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Immunoendocrine abnormalities in the female reproductive system, and lung steroidogenesis during experimental pulmonary tuberculosis. Tuberculosis (Edinb) 2023; 138:102274. [PMID: 36463716 DOI: 10.1016/j.tube.2022.102274] [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: 04/29/2022] [Revised: 11/10/2022] [Accepted: 11/12/2022] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Tuberculosis (TB) caused by Mycobacterium tuberculosis mainly affects the lungs, but can spread to other organs. TB chronically activates the immune and endocrine systems producing remarkable functional changes.So far, it is unknown whether pulmonary non-disseminated TB cause changes in the female reproductive system and lung endocrinology. OBJECTIVE To investigate whether pulmonary TB produces immunoendocrine alterations of the female mice reproductive organs, and lung estradiol synthesis. METHODS BALB/c mice were infected intratracheally with Mycobacterium tuberculosis (Mtb) strain H37Rv. Groups of six non-infected and infected animals were euthanized on different days. Bacillary loads were determined in the lungs, ovaries and uterus. Immunohistochemistry and morphometry studies were performed in histological sections. Serum estradiol wasassayed, and supernatantfrom cultured lung cells was analyzed by Thin Layer Chromatography (TLC). RESULTS Mtb only grew in lung tissue. Histopathology revealed abnormal folliculogenesis and decreased corpora lutea. Altered ovarian expression of IL-6, IL-1β was found. The infection increased serum estradiol. Estradiol synthesis by infected lung cells triplicate after 30 pi days.Aromatase immunostaining was found in the alveolar and bronchial epithelium, being stronger in the infected lungs, mainly in macrophages. CONCLUSION Pulmonary TB affects the histophysiology of the female reproductive system in absence of its local infection, and disturbslung endocrinology.
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Espiritu N, Aguirre L, Jave O, Sanchez L, Kirwan DE, Gilman RH. Congenital transmission of multidrug-resistant tuberculosis. Am J Trop Med Hyg 2014; 91:92-5. [PMID: 24821847 PMCID: PMC4080578 DOI: 10.4269/ajtmh.13-0002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2013] [Accepted: 09/20/2013] [Indexed: 12/13/2022] Open
Abstract
This article presents a case of multidrug-resistant tuberculosis (TB) in a Peruvian infant. His mother was diagnosed with disseminated TB, and treatment commenced 11 days postpartum. The infant was diagnosed with TB after 40 days and died at 2 months and 2 days of age. Congenital transmission of TB to the infant was suspected, because direct postpartum transmission was considered unlikely; also, thorough screening of contacts for TB was negative. Spoligotyping confirmed that both mother and baby were infected with identical strains of the Beijing family (SIT1).
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Affiliation(s)
- Nora Espiritu
- Department of Pediatrics, Hospital Nacional Dos de Mayo, Lima, Peru; Department of Pulmonology, Hospital Nacional Dos de Mayo, Lima, Peru; "Santa Martha" Health Centre, Ministerio de Salud (MINSA), Lima, Peru; Department of Infectious Diseases and Immunity, Imperial College London, London, United Kingdom; Laboratory of the Universidad Peruana Cayetano Heredia, Lima, Peru; Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Lino Aguirre
- Department of Pediatrics, Hospital Nacional Dos de Mayo, Lima, Peru; Department of Pulmonology, Hospital Nacional Dos de Mayo, Lima, Peru; "Santa Martha" Health Centre, Ministerio de Salud (MINSA), Lima, Peru; Department of Infectious Diseases and Immunity, Imperial College London, London, United Kingdom; Laboratory of the Universidad Peruana Cayetano Heredia, Lima, Peru; Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Oswaldo Jave
- Department of Pediatrics, Hospital Nacional Dos de Mayo, Lima, Peru; Department of Pulmonology, Hospital Nacional Dos de Mayo, Lima, Peru; "Santa Martha" Health Centre, Ministerio de Salud (MINSA), Lima, Peru; Department of Infectious Diseases and Immunity, Imperial College London, London, United Kingdom; Laboratory of the Universidad Peruana Cayetano Heredia, Lima, Peru; Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Luis Sanchez
- Department of Pediatrics, Hospital Nacional Dos de Mayo, Lima, Peru; Department of Pulmonology, Hospital Nacional Dos de Mayo, Lima, Peru; "Santa Martha" Health Centre, Ministerio de Salud (MINSA), Lima, Peru; Department of Infectious Diseases and Immunity, Imperial College London, London, United Kingdom; Laboratory of the Universidad Peruana Cayetano Heredia, Lima, Peru; Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Daniela E Kirwan
- Department of Pediatrics, Hospital Nacional Dos de Mayo, Lima, Peru; Department of Pulmonology, Hospital Nacional Dos de Mayo, Lima, Peru; "Santa Martha" Health Centre, Ministerio de Salud (MINSA), Lima, Peru; Department of Infectious Diseases and Immunity, Imperial College London, London, United Kingdom; Laboratory of the Universidad Peruana Cayetano Heredia, Lima, Peru; Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Robert H Gilman
- Department of Pediatrics, Hospital Nacional Dos de Mayo, Lima, Peru; Department of Pulmonology, Hospital Nacional Dos de Mayo, Lima, Peru; "Santa Martha" Health Centre, Ministerio de Salud (MINSA), Lima, Peru; Department of Infectious Diseases and Immunity, Imperial College London, London, United Kingdom; Laboratory of the Universidad Peruana Cayetano Heredia, Lima, Peru; Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
