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Ochonye B, Sanni OF, Emmanuel G, Umoh P, Kalaiwo A, Abang R, Amechi P, Ahkigbe M, Akinpelumi S, Motilewa O. A retrospective study of tuberculosis prevalence and associated factors among HIV-positive key populations in Nigeria. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003461. [PMID: 38995935 PMCID: PMC11244832 DOI: 10.1371/journal.pgph.0003461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 06/17/2024] [Indexed: 07/14/2024]
Abstract
HIV is a major risk factor for active Tuberculosis (TB.) This raises patients' risk of original infection, reinfection, and TB reactivation. Providing healthcare to KPLHIV in developing countries requires TB prevalence research. This study aims to determine the prevalence of TB and HIV co-infection and associated factors among KPLHIV. This is a retrospective cross-sectional study among KP's living with HIV enrolled on care in One Stop Shop (OSS) of Heartland Alliance Ltd/GTE across six states in Nigeria. Data were analysed using IBM SPSS version 25.0. Secondary data analysis of client's records from the RADET files of the KPCARE 1 project from 6 states was conducted. Means with standard deviations were computed for continuous variables like age, and frequency tables were generated for categorical variables. Chi-square tests and t-tests were used for the bivariate analysis of variables. All tests were done at a 5% level of statistical significance (p = 0.05).TB prevalence was 19.1% among KP's living with HIV, with variations observed in age groups, geographic locations, target populations, marital status, educational backgrounds, clinical characteristics, and antiretroviral therapy (ART) history. KPs aged 51 and above exhibited the highest TB prevalence (21.0%), while those aged below 20 years had the lowest (18.2%). Jigawa KPs recorded the highest TB prevalence (38.4%), and Niger had the least (13.3%). TB was more prevalent among People who inject drugs (20.3%), divorced (32.3%), and those who attained Qur'anic education (29.7%). KPs who had to restart ART exhibited the highest TB prevalence (22.0%), whereas those who experienced Interruption in treatment (IIT) reported the lowest at 10.0%. Immune-suppressed KPs (CD4 counts < 200 cells/m3) had a higher TB prevalence of 26.6%. TB prevalence among KPs living with HIV varies greatly, underlining the need for targeted treatments, especially for high-risk categories, to improve HIV treatment outcomes and reduce TB prevalence.
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Affiliation(s)
| | | | - Godwin Emmanuel
- Research and Development Department, Heartland Alliance, Abuja, Nigeria
| | - Paul Umoh
- Research and Development Department, Heartland Alliance, Abuja, Nigeria
| | | | - Roger Abang
- Research and Development Department, Heartland Alliance, Abuja, Nigeria
| | - Paul Amechi
- Research and Development Department, Heartland Alliance, Abuja, Nigeria
| | - Mark Ahkigbe
- Research and Development Department, Heartland Alliance, Abuja, Nigeria
| | | | - Olugbemi Motilewa
- Department of Community Medicine, University of Uyo Teaching Hospital, Uyo, Akwa Ibom State, Nigeria
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Omondi MP. Epidemiology of non-trauma orthopedic conditions among inpatients admitted at a tertiary teaching and referral hospital in Kenya: A chart review. PLoS One 2024; 19:e0303898. [PMID: 38885257 PMCID: PMC11182543 DOI: 10.1371/journal.pone.0303898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 05/03/2024] [Indexed: 06/20/2024] Open
Abstract
Non-traumatic orthopedic conditions are pathological conditions involving musculoskeletal system that includes muscles, tendons, bone and joints and associated with frequent medical and surgical care and high treatment costs. There is paucity of information on the pattern of non-traumatic orthopedic conditions in low and middle income countries. The purpose of this study was to determine the epidemiology of non-traumatic orthopedic conditions among inpatients at the Kenyatta National Hospital in Kenya. This was a cross-sectional study with a sample of 175 charts reviewed. Approximately, 70.3% of the inpatients were aged between 25 to 64 years of age with the mean age of 39.97 years (STD 18.78). Ever married tended to be older 53.5 (95% CI: 46.8-60.2) years than other marital statuses. Approximately, 60.6% were males, 38.9% had comorbidities and 49.1% were casuals or unemployed. All inpatients were Kenyans with Nairobi County comprising 52.6% of all inpatients. Approximately, 77.7% were self-referrals. The commonest non-trauma orthopaedic conditions were infection and non-union (35.4%) and spinal degenerative diseases (20.60%) and the least was limb deformities (1.70%). Compared to females, males were 3.703 (p<0.001) times more likely to have infection and non-union. Patients with primary, secondary and tertiary education were 88.2% (p<0.001), 75.6% (p<0.001) and 68.1% (p = 0.016) less likely to have infection and non-union compared to those with no or preschool education. Widows were 8.500 (p = 0.028) times more likely to have spinal degenerative disease than married. Males were 70.8% (p = 0.031) less likely to have osteoarthritis than females. Inpatients with secondary education were 5.250 (p = 0.040) times more likely to have osteoarthritis than those with no or preschool education. In conclusion, majority of inpatients were young and middle aged adults. Infection and non-union and spinal degenerative diseases were the most common non-trauma orthopedic conditions. While males and those with low education were more likely to have infection and non-union, married were more likely to have spinal degenerative disease. Osteoarthritis was more likely among female admissions.
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Ma Z, Duan S, Wang W, Liu R, Li S, Shang Y, Zhang X, Yuan J, Gao M, Pang Y. Surveillance of close contacts of patients with infectious tuberculosis: a prospective cohort study. Antimicrob Resist Infect Control 2024; 13:59. [PMID: 38853242 PMCID: PMC11163748 DOI: 10.1186/s13756-024-01419-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 06/02/2024] [Indexed: 06/11/2024] Open
Abstract
BACKGROUND A long-term follow-up of close contacts to monitor their infection status is essential to formulate a promising screening strategy. The study aimed to assess the dynamics of tuberculosis (TB) infection using Interferon-γ release assay (IGRA) and determine risk factors associated with TB infection. METHODS Definite TB patients were interviewed and their household contacts were screened for TB infection by IGRA during 12-month longitudinal investigation. RESULTS We included in our analyses 184 household contacts of 92 index TB patients. 87 individuals (47.3%) in contact group progressed to TB infection, of whom 86 developed into IGRA positive within 24 weeks. Close contacts with a higher age and comorbidities are easier to exhibit TB infection. Analysis showed that risk factors for becoming IGRA-positive individuals included residence, older age, comorbidities, BCG scar and high bacterial load. Contacts with BCG scar had a lower IGRA-positive rate. CONCLUSION IGRA conversion generally occurs within 24 weeks after exposure. The TB transmission happens since subclinical TB stage and the presence of BCG scar is an independent protective factor reducing risk of TB infection among close contacts. Repeated IGRA tests are sensible to conducted among close contacts at 24 weeks after exposure to identify the IGRA-positive individuals.
