to guide policies on cost mitigation and to produce a baseline measure for the percentage of TB-affected households experiencing catastrophic costs in Myanmar. METHODS A nationally representative cross-sectional survey was administered to 1000 TB patients in health facilities from December 2015 to February 2016, focusing on costs of TB treatment (direct and indirect), household income, and coping strategies. A total cost was estimated for each household by extrapolating reported costs and comparing them to household income. If the proportion of total costs exceeded 20% of the annual household income, a TB-affected household was deemed to have faced catastrophic costs. RESULTS 60% of TB-affected households faced catastrophic costs in Myanmar. On average, total costs were USD 759, and the largest proportion of this total was accounted for by patient time (USD 365), followed by food costs (USD 200), and medical expenses (USD 130). Low household wealth quintile and undergoing MDR-TB treatment were both significant predictors for households facing catastrophic costs. CONCLUSIONS The high proportion of TB-affected households experiencing catastrophic costs suggests the need for TB-specific social protection programs in patient-centered healthcare. The survey findings have led the government and donors to increase support for MDR-TB patients. The significant proportion of total spending attributable to lost income and food or nutritional supplements suggests that income replacement programs and/or food packages may ameliorate the burdensome costs.
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Lee SS, Chan DPC, Wong NS, Lui GCY, To KW, Kam JKM. Distribution of molecular strains of Mycobacterium tuberculosis in an intermediate burden Asia Pacific city. Epidemiol Infect 2021; 149:e134. [PMID: 34006336 DOI: 10.1017/S0950268821001199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Hong Kong is an intermediate tuberculosis (TB) burden city in Asia Pacific with slow decline of case notification in the last decade. By 24-loci mycobacterial interspersed repetitive units – variable number of tandem repeats genotyping, we examined 534 Mycobacterium tuberculosis isolates collected from culture-positive hospitalised TB patients in a 1.7 million population geographic region in the city. Overall, 286 (75%) were classified as Beijing genotype, of which 216 (76%) and 59 (21%) belonged to modern and ancient sub-lineage, respectively. Only two cases were genetically clustered while spatial clustering was absent. Male gender, permanent residency in Hong Kong and born in Hong Kong or Mainland China were associated with Beijing genotype. The high prevalence of Beijing modern lineage was similar to that in East Asia, which reflected the pattern resulting from population migration. The paucity of clustering suggested that reactivation accounted for most of the TB disease cases, which was and echoed by observation that half were 60 years old or above, and the presence of co-morbid medical conditions. The predominance of reactivation TB cases in intermediate burden localities implies that the detection and control of latent TB infection would be the major challenge in achieving TB elimination.
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Puryear SB, Fatch R, Beesiga B, Kekibiina A, Lodi S, Marson K, Emenyonu NI, Muyindike WR, Kwarisiima D, Hahn JA, Chamie G. Higher Levels of Alcohol Use Are Associated With Latent Tuberculosis Infection in Adults Living With Human Immunodeficiency Virus. Clin Infect Dis 2021; 72:865-868. [PMID: 32374867 DOI: 10.1093/cid/ciaa527] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 12/16/2019] [Accepted: 04/30/2020] [Indexed: 11/13/2022] Open
Abstract
We assessed associations between hazardous alcohol use and latent tuberculosis infection (LTBI) among adults living with human immunodeficiency virus (HIV) in Uganda. We compared tuberculin skin test positivity across medium, high, and very-high alcohol use levels, classified by AUDIT-C scores. In multivariable analysis, very high use was associated with LTBI (adjusted odds ratio 1.61, 95% confidence interval: 1.03-2.50).
