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Gupta A, Chandra E, Anand S, Kumar N, Arora R, Rana D, Mrigpuri P. Latent tuberculosis diagnostics: current scenario and review. Monaldi Arch Chest Dis 2024. [PMID: 38700134 DOI: 10.4081/monaldi.2024.2984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Accepted: 04/03/2024] [Indexed: 05/05/2024] Open
Abstract
This review presents a comprehensive examination of the contemporary landscape pertaining to latent tuberculosis infection (LTBI) diagnostics, with a particular emphasis on the global ramifications and the intricacies surrounding LTBI diagnosis and treatment. It accentuates the imperative of bolstering diagnostic, preventive, and treatment modalities for tuberculosis (TB) to fulfill the ambitious targets set forth by the World Health Organization aimed at reducing TB-related mortalities and the incidence of new TB cases. The document underscores the significance of addressing LTBI as a means of averting the progression to active TB, particularly in regions burdened with high TB prevalence, such as India. An in-depth analysis of the spectrum delineating latent and active TB disease is provided, elucidating the risk factors predisposing individuals with LTBI to progress towards active TB, including compromised immune functionality, concurrent HIV infection, and other immunosuppressive states. Furthermore, the challenges associated with LTBI diagnosis are elucidated, encompassing the absence of a definitive diagnostic assay, and the merits and demerits of tuberculin skin testing (TST) and interferon-γ release assays (IGRAs) are expounded upon. The document underscores the necessity of confronting these challenges and furnishes a meticulous examination of the advantages and limitations of TST and IGRAs, along with the intricacies involved in interpreting their outcomes across diverse demographics and settings. Additionally, attention is drawn towards the heritability of the interferon-γ response to mycobacterial antigens and the potential utility of antibodies in LTBI diagnosis.
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Affiliation(s)
- Amitesh Gupta
- Department of Pulmonary Medicine, Maulana Azad Medical College and associated Lok Nayak Hospital, New Delhi.
| | - Eshutosh Chandra
- Department of Pulmonary Medicine, Maulana Azad Medical College and associated Lok Nayak Hospital, New Delhi.
| | - Shipra Anand
- Department of Pulmonary Medicine, Maulana Azad Medical College and associated Lok Nayak Hospital, New Delhi.
| | - Naresh Kumar
- Department of Pulmonary Medicine, Maulana Azad Medical College and associated Lok Nayak Hospital, New Delhi.
| | - Richa Arora
- Department of Pulmonary Medicine, Maulana Azad Medical College and associated Lok Nayak Hospital, New Delhi.
| | - Divyanshi Rana
- Department of Pulmonary Medicine, Maulana Azad Medical College and associated Lok Nayak Hospital, New Delhi.
| | - Parul Mrigpuri
- Department of Pulmonary Medicine, Vallabhbhai Patel Chest Institute, University of Delhi, New Delhi.
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Lemes BS, Roberto CA, Busanello AR, Kahlow BS, Skare T, Nisihara R. Prevalence of positive tuberculin skin test in a Brazilian sample of rheumatoid arthritis and spondylarthritis patients. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2024; 70:e20230725. [PMID: 38265349 PMCID: PMC10807048 DOI: 10.1590/1806-9282.20230725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 10/22/2023] [Indexed: 01/25/2024]
Abstract
OBJECTIVE Patients with rheumatic diseases have an increased risk of infections, especially tuberculosis. In this study, we aimed to recognize the positivity rate of tuberculosis skin test in patients with rheumatoid arthritis and spondyloarthritis and the characteristics of the patients with positive results. METHODS Retrospective study of tuberculosis skin test results in patients followed from 2004 to 2021 in a single rheumatology unit. Data related to clinical and epidemiological features, along with treatment information referring to the period in which the tuberculosis skin test was performed, were collected from patients' charts. RESULTS A total of 723 tests were identified (448 tests in 269 rheumatoid arthritis patients and 275 in 174 spondyloarthritis patients). In the rheumatoid arthritis sample, 31/275 (11.5%) individuals had positive tests, and in the spondyloarthritis, 38/174 (21.8%) had positive tests. In the rheumatoid arthritis sample, patients with positive tuberculosis skin tests used a higher dose of methotrexate than those with negative results (median of 25 mg/week versus median of 20 mg/week respectively; p=0.02). In the spondyloarthritis sample, tuberculosis skin test positivity was associated with alcohol ingestion (13.1% versus 2.9% in users and non-users respectively; p=0.02) and sulfasalazine use (15.7% of positivity in users versus 5% in non-users; p=0.01). CONCLUSION The tuberculosis skin test-positive prevalence in rheumatoid arthritis was lower than in the spondyloarthritis sample. Patients with rheumatoid arthritis using a higher dosage of methotrexate or with spondyloarthritis using sulfasalazine had more frequency of tuberculosis skin test positivity and should be carefully followed by the attending physician in order to avoid the appearance of full-blown tuberculosis.
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Affiliation(s)
| | | | | | - Bárbara Stadler Kahlow
- Mackenzie Evangelical School of Medicine of Paraná – Curitiba (PR), Brazil
- Mackenzie Evangelical University Hospital, Rheumatology Unit – Curitiba (PR), Brazil
| | - Thelma Skare
- Mackenzie Evangelical School of Medicine of Paraná – Curitiba (PR), Brazil
- Mackenzie Evangelical University Hospital, Rheumatology Unit – Curitiba (PR), Brazil
| | - Renato Nisihara
- Mackenzie Evangelical School of Medicine of Paraná – Curitiba (PR), Brazil
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Palanivel J, Sounderrajan V, Thangam T, Rao SS, Harshavardhan S, Parthasarathy K. Latent Tuberculosis: Challenges in Diagnosis and Treatment, Perspectives, and the Crucial Role of Biomarkers. Curr Microbiol 2023; 80:392. [PMID: 37884822 DOI: 10.1007/s00284-023-03491-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 09/15/2023] [Indexed: 10/28/2023]
Abstract
Tuberculosis (TB) is the major cause of morbidity and mortality globally, which is caused by a single infectious agent Mycobacterium tuberculosis. For years, many TB control programmes are established for effective diagnosis and treatment of active TB cases, but these approaches alone are insufficient for TB eradication. This review aims to discourse on the crucial management of latent tuberculosis infection. This review will first summarize the current status, and methods for diagnosing latent tuberculosis then describes the challenges involved in the diagnosis and treatment of latent tuberculosis, and finally encounters the purpose of biomarkers as predicting tool in latent tuberculosis.
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Affiliation(s)
- Jayanthi Palanivel
- Centre for Drug Discovery and Development, Sathyabama Institute of Science and Technology, Chennai, India
| | - Vignesh Sounderrajan
- Centre for Drug Discovery and Development, Sathyabama Institute of Science and Technology, Chennai, India
| | - T Thangam
- Centre for Drug Discovery and Development, Sathyabama Institute of Science and Technology, Chennai, India
| | - Sudhanarayani S Rao
- Centre for Drug Discovery and Development, Sathyabama Institute of Science and Technology, Chennai, India
| | - Shakila Harshavardhan
- Department of Molecular Microbiology, School of Biotechnology, Madurai Kamaraj University, Madurai, India
| | - Krupakar Parthasarathy
- Centre for Drug Discovery and Development, Sathyabama Institute of Science and Technology, Chennai, India.
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Genome-wide association study of resistance to Mycobacterium tuberculosis infection identifies a locus at 10q26.2 in three distinct populations. PLoS Genet 2021; 17:e1009392. [PMID: 33661925 PMCID: PMC7963100 DOI: 10.1371/journal.pgen.1009392] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 03/16/2021] [Accepted: 02/02/2021] [Indexed: 12/19/2022] Open
Abstract
The natural history of tuberculosis (TB) is characterized by a large inter-individual outcome variability after exposure to Mycobacterium tuberculosis. Specifically, some highly exposed individuals remain resistant to M. tuberculosis infection, as inferred by tuberculin skin test (TST) or interferon-gamma release assays (IGRAs). We performed a genome-wide association study of resistance to M. tuberculosis infection in an endemic region of Southern Vietnam. We enrolled household contacts (HHC) of pulmonary TB cases and compared subjects who were negative for both TST and IGRA (n = 185) with infected individuals (n = 353) who were either positive for both TST and IGRA or had a diagnosis of TB. We found a genome-wide significant locus on chromosome 10q26.2 with a cluster of variants associated with strong protection against M. tuberculosis infection (OR = 0.42, 95%CI 0.35–0.49, P = 3.71×10−8, for the genotyped variant rs17155120). The locus was replicated in a French multi-ethnic HHC cohort and a familial admixed cohort from a hyper-endemic area of South Africa, with an overall OR for rs17155120 estimated at 0.50 (95%CI 0.45–0.55, P = 1.26×10−9). The variants are located in intronic regions and upstream of C10orf90, a tumor suppressor gene which encodes an ubiquitin ligase activating the transcription factor p53. In silico analysis showed that the protective alleles were associated with a decreased expression in monocytes of the nearby gene ADAM12 which could lead to an enhanced response of Th17 lymphocytes. Our results reveal a novel locus controlling resistance to M. tuberculosis infection across different populations. There is strong epidemiological evidence that a proportion of highly exposed individuals remain resistant to M. tuberculosis infection, as shown by a negative result for Tuberculin Skin Test (TST) or IFN-γ Release Assays (IGRAs). We performed a genome-wide association study between resistant and infected individuals, which were carefully selected employing a household contact design to maximize exposure by infectious index patients. We employed stringently defined concordant results for both TST and IGRA assays to avoid misclassifications. We discovered a locus at 10q26.2 associated with resistance to M. tuberculosis infection in a Vietnamese discovery cohort. This locus could be replicated in two independent cohorts from different epidemiological settings and of diverse ancestries enrolled in France and South Africa.