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Affiliation(s)
- Zichun Ma
- Department of Bacteriology and Immunology, Beijing Chest Hospital, Beijing Tuberculosis and Thoracic Tumor Research Institute, Capital Medical University, Postal No 9, Beiguan Street, Tongzhou District, Beijing, 101149, People's Republic of China
| | - Shujuan Duan
- Department of Bacteriology and Immunology, Beijing Chest Hospital, Beijing Tuberculosis and Thoracic Tumor Research Institute, Capital Medical University, Postal No 9, Beiguan Street, Tongzhou District, Beijing, 101149, People's Republic of China
| | - Wei Wang
- Department of Bacteriology and Immunology, Beijing Chest Hospital, Beijing Tuberculosis and Thoracic Tumor Research Institute, Capital Medical University, Postal No 9, Beiguan Street, Tongzhou District, Beijing, 101149, People's Republic of China
| | - Rongmei Liu
- Department of Tuberculosis, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis and Thoracic Tumor Research Institute, Postal No 9, Beiguan Street, Tongzhou District, Beijing, 101149, People's Republic of China
| | - Shanshan Li
- Department of Bacteriology and Immunology, Beijing Chest Hospital, Beijing Tuberculosis and Thoracic Tumor Research Institute, Capital Medical University, Postal No 9, Beiguan Street, Tongzhou District, Beijing, 101149, People's Republic of China
| | - Yuanyuan Shang
- Department of Bacteriology and Immunology, Beijing Chest Hospital, Beijing Tuberculosis and Thoracic Tumor Research Institute, Capital Medical University, Postal No 9, Beiguan Street, Tongzhou District, Beijing, 101149, People's Republic of China
| | - Xuxia Zhang
- Department of Bacteriology and Immunology, Beijing Chest Hospital, Beijing Tuberculosis and Thoracic Tumor Research Institute, Capital Medical University, Postal No 9, Beiguan Street, Tongzhou District, Beijing, 101149, People's Republic of China
| | - Jinfeng Yuan
- Department of Bacteriology and Immunology, Beijing Chest Hospital, Beijing Tuberculosis and Thoracic Tumor Research Institute, Capital Medical University, Postal No 9, Beiguan Street, Tongzhou District, Beijing, 101149, People's Republic of China
| | - Mengqiu Gao
- Department of Tuberculosis, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis and Thoracic Tumor Research Institute, Postal No 9, Beiguan Street, Tongzhou District, Beijing, 101149, People's Republic of China.
| | - Yu Pang
- Department of Bacteriology and Immunology, Beijing Chest Hospital, Beijing Tuberculosis and Thoracic Tumor Research Institute, Capital Medical University, Postal No 9, Beiguan Street, Tongzhou District, Beijing, 101149, People's Republic of China.
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Olmo-Fontánez AM, Scordo JM, Schami A, Garcia-Vilanova A, Pino PA, Hicks A, Mishra R, Jose Maselli D, Peters JI, Restrepo BI, Nargan K, Naidoo T, Clemens DL, Steyn AJC, Thacker VV, Turner J, Schlesinger LS, Torrelles JB. Human alveolar lining fluid from the elderly promotes Mycobacterium tuberculosis intracellular growth and translocation into the cytosol of alveolar epithelial cells. Mucosal Immunol 2024; 17:155-168. [PMID: 38185331 PMCID: PMC11034793 DOI: 10.1016/j.mucimm.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 12/15/2023] [Accepted: 01/03/2024] [Indexed: 01/09/2024]
Abstract
The elderly population is highly susceptible to developing respiratory diseases, including tuberculosis, a devastating disease caused by the airborne pathogen Mycobacterium tuberculosis (M.tb) that kills one person every 18 seconds. Once M.tb reaches the alveolar space, it contacts alveolar lining fluid (ALF), which dictates host-cell interactions. We previously determined that age-associated dysfunction of soluble innate components in human ALF leads to accelerated M.tb growth within human alveolar macrophages. Here we determined the impact of human ALF on M.tb infection of alveolar epithelial type cells (ATs), another critical lung cellular determinant of infection. We observed that elderly ALF (E-ALF)-exposed M.tb had significantly increased intracellular growth with rapid replication in ATs compared to adult ALF (A-ALF)-exposed bacteria, as well as a dampened inflammatory response. A potential mechanism underlying this accelerated growth in ATs was our observation of increased bacterial translocation into the cytosol, a compartment that favors bacterial replication. These findings in the context of our previous studies highlight how the oxidative and dysfunctional status of the elderly lung mucosa determines susceptibility to M.tb infection, including dampening immune responses and favoring bacterial replication within alveolar resident cell populations, including ATs, the most abundant resident cell type within the alveoli.
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Affiliation(s)
- Angélica M Olmo-Fontánez
- Population Health and Host-Pathogen Interactions Programs, Texas Biomedical Research Institute, San Antonio, Texas, USA; Integrated Biomedical Sciences Program, University of Texas Health Science Center at San Antonio, Texas, USA.
| | - Julia M Scordo
- Population Health and Host-Pathogen Interactions Programs, Texas Biomedical Research Institute, San Antonio, Texas, USA; Sam and Ann Barshop Institute for Longevity and Aging Studies, University of Texas Health Science Center at San Antonio, Texas, USA
| | - Alyssa Schami
- Population Health and Host-Pathogen Interactions Programs, Texas Biomedical Research Institute, San Antonio, Texas, USA; Integrated Biomedical Sciences Program, University of Texas Health Science Center at San Antonio, Texas, USA
| | - Andreu Garcia-Vilanova
- Population Health and Host-Pathogen Interactions Programs, Texas Biomedical Research Institute, San Antonio, Texas, USA
| | - Paula A Pino
- Population Health and Host-Pathogen Interactions Programs, Texas Biomedical Research Institute, San Antonio, Texas, USA
| | - Amberlee Hicks
- Population Health and Host-Pathogen Interactions Programs, Texas Biomedical Research Institute, San Antonio, Texas, USA
| | - Richa Mishra
- Global Health Institute, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Diego Jose Maselli
- Division of Pulmonary and Critical Care Medicine, School of Medicine, University of Texas Health Science Center at San Antonio, Texas, USA
| | - Jay I Peters
- Division of Pulmonary and Critical Care Medicine, School of Medicine, University of Texas Health Science Center at San Antonio, Texas, USA
| | - Blanca I Restrepo
- Population Health and Host-Pathogen Interactions Programs, Texas Biomedical Research Institute, San Antonio, Texas, USA; University of Texas Health Science Center at Houston, School of Public Health, Brownsville campus, Brownsville, Texas, USA; South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley, Edinburg, Texas, USA
| | - Kievershen Nargan
- Africa Health Research Institute, University of KwaZulu-Natal, Durban, South Africa
| | - Threnesan Naidoo
- Africa Health Research Institute, University of KwaZulu-Natal, Durban, South Africa; Department of Laboratory Medicine and Pathology, Walter Sisulu University, Mthatha, South Africa
| | - Daniel L Clemens
- University of California, Los Angeles Health Sciences, Los Angeles, California, USA
| | - Adrie J C Steyn
- Africa Health Research Institute, University of KwaZulu-Natal, Durban, South Africa; Department of Microbiology, University of Alabama at Birmingham, Birmingham, Alabama, USA; Centers for AIDS Research and Free Radical Biology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Vivek V Thacker
- Global Health Institute, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland; Department of Infectious Diseases, Medical Microbiology and Hygiene, Medical Faculty Heidelberg, Heidelberg University, 69120 Heidelberg, Germany
| | - Joanne Turner
- Population Health and Host-Pathogen Interactions Programs, Texas Biomedical Research Institute, San Antonio, Texas, USA
| | - Larry S Schlesinger
- Population Health and Host-Pathogen Interactions Programs, Texas Biomedical Research Institute, San Antonio, Texas, USA
| | - Jordi B Torrelles
- Population Health and Host-Pathogen Interactions Programs, Texas Biomedical Research Institute, San Antonio, Texas, USA; International Center for the Advancement of Research and Education (I●CARE), Texas Biomedical Research Institute, San Antonio, TX, US.