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Affiliation(s)
- Sarah B Puryear
- Division of HIV, Infectious Diseases and Global Medicine, University of California San Francisco, San Francisco, California, USA.,Center for AIDS Prevention Studies, University of California San Francisco, San Francisco, California, USA
| | - Robin Fatch
- Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Brian Beesiga
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | - Allen Kekibiina
- Mbarara University of Science and Technology, Mbarara, Uganda
| | - Sara Lodi
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Kara Marson
- Division of HIV, Infectious Diseases and Global Medicine, University of California San Francisco, San Francisco, California, USA
| | - Nneka I Emenyonu
- Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | | | | | - Judith A Hahn
- Division of HIV, Infectious Diseases and Global Medicine, University of California San Francisco, San Francisco, California, USA
| | - Gabriel Chamie
- Division of HIV, Infectious Diseases and Global Medicine, University of California San Francisco, San Francisco, California, USA
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Karamchand S, Williams M, Naidoo P, Decloedt E, Allwood B. Post-tuberculous lung disease: should we be using Theophylline? J Thorac Dis 2021; 13:1230-1238. [PMID: 33717595 PMCID: PMC7947523 DOI: 10.21037/jtd-20-1298] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Tuberculosis affects 10 million people and over 320,000 South Africans every year. A significant proportion of patients treated for tuberculosis develop post-tuberculous lung disease (PTBLD), a disease of chronic respiratory impairment for which there is a lack of affordable treatment options. PTBLD a heterogenous disorder that shares phenotypical features with chronic obstructive lung disease, bronchiectasis, lung fibrosis and destruction as well as pulmonary hypertension. There remains a paucity of proven pharmacotherapy for the management of PTBLD. Theophylline, a widely available and affordable medicine that has largely fell out of favour in high-income settings due to its toxicity and narrow therapeutic index, may be repositioned for the treatment of PTBLD. In this review, we unpack the potential role of theophylline in the management of PTBLD by reviewing the evidence for its bronchodilatory, anti-inflammatory and potential pleotrophic effects.
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Affiliation(s)
- Sumanth Karamchand
- Division of Pulmonology, Western Cape Department of Health, Tygerberg Hospital, Bellville, South Africa
| | - Morne Williams
- Division of Pulmonology, Western Cape Department of Health, Tygerberg Hospital, Bellville, South Africa
| | - Poobalan Naidoo
- Department of Informatics, School of Health Professions, Rutgers University, New Jersey, USA
| | - Eric Decloedt
- Division of Clinical Pharmacology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Bellville, South Africa
| | - Brian Allwood
- Division of Pulmonology, Western Cape Department of Health, Tygerberg Hospital, Bellville, South Africa
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Iqbal P, Soliman A, De Sanctis V, Yassin MA. Association of tuberculosis in patients with chronic myeloid leukemia: a treatment proposal based on literature review. Expert Rev Hematol 2021; 14:211-217. [PMID: 33433245 DOI: 10.1080/17474086.2021.1875818] [Citation(s) in RCA: 6] [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: 01/24/2023]
Abstract
Introduction: Chronic Myeloid leukemia (CML) is one of the first hematological malignancy linked with genetic alterations and have a targeted therapy with Tyrosine Kinase Inhibitors. However, there are certain unanswered questions and many unmet needs which limit its treatment. Concurrent Mycobacterium Tuberculosis (Mtb) infection is one of those significant factors. Tuberculosis (TB) is a highly prevalent disease in association with diabetes mellitus, malignancy, poor socioeconomic environment, HIV, and other immunosuppressive conditions in developed and developing countries. Anti-TB medications can affect other drug's pharmacokinetics by altering liver enzymes metabolism and poses treatment challenge with CML medications.Areas covered: The authors performed a rigorous literature review between 2000 and 2020 using PubMed and Google Scholar, with the main focus on all articles addressing the topic of TB in CML. Authors highlighted the need to improve clinical diagnosis and to define management strategy for this dilemma.Expert opinion: In the current era, there are no clear guidelines or recommendations in the literature that address this problem. The aim of this review was to collect and carefully analyze the literature to highlight the need for comprehensive guidelines and propose an algorithm for better management of TB in patients with CML.