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Farsida, Shabariah R, Hatta M, Patellongi I, Prihantono, Nasrum Massi M, Asadul Islam A, Natzir R, Dwi Bahagia Febriani A, Hamid F, Fatimah, Akaputra R, Aprilia Savitri P. Relationship between expression mRNA gene Treg, Treg, CD4 +, and CD8 + protein levels with TST in tuberculosis children: A nested case-control. Ann Med Surg (Lond) 2021; 61:44-47. [PMID: 33384873 PMCID: PMC7770507 DOI: 10.1016/j.amsu.2020.12.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 12/03/2020] [Accepted: 12/05/2020] [Indexed: 02/06/2023] Open
Abstract
Background The ability of Mycobacterium tuberculosis to survive intracellularly, provides a cellular adaptive immune response played by specific T cells to defend against tuberculosis. The adaptive immune response to Bacillus of Calmette and Guerin (BCG) immunization is responded to by B cells, T Follicular B helper, T regulatory, restriction CD1, CD8+, CD4+, Th1, Th2, and Th17. BCG immunization can cause a tuberculin test reaction to being positive. The tuberculin test is a method for diagnosing TB infection and for screening individuals for latent infection and assessing the rate of TB infection in a given population. Methods a nested case-control survey was conducted on patients with a diagnosis of TB and parents 0–18 years of age from 3 hospitals in Indonesia during September–November 2019 with a total sample of 69 people undergoing clinical examinations, supporting and diagnosing subjects, blood sampling 1–2 cc for examination mRNA gene Treg, Treg, CD 4+, and CD 8+, then centrifuged at 3000 rpm for 10 min to support blood cells and serum. Results There was a significant relationship between expression of mRNA gene Treg with TST (p = 0,000), Treg with TST (p = 0,000), and CD4+ with TST (p = 0,000). Meanwhile, CD8 + was not significantly associated with TST (p = 0.118). Conclusions It is necessary to check the expression of mRNA gene Treg, Treg, CD4+, and CD8+ with more samples to find the mean value that shows the protective value of further TB. The Mantoux tuberculin skin test (TST) is one of the criteria to determine whether a person is infected with Mycobacterium tuberculosis. It is often used to screen individuals for latent infection and assess rates of TB infection in a given population. tuberculin test results with induration diameter> 10 mm were positive regardless of the cause. Patients in this study were children who had been vaccinated against BCG and diagnosed with TB in their early toddler years. It was necessary to see the adaptive immune response that existed when the child was infected with TB. The main immune response that acts as protection against TB is played by cellular immunity, namely CD4 and CD8 T cells. We thought that if we could find between TST and adaptive immune response, TST could be a prior test to determine prognosis or disease progression. We found a strong correlation between immune activation and Treg cell frequency in TST positive persons. A higher Treg consentration was found in TST positive subjects. Nevertheless, local immune responses may differ from those in peripheral blood and exploring this interaction in the site of active infection will give important clues about their involvement in protection or pathogenesis . According to our studies the increased Treg cell frequency observed in the blood of people with active tuberculosis is likely a response to inflammation and bacterial burden.
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Affiliation(s)
- Farsida
- Faculty of Medicine and Health, Universitas Muhammadiyah Jakarta, Indonesia
| | - Rahmini Shabariah
- Faculty of Medicine and Health, Universitas Muhammadiyah Jakarta, Indonesia
| | - Mochammad Hatta
- Faculty of Medicine, Universitas Hasanuddin Makassar, Indonesia
| | | | - Prihantono
- Faculty of Medicine, Universitas Hasanuddin Makassar, Indonesia
| | | | | | - Rosdiana Natzir
- Faculty of Medicine, Universitas Hasanuddin Makassar, Indonesia
| | | | - Firdaus Hamid
- Faculty of Medicine, Universitas Hasanuddin Makassar, Indonesia
| | - Fatimah
- Faculty of Medicine and Health, Universitas Muhammadiyah Jakarta, Indonesia
| | - Risky Akaputra
- Faculty of Medicine and Health, Universitas Muhammadiyah Jakarta, Indonesia
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Farsida, Hatta M, Patellongi I, Prihantono, Shabariyah R, Larasati Laras RA, Islam AA, Natzir R, Massi MN, Hamid F, Bahagia AD. The correlation of Foxp3 + gene and regulatory T cells with scar BCG formation among children with Tuberculosis. J Clin Tuberc Other Mycobact Dis 2020; 21:100202. [PMID: 33319069 PMCID: PMC7725952 DOI: 10.1016/j.jctube.2020.100202] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Tuberculosis infection causes a complex immunological response, where interactions between the pathogen and the host are unique, making it difficult to treat and control this disease. According to WHO, an estimated 1 million children became ill with TB, and 233,000 children died of TB in 2017. Bacillus Calmette-Guérin (BCG) vaccines continue to be the only vaccines to prevent Tuberculosis (TB). Studies suggesting the association of BCG scar with decreased childhood mortality in developing countries have rekindled the interest in BCG scar. However, the direct effect of the BCG scar remains unknown. We examined 76 cases in this study. All Subjects were diagnosed with Tuberculosis. BCG scars were examined directly when physical examination at the BCG vaccination site was performed. Tuberculin Skin Test was performed with 0.1 ml purified protein derivative (PPD) solution (5TU PPD/0.1 ml) injected intradermally. We examined the FOXP3 gene by real-time PCR and the level of Treg byELISA. The comparison of the mean Treg gene expression and the Treg protein content was higher in the positive scar group than in the negative scar group. It shows that Treg plays a role in the Tuberculosis during its active phase development. Treg protein levels were higher in the combination of positive TST and scar. It shows that BCG scarring is an essential marker of a well-functioning immune system. Cheap and straightforward initiatives like early BCG vaccinations, monitoring BCG scarring, and revaccinating scar-negative children could have an enormous immediate impact on global child survival.
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Affiliation(s)
- Farsida
- Faculty of Medicine, Universitas Muhammadiyah Jakarta, Indonesia
| | - Mochammad Hatta
- Faculty of Medicine, Universitas Hasanuddin Makassar, Indonesia
| | | | - Prihantono
- Faculty of Medicine, Universitas Hasanuddin Makassar, Indonesia
| | | | | | | | - Rosdiana Natzir
- Faculty of Medicine, Universitas Hasanuddin Makassar, Indonesia
| | | | - Firdaus Hamid
- Faculty of Medicine, Universitas Hasanuddin Makassar, Indonesia
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Depression and recovery of IL-17A secretion in mitogen responses in patients with active tuberculosis-a prospective observational study. J Formos Med Assoc 2020; 120:1080-1089. [PMID: 33020006 DOI: 10.1016/j.jfma.2020.09.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 08/28/2020] [Accepted: 09/15/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND/PURPOSE T-helper cell 17 (Th17) is a distinct subset of CD4+ T lymphocytes that is important in the pathogenesis of Mycobacterium tuberculosis infection. This study aims to investigate the characteristics of interleukin (IL)-17A and Th17-related cytokines after stimulation with phytohemagglutinin in patients with active tuberculosis (TB). METHODS This prospective cohort study enrolled patients with culture-confirmed active TB. QuantiFERON-TB Gold In-Tube (QFT-GIT) assay was performed upon TB diagnosis and at 2 months after TB treatment. Their non-TB-specific secretion of IL-17A and Th17-related cytokines were measured in supernatants of mitogen tubes in QFT-GIT and compared to those of active TB contacts with or without latent TB infection. We analyzed the association between IL-17A secretions and TB presentation and treatment outcomes. RESULTS A total of 108 patients with TB and 64 non-TB cases were enrolled. The secretion of IL-17A, IL-21, IL-23, and IL-6 were lower in active TB patients upon TB diagnosis. In active TB patients, lower IL-17A secretions were associated with higher grades of sputum smear. In the multivariate analysis, lower IL-17A secretions served as an independent factor associated with 2-month culture non-conversion (odds ratio 23.04, 95% confidence interval [CI] 1.69-84.78) and on-treatment mortality (hazard ratio 28.54, 95% CI 1.30-99.25). The levels of IL-23, and IL-6 significantly increased after 2 months of anti-TB treatment. CONCLUSION The non-TB-specific IL-17A secretions were lower in active TB patients upon TB diagnosis and associated with higher disease severity and worse treatment outcomes. Trend of recovery of the depressed Th17-related cytokines was noted after effective anti-TB treatment.
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Carranza C, Pedraza-Sanchez S, de Oyarzabal-Mendez E, Torres M. Diagnosis for Latent Tuberculosis Infection: New Alternatives. Front Immunol 2020; 11:2006. [PMID: 33013856 PMCID: PMC7511583 DOI: 10.3389/fimmu.2020.02006] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 07/24/2020] [Indexed: 12/29/2022] Open
Abstract
Latent tuberculosis infection (LTBI) is a subclinical mycobacterial infection defined on the basis of cellular immune response to mycobacterial antigens. The tuberculin skin test (TST) and the interferon gamma release assay (IGRA) are currently used to establish the diagnosis of LTB. However, neither TST nor IGRA is useful to discriminate between active and latent tuberculosis. Moreover, these tests cannot be used to predict whether an individual with LTBI will develop active tuberculosis (TB) or whether therapy for LTBI could be effective to decrease the risk of developing active TB. Therefore, in this article, we review current approaches and some efforts to identify an immunological marker that could be useful in distinguishing LTBI from TB and in evaluating the effectiveness of treatment of LTB on the risk of progression to active TB.
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Affiliation(s)
- Claudia Carranza
- Departamento de Microbiología, Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico
| | - Sigifredo Pedraza-Sanchez
- Unidad de Bioquímica Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubirán, Mexico City, Mexico
| | | | - Martha Torres
- Departamento de Microbiología, Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico.,Subdirección de Investigación Biomédica, Instituto Nacional de Enfermedades Respiratorias Ismael Cosio Villegas, Mexico City, Mexico
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Characterization of cytokine profile to distinguish latent tuberculosis from active tuberculosis and healthy controls. Cytokine 2020; 135:155218. [PMID: 32771857 DOI: 10.1016/j.cyto.2020.155218] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 07/08/2020] [Accepted: 07/20/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND Tuberculosis (TB) is an infectious disease and its mortality rate ranks first. Latent tuberculosis infection (LTBI) means that a patient is infected with Mycobacterium tuberculosis, but has no relative clinical symptoms. It has been estimated that approximately 10% of patients with LTBI would develop into active tuberculosis. Therefore, it was urgent to search for more efficient biomarkers to discriminate LTBI from healthy population. METHODS The Luminex assay was employed to detect the quantity of cytokines secreted by mononuclear cells from peripheral blood stimulated with the ESAT6 protein among TB, LTBI and healthy controls. The cytokine profile was analyzed by principal components analysis and the receiver operating characteristic curve analysis. RESULTS The principal components analysis indicated that LTBI and TB were clearly separated from healthy controls, and that LTBI was also successfully differentiated from healthy controls. The cytokine profiling method to distinguish LTBI from healthy controls has a sensitivity and specificity of 100%. Nine potential biomarkers, including IL-23, IL-21, HGF, Bngf, IL-27, IL-31, IL-1β, IL-22 and IL-18, were identified, and these cytokines were considered as a potential cytokine complex for more effectively discriminating LTBI from healthy controls. CONCLUSION IL-23, IL-21, HGF, Bngf, IL-27, IL-31, IL-1β, IL-22 and IL-18 were demonstrated to be the potential cytokine complex for the assessment between LTBI and healthy controls.