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5
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Olmo-Fontánez AM, Turner J. Tuberculosis in an Aging World. Pathogens 2022; 11:pathogens11101101. [PMID: 36297158 PMCID: PMC9611089 DOI: 10.3390/pathogens11101101] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 09/18/2022] [Accepted: 09/22/2022] [Indexed: 11/29/2022] Open
Abstract
Tuberculosis (TB) is one of the leading causes of death due to its being an infectious disease, caused by the airborne pathogen Mycobacterium tuberculosis (M.tb). Approximately one-fourth of the world’s population is infected with latent M.tb, and TB is considered a global threat killing over 4000 people every day. The risk of TB susceptibility and mortality is significantly increased in individuals aged 65 and older, confirming that the elderly represent one of the largest reservoirs for M.tb infection. The elderly population faces many challenges that increase their risk of developing respiratory diseases, including TB. The challenges the elderly face in this regard include the following: decreased lung function, immuno-senescence, inflammaging, adverse drug effects, low tolerance to anti-TB drugs, lack of suitable diagnoses/interventions, and age-associated comorbidities. In order to find new therapeutic strategies to maintain lung homeostasis and resistance to respiratory infections as we age, it is necessary to understand the molecular and cellular mechanisms behind natural lung aging. This review focuses primarily on why the elderly are more susceptible to TB disease and death, with a focus on pulmonary function and comorbidities.
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Affiliation(s)
- Angélica M. Olmo-Fontánez
- Host Pathogen Interactions and Population Health Programs, Texas Biomedical Research Institute, San Antonio, TX 78227, USA
- Integrated Biomedical Sciences Program, University of Texas Health Science Center, San Antonio, TX 78229, USA
| | - Joanne Turner
- Host Pathogen Interactions and Population Health Programs, Texas Biomedical Research Institute, San Antonio, TX 78227, USA
- Correspondence:
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Sundaresh B, Xu S, Noonan B, Mansour MK, Leong JM, van Opijnen T. Host-informed therapies for the treatment of pneumococcal pneumonia. Trends Mol Med 2021; 27:971-989. [PMID: 34376327 DOI: 10.1016/j.molmed.2021.07.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 07/06/2021] [Accepted: 07/12/2021] [Indexed: 12/11/2022]
Abstract
Over the past two decades, traditional antimicrobial strategies have lost efficacy due to a rapid rise in antibiotic resistance and limited success in developing new antibiotics. Rather than relying on therapeutics solely targeting the bacterial pathogen, therapies are emerging that simultaneously focus on host responses. Here, we describe the most promising 'host-informed therapies' (HITs) in two categories: those that aid patients with fully functional immune systems, and those that aid patients with perturbed immune processes. Using Streptococcus pneumoniae, the leading cause of bacterial pneumonia, as a case study, we show HITs as an attractive option for supplementing infection management. However, to broaden their applicability and design new strategies, targeted research and clinical trials will be essential.
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Affiliation(s)
| | - Shuying Xu
- Department of Molecular Biology and Microbiology, Tufts University School of Medicine, Boston, MA, USA; Graduate Program in Immunology, Tufts Graduate School of Biomedical Sciences, Boston, MA, USA
| | - Brian Noonan
- Stuart B. Levy Center for Integrated Management of Antimicrobial Resistance, Tufts Medical Center, Boston, MA, USA
| | - Michael K Mansour
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - John M Leong
- Department of Molecular Biology and Microbiology, Tufts University School of Medicine, Boston, MA, USA; Stuart B. Levy Center for Integrated Management of Antimicrobial Resistance, Tufts Medical Center, Boston, MA, USA.
| | - Tim van Opijnen
- Department of Biology, Boston College, Chestnut Hill, MA, USA; Stuart B. Levy Center for Integrated Management of Antimicrobial Resistance, Tufts Medical Center, Boston, MA, USA.
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Devalraju KP, Tripathi D, Neela VSK, Paidipally P, Radhakrishnan RK, Singh KP, Ansari MS, Jaeger M, Netea-Maier RT, Netea MG, Park S, Cheng SY, Valluri VL, Vankayalapati R. Reduced thyroxine production in young household contacts of tuberculosis patients increases active tuberculosis disease risk. JCI Insight 2021; 6:e148271. [PMID: 34236051 PMCID: PMC8410087 DOI: 10.1172/jci.insight.148271] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 05/26/2021] [Indexed: 12/03/2022] Open
Abstract
In the current study, we followed 839 household contacts (HHCs) of tuberculosis (TB) patients for 2 years and identified the factors that enhanced the development of TB. Fourteen of the 17 HHCs who progressed to TB were in the 15- to 30-year-old age group. At baseline (the “0“ time point, when all the individuals were healthy), the concentration of the thyroid hormone thyroxine (T4) was lower, and there were increased numbers of Tregs in PBMCs of TB progressors. At baseline, PBMCs from TB progressors stimulated with early secretory antigenic target 6 (ESAT-6) and 10 kDa culture filtrate antigen (CFP-10) produced less IL-1α. Thyroid hormones inhibited Mycobacterium tuberculosis (Mtb) growth in macrophages in an IL-1α–dependent manner. Mtb-infected Thra1PV/+ (mutant thyroid hormone receptor) mice had increased mortality and reduced IL-1α production. Our findings suggest that young HHCs who exhibit decreased production of thyroid hormones are at high risk of developing active TB disease.
