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Carnero Canales CS, Marquez Cazorla JI, Marquez Cazorla RM, Roque-Borda CA, Polinário G, Figueroa Banda RA, Sábio RM, Chorilli M, Santos HA, Pavan FR. Breaking barriers: The potential of nanosystems in antituberculosis therapy. Bioact Mater 2024; 39:106-134. [PMID: 38783925 PMCID: PMC11112550 DOI: 10.1016/j.bioactmat.2024.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 04/17/2024] [Accepted: 05/05/2024] [Indexed: 05/25/2024] Open
Abstract
Tuberculosis (TB), caused by Mycobacterium tuberculosis, continues to pose a significant threat to global health. The resilience of TB is amplified by a myriad of physical, biological, and biopharmaceutical barriers that challenge conventional therapeutic approaches. This review navigates the intricate landscape of TB treatment, from the stealth of latent infections and the strength of granuloma formations to the daunting specters of drug resistance and altered gene expression. Amidst these challenges, traditional therapies often fail, contending with inconsistent bioavailability, prolonged treatment regimens, and socioeconomic burdens. Nanoscale Drug Delivery Systems (NDDSs) emerge as a promising beacon, ready to overcome these barriers, offering better drug targeting and improved patient adherence. Through a critical approach, we evaluate a spectrum of nanosystems and their efficacy against MTB both in vitro and in vivo. This review advocates for the intensification of research in NDDSs, heralding their potential to reshape the contours of global TB treatment strategies.
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Affiliation(s)
| | | | | | - Cesar Augusto Roque-Borda
- Tuberculosis Research Laboratory, School of Pharmaceutical Science, Sao Paulo State University (UNESP), Araraquara, 14800-903, Brazil
| | - Giulia Polinário
- Tuberculosis Research Laboratory, School of Pharmaceutical Science, Sao Paulo State University (UNESP), Araraquara, 14800-903, Brazil
| | | | - Rafael Miguel Sábio
- School of Pharmaceutical Science, Sao Paulo State University (UNESP), Araraquara, 14800-903, Brazil
- Department of Biomaterials and Biomedical Technology, University Medical Center Groningen (UMCG), University of Groningen, Groningen, 9713 AV, the Netherlands
| | - Marlus Chorilli
- School of Pharmaceutical Science, Sao Paulo State University (UNESP), Araraquara, 14800-903, Brazil
| | - Hélder A. Santos
- Department of Biomaterials and Biomedical Technology, University Medical Center Groningen (UMCG), University of Groningen, Groningen, 9713 AV, the Netherlands
- Drug Research Program, Division of Pharmaceutical Chemistry and Technology, Faculty of Pharmacy, University of Helsinki, Helsinki, FI-00014, Finland
| | - Fernando Rogério Pavan
- Tuberculosis Research Laboratory, School of Pharmaceutical Science, Sao Paulo State University (UNESP), Araraquara, 14800-903, Brazil
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Krishnamoorthy Y, Ezhumalai K, Murali S, Rajaa S, Majella MG, Sarkar S, Lakshminarayanan S, Joseph NM, Soundappan G, Prakash Babu S, Horsburgh C, Hochberg N, Johnson WE, Knudsen S, Pentakota SR, Salgame P, Roy G, Ellner J. Development of prognostic scoring system for predicting 1-year mortality among pulmonary tuberculosis patients in South India. J Public Health (Oxf) 2023; 45:e184-e195. [PMID: 36038507 PMCID: PMC10273380 DOI: 10.1093/pubmed/fdac087] [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: 10/28/2021] [Revised: 05/13/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Development of a prediction model using baseline characteristics of tuberculosis (TB) patients at the time of diagnosis will aid us in early identification of the high-risk groups and devise pertinent strategies accordingly. Hence, we did this study to develop a prognostic-scoring model for predicting the death among newly diagnosed drug sensitive pulmonary TB patients in South India. METHODS We undertook a longitudinal analysis of cohort data under the Regional Prospective Observational Research for Tuberculosis India consortium. Multivariable cox regression using the stepwise backward elimination procedure was used to select variables for the model building and the nomogram-scoring system was developed with the final selected model. RESULTS In total, 54 (4.6%) out of the 1181 patients had died during the 1-year follow-up period. The TB mortality rate was 0.20 per 1000 person-days. Eight variables (age, gender, functional limitation, anemia, leukopenia, thrombocytopenia, diabetes, neutrophil-lymphocyte ratio) were selected and a nomogram was built using these variables. The discriminatory power was 0.81 (95% confidence interval: 0.75-0.86) and this model was well-calibrated. Decision curve analysis showed that the model is beneficial at a threshold probability ~15-65%. CONCLUSIONS This scoring system could help the clinicians and policy makers to devise targeted interventions and in turn reduce the TB mortality in India.