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Affiliation(s)
- Phool Iqbal
- Department of Internal Medicine, Hamad Medical Corporation, (HMC), Doha, Qatar
| | - Ashraf Soliman
- Pediatrics and Endocrinology Department of Pediatrics, Hamad Medical Center, Doha, Qatar.,Department of Pediatrics, University of Alexandria, Alexandria, Egypt
| | - Vincenzo De Sanctis
- Pediatric and Adolescent Outpatient Clinic, Quisisana Hospital, Ferrara, Italy
| | - Mohamed A Yassin
- Hematology Section, National Center for Cancer Care and Research, Hamad Medical Corporation, (HMC), Doha, Qatar
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Ruddraraju KV, Aggarwal D, Zhang ZY. Therapeutic Targeting of Protein Tyrosine Phosphatases from Mycobacterium tuberculosis. Microorganisms 2020; 9:E14. [PMID: 33374544 DOI: 10.3390/microorganisms9010014] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 12/17/2020] [Accepted: 12/21/2020] [Indexed: 12/18/2022] Open
Abstract
Tuberculosis (TB) is an airborne infectious disease caused by Mycobacterium tuberculosis (Mtb). According to the World Health Organization, an estimated 10 million people developed TB in 2018. The occurrence of drug-resistant TB demands therapeutic agents with novel mechanisms of action. Antivirulence is an alternative strategy that targets bacterial virulence factors instead of central growth pathways to treat disease. Mycobacterium protein tyrosine phosphatases, mPTPA and mPTPB, are secreted by Mtb into the cytoplasm of macrophages and are required for survival and growth of infection within the host. Here we present recent advances in understanding the roles of mPTPA and mPTPB in the pathogenesis of TB. We also focus on potent, selective, and well-characterized small molecule inhibitors reported in the last decade for mPTPA and mPTPB.
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Yuyaem T, Sudchada P, Srisuttiyakorn C, Juntawong J, Khanngern N, Watcharapokin N, Chansangiam P. Ethambutol Induced Lichenoid Drug Eruption: A Case Report. Curr Drug Saf 2020; 16:296-298. [PMID: 33334297 DOI: 10.2174/1574886315666201217095950] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 10/09/2020] [Accepted: 10/28/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND A rare type of cutaneous adverse drug reaction (CADR), lichenoid drug eruption (LDE), can be associated with ethambutol. CASE REPORT A 60-year-old woman with spinal tuberculosis received multiple anti-TB medications and developed rashes after 3 months of the treatments. A skin biopsy from the posterior auricular area confirmed lichenoid dermatitis, and the Naranjo causality assessment indicated ethambutol as a probable cause of LDE in the patient. The rashes slowly improved after discontinuation of ethambutol. Unfortunately, the residual of brown hyperpigmentation on the body still persisted for over 16 months. CONCLUSION The medications were reduced to isoniazid 300 mg/day and rifampicin 450 mg /day as planned for another 3 months. This case report points out the essentials of early recognition of ethambutol LDE by health care professionals.
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Affiliation(s)
- Thitaree Yuyaem
- Department of Pharmacy, Nangrong Hospital, Buriram, Thailand
| | - Patcharaporn Sudchada
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand
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Chisale MRO, Sinyiza F, Kaseka P, Wu JST, Chimbatata C, Mbakaya BC, Kamudumuli PS, Kayira AB. Cancer obscures extrapulmonary tuberculosis (EPTB) at a tertiary hospital in Northern Malawi. Epidemiol Infect 2020; 149:e3. [PMID: 33077001 PMCID: PMC8057459 DOI: 10.1017/s095026882000254x] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 08/23/2020] [Accepted: 10/14/2020] [Indexed: 11/07/2022] Open
Abstract
Data on the prevalence of extrapulmonary tuberculosis (EPTB) patients are limited in many African countries including Malawi. We conducted a retrospective review of all histology reports for cancer suspected patients at Mzuzu Central Hospital (MZCH) between 2013 and 2018 to determine the proportion of EPTB cases among cancer suspected patients and characterised them epidemiologically. All reports with inconclusive findings were excluded. In total, 2214 reports were included in the review, 47 of which reported EPTB, representing 2.1% (95% CI 1.6-2.8). The incidence of EPTB was significantly associated with sex, age and HIV status. Men were more than twice (OR 2.1; 95% CI 1.2-3.9) as likely to have EPTB as women while those with HIV were more than six times (OR 6.4; 95% CI 1.7-24.8) as likely to have EPTB compared to those who were HIV-negative. EPTB demonstrated an inverse relationship with age. The highest proportion of EPTB was found from neck lymph nodes (10.3% (5.4-17.2)). A reasonable number of EPTB cases are diagnosed late or missed in Malawi's hospitals. There is a need for concerted efforts to increase EPTB awareness and likely come up with a policy to consider EPTB as a differential diagnosis in cancer suspected patients.