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Gaps in Study Design for Immune Parameter Research for Latent Tuberculosis Infection: A Systematic Review. J Immunol Res 2020; 2020:8074183. [PMID: 32377537 PMCID: PMC7191376 DOI: 10.1155/2020/8074183] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Accepted: 03/16/2020] [Indexed: 01/09/2023] Open
Abstract
Background Immune parameters (IP) have been extensively studied to distinguish between latent tuberculosis (LTBI) and active tuberculosis (TB). Objective To determine the IP associated with LTBI, compared to active TB and individuals not infected by M. tuberculosis published in literature. Methods We conducted a systematic search using Google Scholar and PubMed databases, combining the MeSH terms latent tuberculosis, Mycobacterium tuberculosis, cytokines, and biological markers, with the free terms, biomarkers and cytokines. Spanish, English, and Portuguese articles comparing the concentration of IP associated with LTBI, either in plasma/serum or in vitro, in adults and nonimmunocompromised versus individuals with TB or without M. tuberculosis infection between 2006 July and 2018 July were included. Two blinded reviewers carried out the searches, read the abstracts, and selected the articles for analysis. Participants' information, diagnostic criteria, IP, detection methods, and biases were collected. Results We analyzed 36 articles (of 637 abstracts) with 93 different biomarkers in different samples. We found 24 parameters that were increased only in active TB (TGF-α, CSF3, CSF2, CCL1 [I-309], IL-7, TGF-β1, CCL3 [MIP-1α], sIL-2R, TNF-β, CCL7 [MCP-3], IFN-α, fractalkine, I-TAG, CCL8 [MCP-2], CCL21 [6Ckine], PDGF, IL-22, VEGF-A, LXA4, PGE2, PGF2α, sCD163, sCD14, and 15-Epi-LXA4), five were elevated in LTBI (IL-5, IL-17F, IL-1, CCL20 [MIP-3α], and ICAM-1), and two substances were increased among uninfected individuals (IL-23 and basic FGF). We found high heterogeneity between studies including failure to account for the time/illness of the individuals studied; varied samples and protocols; different clinical classification of TB; different laboratory methods for IP detection, which in turn leads to variable units of measurement and assay sensitivities; and selection bias regarding TST and booster effect. None of the studies adjusted the analysis for the effect of ethnicity. Conclusions It is mandatory to harmonize the study of immune parameters for LTBI diagnosis. This systematic review is registered with PROSPERO CRD42017073289.
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Vecchione MB, Laufer N, Sued O, Corti M, Salomon H, Quiroga MF. 7-oxo-DHEA enhances impaired M. tuberculosis-specific T cell responses during HIV-TB coinfection. J Biomed Sci 2020; 27:20. [PMID: 31906962 PMCID: PMC6943934 DOI: 10.1186/s12929-019-0604-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 12/19/2019] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Mycobacterium tuberculosis (Mtb) is the causative agent of tuberculosis (TB), affecting approximately one third of the world's population. Development of an adequate immune response will determine disease progression or progress to chronic infection. Risk of developing TB among human immunodeficiency virus (HIV)-coinfected patients (HIV-TB) is 20-30 times higher than those without HIV infection, and a synergistic interplay between these two pathogens accelerates the decline in immunological functions. TB treatment in HIV-TB coinfected persons is challenging and it has a prolonged duration, mainly due to the immune system failure to provide an adequate support for the therapy. Therefore, we aimed to study the role of the hormone 7-oxo-dehydroepiandrosterone (7-OD) as a modulator of anti-tuberculosis immune responses in the context of HIV-TB coinfection. METHODS A cross-sectional study was conducted among HIV-TB patients and healthy donors (HD). We characterized the ex vivo phenotype of CD4 + T cells and also evaluated in vitro antigen-specific responses by Mtb stimulation of peripheral blood mononuclear cells (PBMCs) in the presence or absence of 7-OD. We assessed lymphoproliferative activity, cytokine production and master transcription factor profiles. RESULTS Our results show that HIV-TB patients were not able to generate successful anti-tubercular responses in vitro compared to HD, as reduced IFN-γ/IL-10 and IFN-γ/IL-17A ratios were observed. Interestingly, treatment with 7-OD enhanced Th1 responses by increasing Mtb-induced proliferation and the production of IFN-γ and TNF-α over IL-10 levels. Additionally, in vitro Mtb stimulation augmented the frequency of cells with a regulatory phenotype, while 7-OD reduced the proportion of these subsets and induced an increase in CD4 + T-bet+ (Th1) subpopulation, which is associated with clinical data linked to an improved disease outcome. CONCLUSIONS We conclude that 7-OD modifies the cytokine balance and the phenotype of CD4 + T cells towards a more favorable profile for mycobacteria control. These results provide new data to delineate novel treatment approaches as co-adjuvant for the treatment of TB.
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Affiliation(s)
- María Belén Vecchione
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Universidad de Buenos Aires, Instituto de Investigaciones Biomédicas en Retrovirus y Sida (INBIRS), Buenos Aires, Argentina
| | - Natalia Laufer
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Universidad de Buenos Aires, Instituto de Investigaciones Biomédicas en Retrovirus y Sida (INBIRS), Buenos Aires, Argentina
| | - Omar Sued
- Área de Investigaciones Clínicas, Fundación Huésped, Buenos Aires, Argentina
| | - Marcelo Corti
- División "B" VIH/Sida, Hospital Francisco J. Muñiz, Buenos Aires, Argentina
| | - Horacio Salomon
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Universidad de Buenos Aires, Instituto de Investigaciones Biomédicas en Retrovirus y Sida (INBIRS), Buenos Aires, Argentina
| | - Maria Florencia Quiroga
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Universidad de Buenos Aires, Instituto de Investigaciones Biomédicas en Retrovirus y Sida (INBIRS), Buenos Aires, Argentina.
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Wilkie M, Satti I, Minhinnick A, Harris S, Riste M, Ramon RL, Sheehan S, Thomas ZRM, Wright D, Stockdale L, Hamidi A, O'Shea MK, Dwivedi K, Behrens HM, Davenne T, Morton J, Vermaak S, Lawrie A, Moss P, McShane H. A phase I trial evaluating the safety and immunogenicity of a candidate tuberculosis vaccination regimen, ChAdOx1 85A prime - MVA85A boost in healthy UK adults. Vaccine 2019; 38:779-789. [PMID: 31735500 PMCID: PMC6985898 DOI: 10.1016/j.vaccine.2019.10.102] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 10/30/2019] [Accepted: 10/31/2019] [Indexed: 11/18/2022]
Abstract
Background This phase I trial evaluated the safety and immunogenicity of a candidate tuberculosis vaccination regimen, ChAdOx1 85A prime-MVA85A boost, previously demonstrated to be protective in animal studies, in healthy UK adults. Methods We enrolled 42 healthy, BCG-vaccinated adults into 4 groups: low dose Starter Group (n = 6; ChAdOx1 85A alone), high dose groups; Group A (n = 12; ChAdOx1 85A), Group B (n = 12; ChAdOx1 85A prime – MVA85A boost) or Group C (n = 12; ChAdOx1 85A – ChAdOx1 85A prime – MVA85A boost). Safety was determined by collection of solicited and unsolicited vaccine-related adverse events (AEs). Immunogenicity was measured by antigen-specific ex-vivo IFN-γ ELISpot, IgG serum ELISA, and antigen-specific intracellular IFN-γ, TNF-α, IL-2 and IL-17. Results AEs were mostly mild/moderate, with no Serious Adverse Events. ChAdOx1 85A induced Ag85A-specific ELISpot and intracellular cytokine CD4+ and CD8+ T cell responses, which were not boosted by a second dose, but were boosted with MVA85A. Polyfunctional CD4+ T cells (IFN-γ, TNF-α and IL-2) and IFN-γ+, TNF-α+ CD8+ T cells were induced by ChAdOx1 85A and boosted by MVA85A. ChAdOx1 85A induced serum Ag85A IgG responses which were boosted by MVA85A. Conclusion A ChAdOx1 85A prime – MVA85A boost is well tolerated and immunogenic in healthy UK adults.
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Affiliation(s)
- Morven Wilkie
- The Jenner Institute, University of Oxford, Oxford OX3 7DQ, UK
| | - Iman Satti
- The Jenner Institute, University of Oxford, Oxford OX3 7DQ, UK
| | | | | | - Michael Riste
- The Jenner Institute, University of Oxford, Oxford OX3 7DQ, UK
| | | | - Sharon Sheehan
- The Jenner Institute, University of Oxford, Oxford OX3 7DQ, UK
| | | | - Daniel Wright
- The Jenner Institute, University of Oxford, Oxford OX3 7DQ, UK
| | - Lisa Stockdale
- The Jenner Institute, University of Oxford, Oxford OX3 7DQ, UK
| | - Ali Hamidi
- The Jenner Institute, University of Oxford, Oxford OX3 7DQ, UK
| | | | - Kritica Dwivedi
- The Jenner Institute, University of Oxford, Oxford OX3 7DQ, UK
| | | | - Tamara Davenne
- The Jenner Institute, University of Oxford, Oxford OX3 7DQ, UK
| | - Joshua Morton
- The Jenner Institute, University of Oxford, Oxford OX3 7DQ, UK
| | | | - Alison Lawrie
- The Jenner Institute, University of Oxford, Oxford OX3 7DQ, UK
| | - Paul Moss
- Institute of Immunology and Immunotherapy, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
| | - Helen McShane
- The Jenner Institute, University of Oxford, Oxford OX3 7DQ, UK.
