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Mycobacterial Heat Shock Proteins in Sarcoidosis and Tuberculosis. Int J Mol Sci 2023; 24:ijms24065084. [PMID: 36982159 PMCID: PMC10048904 DOI: 10.3390/ijms24065084] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 03/01/2023] [Accepted: 03/05/2023] [Indexed: 03/09/2023] Open
Abstract
Pathological similarities between sarcoidosis (SA) and tuberculosis (TB) suggest the role of mycobacterial antigens in the etiopathogenesis of SA. The Dubaniewicz group revealed that not whole mycobacteria, but Mtb-HSP70, Mtb-HSP 65, and Mtb-HSP16 were detected in the lymph nodes, sera, and precipitated immune complexes in patients with SA and TB. In SA, the Mtb-HSP16 concentration was higher than that of Mtb-HSP70 and that of Mtb-HSP65, whereas in TB, the Mtb-HSP16 level was increased vs. Mtb-HSP70. A high Mtb-HSP16 level, induced by low dose-dependent nitrate/nitrite (NOx), may develop a mycobacterial or propionibacterial genetic dormancy program in SA. In contrast to TB, increased peroxynitrite concentration in supernatants of peripheral blood mononuclear cell cultures treated with Mtb-HSP may explain the low level of NOx detected in SA. In contrast to TB, monocytes in SA were resistant to Mtb-HSP-induced apoptosis, and CD4+T cell apoptosis was increased. Mtb-HSP-induced apoptosis of CD8+T cells was reduced in all tested groups. In Mtb-HSP-stimulated T cells, lower CD8+γδ+IL-4+T cell frequency with increased TNF-α,IL-6,IL-10 and decreased INF-γ,IL-2,IL-4 production were present in SA, as opposed to an increased presence of CD4+γδ+TCR cells with increased TNF-α,IL-6 levels in TB, vs. controls. Mtb-HSP modulating the level of co-stimulatory molecules, regulatory cells, apoptosis, clonal deletion, epitope spread, polyclonal activation and molecular mimicry between human and microbial HSPs may also participate in the induction of autoimmunity, considered in SA. In conclusion, in different genetically predisposed hosts, the same antigens, e.g., Mtb-HSP, may induce the development of TB or SA, including an autoimmune response in sarcoidosis.
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Duvall A, Greenacre C, Grunkemeyer V, Craig L. Cutaneous Mycobacteriosis Caused by Mycobacterium kansasii in a Yellow-naped Amazon Parrot ( Amazona auropalliata). J Avian Med Surg 2021; 35:227-234. [PMID: 34256554 DOI: 10.1647/20-00036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
An approximately 25-year-old, female, yellow-naped Amazon parrot (Amazona auropalliata) was evaluated for a chronic, raised, ulcerative mass on the lateral aspect of the left thigh. Histopathology of an excisional biopsy revealed severe, chronic, multifocal-to-coalescing, ulcerated dermal and subcutaneous granulomas. No infectious organisms were observed on Ziehl-Neelsen or Gomori methenamine silver stains. The parrot was treated with oral sulfamethoxazoletrimethoprim and meloxicam. When reexamined 2 weeks later, the biopsy site had healed. Surgical biopsies were resubmitted 14 months after the original presentation due to recurrence of similar ulcerative lesions on the right leg. Histopathology revealed a similar inflammatory pattern, and hematoxylin-eosin, Ziehl-Neelsen, and silver stains on the biopsy samples were all negative. A Fite-Faraco stain revealed rare acid-fast bacilli throughout the lesion. Tissue polymerase chain reaction test was negative for Mycobacterium avium and Mycobacterium genavense. Mycobacterial culture and subsequent genotyping revealed Mycobacterium kansasii. Mycobacterium kansasii is a significant cause of mycobacteriosis in humans and, therefore, should be considered a potential zoonotic organism. This report describes an unusual primary cutaneous presentation of avian mycobacteriosis.