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Affiliation(s)
- Kamakshi Prudhula Devalraju
- Immunology and Molecular Biology Department, Bhagwan Mahavir Medical Research Centre, Hyderabad, Telangana, India
| | - Deepak Tripathi
- Department of Pulmonary Immunology, Center for Biomedical Research, University of Texas Health Science Center, Tyler, Texas, USA
| | - Venkata Sanjeev Kumar Neela
- Immunology and Molecular Biology Department, Bhagwan Mahavir Medical Research Centre, Hyderabad, Telangana, India
| | - Padmaja Paidipally
- Department of Pulmonary Immunology, Center for Biomedical Research, University of Texas Health Science Center, Tyler, Texas, USA
| | - Rajesh Kumar Radhakrishnan
- Department of Pulmonary Immunology, Center for Biomedical Research, University of Texas Health Science Center, Tyler, Texas, USA
| | - Karan P Singh
- Department of Epidemiology and Biostatistics, School of Community and Rural Health, University of Texas Health Science Center, Tyler, Texas, USA
| | - Mohammad Soheb Ansari
- Immunology and Molecular Biology Department, Bhagwan Mahavir Medical Research Centre, Hyderabad, Telangana, India
| | - Martin Jaeger
- Department of Internal Medicine, Division of Endocrinology, and.,Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, Netherlands
| | | | - Mihai G Netea
- Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, Netherlands
| | - Sunmi Park
- Laboratory of Molecular Biology, National Cancer Institute, NIH, Bethesda, Maryland, USA
| | - Sheue-Yann Cheng
- Laboratory of Molecular Biology, National Cancer Institute, NIH, Bethesda, Maryland, USA
| | - Vijaya Lakshmi Valluri
- Immunology and Molecular Biology Department, Bhagwan Mahavir Medical Research Centre, Hyderabad, Telangana, India
| | - Ramakrishna Vankayalapati
- Department of Pulmonary Immunology, Center for Biomedical Research, University of Texas Health Science Center, Tyler, Texas, USA
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Kootbodien T, Iyaloo S, Wilson K, Naicker N, Kgalamono S, Haman T, Mathee A, Rees D. Environmental Silica Dust Exposure and Pulmonary Tuberculosis in Johannesburg, South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16101867. [PMID: 31137851 PMCID: PMC6571666 DOI: 10.3390/ijerph16101867] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 04/12/2019] [Accepted: 04/19/2019] [Indexed: 12/30/2022]
Abstract
Background: Occupational crystalline silica dust exposure is associated with an elevated risk of pulmonary tuberculosis (PTB). However, there is less evidence for an association with environmental silica dust exposure. Methods: A cross-sectional study of 310 participants was conducted in an exposed community living within 2 km of gold mine tailings and an unexposed population residing more than 10 km from the nearest gold mine tailing. Chest radiographs (n = 178) were read for PTB, past or current, by three readers. Results: Past or current PTB was radiologically identified in 14.4% (95%CI 9.2–21.8) in the exposed and 7.5% (95%CI 2.8–18.7) in the unexposed groups. Multivariate logistic regression models suggested that PTB prevalence was independently associated with exposure to second-hand smoke (OR = 8.13, 95%CI 1.16–57.22), a lower body mass index (OR = 0.88, 95%CI 0.80–0.98), previous diagnosis and treatment of PTB (OR = 8.98, 95%CI 1.98–40.34), and exposure to dust in the workplace from sand, construction, and/or mining industries (OR = 10.2, 95%CI 2.10–50.11). Conclusion: We found no association between PTB and environmental exposure to gold mine tailing dust. However, workplace silica dust exposure is a significant risk factor for PTB in South Africa, and PTB patients of working age should be screened for silica exposure.
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Affiliation(s)
- Tahira Kootbodien
- National Institute for Occupational Health, National Health Laboratory Service, Constitution Hill, Johannesburg 2001, South Africa.
| | - Samantha Iyaloo
- National Institute for Occupational Health, National Health Laboratory Service, Constitution Hill, Johannesburg 2001, South Africa.
| | - Kerry Wilson
- National Institute for Occupational Health, National Health Laboratory Service, Constitution Hill, Johannesburg 2001, South Africa.
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Parktown 2193, South Africa.
| | - Nisha Naicker
- National Institute for Occupational Health, National Health Laboratory Service, Constitution Hill, Johannesburg 2001, South Africa.
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Parktown 2193, South Africa.
- Environmental Health Department, Faculty of Health Sciences, University of Johannesburg, Johannesburg 2000, South Africa.
| | - Spo Kgalamono
- National Institute for Occupational Health, National Health Laboratory Service, Constitution Hill, Johannesburg 2001, South Africa.
| | - Tanya Haman
- Environmental Health Department, Faculty of Health Sciences, University of Johannesburg, Johannesburg 2000, South Africa.
- Environment and Health Research Unit, South African Medical Research Council, Johannesburg 2000, South Africa.
| | - Angela Mathee
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Parktown 2193, South Africa.
- Environmental Health Department, Faculty of Health Sciences, University of Johannesburg, Johannesburg 2000, South Africa.
- Environment and Health Research Unit, South African Medical Research Council, Johannesburg 2000, South Africa.
| | - David Rees
- National Institute for Occupational Health, National Health Laboratory Service, Constitution Hill, Johannesburg 2001, South Africa.
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Parktown 2193, South Africa.
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Wachinou AP, Agodokpessi G, Agbodande A, Affolabi D, Esse M, Adjibode O, Anagonou S. [Tuberculosis in older persons in African setting: Epidemiological, diagnostic and evolutive features]. REVUE DE PNEUMOLOGIE CLINIQUE 2018; 74:444-451. [PMID: 30279016 DOI: 10.1016/j.pneumo.2018.08.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 08/21/2018] [Accepted: 08/25/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To determine the epidemiological, diagnostic and evolutives features of tuberculosis (TB) in older subjects in Benin. PATIENTS AND METHODS This was a retrospective cohort study of adults TB patients (age≥15 years) who were notified at all the Basic Management Units (BMU) in Benin from January 1st, 2013 to December 31st. Older subjects (age≥60 years) were compared to those less than 60 years named young subjects. The threshold of significance was set at 5%. RESULTS The analysis was carried out on 6531 cases adults cases notified during the period. 601 (9.2%) were 60 years old or above. The case notification rate (CNR) in elders was more than twice the CNR in young people (68 cases vs. 31 cases per 100,000 population). Older subjects were less often infected with HIV (9.3%) than young's (16.7%), P<0.0001. In new bacteriologically confirmed pulmonary TB negative for HIV, unfavorable treatment outcomes were more frequent in older subjects than in young subjects with more deaths (7.5% vs. 3.0%). On the other hand, in bacteriological confirmed TB seropositive for HIV and all the other cases, treatment outcomes were comparable between the two groups. CONCLUSION The high CNR and the high death rate in older subjects should plead for a specific care for an adapted management of TB case in this group.
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Affiliation(s)
- A P Wachinou
- Centre national hospitalier universitaire de pneumo-phtisiologie, Cotonou, Bénin; Faculté des sciences de la santé, université d'Abomey-Calavi, Cotonou, Bénin.