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13
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Kaipilyawar V, Salgame P. Infection resisters: targets of new research for uncovering natural protective immunity against Mycobacterium tuberculosis. F1000Res 2019; 8. [PMID: 31602294 PMCID: PMC6774050 DOI: 10.12688/f1000research.19805.1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/20/2019] [Indexed: 12/17/2022] Open
Abstract
“Infection resisters” are broadly defined as individuals who despite significant exposure to
Mycobacterium tuberculosis remain persistently unreactive to conventional detection assays, suggesting that they remain uninfected or rapidly clear their infection early on following exposure. In this review, we highlight recent studies that point to underlying host immune mechanisms that could mediate this natural resistance. We also illustrate some additional avenues that are likely to be differently modulated in resisters and possess the potential to be targeted, ranging from early mycobacterial sensing leading up to subsequent killing. Emerging research in this area can be harnessed to provide valuable insights into the development of novel therapeutic and vaccine strategies against
M. tuberculosis.
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Affiliation(s)
- Vaishnavi Kaipilyawar
- Center for Emerging Pathogens, Rutgers-New Jersey Medical School, International Center for Public Health, 225 Warren St, Newark, NJ, 07103, USA
| | - Padmini Salgame
- Center for Emerging Pathogens, Rutgers-New Jersey Medical School, International Center for Public Health, 225 Warren St, Newark, NJ, 07103, USA
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14
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Bai X, Aerts SL, Verma D, Ordway DJ, Chan ED. Epidemiologic Evidence of and Potential Mechanisms by Which Second-Hand Smoke Causes Predisposition to Latent and Active Tuberculosis. Immune Netw 2018; 18:e22. [PMID: 29984040 PMCID: PMC6026693 DOI: 10.4110/in.2018.18.e22] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 06/15/2018] [Accepted: 06/16/2018] [Indexed: 12/13/2022] Open
Abstract
Many studies have linked cigarette smoke (CS) exposure and tuberculosis (TB) infection and disease although much fewer have studied second-hand smoke (SHS) exposure. Our goal is to review the epidemiologic link between SHS and TB as well as to summarize the effects SHS and direct CS on various immune cells relevant for TB. PubMed searches were performed using the key words "tuberculosis" with "cigarette," "tobacco," or "second-hand smoke." The bibliography of relevant papers were examined for additional relevant publications. Relatively few studies associate SHS exposure with TB infection and active disease. Both SHS and direct CS can alter various components of host immunity resulting in increased vulnerability to TB. While the epidemiologic link of these 2 health maladies is robust, more definitive, mechanistic studies are required to prove that SHS and direct CS actually cause increased susceptibility to TB.
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Affiliation(s)
- Xiyuan Bai
- Department of Medicine, Denver Veterans Affairs Medical Center, University of Colorado Anschutz Medical Center, Denver, CO 80045, USA
- Department of Medicine and Office of Academic Affairs, National Jewish Health, Denver, CO 80206, USA
- Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado Anschutz Medical Campus, Denver, CO 80045, USA
| | - Shanae L. Aerts
- Department of Medicine and Office of Academic Affairs, National Jewish Health, Denver, CO 80206, USA
| | - Deepshikha Verma
- Department of Microbiology, Immunology, and Pathology, Mycobacteria Research Laboratories, Colorado State University, Fort Collins, CO 80523, USA
| | - Diane J. Ordway
- Department of Microbiology, Immunology, and Pathology, Mycobacteria Research Laboratories, Colorado State University, Fort Collins, CO 80523, USA
| | - Edward D. Chan
- Department of Medicine, Denver Veterans Affairs Medical Center, University of Colorado Anschutz Medical Center, Denver, CO 80045, USA
- Department of Medicine and Office of Academic Affairs, National Jewish Health, Denver, CO 80206, USA
- Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado Anschutz Medical Campus, Denver, CO 80045, USA
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15
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The Immunoregulation of Th17 in Host against Intracellular Bacterial Infection. Mediators Inflamm 2018; 2018:6587296. [PMID: 29743811 PMCID: PMC5884031 DOI: 10.1155/2018/6587296] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Accepted: 02/04/2018] [Indexed: 12/14/2022] Open
Abstract
T helper 17 cells (Th17) constitute a distinct subset of helper T cells with a unique transcriptional profile (STAT3, RORγ, and RORα), cytokine production pattern (IL17 family), and requirement of specific cytokines for their differentiation (TGF-β, IL6, IL21, and IL23). Recent studies involving experimental animals and humans have shown that Th17/IL17 plays a crucial role in host defense against a variety of pathogens, including bacteria and viruses. The underlying mechanisms by which Th17 performs include dendritic cell (DC) regulation, neutrophil recruitment, Th1 modulation, and T regulatory cell (Treg) balance. In recent years, researchers have generated an accumulating wealth of evidence on the role of Th17/IL17 in protective immunity to intracellular bacterial pathogens, such as Mycobacterium tuberculosis and Chlamydia trachomatis, which are one of the most important pathogens that inflict significant socioeconomic burden across the globe. In this article, we reviewed the current literature on the functions and mechanisms by which Th17/IL17 responds to intracellular bacterial infections. A better understanding of Th17/IL17 immunity to pathogens would be crucial for developing effective prophylactics and therapeutics.
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16
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Coulter F, Parrish A, Manning D, Kampmann B, Mendy J, Garand M, Lewinsohn DM, Riley EM, Sutherland JS. IL-17 Production from T Helper 17, Mucosal-Associated Invariant T, and γδ Cells in Tuberculosis Infection and Disease. Front Immunol 2017; 8:1252. [PMID: 29075255 PMCID: PMC5641565 DOI: 10.3389/fimmu.2017.01252] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Accepted: 09/20/2017] [Indexed: 11/13/2022] Open
Abstract
IL-17-producing cells have been shown to be important in the early stages of Mycobacterium tuberculosis (Mtb) infection in animal models. However, there are very little data on the role of IL-17 in human studies of tuberculosis (TB). We recruited TB patients and their highly exposed contacts who were further categorized based on results from an IFN-γ-release assay (IGRA): (1) IGRA positive (IGRA+) at recruitment (latently TB infected), (2) IGRA negative (IGRA-) at recruitment and 6 months [non-converters (NC)], and (3) IGRA- at recruitment and IGRA+ at 6 months (converters). Whole blood was stimulated with mycobacterial antigens and analyzed using T helper (Th) 17 multiplex cytokine assays. Th17, Vγ9Vδ2+, and CD161++Vα7.2+ mucosal-associated invariant T (MAIT) cells were analyzed by flow cytometry. The majority of IL-17 was produced by CD26+CD4+ Th17 cells (median 71%) followed by γδ T cells (6.4%) and MAIT cells (5.8%). TB patients had a significantly lower proportion of Th17 cells and CD4+CD161+Vα7.2+ cells producing both IL-17 and IFN-γ compared to LTBI subjects. IGRA NC had significantly lower levels of CD26-CD4+ and CD8+ MAIT cells producing IL-17 compared to IGRA C but had significantly higher levels of IL-17A, IL-17F, IL-21, and IL-23 in ESAT-6/CFP-10-stimulated supernatants compared to IGRA C. These data provide new insights into the role of IL-17 and IL-17-producing cells at three key stages of the Mtb infection spectrum.
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Affiliation(s)
- Felicity Coulter
- Vaccines and Immunity Theme, Medical Research Council Unit, Banjul, Gambia
- Department of Immunology and Infection, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Amy Parrish
- Vaccines and Immunity Theme, Medical Research Council Unit, Banjul, Gambia
- Department of Immunology and Infection, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Declan Manning
- Vaccines and Immunity Theme, Medical Research Council Unit, Banjul, Gambia
- The University of Manchester, Manchester, United Kingdom
| | - Beate Kampmann
- Vaccines and Immunity Theme, Medical Research Council Unit, Banjul, Gambia
| | - Joseph Mendy
- Vaccines and Immunity Theme, Medical Research Council Unit, Banjul, Gambia
| | - Mathieu Garand
- Vaccines and Immunity Theme, Medical Research Council Unit, Banjul, Gambia
| | - David M. Lewinsohn
- Pulmonary and Critical Care Medicine, Portland VA Medical Center and Oregon Health & Science University, Portland, OR, United States
| | - Eleanor M. Riley
- Department of Immunology and Infection, London School of Hygiene and Tropical Medicine, London, United Kingdom
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17
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Abstract
Immunity against Mycobacterium tuberculosis requires a balance between adaptive immune responses to constrain bacterial replication and the prevention of potentially damaging immune activation. Regulatory T (Treg) cells express the transcription factor Foxp3+ and constitute an essential counterbalance of inflammatory Th1 responses and are required to maintain immune homeostasis. The first reports describing the presence of Foxp3-expressing CD4+ Treg cells in tuberculosis (TB) emerged in 2006. Different Treg cell subsets, most likely specialized for different tissues and microenvironments, have been shown to expand in both human TB and animal models of TB. Recently, additional functional roles for Treg cells have been demonstrated during different stages and spectrums of TB disease. Foxp3+ regulatory cells can quickly expand during early infection and impede the onset of cellular immunity and persist during chronic TB infection. Increased frequencies of Treg cells have been associated with a detrimental outcome of active TB, and may be dependent on the M. tuberculosis strain, animal model, local environment, and the stage of infection. Some investigations also suggest that Treg cells are required together with effector T cell responses to obtain reduced pathology and sterilizing immunity. In this review, we will first provide an overview of the regulatory cells and mechanisms that control immune homeostasis. Then, we will review what is known about the phenotype and function of Treg cells from studies in human TB and experimental animal models of TB. We will discuss the potential role of Treg cells in the progression of TB disease and the relevance of this knowledge for future efforts to prevent, modulate, and treat TB.