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Affiliation(s)
| | - Komala Ezhumalai
- Department of Preventive & Social Medicine, JIPMER, Puducherry 605 006, India
| | - Sharan Murali
- Department of Preventive & Social Medicine, JIPMER, Puducherry 605 006, India
| | - Sathish Rajaa
- Department of Preventive & Social Medicine, JIPMER, Puducherry 605 006, India
| | | | - Sonali Sarkar
- Department of Preventive & Social Medicine, JIPMER, Puducherry 605 006, India
| | | | | | | | | | - Charles Horsburgh
- Department of Epidemiology, Boston University School of Public Health, Boston, MA 02118, USA
| | - Natasha Hochberg
- Department of Medicine, Section of Infectious Diseases, Boston University School of Medicine, Boston, MA 02118, USA
| | - W Evan Johnson
- Department of Medicine and Biostatistics, Boston University School of Medicine, Boston, MA 02118, USA
| | - Selby Knudsen
- Department of Medicine, Section of Infectious Diseases, Boston University School of Medicine, Boston, MA 02118, USA
| | - Sri Ram Pentakota
- Department of Medicine, Rutgers New Jersey Medical School, Newark, New Jersey 07103, USA
| | - Padmini Salgame
- Department of Medicine, Rutgers New Jersey Medical School, Newark, New Jersey 07103, USA
| | - Gautam Roy
- Department of Preventive & Social Medicine, JIPMER, Puducherry 605 006, India
| | - Jerrold Ellner
- Department of Medicine, Rutgers New Jersey Medical School, Newark, New Jersey 07103, USA
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Sánchez-Jiménez R, Cerón E, Bernal-Alcántara D, Castillejos-López M, Gonzalez-Trujano E, Negrete-García MC, Alvarado-Vásquez N. Association between IL-15 and insulin plasmatic concentrations in patients with pulmonary tuberculosis and type 2 diabetes. Tuberculosis (Edinb) 2018; 111:114-120. [PMID: 30029895 DOI: 10.1016/j.tube.2018.06.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 05/31/2018] [Accepted: 06/07/2018] [Indexed: 11/30/2022]
Abstract
IL-15 is part of the immune response in pulmonary tuberculosis (PTB) but amazingly, it may also induce physiological effects similar to those of insulin. We evaluated the IL-15 and insulin plasmatic levels in adults with PTB and with or without type 2 diabetes mellitus (DM2), who received previous antituberculosis therapy for at least 2 months. We analyzed the concentrations of glucose, glycated hemoglobin, insulin, as well as levels of IL-15, IL-2, IFN-γ, and TNF-α in patients with PTB, patients with PTB-DM2, household contacts with DM2 (C-DM2), and healthy household contacts (H-C). Our results showed unexpected high levels of glucose, insulin, and IL-15 in the PTB and C-DM2 groups. In comparison, low levels of these same indicators were observed in the PTB-DM2 and H-C groups. Interestingly, our analysis showed a positive correlation of IL-15 with insulin in the PTB group (r = 0.73) and in the C-DM2 group (r = 0.66). In comparison, a weak correlation between IL-15 and insulin was observed in the PTB-DM group (r = 0.10) and in the H-C group (ρ = 0.26). Our results suggest an association between IL-15 and insulin levels in the patient with PTB. Intriguingly, this association was weaker in the patient with PTB-DM2.
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Affiliation(s)
- Roberto Sánchez-Jiménez
- Graduate and Research Section, Higher School of Medicine of the National Polytechnic Institute, Mexico City, 11340, Mexico
| | - Eduarda Cerón
- Department of Biochemistry, National Institute of Respiratory Diseases "Ismael Cosío Villegas", Mexico City, 14080, Mexico
| | - Demetrio Bernal-Alcántara
- Department of Biochemistry, National Institute of Respiratory Diseases "Ismael Cosío Villegas", Mexico City, 14080, Mexico
| | - Manuel Castillejos-López
- Epidemiological Surveillance Unit, National Institute of Respiratory Diseases "Ismael Cosío Villegas", Mexico City, 14080, Mexico
| | - Eva Gonzalez-Trujano
- National Institute of Psychiatry "Ramón de la Fuente Muñiz", Mexico City, 14370, Mexico
| | - Maria Cristina Negrete-García
- Department of Biochemistry, National Institute of Respiratory Diseases "Ismael Cosío Villegas", Mexico City, 14080, Mexico
| | - Noé Alvarado-Vásquez
- Department of Biochemistry, National Institute of Respiratory Diseases "Ismael Cosío Villegas", Mexico City, 14080, Mexico.