| | - G Agodokpessi
- Centre national hospitalier universitaire de pneumo-phtisiologie, Cotonou, Bénin; Faculté des sciences de la santé, université d'Abomey-Calavi, Cotonou, Bénin
| | - A Agbodande
- Faculté des sciences de la santé, université d'Abomey-Calavi, Cotonou, Bénin; Service de médecine interne, Centre national hospitalier universitaire Hubert K. Maga (CNHU-HKM), Cotonou, Bénin
| | - D Affolabi
- Centre national hospitalier universitaire de pneumo-phtisiologie, Cotonou, Bénin; Faculté des sciences de la santé, université d'Abomey-Calavi, Cotonou, Bénin
| | - M Esse
- Centre national hospitalier universitaire de pneumo-phtisiologie, Cotonou, Bénin
| | - O Adjibode
- Centre national hospitalier universitaire de pneumo-phtisiologie, Cotonou, Bénin
| | - S Anagonou
- Centre national hospitalier universitaire de pneumo-phtisiologie, Cotonou, Bénin; Faculté des sciences de la santé, université d'Abomey-Calavi, Cotonou, Bénin
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Juan-García J, García-García S, Guerra-Laso JM, Raposo-García S, Diez-Tascón C, Nebreda-Mayoral T, López-Fidalgo E, López-Medrano R, Fernández-Maraña A, Rivero-Lezcano OM. In vitro infection with Mycobacterium tuberculosis induces a distinct immunological pattern in blood from healthy relatives of tuberculosis patients. Pathog Dis 2018; 75:4430633. [PMID: 29048475 DOI: 10.1093/femspd/ftx109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 10/09/2017] [Indexed: 11/14/2022] Open
Abstract
Part of the susceptibility to tuberculosis has a genetic basis, which is clear in primary immunodeficiencies, but is less evident in apparently immunocompetent subjects. Immune responses were analysed in blood samples from tuberculosis patients and their healthy first-degree relatives who were infected in vitro with mycobacteria (either Mycobacterium tuberculosis or M. bovis BCG). The antimicrobial activity against M. tuberculosis in blood from relatives was significantly lower than that observed in healthy controls. Tuberculosis patients exhibited a higher number of neutrophils, and monocyte phagocytosis was inhibited in both relatives and tuberculosis patients. A remarkable finding was that the production of reactive oxygen species by infected neutrophils was higher in relatives than in healthy controls. A higher production of TNFα in infected blood from relatives was also observed. These results may indicate that relatives display a stronger inflammatory response and that their immune response to M. tuberculosis is different from those of unrelated controls. First-degree relatives may represent a highly informative group for the analysis of tuberculosis susceptibility.
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Affiliation(s)
- Javier Juan-García
- Servicio de Neumología, Complejo Asistencial Universitario de León, 24008 León, Spain
| | - Silvia García-García
- Servicio de Neumología, Complejo Asistencial Universitario de León, 24008 León, Spain
| | | | - Sara Raposo-García
- Servicio de Medicina Interna, Complejo Asistencial Universitario de León, 24008 León, Spain
| | - Cristina Diez-Tascón
- Servicio de Anatomía Patológica, Complejo Asistencial Universitario de León, 24008 León, Spain.,Institute of Biomedicine (IBIOMED), University of León, 24071 León, Spain
| | - Teresa Nebreda-Mayoral
- Servicio de Microbiología Clínica, Complejo Asistencial Universitario de León, 24008 León, Spain
| | - Eduardo López-Fidalgo
- Unidad de Investigación, Complejo Asistencial Universitario de León, 24008 León, Spain
| | | | | | - Octavio Miguel Rivero-Lezcano
- Institute of Biomedicine (IBIOMED), University of León, 24071 León, Spain.,Unidad de Investigación, Complejo Asistencial Universitario de León, 24008 León, Spain.,Fundación Instituto de Estudios de Ciencias de la Salud de Castilla y León, Parque de Santa Clara s/n. 42002 Soria, Spain
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11
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Ault R, Dwivedi V, Koivisto E, Nagy J, Miller K, Nagendran K, Chalana I, Pan X, Wang SH, Turner J. Altered monocyte phenotypes but not impaired peripheral T cell immunity may explain susceptibility of the elderly to develop tuberculosis. Exp Gerontol 2018; 111:35-44. [PMID: 29991459 DOI: 10.1016/j.exger.2018.06.029] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 05/24/2018] [Accepted: 06/29/2018] [Indexed: 12/15/2022]
Abstract
Tuberculosis (TB) is the leading killer due to a single infectious disease worldwide. With the aging of the global population, the case rate and deaths due to TB are highest in the elderly population. While general immunosenescence associated with old age is thought to contribute to the susceptibility of the elderly to develop active TB disease, very few studies of immune function in elderly individuals with Mycobacterium tuberculosis (M.tb) infection or disease have been performed. In particular, impaired adaptive T cell immunity to M.tb is one proposed mechanism for the elderly's increased susceptibility primarily on the basis of the decreased delayed type hypersensitivity response to tuberculin-purified protein derivative in the skin of elderly individuals. To investigate immunological reasons why the elderly are susceptible to develop active TB disease, we performed a cross-sectional observational study over a five year period (2012-2016) enrolling participants from 2 age groups (adults: 25-44 years; elderly: 65 and older) and 3 M.tb infection statuses (active TB, latent TB infection, and healthy controls without history of M.tb infection). We hypothesized that impaired peripheral T cell immunity plays a role in the biological susceptibility of the elderly to TB. Contrary to our hypothesis, we observed no evidence of impaired M.tb specific T cell frequency or altered production of cytokines implicated in M.tb control (IFN-γ, IL-10) in peripheral blood in the elderly. Instead, we observed alterations in monocyte proportion and phenotype with age and M.tb infection that suggest their potential role in the susceptibility of the elderly to develop active TB. Our results suggest a potential link between the known widespread low-grade systemic inflammation of old age, termed "inflammaging," with the elderly's specific susceptibility to developing active TB. Moreover, our results highlight the need for further research into the biological reasons why the elderly are more susceptible to disease and death from TB, so that public health systems can be better equipped to face the present and future problem of TB in an aging global population.
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Affiliation(s)
- Russell Ault
- Department of Microbial Infection and Immunity, The Ohio State University, Columbus, OH, USA; Texas Biomedical Research Institute, San Antonio, TX, USA
| | - Varun Dwivedi
- Department of Microbial Infection and Immunity, The Ohio State University, Columbus, OH, USA; Texas Biomedical Research Institute, San Antonio, TX, USA
| | - Elisha Koivisto
- Department of Microbial Infection and Immunity, The Ohio State University, Columbus, OH, USA
| | - Jenna Nagy
- Department of Microbial Infection and Immunity, The Ohio State University, Columbus, OH, USA
| | - Karin Miller
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kokila Nagendran
- Division of Infectious Diseases, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA
| | - Indu Chalana
- Division of Infectious Diseases, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA
| | - Xueliang Pan
- Center for Biostatistics, The Ohio State University, Columbus, OH, USA
| | - Shu-Hua Wang
- Department of Microbial Infection and Immunity, The Ohio State University, Columbus, OH, USA; Division of Infectious Diseases, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA
| | - Joanne Turner
- Department of Microbial Infection and Immunity, The Ohio State University, Columbus, OH, USA; Texas Biomedical Research Institute, San Antonio, TX, USA.