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18
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Stephen-Victor E, Sharma VK, Das M, Karnam A, Saha C, Lecerf M, Galeotti C, Kaveri SV, Bayry J. IL-1β, But Not Programed Death-1 and Programed Death Ligand Pathway, Is Critical for the Human Th17 Response to Mycobacterium tuberculosis. Front Immunol 2016; 7:465. [PMID: 27867382 PMCID: PMC5095489 DOI: 10.3389/fimmu.2016.00465] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 10/17/2016] [Indexed: 01/29/2023] Open
Abstract
The programed death-1 (PD-1)–programed death ligand-1 (PD-L1) and PD-L2 co-inhibitory pathway has been implicated in the evasion strategies of Mycobacterium tuberculosis. Specifically, M. tuberculosis-induced PD-L1 orchestrates expansion of regulatory T cells and suppression of Th1 response. However, the role of PD pathway in regulating Th17 response to M. tuberculosis has not been investigated. In the present report, we demonstrate that M. tuberculosis and M. tuberculosis-derived antigen fractions have differential abilities to mediate human monocyte- and dendritic cell (DC)-mediated Th17 response and were independent of expression of PD-L1 or PD-L2 on aforementioned antigen-presenting cells. Importantly, we observed that blockade of PD-L1 or PD-1 did not significantly modify either the frequencies of Th17 cells or the production of IL-17 from CD4+ T cells though IFN-γ response was significantly enhanced. On the contrary, IL-1β from monocytes and DCs were critical for the Th17 response to M. tuberculosis. Together, our results indicate that IL-1β, but not members of the programed death pathway, is critical for human Th17 response to M. tuberculosis.
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Affiliation(s)
- Emmanuel Stephen-Victor
- Institut National de la Santé et de la Recherche Médicale Unité 1138, Paris, France; UMR S 1138, Sorbonne Universités, UPMC Univ Paris, Paris, France; Centre de Recherche des Cordeliers, Equipe - Immunopathology and Therapeutic Immunointervention, Paris, France
| | - Varun Kumar Sharma
- Institut National de la Santé et de la Recherche Médicale Unité 1138, Paris, France; Centre de Recherche des Cordeliers, Equipe - Immunopathology and Therapeutic Immunointervention, Paris, France
| | - Mrinmoy Das
- Institut National de la Santé et de la Recherche Médicale Unité 1138, Paris, France; UMR S 1138, Sorbonne Universités, UPMC Univ Paris, Paris, France; Centre de Recherche des Cordeliers, Equipe - Immunopathology and Therapeutic Immunointervention, Paris, France
| | - Anupama Karnam
- Institut National de la Santé et de la Recherche Médicale Unité 1138, Paris, France; UMR S 1138, Sorbonne Universités, UPMC Univ Paris, Paris, France; Centre de Recherche des Cordeliers, Equipe - Immunopathology and Therapeutic Immunointervention, Paris, France
| | - Chaitrali Saha
- Institut National de la Santé et de la Recherche Médicale Unité 1138, Paris, France; Centre de Recherche des Cordeliers, Equipe - Immunopathology and Therapeutic Immunointervention, Paris, France
| | - Maxime Lecerf
- Institut National de la Santé et de la Recherche Médicale Unité 1138, Paris, France; UMR S 1138, Sorbonne Universités, UPMC Univ Paris, Paris, France; Centre de Recherche des Cordeliers, Equipe - Immunopathology and Therapeutic Immunointervention, Paris, France; UMR S 1138, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Caroline Galeotti
- Institut National de la Santé et de la Recherche Médicale Unité 1138, Paris, France; UMR S 1138, Sorbonne Universités, UPMC Univ Paris, Paris, France; Centre de Recherche des Cordeliers, Equipe - Immunopathology and Therapeutic Immunointervention, Paris, France
| | - Srinivas V Kaveri
- Institut National de la Santé et de la Recherche Médicale Unité 1138, Paris, France; UMR S 1138, Sorbonne Universités, UPMC Univ Paris, Paris, France; Centre de Recherche des Cordeliers, Equipe - Immunopathology and Therapeutic Immunointervention, Paris, France; UMR S 1138, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Jagadeesh Bayry
- Institut National de la Santé et de la Recherche Médicale Unité 1138, Paris, France; UMR S 1138, Sorbonne Universités, UPMC Univ Paris, Paris, France; Centre de Recherche des Cordeliers, Equipe - Immunopathology and Therapeutic Immunointervention, Paris, France; UMR S 1138, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
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19
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Heidarnezhad F, Asnaashari A, Rezaee SA, Ghezelsofla R, Ghazvini K, Valizadeh N, Basiri R, Ziaeemehr A, Sobhani S, Rafatpanah H. Evaluation of Interleukin17and Interleukin 23 expression in patients with active and latent tuberculosis infection. IRANIAN JOURNAL OF BASIC MEDICAL SCIENCES 2016; 19:844-850. [PMID: 27746865 PMCID: PMC5048119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2015] [Accepted: 04/28/2016] [Indexed: 12/05/2022]
Abstract
OBJECTIVES Tuberculosis is one of the most important infectious diseases with high mortality rates worldwide, especially in developing countries. Interleukin17 (IL-17) is an important acquired immunity cytokine, which is mainly produced by CD4+TH17 cells. It can recruit neutrophils and macrophages to the infected site in the lungs. IL-23 is one of the most important inducers of IL-17. In the present study, the expressions of IL-23 and IL-17 were examined in the pathogenesis of tuberculosis. MATERIALS AND METHODS Peripheral blood mononuclear cells (PBMCs) were isolated from subjects with latent tuberculosis infection (LTB) and newly diagnosed active tuberculosis patients (ATB). PBMCs were activated with purified protein derivative (PPD) for 72 hr. Activated cells were harvested, RNA was extracted, and cDNA was synthesized. IL-17 and IL-23 mRNA expressions were evaluated by real-time PCR. The frequency of Th17 cells was examined by flowcytometry. RESULTS The expressions of IL-17 and IL-23 mRNA were lower in patients than subjects with LTB (P<0.05). The frequency of IL-17 producing CD4+ T cells in patients with active TB was lower than LTB subjects (P<0.05). CONCLUSION The results of the present study might suggest that IL-17 and IL-23 play critical roles in the immune response against TB.
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Affiliation(s)
- Fatemeh Heidarnezhad
- Inflammation and Inflammatory Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amir Asnaashari
- Chronic Obstructive Pulmonary Disease Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Abdolrahim Rezaee
- Inflammation and Inflammatory Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Roghayeh Ghezelsofla
- Inflammation and Inflammatory Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Kiarash Ghazvini
- Antimicrobial Resistance Research Canter, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Narges Valizadeh
- Inflammation and Inflammatory Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Reza Basiri
- Chronic Obstructive Pulmonary Disease Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Aghigh Ziaeemehr
- Inflammation and Inflammatory Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Somayeh Sobhani
- Inflammation and Inflammatory Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Houshang Rafatpanah
- Rheumatic Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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20
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Toulza F, Tsang L, Ottenhoff THM, Brown M, Dockrell HM. Mycobacterium tuberculosis-specific CD4+ T-cell response is increased, and Treg cells decreased, in anthelmintic-treated patients with latent TB. Eur J Immunol 2016; 46:752-61. [PMID: 26638865 DOI: 10.1002/eji.201545843] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Revised: 11/09/2015] [Accepted: 11/30/2015] [Indexed: 11/07/2022]
Abstract
In many settings, adults with active or latent tuberculosis will also be coinfected with helminths. Our study aimed to investigate how anthelmintic treatment modulates antimycobacterial immunity, in a setting where helminth reinfection should not occur. We investigated the potential impact of helminth infection on immune responses to Mycobacterium tuberculosis (Mtb) in patients with latent Mtb infection with or without helminth infection (Strongyloides or Schistosoma), and tested T-cell responses before and after anthelmintic treatment. The study was performed in migrants resident in the United Kingdom, where reexposure and reinfection following anthelmintic treatment would not occur. The frequency of CD4(+) IFN-γ(+) T cells was measured following stimulation with Mtb Purified Protein Derivative or ESAT-6/CFP-10 antigen, and concentrations of IFN-γ in culture supernatants measured by ELISA and multiplex bead array. Helminth infection was associated with a lower frequency of CD4(+) IFN-γ(+) T cells, which increased following treatment. Patients with helminth infection showed a significant increase in CD4(+) FoxP3(+) T cells (Treg) compared to those without helminth infection. There was a decrease in the frequency of Treg cells, and an associated increase in CD4(+) IFN-γ(+) T cells after the anthelmintic treatment. Here, we show a potential role of Treg cells in reducing the frequency and function of antimycobacterial CD4(+) IFN-γ(+) T cells, and that these effects are reversed after anthelmintic treatment.
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Affiliation(s)
- Frederic Toulza
- Department of Immunology and Infection, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Lillian Tsang
- Hospital for Tropical Diseases, University College Hospital, and Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK
| | - Tom H M Ottenhoff
- Department of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands
| | - Michael Brown
- Department of Immunology and Infection, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.,Hospital for Tropical Diseases, University College Hospital, and Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK
| | - Hazel M Dockrell
- Department of Immunology and Infection, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
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21
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Sarre C, González-Hernández A, Van Coppernolle S, Grit R, Grauwet K, Van Meulder F, Chiers K, Van den Broeck W, Geldhof P, Claerebout E. Comparative immune responses against Psoroptes ovis in two cattle breeds with different susceptibility to mange. Vet Res 2015; 46:131. [PMID: 26582546 PMCID: PMC4652412 DOI: 10.1186/s13567-015-0277-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 10/19/2015] [Indexed: 12/22/2022] Open
Abstract
The sheep scab mite, Psoroptes ovis, is a major problem in the beef cattle industry, especially in Belgian Blue (BB) cattle. This breed is naturally more predisposed to psoroptic mange but reasons for this high susceptibility remain unknown. Different immune responses could be a potential cause; thus in this study, the cutaneous immune response and in vitro cellular immune response after antigen re-stimulation were examined in naturally infested BB. Cytokine production in the skin and in circulating re-stimulated peripheral blood mononuclear cells (PBMC) demonstrated a mixed pro-inflammatory Th2/Th17 profile, with transcription of IL-4, IL-13, IL-6 and IL-17. Strong IL-17 up-regulation in the skin of BB was associated with an influx of eosinophils and other immune cells, potentially leading towards more severe symptoms. Virtually no changes in cutaneous IFN-γ transcription were detected, while there was substantial IFN-γ up-regulation in re-stimulated PBMC from infested and uninfested animals, potentially indicating a role of this pro-inflammatory cytokine in the innate immune response. In Holstein–Friesian (HF) cattle, generally more resistant to P. ovis infection, a largely similar immunologic response was observed. Differences between HF and BB were the lack of cutaneous IL-17 response in infested HF and low transcription levels of IFN-γ and high IL-10 transcription in re-stimulated PBMC from both infested and uninfested animals. Further research is needed to identify potential cell sources and biological functions for these cytokines and to fully unravel the basis of this different breed susceptibility to P. ovis.
