Elevated antigen-specific IFN-γ responses in bronchoalveolar lavage fluid impervious to clinical comorbidities improve the pulmonary tuberculosis diagnosis

Pulmonary tuberculosis and diabetes mellitus: Epidemiology, pathogenesis and therapeutic management (Review)

The dual burden of pulmonary tuberculosis (PTB) and diabetes mellitus (DM) is a major global public health concern. There is increasing evidence to indicate an association between PTB and DM. DM is associated with immune dysfunction and altered immune components. Hyperglycemia weakens the innate immune response by affecting the function of macrophages, dendritic cells, neutrophils, and natural killer cells, and also disrupts the adaptive immune response, thus promoting the susceptibility of PTB in patients with DM. Antituberculosis drugs often cause the impairment of liver and kidney function in patients with PTB, and the infection with Mycobacterium tuberculosis weaken pancreatic endocrine function by causing islet cell amyloidosis, which disrupts glucose metabolism and thus increases the risk of developing DM in patients with PTB. The present review discusses the association between PTB and DM from the perspective of epidemiology, pathogenesis, and treatment management. The present review aims to provide information for the rational formulation of treatment strategies for patients with PTB-DM.

Diagnostic value of microRNA-155 in active tuberculosis: A systematic review and meta-analysis

BACKGROUND

Tuberculosis (TB) is a preventable and treatable disease, but the increased mortality and morbidity associated with TB continues to be a leading cause of death globally. MicroRNA (miRNA)-155 has been recognized as a marker of many lung diseases. However, the effectiveness of this marker for diagnosing TB remains unclear.

METHODS

A detailed search (updated on February 6, 2021) of literature published in the Wanfang database, EMBASE, PubMed, CNKI, and Cochrane Library was conducted to identify eligible studies suitable for inclusion in the current research. The positive likelihood ratio, negative likelihood ratio, specificity, area under the curve, sensitivity, and diagnostic odds ratio were used to investigate the diagnostic potential of miRNA-155.

RESULTS

A total of 122 studies related to active TB, which completely complied with the inclusion and exclusion criteria of our meta-analysis, were included. The overall results suggested a moderately high diagnostic accuracy and efficacy of miRNA-155, with a specificity of 0.85 (95% confidence interval = 0.77-0.91) and sensitivity of 0.87 (95% confidence interval = 0.76-0.93). The result based on dysregulated status demonstrated that the upregulated group yielded better accuracy and efficacy than the downregulated group. Notably, the accuracy and efficacy of miRNA-155 in pediatric TB were higher than those in adult TB. The results showed that the accuracy and efficacy of miRNA-155 in children were higher than those in adults.

CONCLUSION

The results of the meta-analysis suggested that miRNA-155 could serve as an effective biomarker for identifying active TB.