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Affiliation(s)
| | | | | | - Linden Craig
- University of Tennessee, Knoxville, TN 37996, USA
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Bruno D, Tanti G, Cingolani A, Ria F, Gremese E, Mirone L. Simultaneous Onset of Mycobacterium kansasii Pulmonary Infection and Systemic Lupus Erythematosus: A Case Report. AMERICAN JOURNAL OF CASE REPORTS 2021; 22:e929866. [PMID: 34006819 PMCID: PMC8141339 DOI: 10.12659/ajcr.929866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Patient: Female, 19-year-old Final Diagnosis: Systemic lupus erythematosus Symptoms: Cough • Fever • malaise and fatigue • polyarthralgia • skin rash Medication: — Clinical Procedure: — Specialty: Rheumatology
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Affiliation(s)
- Dario Bruno
- Division of Rheumatology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giacomo Tanti
- Division of Rheumatology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Antonella Cingolani
- Department of Laboratory and Infectious Disease Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Department of Safety and Bioethics, Section of Infectious Diseases, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Francesco Ria
- Department of Medicine and Translational Surgery, Università Cattolica del Sacro Cuore, Rome, Italy.,Department of Laboratory Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Elisa Gremese
- Division of Rheumatology, Università Cattolica del Sacro Cuore, Rome, Italy.,Division of Rheumatology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Luisa Mirone
- Division of Rheumatology, Università Cattolica del Sacro Cuore, Rome, Italy.,Division of Rheumatology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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Shaharir SS, Sulaiman Sahari N, Mohamed Fuad Z, Zukiman WZHW, Mohd Yusof NH, Sulong A, Periasamy P. Non-tuberculous mycobacterium bacteraemia in a pregnant systemic lupus erythematosus (SLE) patient: a case review and pooled case analysis. Clin Rheumatol 2017; 37:837-847. [DOI: 10.1007/s10067-017-3855-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 09/20/2017] [Accepted: 09/25/2017] [Indexed: 10/18/2022]
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Ng SSY, Tay YK, Koh MJA, Thoon KC, Sng LH. Pediatric Cutaneous Nontuberculous Mycobacterium Infections in Singapore. Pediatr Dermatol 2015; 32:488-94. [PMID: 25845296 DOI: 10.1111/pde.12575] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Nontuberculous mycobacterium (NTM) infections are rare in children, with limited published studies. The course of the disease can be variable and there are no accepted treatment guidelines for the management of NTM infections in children. OBJECTIVE To review a cohort of pediatric patients admitted to a tertiary pediatric hospital in Singapore for cutaneous NTM infections. METHODS A retrospective review was performed of all children admitted to KK Women's and Children's Hospital with cutaneous NTM infections from 2002 to 2012. RESULTS Sixty-seven patients with positive NTM cultures from various body sites were identified. Eight of the 67 patients (11.9%) presented with cutaneous NTM without evidence of systemic involvement. The mean age at diagnosis for these eight patients was 10 years (range 5-21 yrs). Mycobacterium abscessus was the most common NTM isolated (five patients), followed by Mycobacterium hemophilium (two patients) and Mycobacterium kansasii (one patient). Most patients presented with isolated skin abscesses. Two patients were immunocompromised. Six patients required multidrug antibiotic treatment for a median duration of 5.5 months (range 3-17 mos). The median follow-up duration was 8.5 months (range 2 wks-29 mos). CONCLUSION Although the incidence of cutaneous NTM is rare, the diagnosis should be considered in patients presenting with chronic wounds. Most patients require treatment with multidrug antibiotic therapy, although uncomplicated abscesses can be treated with surgical incision and drainage alone.
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Affiliation(s)
- Shanna Shan-Yi Ng
- Department of Dermatology, Changi General Hospital, Singapore City, Singapore
| | - Yong-Kwang Tay
- Department of Dermatology, Changi General Hospital, Singapore City, Singapore
| | | | - Koh-Cheng Thoon
- KK Women's and Children's Hospital, Singapore City, Singapore
| | - Li-Hwei Sng
- Singapore General Hospital, Singapore City, Singapore
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[Lupus erythematosus. Wide range of symptoms through clinical variation, associated diseases and imitators]. Hautarzt 2010; 61:676-82. [PMID: 20549478 DOI: 10.1007/s00105-010-1939-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The typical clinical forms of cutaneous lupus erythematosus (LE) are the butterfly rash, acute, subacute and chronic cutaneous lupus, intermediate lupus (lupus tumidus), chilblain- and bullous lupus, lupus profundus, and ulcerating lesions on the mucous membrane. Besides the typical lupus forms, nonspecific skin lesions are also observed such as dermal mucinosis, acneiform skin lesions, different variants of livedo, necrotizing vasculitis with ulcers, purpura, urticaria vasculitis, neutrophilic dermatosis, hyperpigmentation, hair and nail changes as well as overlap syndromes with erythema multiforme, scleroderma, Sjögren syndrome, Raynaud phenomenon, lichen planus, bullous pemphigoid und psoriasis. There are lupus imitators which create differential diagnostic challenges, such as infections with atypical mycobacteria or subcutaneous T-cell lymphoma both of which are similar to lupus profundus. All these skin lesions can present as maximal pathological findings seen in lupus or be caused by a variety of pathological laboratory findings such as the anti-phospholipid antibodies or a deficiency of complement factors. In the latter situation severe lupus often with complications can be expected.