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Affiliation(s)
- Charlotte Sarre
- Department of Virology, Parasitology and Immunology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
| | - Ana González-Hernández
- Department of Virology, Parasitology and Immunology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
| | - Stefanie Van Coppernolle
- Department of Virology, Parasitology and Immunology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
| | - Rika Grit
- Department of Virology, Parasitology and Immunology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
| | - Korneel Grauwet
- Department of Virology, Parasitology and Immunology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
| | - Frederik Van Meulder
- Department of Virology, Parasitology and Immunology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
| | - Koen Chiers
- Department of Pathology, Bacteriology and Poultry Diseases, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
| | - Wim Van den Broeck
- Department of Morphology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
| | - Peter Geldhof
- Department of Virology, Parasitology and Immunology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
| | - Edwin Claerebout
- Department of Virology, Parasitology and Immunology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
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22
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Th1 and Th17 Cells in Tuberculosis: Protection, Pathology, and Biomarkers. Mediators Inflamm 2015; 2015:854507. [PMID: 26640327 PMCID: PMC4657112 DOI: 10.1155/2015/854507] [Citation(s) in RCA: 175] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 10/11/2015] [Indexed: 12/24/2022] Open
Abstract
The outcome of Mycobacterium tuberculosis (Mtb) infection ranges from a complete pathogen clearance through asymptomatic latent infection (LTBI) to active tuberculosis (TB) disease. It is now understood that LTBI and active TB represent a continuous spectrum of states with different degrees of pathogen “activity,” host pathology, and immune reactivity. Therefore, it is important to differentiate LTBI and active TB and identify active TB stages.
CD4+ T cells play critical role during Mtb infection by mediating protection, contributing to inflammation, and regulating immune response. Th1 and Th17 cells are the main effector CD4+ T cells during TB. Th1 cells have been shown to contribute to TB protection by secreting IFN-γ and activating antimycobacterial action in macrophages. Th17 induce neutrophilic inflammation, mediate tissue damage, and thus have been implicated in TB pathology. In recent years new findings have accumulated that alter our view on the role of Th1 and Th17 cells during Mtb infection. This review discusses these new results and how they can be implemented for TB diagnosis and monitoring.
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Huaman MA, Henson D, Ticona E, Sterling TR, Garvy BA. Tuberculosis and Cardiovascular Disease: Linking the Epidemics. TROPICAL DISEASES TRAVEL MEDICINE AND VACCINES 2015; 1. [PMID: 26835156 PMCID: PMC4729377 DOI: 10.1186/s40794-015-0014-5] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The burden of tuberculosis and cardiovascular disease (CVD) is enormous worldwide. CVD rates are rapidly increasing in low- and middle-income countries. Public health programs have been challenged with the overlapping tuberculosis and CVD epidemics. Monocyte/macrophages, lymphocytes and cytokines involved in cellular mediated immune responses against Mycobacterium tuberculosis are also main drivers of atherogenesis, suggesting a potential pathogenic role of tuberculosis in CVD via mechanisms that have been described for other pathogens that establish chronic infection and latency. Studies have shown a pro-atherogenic effect of antibody-mediated responses against mycobacterial heat shock protein-65 through cross reaction with self-antigens in human vessels. Furthermore, subsets of mycobacteria actively replicate during latent tuberculosis infection (LTBI), and recent studies suggest that LTBI is associated with persistent chronic inflammation that may lead to CVD. Recent epidemiologic work has shown that the risk of CVD in persons who develop tuberculosis is higher than in persons without a history of tuberculosis, even several years after recovery from tuberculosis. Together, these data suggest that tuberculosis may play a role in the pathogenesis of CVD. Further research to investigate a potential link between tuberculosis and CVD is warranted.
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Affiliation(s)
- Moises A Huaman
- Division of Infectious Diseases, Department of Medicine, University of Kentucky, Lexington, KY, USA
| | - David Henson
- Division of Infectious Diseases, Department of Medicine, University of Kentucky, Lexington, KY, USA
| | - Eduardo Ticona
- Infectious Diseases & Tropical Medicine Research Unit, Hospital Nacional Dos de Mayo, Lima, Peru
| | - Timothy R Sterling
- Division of Infectious Diseases, Department of Medicine, Vanderbilt University, Nashville, TN, USA
| | - Beth A Garvy
- Division of Infectious Diseases, Department of Medicine, University of Kentucky, Lexington, KY, USA; Department of Microbiology, Immunology and Molecular Genetics, University of Kentucky, Lexington, KY, USA
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Expression Profiles of Cytokine mRNAs in the Pleural Fluid Reveal Differences Among Tuberculosis, Malignancies, and Pneumonia-Exudative Pleural Effusions. Lung 2015; 193:1001-7. [PMID: 26407584 DOI: 10.1007/s00408-015-9809-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Accepted: 09/21/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Tuberculosis (TB) and malignant diseases are the most common causes of lymphocytic pleural effusion in adults. Serum and pleural fluid cytokine levels have been analyzed to help in the differential diagnosis, but with limited results. PURPOSE This study investigates transcription levels of selected cytokine genes in pleural effusion of patients under investigation for TB. METHODS This was a prospective study that included adult patients under investigation for pleural effusion in Brazil. The expression of 19 cytokine genes was analyzed by RT-qPCR. RESULTS The majority of cytokine-related genes expressed in pleural fluid of TB patients were similar in non-TB patients, except for RORA and RORC genes, which showed a statistically higher level in TB. All cytokines in the Th17 pattern were induced in TB patients' pleural fluid. Patients with malignant pleural effusion expressed higher levels of IFN-α1, IFN-β1, TNF-α, IL-4 and IL-6, and suppression of TGFβ-1. CONCLUSION There is still a lot to understand about the cytokine roles in the pro- and anti-inflammatory environment of exudative pleural effusions. The data presented here showed an increased expression of Th17 pattern cytokines genes in TB patients that could be used as markers to differentiate tuberculous pleuritis from other common causes of exudative pleural effusion.
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Latent tuberculosis infection: myths, models, and molecular mechanisms. Microbiol Mol Biol Rev 2015; 78:343-71. [PMID: 25184558 DOI: 10.1128/mmbr.00010-14] [Citation(s) in RCA: 156] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The aim of this review is to present the current state of knowledge on human latent tuberculosis infection (LTBI) based on clinical studies and observations, as well as experimental in vitro and animal models. Several key terms are defined, including "latency," "persistence," "dormancy," and "antibiotic tolerance." Dogmas prevalent in the field are critically examined based on available clinical and experimental data, including the long-held beliefs that infection is either latent or active, that LTBI represents a small population of nonreplicating, "dormant" bacilli, and that caseous granulomas are the haven for LTBI. The role of host factors, such as CD4(+) and CD8(+) T cells, T regulatory cells, tumor necrosis factor alpha (TNF-α), and gamma interferon (IFN-γ), in controlling TB infection is discussed. We also highlight microbial regulatory and metabolic pathways implicated in bacillary growth restriction and antibiotic tolerance under various physiologically relevant conditions. Finally, we pose several clinically important questions, which remain unanswered and will serve to stimulate future research on LTBI.
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Regulatory T-cell subsets in response to specific Mycobacterium tuberculosis antigens in vitro distinguish among individuals with different QTF and TST reactivity. Clin Immunol 2015; 157:145-55. [PMID: 25728490 DOI: 10.1016/j.clim.2015.02.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Revised: 01/20/2015] [Accepted: 02/18/2015] [Indexed: 11/21/2022]
Abstract
Regulatory T cells (Tregs), a subset of CD4+ T cells related with immune regulation, have been associated with active and latent tuberculosis infection (LTBI). Treg frequencies were evaluated by multicolor flow cytometry (FC) in peripheral blood mononuclear cells (PBMCs) stimulated with mycobacterial antigens ESAT-6, CFP-10, and TB7.7 to assess their capacity to distinguish subjects with different reactivity to the QuantiFERON-TB® Gold In-Tube (QFT-IT) test and the tuberculin skin test (TST). Increased frequencies of CD4+CD25highCD39+ cells were found for the [TST+, QTF+] compared with the [TST+, QTF-] group. Also, higher frequencies were observed for the [TST+, QTF+] compared with the [TST+, QTF-] and [TST-, QTF-] groups in CD4+CD25highFoxp3+ and CD4+CD25highCD39+Foxp3+ populations. Receiver operating characteristics (ROC curve) analysis confirmed these discriminating results. QFT-IT and TST quantitative values correlated with several Treg population frequencies.
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Silva BDS, Tannus-Silva DGS, Rabahi MF, Kipnis A, Junqueira-Kipnis AP. The use of Mycobacterium tuberculosis HspX and GlcB proteins to identify latent tuberculosis in rheumatoid arthritis patients. Mem Inst Oswaldo Cruz 2015; 109:29-37. [PMID: 25317705 PMCID: PMC4238770 DOI: 10.1590/0074-0276140140] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Accepted: 10/03/2013] [Indexed: 01/22/2023] Open
Abstract
Understanding the social conditions and immunological characteristics that allow some
human immunodeficiency virus (HIV)-exposed patients to remain uninfected represents
an on-going challenge. In this study, the socio-demographic and sexual behaviour
characteristics and immune activation profiles of uninfected individuals exposed to
HIV-infected partners were investigated. A confidential and detailed questionnaire
was administered and venous blood was tested using HIV-1/enzyme immunoassays, plasma
HIV-1 RNA levels/bDNA and immunophenotyping/flow cytometry to determine the
frequencies of CD4 and CD8 T cells expressing activation markers. The data analysis
showed significant differences (p < 0.05) for immune parameters in individuals who
were uninfected, albeit exposed to HIV-infected partners, compared with unexposed
individuals. In particular, the exposed, uninfected individuals had a higher
frequency (median, minimum-maximum) of CD4+HLA-DR+ (4.2,
1.8-6.1), CD8+HLA-DR+ (4.6, 0.9-13.7),
CD4+CD45RO+ (27.5, 14.2-46.6),
CD4+CD45RO+CD62L+ (46.7, 33.9-67.1),
CD8+CD45RA+HLA-DR+ (12.1, 3.4-35.8) and
CD8+CD45RO+HLA-DR+ (9.0, 3.2-14.8) cells, a
decreased percentage of CD8+CD28+ cells (11.7, 4.5-24.0) and a
lower cell-surface expression of Fcγ-R/CD16 on monocytes (56.5, 22.0-130.0). The
plasma HIV-1 RNA levels demonstrated detectable RNA virus loads in 57% of the
HIV-1+ female partners. These findings demonstrate an activation
profile in both CD4 and CD8 peripheral T cells from HIV-1 exposed seronegative
individuals of serodiscordant couples from a referral centre in Belo Horizonte, state
of Minas Gerais.