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Muñoz-Torrico M, Caminero-Luna J, Migliori GB, D'Ambrosio L, Carrillo-Alduenda JL, Villareal-Velarde H, Torres-Cruz A, Flores-Vergara H, Martínez-Mendoza D, García-Sancho C, Centis R, Salazar-Lezama MÁ, Pérez-Padilla R. Diabetes is Associated with Severe Adverse Events in Multidrug-Resistant Tuberculosis. Arch Bronconeumol 2017; 53:245-250. [PMID: 28089216 DOI: 10.1016/j.arbres.2016.10.021] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 10/25/2016] [Accepted: 10/26/2016] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Diabetes mellitus (DM), a very common disease in Mexico, is a well-known risk factor for tuberculosis (TB). However, it is not known by which extent DM predisposes to adverse events (AE) to anti-TB drugs and/or to worse outcomes in patients with multidrug-resistant (MDR-TB) and extensively drug-resistant TB (XDR-TB). The main objective of this study was to describe the outcomes of TB treatment, the impact of DM and the prevalence of AE in a cohort of patients with MDR-/XDR pulmonary TB treated at the national TB referral centre in Mexico City. RESULTS Ninety patients were enrolled between 2010 and 2015: 73 with MDR-TB (81.1%), 11 with pre-XDR-TB (12.2%) and 6 (6.7%) with XDR-TB, including 49 (54.4%) with DM, and 3 with Human Immunodeficiency Virus (HIV) co-infection (3.3%). In 98% of patients, diagnosis was made by culture and drug susceptibility testing, while in a single case the diagnosis was made by a molecular test. The presence of DM was associated with an increased risk of serious drug-related AEs, such as nephrotoxicity (Odds Ratio [OR]=6.5; 95% Confidence Interval [95% CI]: 1.9-21.8) and hypothyroidism (OR=8.8; 95% CI: 1.8-54.2), but not for a worse outcome. CONCLUSIONS Our data suggest that DM does not impact second-line TB treatment outcomes, but patients with DM have a higher risk of developing serious AEs to drug-resistant TB treatment, such as nephrotoxicity and hypothyroidism.
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Affiliation(s)
- Marcela Muñoz-Torrico
- Clínica de Tuberculosis, Instituto Nacional de Enfermedades Respiratorias de México (INER), Ciudad de México, México
| | - José Caminero-Luna
- Departamento de Neumología, Hospital Universitario de Gran Canaria «Dr. Negrín», Las Palmas, Canarias, España
| | | | - Lia D'Ambrosio
- WHO Collaborating Centre for TB and Lung Diseases, Maugeri Institute, IRCCS, Tradate, Italia; Public Health Consulting Group, Lugano, Suiza
| | - José Luis Carrillo-Alduenda
- Clínica del Sueño, Instituto Nacional de Enfermedades Respiratorias de México (INER), Ciudad de México, México
| | - Héctor Villareal-Velarde
- Clínica de Tuberculosis, Instituto Nacional de Enfermedades Respiratorias de México (INER), Ciudad de México, México
| | - Alfredo Torres-Cruz
- Clínica de Tuberculosis, Instituto Nacional de Enfermedades Respiratorias de México (INER), Ciudad de México, México
| | - Héctor Flores-Vergara
- Clínica de Tuberculosis, Instituto Nacional de Enfermedades Respiratorias de México (INER), Ciudad de México, México
| | - Dina Martínez-Mendoza
- Clínica de Tuberculosis, Instituto Nacional de Enfermedades Respiratorias de México (INER), Ciudad de México, México
| | - Cecilia García-Sancho
- Departamento de Epidemiología, Instituto Nacional de Enfermedades Respiratorias de México (INER), Ciudad de México, México
| | - Rosella Centis
- WHO Collaborating Centre for TB and Lung Diseases, Maugeri Institute, IRCCS, Tradate, Italia
| | - Miguel Ángel Salazar-Lezama
- Clínica de Tuberculosis, Instituto Nacional de Enfermedades Respiratorias de México (INER), Ciudad de México, México
| | - Rogelio Pérez-Padilla
- Clínica del Sueño, Instituto Nacional de Enfermedades Respiratorias de México (INER), Ciudad de México, México
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