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Affiliation(s)
- M. R. O. Chisale
- Mzuzu University, Faculty of Sciences, Technology and Innovations, Biological Sciences, P/Bag 201 Luwinga, Mzuzu, Malawi
- Ministry of Health, Mzuzu Central Hospital, P/Bag 209, Luwinga, Mzuzu, Malawi
- Luke International, Mzuzu, Malawi
| | - F. Sinyiza
- Ministry of Health, Mzuzu Central Hospital, P/Bag 209, Luwinga, Mzuzu, Malawi
| | - P. Kaseka
- Ministry of Health, Mzuzu Central Hospital, P/Bag 209, Luwinga, Mzuzu, Malawi
| | - J. S. T. Wu
- Luke International, Mzuzu, Malawi
- Pingtung Christian Hospital, Overseas Services, Taipei, Taiwan
| | - C. Chimbatata
- Ministry of Health, Mzuzu Central Hospital, P/Bag 209, Luwinga, Mzuzu, Malawi
| | | | | | - A. B. Kayira
- Ministry of Health, Mzuzu Central Hospital, P/Bag 209, Luwinga, Mzuzu, Malawi
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Haas MK, Aiona K, Erlandson KM, Belknap RW. Higher Completion Rates with Self-administered Once-weekly Isoniazid-Rifapentine versus Daily Rifampin in Adults with Latent Tuberculosis. Clin Infect Dis 2020; 73:e3459-e3467. [PMID: 32915203 DOI: 10.1093/cid/ciaa1364] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 05/06/2020] [Accepted: 09/09/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Treatment of latent tuberculosis infection (LTBI) is important for tuberculosis (TB) prevention, and short course rifamycin-based therapies are preferred. Once-weekly isoniazid-rifapentine by self-administered therapy (3HP-SAT) has never been compared with four months of daily rifampin (4R). METHODS Retrospective cohort study of adults >18 initiating LTBI treatment with either 3HP-SAT or 4R in a United States (US)-based TB clinic between April 11, 2016-December 31 st, 2018. We evaluated treatment completion through pharmacy fills and reviewed charts for reasons of non-completion, including adverse events. Chi-square tests and a log-binomial multivariable model were used to compare treatment completion and adverse events (AEs). RESULTS 560 individuals (42%) initiated 3HP-SAT and 773 (58%) initiated 4R. Median age was 38, 55% were female, and 89% were born outside of the U.S. Among those aged 18-49, treatment completion with 3HP-SAT was 79% compared to 68% with 4R (adjusted risk ratio (aRR) of 1.17 [95% CI 1.17-1.27, p<0.0001]). Among Individuals aged >=50 years, treatment completion with 3HP-SAT was 87% compared to 64% with 4R (aRR 1.35 [95% CI 1.19-1.52, p<0.0001]). Compared to 4R, there was no difference in risk of AEs in the 18-49 age group (aRR 0.93 [95% CI 1.48-0.75] p=0.75). Reduced risk of AEs was noted among patients aged >=50 who received 3HP-SAT (aRR 0.37 [0.16-0.85] p=0.02). CONCLUSION 3HP-SAT was associated with higher LTBI treatment completion and lower rates of AEs compared to 4R in individuals aged 50 and older. Expanding 3HP-SAT as an option for patients with LTBI may enhance TB prevention strategies in the U.S.
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Affiliation(s)
- Michelle K Haas
- Denver Health and Hospital Authority, Denver Public Health, Denver, Colorado.,Division of Infectious Diseases, Department of Medicine, University of Colorado-Denver Anschutz Medical Campus, Aurora, Colorado
| | - Kaylynn Aiona
- Denver Health and Hospital Authority, Denver Public Health, Denver, Colorado
| | - Kristine M Erlandson
- Division of Infectious Diseases, Department of Medicine, University of Colorado-Denver Anschutz Medical Campus, Aurora, Colorado.,Division of Geriatric Medicine, Department of Medicine, University of Colorado-Denver Anschutz Medical Campus, Aurora, Colorado
| | - Robert W Belknap
- Denver Health and Hospital Authority, Denver Public Health, Denver, Colorado.,Division of Infectious Diseases, Department of Medicine, University of Colorado-Denver Anschutz Medical Campus, Aurora, Colorado
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