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12
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KAZEMPOUR DIZAJI M, KAZEMNEJAD A, TABARSI P, ZAYERI F. Risk Factors Associated with Survival of Pulmonary Tuberculosis. IRANIAN JOURNAL OF PUBLIC HEALTH 2018; 47:980-987. [PMID: 30181996 PMCID: PMC6119565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND We conducted this study among adults with pulmonary tuberculosis (TB) who received treatment, in order to determine the risk factors associated with survival of during treatments. METHODS A retrospective cohort study was conducted from 2005-2015 with newly registered TB patients in the Hospital of Masih Daneshvari Doctor, Tehran, Iran. Overall, 5313 patients met our study's cohort definition, but the analysis was performed on 2299 patients (43.2%) who had a correct address and they could be traced-out by the Medical - registry. Time in days was used in survival model and patients who were still alive (until last follow-up date) considered as censored. To study the effect of risk factors on patients' survival, the generalized gamma regression model was used. RESULTS Based on the results of univariate analysis, gender (RR=2 (95% CI: 1.1-3.7), high school education (Relative Risk: RR=0.3 (95% CI: 0.2-0.7), higher education (RR=0.3 (95% CI: 0.1-0.9), smoker (RR=2.5 (95% CI: 1.4-4.2), drug user (RR=2.4 (95% CI: 1.4-4), TB contact (RR=0.5 (95% CI: 0.3-0.8) and HIV positive (RR=4 (95% CI: 1.7-9.2) affected patients' survival. Moreover, the results of multivariate analysis showed that, gender (RR=5.5 (95% CI: 2.2-13.5), age (RR=1.1 (95% CI: 1-1.1), adverse drug effect (RR=2.5 (95% CI: 1.2-5.4), smoker (RR=3.3 (95% CI: 1.2-9.4), TB contact (RR=0.2 (95% CI: 0.1-0.5), diabetic mellitus (RR=3 (95% CI: 1-8.3), HIV positive (RR=26 (95% CI: 4.6-145.9) and comorbidities (RR=4.9 (95% CI: 2-11.6) were identified as factors affecting patients' survival. CONCLUSION Our data indicated associated risk factors in TB mortality and could suggest way to progressing national tuberculosis program (NTP) for predicating and plan for effective interventional strategies.
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Affiliation(s)
- Mehdi KAZEMPOUR DIZAJI
- Dept. of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Anoshirvan KAZEMNEJAD
- Dept. of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran,Corresponding Author:
| | - Payam TABARSI
- Mycobacteriology Research Center, National Research Institute for Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran, Clinical Tuberculosis and Epidemiology Research Center, National Research Institute for Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farid ZAYERI
- Dept. of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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13
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Rivero-Lezcano OM, Blanco-Conde S, López-Medrano R, López-Fidalgo E, Caño-Herrero M, Nebreda-Mayoral T. Blood antimicrobial activity varies against different Mycobacterium spp. Tuberculosis (Edinb) 2017; 107:80-87. [PMID: 29050776 DOI: 10.1016/j.tube.2017.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 08/17/2017] [Accepted: 08/23/2017] [Indexed: 11/17/2022]
Abstract
In vitro analysis of mycobacterial pathogenicity or host susceptibility has traditionally relied on the infection of macrophages, the target cell of mycobacteria, despite difficulties reproducing their antimycobacterial activity. We have employed alternative models, namely whole blood and leukocytes in plasma, from QuantiFERON negative individuals, and performed infections with the pathogenic M. tuberculosis, the less pathogenic M. avium, M. kansasii and M. chelonae and the occasionally pathogenic M. gordonae and M. bovis. The anticoagulant used in blood extraction, heparin or EDTA, had a major influence in the outcome of the infection. Thus, while in the heparinized models a similar number of bacteria were enumerated in the inoculum and after seven days, in the presence of EDTA a killing effect was observed, despite the inhibitory effect of EDTA on cellular functions like the production of cytokines or reactive oxygen species (ROS). A special case was the rapidly growing mycobacteria M. chelonae, that multiplied in heparinized models but was eliminated in models with EDTA. We verified that EDTA is not responsible for the bactericidal effect, but acts as a bacteriostatic agent. Further work will determine whether blood derived models are a better alternative to the classical macrophage.
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Affiliation(s)
- Octavio Miguel Rivero-Lezcano
- Unidad de Investigación, Complejo Asistencial Universitario de León (CAULE), Altos de Nava, s/n, 24008 León, Spain; Institute of Biomedicine (IBIOMED), Universidad de León, León, Spain; Fundación Instituto de Estudios de Ciencias de la Salud de Castilla y León (IECSCYL), Soria, Spain.
| | - Sara Blanco-Conde
- Servicio de Análisis Clínicos, Complejo Asistencial Universitario de León (CAULE), Altos de Nava, s/n, 24008 León, Spain
| | - Ramiro López-Medrano
- Servicio de Microbiología, Hospital del Bierzo, Médicos sin Fronteras, 7, Fuentesnuevas-Ponferrada, 24404 León, Spain
| | - Eduardo López-Fidalgo
- Unidad de Investigación, Complejo Asistencial Universitario de León (CAULE), Altos de Nava, s/n, 24008 León, Spain
| | - Manuela Caño-Herrero
- Servicio de Microbiología Clínica, Complejo Asistencial Universitario de León (CAULE), Altos de Nava, s/n, 24008 León, Spain
| | - Teresa Nebreda-Mayoral
- Servicio de Microbiología Clínica, Complejo Asistencial Universitario de León (CAULE), Altos de Nava, s/n, 24008 León, Spain
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14
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Raposo-García S, Guerra-Laso JM, García-García S, Juan-García J, López-Fidalgo E, Diez-Tascón C, Nebreda-Mayoral T, López-Medrano R, Rivero-Lezcano OM. Immunological response to Mycobacterium tuberculosis infection in blood from type 2 diabetes patients. Immunol Lett 2017; 186:41-45. [PMID: 28377108 DOI: 10.1016/j.imlet.2017.03.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 03/30/2017] [Accepted: 03/31/2017] [Indexed: 12/19/2022]
Abstract
The convergence of tuberculosis and diabetes represents a co-epidemic that threatens progress against tuberculosis. We have investigated type 2 diabetes as a risk factor for tuberculosis susceptibility, and have used as experimental model whole blood infected in vitro with Mycobacterium tuberculosis. Blood samples from diabetic patients were found to have a higher absolute neutrophil count that non-diabetic controls, but their immune functionality seemed impaired because they displayed a lower capacity to phagocytose M. tuberculosis, a finding that had been previously reported only for monocytes. In contrast, an increased production of TNFα was detected in infected blood from diabetic patients. Despite the altered phagocytic capacity showed by cells from these patients, the antimicrobial activity measured in both whole blood and monocyte derived macrophages was similar to that of controls. This unexpected result prompts further improvements in the whole blood model to analyze the immune response of diabetes patients to tuberculosis.
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Affiliation(s)
- Sara Raposo-García
- Servicio de Medicina Interna, Complejo Asistencial Universitario de León, Altos de Nava s/n, 24008 León, Spain
| | - José Manuel Guerra-Laso
- Servicio de Medicina Interna, Complejo Asistencial Universitario de León, Altos de Nava s/n, 24008 León, Spain
| | - Silvia García-García
- Servicio de Neumología, Complejo Asistencial Universitario de León, Altos de Nava s/n, 24008 León, Spain
| | - Javier Juan-García
- Servicio de Neumología, Complejo Asistencial Universitario de León, Altos de Nava s/n, 24008 León, Spain
| | - Eduardo López-Fidalgo
- Unidad de Investigación, Complejo Asistencial Universitario de León, Altos de Nava s/n, 24008 León, Spain
| | - Cristina Diez-Tascón
- Servicio de Anatomía Patológica, Complejo Asistencial Universitario de León, Altos de Nava s/n, 24008 León, Spain; Institute of Biomedicine (IBIOMED), University of León, León, Spain
| | - Teresa Nebreda-Mayoral
- Servicio de Microbiología Clínica, Complejo Asistencial Universitario de León, Altos de Nava s/n, 24008 León, Spain
| | | | - Octavio Miguel Rivero-Lezcano
- Unidad de Investigación, Complejo Asistencial Universitario de León, Altos de Nava s/n, 24008 León, Spain; Institute of Biomedicine (IBIOMED), University of León, León, Spain; Fundación Instituto de Estudios de Ciencias de la Salud de Castilla y León, Soria, Spain.