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Affiliation(s)
- Bruna Daniella Souza Silva
- Departamento de Microbiologia, Imunologia, Parasitologia e Patologia, Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás, GoiâniaGO, Brasil, Departamento de Microbiologia, Imunologia, Parasitologia e Patologia , Instituto de Patologia Tropical e Saúde Pública , Universidade Federal de Goiás , Goiânia , GO , Brasil
| | - Daniela Graner Schuwartz Tannus-Silva
- Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Goiás, GoiâniaGO, Brasil, Departamento de Clínica Médica , Faculdade de Medicina , Universidade Federal de Goiás , Goiânia , GO , Brasil
| | - Marcelo Fouad Rabahi
- Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Goiás, GoiâniaGO, Brasil, Departamento de Clínica Médica , Faculdade de Medicina , Universidade Federal de Goiás , Goiânia , GO , Brasil
| | - Andre Kipnis
- Departamento de Microbiologia, Imunologia, Parasitologia e Patologia, Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás, GoiâniaGO, Brasil, Departamento de Microbiologia, Imunologia, Parasitologia e Patologia , Instituto de Patologia Tropical e Saúde Pública , Universidade Federal de Goiás , Goiânia , GO , Brasil
| | - Ana Paula Junqueira-Kipnis
- Departamento de Microbiologia, Imunologia, Parasitologia e Patologia, Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás, GoiâniaGO, Brasil, Departamento de Microbiologia, Imunologia, Parasitologia e Patologia , Instituto de Patologia Tropical e Saúde Pública , Universidade Federal de Goiás , Goiânia , GO , Brasil
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Silva BDS, Tannus-Silva DGS, Rabahi MF, Kipnis A, Junqueira-Kipnis AP. The use of Mycobacterium tuberculosis HspX and GlcB proteins to identify latent tuberculosis in rheumatoid arthritis patients. Mem Inst Oswaldo Cruz 2015. [PMID: 24626307 PMCID: PMC4005526 DOI: 10.1590/0074-02760140140] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Rheumatoid arthritis (RA) is an autoimmune disease characterised by the destruction
of articular cartilage and bone damage. The chronic treatment of RA patients causes a
higher susceptibility to infectious diseases such as tuberculosis (TB); one-third of
the world’s population is latently infected (LTBI) with Mycobacterium
tuberculosis (Mtb). The tuberculin skin test is used to identify
individuals LTBI, but many studies have shown that this test is not suitable for RA
patients. The goal of this work was to test the specific cellular immune responses to
the Mtb malate synthase (GlcB) and heat shock protein X (HspX) antigens of RA
patients and to correlate those responses with LTBI status. The T-helper (Th)1, Th17
and Treg-specific immune responses to the GlcB and HspX Mtb antigens were analysed in
RA patients candidates for tumour necrosis factor-α blocker treatment. Our results
demonstrated that LTBI RA patients had Th1-specific immune responses to GlcB and
HspX. Patients were followed up over two years and 14.3% developed active TB. After
the development of active TB, RA patients had increased numbers of Th17 and Treg
cells, similar to TB patients. These results demonstrate that a GlcB and HspX antigen
assay can be used as a diagnostic test to identify LTBI RA patients.
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Affiliation(s)
- Bruna Daniella Souza Silva
- Departamento de Microbiologia, Imunologia, Parasitologia e Patologia, Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás, GoiâniaGO, Brasil, Departamento de Microbiologia, Imunologia, Parasitologia e Patologia , Instituto de Patologia Tropical e Saúde Pública , Universidade Federal de Goiás , Goiânia , GO , Brasil
| | - Daniela Graner Schuwartz Tannus-Silva
- Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Goiás, GoiâniaGO, Brasil, Departamento de Clínica Médica , Faculdade de Medicina , Universidade Federal de Goiás , Goiânia , GO , Brasil
| | - Marcelo Fouad Rabahi
- Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Goiás, GoiâniaGO, Brasil, Departamento de Clínica Médica , Faculdade de Medicina , Universidade Federal de Goiás , Goiânia , GO , Brasil
| | - Andre Kipnis
- Departamento de Microbiologia, Imunologia, Parasitologia e Patologia, Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás, GoiâniaGO, Brasil, Departamento de Microbiologia, Imunologia, Parasitologia e Patologia , Instituto de Patologia Tropical e Saúde Pública , Universidade Federal de Goiás , Goiânia , GO , Brasil
| | - Ana Paula Junqueira-Kipnis
- Departamento de Microbiologia, Imunologia, Parasitologia e Patologia, Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás, GoiâniaGO, Brasil, Departamento de Microbiologia, Imunologia, Parasitologia e Patologia , Instituto de Patologia Tropical e Saúde Pública , Universidade Federal de Goiás , Goiânia , GO , Brasil
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García Jacobo RE, Serrano CJ, Enciso Moreno JA, Gaspar Ramírez O, Trujillo Ochoa JL, Uresti Rivera EE, Portales Pérez DP, González-Amaro R, García Hernández MH. Analysis of Th1, Th17 and regulatory T cells in tuberculosis case contacts. Cell Immunol 2014; 289:167-73. [PMID: 24841855 DOI: 10.1016/j.cellimm.2014.03.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Revised: 02/20/2014] [Accepted: 03/24/2014] [Indexed: 11/27/2022]
Abstract
We have hypothesized that individuals infected with Mycobacteriumtuberculosis that exhibit different patterns of immune reactivity in serial interferon (IFN)-γ release assays (IGRA's) correspond to different status within the immune spectrum of latent tuberculosis (TB). Accordingly, we analyzed the possible association between the consistent results (negative or positive) in an IGRA test and relevant immune parameters, mainly the levels of Th1 and Th17 lymphocytes and T regulatory (Treg) cells in the peripheral blood of TB case contacts. We found that individuals with a persistently positive IGRA showed increased levels of Th1 and Th17 lymphocytes upon in vitro stimulation with MTB antigens. In addition, a significant increase in the proportion of CD4+CTLA-4+ and CD4+Foxp3+ cells was detected in assays with blood samples from these individuals. Our data support that different immune phenotypes can be identified into the spectrum of latent TB, by combining different parameters of immune reactivity against MTB.
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Affiliation(s)
- R E García Jacobo
- Unidad de Investigación Médica-Zacatecas, Instituto Mexicano del Seguro Social, IMSS, Mexico
| | - C J Serrano
- Unidad de Investigación Médica-Zacatecas, Instituto Mexicano del Seguro Social, IMSS, Mexico
| | - J A Enciso Moreno
- Unidad de Investigación Médica-Zacatecas, Instituto Mexicano del Seguro Social, IMSS, Mexico
| | - O Gaspar Ramírez
- Centro de Investigación y Asistencia en Tecnología y Diseño del Estado de Jalisco, A.C. Unidad Noreste., Monterrey, Nuevo León, Mexico
| | - J L Trujillo Ochoa
- Unidad de Investigación Médica-Zacatecas, Instituto Mexicano del Seguro Social, IMSS, Mexico
| | - E E Uresti Rivera
- Departamento de Inmunología y Biología Celular y Molecular, Facultad de Ciencias Químicas, UASLP, San Luis Potosí, SLP, Mexico
| | - D P Portales Pérez
- Departamento de Inmunología y Biología Celular y Molecular, Facultad de Ciencias Químicas, UASLP, San Luis Potosí, SLP, Mexico
| | - R González-Amaro
- Departamento de Inmunología, Facultad de Medicina, UASLP, San Luis Potosí, SLP, Mexico
| | - M H García Hernández
- Unidad de Investigación Médica-Zacatecas, Instituto Mexicano del Seguro Social, IMSS, Mexico.
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Siddiqui KF, Amir M, Gurram RK, Khan N, Arora A, Rajagopal K, Agrewala JN. Latency-associated protein Acr1 impairs dendritic cell maturation and functionality: a possible mechanism of immune evasion by Mycobacterium tuberculosis. J Infect Dis 2013; 209:1436-45. [PMID: 24218502 DOI: 10.1093/infdis/jit595] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Mycobacterium tuberculosis (M. tuberculosis) in latently infected individuals survives and thwarts the attempts of eradication by the immune system. During latency, Acr1 is predominantly expressed by the bacterium. However, whether M. tuberculosis exploits its Acr1 in impairing the host immunity remains widely unexplored. Hence, currently we have investigated the role of Acr1 in influencing the differentiation and function of dendritic cells (DCs), which play a cardinal role in innate and adaptive immunity. Therefore, for the first time, we have revealed a novel mechanism of mycobacterial Acr1 in inhibiting the maturation and differentiation of DCs by inducing tolerogenic phenotype by modulating the expression of PD-L1; Tim-3; indoleamine 2, 3-dioxygenase (IDO); and interleukin 10. Furthermore, Acr1 interferes in the differentiation of DCs by targeting STAT-6 and STAT-3 pathways. Continuous activation of STAT-3 inhibited the translocation of NF-κB in Acr1-treated DCs. Furthermore, Acr1 also augmented the induction of regulatory T cells. These DCs displayed decline in their antigen uptake capacity and reduced ability to help T cells. Interestingly, M. tuberculosis exhibited better survival in Acr1-treated DCs. Thus, this study provides a crucial insight into a strategy adopted by M. tuberculosis to survive in the host by impairing the function of DCs.