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Abstract
Immunocompromised patients with rheumatic diseases have an increased risk of infections. A major risk factor for infection seems to be the immunosuppressive therapy used. Newer therapies for RA may lead to increased rates of infection by opportunistic pathogens such as Mycobacteria tuberculosis. Because disease manifestation may mimic signs and symptoms of infection, prompt diagnosis may be difficult. Familiarity with the likely infections and their causes should aid in obtaining the appropriate culture specimens.
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Affiliation(s)
- Stephen B Greenberg
- Departments of Medicine, Molecular Virology, and Microbiology, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA.
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Bouza E, Moya JG, Muñoz P. Infections in systemic lupus erythematosus and rheumatoid arthritis. Infect Dis Clin North Am 2001; 15:335-61, vii. [PMID: 11447699 DOI: 10.1016/s0891-5520(05)70149-5] [Citation(s) in RCA: 86] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Patients with systemic lupus erythematosus have a higher infection rate than the general population. It is estimated that at least 50% of them will suffer a severe infectious episode during the course of the disease. Improvements in the control of the disease are discussed in this article.
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Affiliation(s)
- E Bouza
- Clinical Microbiology and Infectious Disease Service, Hospital General Universitario Gregorio Marañón, University of Madrid, Madrid, Spain.
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Kotb R, Dhôte R, Garcia-Ricart F, Permal S, Carlotti A, Arfi C, Christoforov B. Cutaneous and mediastinal lymphadenitis due to Mycobacterium kansasii. J Infect 2001; 42:277-8. [PMID: 11545572 DOI: 10.1053/jinf.2000.0800] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Mycobacterium kansasii most commonly causes a slowly progressive pulmonary disease. Skin and disseminated infections are seen less frequently and only in immunocompromised hosts. To our knowledge, no case of Mycobacterium kansasii infection or skin infection associated with additional organ involvement in an immunocompetent patient has been reported.
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Affiliation(s)
- R Kotb
- Service de Medecine Interne, hôpital Cochin, 27 rue Faubourg Saint-Jacques, 75014 Paris, France
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Ibarrola M, Baraia-Etxaburu J, Sánchez R, Teira R, Unzaga J, Miguel Santamaría J. [Disseminated disease by Mycobacterium kansasii resistant to isoniazid and rifampin in patients] with AIDS]. Enferm Infecc Microbiol Clin 2001; 19:80-2. [PMID: 11333577 DOI: 10.1016/s0213-005x(01)72568-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Abstract
A patient presented with chronic leg ulcers after a mowing accident. He received several courses of antibiotics for presumed cellulitis, underwent surgical debridement, and was treated empirically with cyclosporin for presumed pyoderma gangrenosum, all without improvement. Cultures from prior debridement revealed Mycobacterium kansasii, and he was successfully treated with triple antituberculous regimen. Cutaneous infections due to this slow growing Mycobacterium are rare and may resemble cellulitis or sporotrichosis. Mycobacterium kansasii should be included in the differential diagnosis of skin infections with an indolent course and lack of response to antibiotics.
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Affiliation(s)
- B Razavi
- Division of Infectious Diseases, Washington University, St. Louis, Missouri, USA.
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Garcia-Ricart F, Permal S, Kotb R, Dhote R, Carlotti A, Arfi C, Christoforov B. Un état (assez) proche de l’Ohio. Rev Med Interne 2000. [DOI: 10.1016/s0248-8663(00)89271-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Braun-Falco O, Plewig G, Wolff HH, Burgdorf WHC. Bacterial Diseases. Dermatology 2000. [DOI: 10.1007/978-3-642-97931-6_4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
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