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15
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López-Medrano R, Guerra-Laso JM, López-Fidalgo E, Diez-Tascón C, García-García S, Blanco-Conde S, Rivero-Lezcano OM. Plasma contributes to the antimicrobial activity of whole blood against Mycobacterium tuberculosis. Innate Immun 2016; 22:557-66. [PMID: 27554054 DOI: 10.1177/1753425916663311] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 06/29/2016] [Indexed: 11/16/2022] Open
Abstract
The whole blood model for infection has proven useful to analyze the immunological response to Mycobacterium tuberculosis, because it exerts a significant antimicrobial activity. Although this activity has been generally assumed to be cellular, we have found that the leukocyte fraction of blood from healthy volunteers did not kill the bacilli. We have discovered that plasma was responsible for a large proportion, but not all, of the antimicrobial activity. Furthermore, infected monocytes controlled the mycobacterial multiplication when cultivated in the presence of plasma. Intriguingly, serum from the same donors did not share this activity, although it was able to eliminate the non-pathogenic Mycobacterium gordonae To identify the remaining components that participate in the antimycobacterial activity we fractionated blood in leukocytes, plasma, erythrocytes and platelets, and analyzed the bactericidal power of each fraction and their combinations using a factorial design. We found that erythrocytes, but not platelets, participated and showed by flow cytometry that mycobacteria physically associated with erythrocytes. We propose that in exposed healthy individuals that show 'early clearance' of the mycobacteria, the innate response is predominantly humoral, probably through the effect of antimicrobial peptides and proteins.
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Affiliation(s)
| | - José Manuel Guerra-Laso
- Servicio de Medicina Interna, Complejo Asistencial Universitario de León, (CAULE), León, Spain
| | - Eduardo López-Fidalgo
- Unidad de Investigación, Complejo Asistencial Universitario de León (CAULE), León, Spain
| | - Cristina Diez-Tascón
- Servicio de Anatomía Patológica, Complejo Asistencial Universitario de León (CAULE), León, Spain Institute of Biomedicine (IBIOMED), Universidad de León, León, Spain
| | - Silvia García-García
- Servicio de Neumología, Complejo Asistencial Universitario de León (CAULE), León, Spain
| | - Sara Blanco-Conde
- Servicio de Análisis Clínicos, Complejo Asistencial Universitario de León (CAULE), León, Spain
| | - Octavio Miguel Rivero-Lezcano
- Unidad de Investigación, Complejo Asistencial Universitario de León (CAULE), León, Spain Institute of Biomedicine (IBIOMED), Universidad de León, León, Spain Fundación Instituto de Estudios de Ciencias de la Salud de Castilla y León (IECSCYL), León, Spain
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16
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Differences between Mycobacterium-Host Cell Relationships in Latent Tuberculous Infection of Mice Ex Vivo and Mycobacterial Infection of Mouse Cells In Vitro. J Immunol Res 2016; 2016:4325646. [PMID: 27066505 PMCID: PMC4811625 DOI: 10.1155/2016/4325646] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Revised: 02/07/2016] [Accepted: 02/23/2016] [Indexed: 12/22/2022] Open
Abstract
The search for factors that account for the reproduction and survival of mycobacteria, including vaccine strains, in host cells is the priority for studies on tuberculosis. A comparison of BCG-mycobacterial loads in granuloma cells obtained from bone marrow and spleens of mice with latent tuberculous infection and cells from mouse bone marrow and peritoneal macrophage cultures infected with the BCG vaccine in vitro has demonstrated that granuloma macrophages each normally contained a single BCG-Mycobacterium, while those acutely infected in vitro had increased mycobacterial loads and death rates. Mouse granuloma cells were observed to produce the IFNγ, IL-1α, GM-CSF, CD1d, CD25, CD31, СD35, and S100 proteins. None of these activation markers were found in mouse cell cultures infected in vitro or in intact macrophages. Lack of colocalization of lipoarabinomannan-labeled BCG-mycobacteria with the lysosomotropic LysoTracker dye in activated granuloma macrophages suggests that these macrophages were unable to destroy BCG-mycobacteria. However, activated mouse granuloma macrophages could control mycobacterial reproduction in cells both in vivo and in ex vivo culture. By contrast, a considerable increase in the number of BCG-mycobacteria was observed in mouse bone marrow and peritoneal macrophages after BCG infection in vitro, when no expression of the activation-related molecules was detected in these cells.
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17
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Byng-Maddick R, Noursadeghi M. Does tuberculosis threaten our ageing populations? BMC Infect Dis 2016; 16:119. [PMID: 26968654 PMCID: PMC4787032 DOI: 10.1186/s12879-016-1451-0] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Accepted: 03/02/2016] [Indexed: 12/31/2022] Open
Abstract
Background The global population is ageing quickly and our understanding of age-related changes in the immune system suggest that the elderly will have less immunological protection from active tuberculosis (TB). Discussion Ongoing global surveillance of TB notifications shows increasing age of patients with active TB. This effect of age is compounded by changes to clinical manifestations of disease, confounding of diagnostic tests and increased rates of adverse reactions to antimicrobial treatment of TB. Future epidemiological surveillance, development of diagnostic tests and trials of treatment shortening should all include a focus on ageing people. Summary More detailed surveillance of TB notifications in elderly people should be undertaken and carefully evaluated. Risk stratification will help target care for those in greatest need, particularly those with comorbidities or on immunosuppressive therapies. Novel diagnostics and treatment regimes should be designed specifically to be used in this cohort.
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Affiliation(s)
- Rachel Byng-Maddick
- Division of Infection and Immunity, University College London, Cruciform Building, Gower Street, London, WC1E 6BT, UK.
| | - Mahdad Noursadeghi
- Division of Infection and Immunity, University College London, Cruciform Building, Gower Street, London, WC1E 6BT, UK
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18
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Guerra-Laso JM, Raposo-García S, García-García S, Diez-Tascón C, Rivero-Lezcano OM. Microarray analysis of Mycobacterium tuberculosis-infected monocytes reveals IL26 as a new candidate gene for tuberculosis susceptibility. Immunology 2015; 144:291-301. [PMID: 25157980 DOI: 10.1111/imm.12371] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Revised: 07/29/2014] [Accepted: 08/21/2014] [Indexed: 01/01/2023] Open
Abstract
Differences in the activity of monocytes/macrophages, important target cells of Mycobacterium tuberculosis, might influence tuberculosis progression. With the purpose of identifying candidate genes for tuberculosis susceptibility we infected monocytes from both healthy elderly individuals (a tuberculosis susceptibility group) and elderly tuberculosis patients with M. tuberculosis, and performed a microarray experiment. We detected 78 differentially expressed transcripts and confirmed these results by quantitative PCR of selected genes. We found that monocytes from tuberculosis patients showed similar expression patterns for these genes, regardless of whether they were obtained from younger or older patients. Only one of the detected genes corresponded to a cytokine: IL26, a member of the interleukin-10 (IL-10) cytokine family which we found to be down-regulated in infected monocytes from tuberculosis patients. Non-infected monocytes secreted IL-26 constitutively but they reacted strongly to M. tuberculosis infection by decreasing IL-26 production. Furthermore, IL-26 serum concentrations appeared to be lower in the tuberculosis patients. When whole blood was infected, IL-26 inhibited the observed pathogen-killing capability. Although lymphocytes expressed IL26R, the receptor mRNA was not detected in either monocytes or neutrophils, suggesting that the inhibition of anti-mycobacterial activity may be mediated by lymphocytes. Additionally, IL-2 concentrations in infected blood were lower in the presence of IL-26. The negative influence of IL-26 on the anti-mycobacterial activity and its constitutive presence in both serum and monocyte supernatants prompt us to propose IL26 as a candidate gene for tuberculosis susceptibility.