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Jana N, Barik S, Arora N, Singh AK. Tuberculosis in pregnancy: the challenges for South Asian countries. J Obstet Gynaecol Res 2012; 38:1125-36. [PMID: 22563776 DOI: 10.1111/j.1447-0756.2012.01856.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM Despite tuberculosis (TB) being a global problem, maternal TB remains an unrecognized and underestimated tragedy, especially in South Asian countries. Therefore, we performed a non-systematic review regarding implications of maternal TB on obstetric and perinatal outcomes in the South Asian context. MATERIAL AND METHODS We reviewed original studies, both descriptive and analytical, that originated from South Asian countries following an electronic search supplemented by a manual search. Although relevant studies from developed countries were reviewed, they were not included in the tabulation process because those studies had different socioeconomic/epidemiological background. RESULTS Diagnosis of TB is often delayed during pregnancy, because of its non-specific symptoms, and overlapping presentation with other infectious diseases. Poverty, undernutrition, lack of social support and poor health infrastructure along with complications of TB and need for prolonged medications lead to increased maternal morbidity and mortality. Maternal TB in general (except lymphadenitis), is associated with an increased risk of small-for-gestational age, preterm and low-birthweight neonates, and high perinatal mortality. These adverse perinatal outcomes are even more pronounced in women with advanced disease, late diagnosis, and incomplete or irregular drug treatment. There could be a synergy of TB, socioeconomic and nutritional factors, which might have contributed to adverse perinatal effects, especially in low-income countries. CONCLUSIONS As active TB poses grave maternal and perinatal risks, early, appropriate and adequate anti-TB treatment is a mainstay for successful pregnancy outcome. The current knowledge gaps in perinatal implications of maternal TB can be addressed by a multicenter comparative cohort study.
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MESH Headings
- Antitubercular Agents/therapeutic use
- Asia, Western/epidemiology
- Female
- HIV Infections/complications
- Humans
- Infant, Newborn
- Infant, Newborn, Diseases/diagnosis
- Infant, Newborn, Diseases/epidemiology
- Infant, Newborn, Diseases/therapy
- Lactation
- Pregnancy
- Pregnancy Complications, Infectious/diagnosis
- Pregnancy Complications, Infectious/epidemiology
- Pregnancy Complications, Infectious/therapy
- Socioeconomic Factors
- Tuberculosis/diagnosis
- Tuberculosis/epidemiology
- Tuberculosis/therapy
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Affiliation(s)
- Narayan Jana
- Department of Obstetrics and Gynaecology, Burdwan Medical College, Burdwan, India.
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Peng W, Yang J, Liu E. Analysis of 170 cases of congenital TB reported in the literature between 1946 and 2009. Pediatr Pulmonol 2011; 46:1215-24. [PMID: 21626715 DOI: 10.1002/ppul.21490] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2010] [Revised: 03/24/2011] [Accepted: 03/26/2011] [Indexed: 12/29/2022]
Abstract
INTRODUCTION Congenital tuberculosis is a rare disease. The mortality is very high. Through a review of our own cases and the world literature, we describe clinical manifestations, treatment, and prognosis of this disease. METHODS A total of 170 subjects with congenital tuberculosis that 6 cases identified by the authors and 164 cases identified in other case series were included in this study. All patients were diagnosed according to Cantwell's criteria. The data were analyzed using SPSS, version 17.0 spss. RESULTS There were 70 premature babies among the 170 infants with congenital tuberculosis. The average onset age was 20 days. The mothers of 162 patients were diagnosed as having active tuberculosis during pregnancy or after parturition. Nonspecific signs and symptoms were found in these 170 cases, such as fever, respiratory distress, and hepatosplenomegaly, etc. Abnormal chest radiographs were found in 133 infants, of whom 83 cases showed miliary tuberculosis and multiple pulmonary nodules. Sixty-eight infants died from among the 169 cases. The mortality dropped to 21.7% after treatment with anti-tuberculosis medication. The blood leukocyte count (P < 0.001), anti-tuberculosis treatment (P < 0.001), age of onset (P = 0.004), and presence of intracranial lesions (P < 0.001) affected the prognosis of congenital tuberculosis. CONCLUSIONS The majority of infants with congenital tuberculosis onset within 2-3 weeks after delivery had no specific manifestations. Anti-tuberculosis medication could reduce the mortality. The age of onset, presence of intracranial lesions, anti-tuberculosis treatment, specific image performances and leukocyte count were related to the prognosis of congenital tuberculosis.
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Affiliation(s)
- Wansheng Peng
- Department of Pediatrics, the First Affiliation Hospital of Bengbu Medical College, Bengbu, PR China
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