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Affiliation(s)
- José M Guerra-Laso
- Servicios de Medicina Interna, Complejo Asistencial Universitario de León (CAULE), León, Spain
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19
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Bueno V, Sant'Anna OA, Lord JM. Ageing and myeloid-derived suppressor cells: possible involvement in immunosenescence and age-related disease. AGE (DORDRECHT, NETHERLANDS) 2014; 36:9729. [PMID: 25399072 PMCID: PMC4233024 DOI: 10.1007/s11357-014-9729-x] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 11/04/2014] [Indexed: 05/02/2023]
Abstract
Infections, cancer and autoimmune diseases occur more frequently in the elderly, and although many factors contribute to this, the age-related remodelling of the immune system, termed immunosenescence, plays a major role. Over the last two decades, studies have evaluated the effect of ageing on both the adaptive and innate arms of the immune system and demonstrated compromised function in several cells including lymphocytes (naïve, effector and memory), regulatory T and B cells, monocytes, neutrophils and NK cells. In addition, a well-documented feature of ageing is the increase in systemic inflammatory status (inflammageing), with raised serum levels of IL6, TNFα and CRP as well as reduced IL10. Recently, myeloid-derived suppressor cells have been the focus of many reports as these cells show immunosuppressive properties and are present in higher frequency during infections, cancer and autoimmunity. Importantly, there have been publications showing increased numbers of myeloid-derived suppressor cells in aged mice and humans. In this review, we discuss the current literature on myeloid-derived suppressor cells, their possible role in altered immune function in the elderly, and whether it may be possible to manipulate these cells to alleviate age-related immune dysfunction.
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Affiliation(s)
- Valquiria Bueno
- Department of Microbiology Immunology and Parasitology, UNIFESP Federal University of São Paulo, São Paulo, Brazil,
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20
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Turner RC, Lucke-Wold B, Lucke-Wold N, Elliott AS, Logsdon AF, Rosen CL, Huber JD. Neuroprotection for ischemic stroke: moving past shortcomings and identifying promising directions. Int J Mol Sci 2013; 14:1890-917. [PMID: 23344061 PMCID: PMC3565354 DOI: 10.3390/ijms14011890] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2012] [Revised: 01/04/2013] [Accepted: 01/10/2013] [Indexed: 02/05/2023] Open
Abstract
The translation of neuroprotective agents for ischemic stroke from bench-to-bedside has largely failed to produce improved treatments since the development of tissue plasminogen activator (tPA). One possible reason for lack of translation is the failure to acknowledge the greatest risk factor for stroke, age, and other common comorbidities such as hypertension, obesity, and diabetes that are associated with stroke. In this review, we highlight both mechanisms of studying these factors and results of those that have been addressed. We also discuss the potential role of other lifestyle factors associated with an increased stroke risk such as sleep fragmentation and/or deprivation. Furthermore, many proposed therapeutic agents have targeted molecular mechanisms occurring soon after the onset of ischemia despite data indicating delayed patient presentation following ischemic stroke. Modulating inflammation has been identified as a promising therapeutic avenue consistent with preliminary success of ongoing clinical trials for anti-inflammatory compounds such as minocycline. We review the role of inflammation in stroke and in particular, the role of inflammatory cell recruitment and macrophage phenotype in the inflammatory process. Emerging evidence indicates an increasing role of neuro-immune crosstalk, which has led to increased interest in identification of peripheral biomarkers indicative of neural injury. It is our hope that identification and investigation of factors influencing stroke pathophysiology may lead to improved therapeutics.
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Affiliation(s)
- Ryan C. Turner
- Department of Neurosurgery, One Medical Center Drive, West Virginia University School of Medicine, P.O. Box 9183, Morgantown, WV 26506, USA; E-Mails: (R.C.T.); (B.L.-W.); (A.S.E.)
- The Center for Neuroscience, West Virginia University School of Medicine, Morgantown, WV 26506, USA; E-Mails: (N.L.-W.); (A.F.L.); (J.D.H.)
| | - Brandon Lucke-Wold
- Department of Neurosurgery, One Medical Center Drive, West Virginia University School of Medicine, P.O. Box 9183, Morgantown, WV 26506, USA; E-Mails: (R.C.T.); (B.L.-W.); (A.S.E.)
- The Center for Neuroscience, West Virginia University School of Medicine, Morgantown, WV 26506, USA; E-Mails: (N.L.-W.); (A.F.L.); (J.D.H.)
| | - Noelle Lucke-Wold
- The Center for Neuroscience, West Virginia University School of Medicine, Morgantown, WV 26506, USA; E-Mails: (N.L.-W.); (A.F.L.); (J.D.H.)
- Department of Health Restoration, West Virginia University School of Nursing, Morgantown, WV 26506, USA
| | - Alisa S. Elliott
- Department of Neurosurgery, One Medical Center Drive, West Virginia University School of Medicine, P.O. Box 9183, Morgantown, WV 26506, USA; E-Mails: (R.C.T.); (B.L.-W.); (A.S.E.)
- The Center for Neuroscience, West Virginia University School of Medicine, Morgantown, WV 26506, USA; E-Mails: (N.L.-W.); (A.F.L.); (J.D.H.)
| | - Aric F. Logsdon
- The Center for Neuroscience, West Virginia University School of Medicine, Morgantown, WV 26506, USA; E-Mails: (N.L.-W.); (A.F.L.); (J.D.H.)
- Department of Basic Pharmaceutical Sciences, West Virginia University School of Pharmacy, Morgantown, WV 26506, USA
| | - Charles L. Rosen
- Department of Neurosurgery, One Medical Center Drive, West Virginia University School of Medicine, P.O. Box 9183, Morgantown, WV 26506, USA; E-Mails: (R.C.T.); (B.L.-W.); (A.S.E.)
- The Center for Neuroscience, West Virginia University School of Medicine, Morgantown, WV 26506, USA; E-Mails: (N.L.-W.); (A.F.L.); (J.D.H.)
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +1-304-293-5041; Fax: +1-304-293-4819
| | - Jason D. Huber
- The Center for Neuroscience, West Virginia University School of Medicine, Morgantown, WV 26506, USA; E-Mails: (N.L.-W.); (A.F.L.); (J.D.H.)
- Department of Basic Pharmaceutical Sciences, West Virginia University School of Pharmacy, Morgantown, WV 26506, USA
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