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Affiliation(s)
- Kaneez F Siddiqui
- Institute of Microbial Technology, Council of Scientific and Industrial Research (CSIR), Chandigarh, India
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Tong ZH, Shi HZ. Subpopulations of helper T lymphocytes in tuberculous pleurisy. Tuberculosis (Edinb) 2013; 93:279-84. [PMID: 23477939 DOI: 10.1016/j.tube.2013.02.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2012] [Revised: 02/08/2013] [Accepted: 02/11/2013] [Indexed: 12/11/2022]
Abstract
Although it is curable, tuberculosis continues to be is a major global public health problem, especially in developing countries. Tuberculous pleural effusion (TPE) is one of the most common forms of extrapulmonary tuberculosis. It has been well documented that CD4(+) T lymphocytes are dominant leukocytes present in TPE. Traditionally, CD4(+) T cells have been classified into two functionally distinct subsets, helper T-cell type 1 (Th1) and Th2 cells, based on their cytokine production profiles. Recently, regulatory T cells, Th17 cells, Th9 cells, and Th22 cells have been added to the 'portfolio' of Th cells. In this review, we summarize recent findings regarding the phenotypic characteristics of the above Th cells, the mechanisms of differentiation and recruitment of Th cells into pleural space, and the immune regulation of Th cells in TPE environment. We also describe the interplay between different Th cells, as well as between Th cells and other type of cells, such as pleural mesothelial cells in TPE. Further studies should be directed at identifying the mediators and mechanisms involved in the immunoregulatory properties of pleural Th cells in tuberculosis infection.
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Affiliation(s)
- Zhao-Hui Tong
- Department of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing 100020, China
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Chun RF, Adams JS, Hewison M. Immunomodulation by vitamin D: implications for TB. Expert Rev Clin Pharmacol 2012; 4:583-91. [PMID: 22046197 DOI: 10.1586/ecp.11.41] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
TB remains a major cause of mortality throughout the world. Low vitamin D status has been linked to increased risk of TB and other immune disorders. These observations suggest a role for vitamin D as a modulator of normal human immune function. This article will detail the cellular and molecular mechanisms by which vitamin D regulates the immune system and how vitamin D insufficiency may lead to immune dysregulation. The importance of vitamin D bioavailability as a mechanism for defining the immunomodulatory actions of vitamin D and its impact on TB will also be discussed. The overall aim will be to provide a fresh perspective on the potential benefits of vitamin D supplementation in the prevention and treatment of TB.
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Affiliation(s)
- Rene F Chun
- Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, 615 Charles E. Young Drive South, Los Angeles, CA 90095, USA
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CD19(+)CD1d(+)CD5(+) B cell frequencies are increased in patients with tuberculosis and suppress Th17 responses. Cell Immunol 2012; 274:89-97. [PMID: 22361174 DOI: 10.1016/j.cellimm.2012.01.007] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2011] [Revised: 01/15/2012] [Accepted: 01/25/2012] [Indexed: 12/13/2022]
Abstract
Although the importance of B cells in the host immune response upon Mycobacterium tuberculosis infection has been recognized, a conclusive role for B cells has yet to be determined. In the present study, we found that primary CD19(+) B cells isolated from patients with tuberculosis significantly inhibited Th17, but not Th1, cell activation. Moreover, the suppressive activity was mediated by a CD19(+)CD1d(+)CD5(+) B cell population. Notably, patients with tuberculosis were found to have significantly higher frequencies of CD19(+)CD1d(+)CD5(+) B cells with stronger suppressive activity than such cells from healthy donors. Furthermore, the frequency of CD19(+)CD1d(+)CD5(+) B cells in peripheral blood was inversely correlated with that of Th17 cells in patients with tuberculosis. This finding that B cells negatively regulate Th17 responses provides a novel mechanism in the regulation of CD4(+) T cell responses-aside from regulatory T cells-during M. tuberculosis infection, which may impact the clinical outcome of tuberculosis.
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Abstract
PURPOSE OF REVIEW The increase in incidence and prevalence of allergic disease remains a mystery and cannot be explained solely by genetic factors. The hygiene hypothesis provides the strongest epidemiological explanation for the rise in allergic disease. This review evaluates the recent epidemiological and mechanistic research in the role of infectious agents in the pathogenesis of or protection from allergic disease. RECENT FINDINGS Recent literature has extended the epidemiological findings of the protective effect of being born and reared in a farm environment and associates an increased diversity of organisms in house-dust samples with protection from allergic disease. Furthermore, human and animal studies provide increasing evidence for the role of both the innate and adaptive immune systems, including regulatory cells, as mediators of this protective effect. SUMMARY There is evidence that exposure to some infectious organisms can protect from atopy, whereas other infections appear to promote allergic diseases. The timing of exposure to infection and the properties of the infectious agent, in addition to the genetic susceptibility of the host, play an important role in the future development of allergic disease.
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Multifunctional CD4 T cell responses in patients with active tuberculosis. Sci Rep 2012; 2:216. [PMID: 22355730 PMCID: PMC3253855 DOI: 10.1038/srep00216] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2011] [Accepted: 12/12/2011] [Indexed: 01/12/2023] Open
Abstract
The roles of multifunctional CD4 T cells in human tuberculosis are not well defined. In this study, we found that patients with tuberculosis had decreased PMA/ionomycin stimulated multifunctional CD4 T cells, and increased Mycobacterium tuberculosis antigen-specific multifunctional CD4 T cells, when compared to individuals with latent tuberculosis infection and healthy controls. PMA/ionomycin stimulated IFN-γ+IL-2+TNF-α+ CD4 T cell responses were decreased in patients with smear-positive tuberculosis compared to those with smear-negative tuberculosis. The percentage of IFN-γ+IL-2+TNF-α+ CD4 T cells in smear positive tuberculosis patients negatively correlated with the grade of sputum smear Acid-Fast Bacilli and high-resolution computed tomography score. Therefore, our findings argue against the notion that Mycobacterium tuberculosis antigen-specific multifunctional Th1 responses in peripheral blood can serve as correlates of protective immunity against tuberculosis; they suggest that the decrease in PMA/ionomycin stimulated IFN-γ+IL-2+TNF-α+ CD4 T cells may be applied for clinical diagnosis of active tuberculosis.
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John SH, Kenneth J, Gandhe AS. Host biomarkers of clinical relevance in tuberculosis: review of gene and protein expression studies. Biomarkers 2011; 17:1-8. [DOI: 10.3109/1354750x.2011.628048] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Th1/Th17 cell induction and corresponding reduction in ATP consumption following vaccination with the novel Mycobacterium tuberculosis vaccine MVA85A. PLoS One 2011; 6:e23463. [PMID: 21887254 PMCID: PMC3162567 DOI: 10.1371/journal.pone.0023463] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2011] [Accepted: 07/18/2011] [Indexed: 11/21/2022] Open
Abstract
Vaccination with Bacille Calmette-Guérin (BCG) has traditionally been used for protection against disease caused by the bacterium Mycobacterium tuberculosis (M.tb). The efficacy of BCG, especially against pulmonary tuberculosis (TB) is variable. The best protection is conferred in temperate climates and there is close to zero protection in many tropical areas with a high prevalence of both tuberculous and non-tuberculous mycobacterial species. Although interferon (IFN)-γ is known to be important in protection against TB disease, data is emerging on a possible role for interleukin (IL)-17 as a key cytokine in both murine and bovine TB vaccine studies, as well as in humans. Modified Vaccinia virus Ankara expressing Antigen 85A (MVA85A) is a novel TB vaccine designed to enhance responses induced by BCG. Antigen-specific IFN-γ production has already been shown to peak one week post-MVA85A vaccination, and an inverse relationship between IL-17-producing cells and regulatory T cells expressing the ectonucleosidease CD39, which metabolises pro-inflammatory extracellular ATP has previously been described. This paper explores this relationship and finds that consumption of extracellular ATP by peripheral blood mononuclear cells from MVA85A-vaccinated subjects drops two weeks post-vaccination, corresponding to a drop in the percentage of a regulatory T cell subset expressing the ectonucleosidase CD39. Also at this time point, we report a peak in co-production of IL-17 and IFN-γ by CD4+ T cells. These results suggest a relationship between extracellular ATP and effector responses and unveil a possible pathway that could be targeted during vaccine design.
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Imbalance of Th17 cells and regulatory T cells in tuberculous pleural effusion. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2011; 18:1608-15. [PMID: 21813663 DOI: 10.1128/cvi.05214-11] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Both T helper interleukin 17 (IL-17)-producing cells (Th17 cells) and regulatory T cells (Tregs) have been found to be increased in human tuberculous pleural effusion (TPE); however, the possible interaction between Th17 cells and Tregs in TPE remains to be elucidated. The objective of the present study was to investigate the distribution of Th17 cells in relation to Tregs, as well as the mechanism of Tregs in regulating generation and differentiation of Th17 cells in TPE. In the present study, the numbers of Th17 cells and Tregs in TPE and blood were determined by flow cytometry. The regulation and mechanism of CD39(+) Tregs on generation and differentiation of Th17 cells were explored. Our data demonstrated that the numbers of Th17 cells and CD39(+) Tregs were both increased in TPE compared with blood. Th17 cell numbers were correlated negatively with Tregs in TPE but not in blood. When naïve CD4(+) T cells were cultured with CD39(+) Tregs, Th17 cell numbers decreased as CD39(+) Treg numbers increased, and the addition of the anti-latency-associated peptide monoclonal antibody to the coculture reversed the inhibitory effect exerted by CD39(+) Tregs. This study shows that Th17/Treg imbalance exists in TPE and that pleural CD39(+) Tregs inhibit generation and differentiation of Th17 cells via a latency-associated peptide-dependent mechanism.
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Wergeland I, Aßmus J, Dyrhol-Riise AM. T Regulatory Cells and Immune Activation in Mycobacterium tuberculosis Infection and the Effect of Preventive Therapy. Scand J Immunol 2011; 73:234-42. [DOI: 10.1111/j.1365-3083.2010.02496.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Tomioka H, Tatano Y, Sano C, Shimizu T. Development of new antituberculous drugs based on bacterial virulence factors interfering with host cytokine networks. J Infect Chemother 2011; 17:302-17. [PMID: 21243398 DOI: 10.1007/s10156-010-0177-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2010] [Indexed: 12/27/2022]
Abstract
The worldwide increase in the prevalence of tuberculosis (TB), especially multidrug-resistant TB and extensively drug-resistant TB, is an important global health concern, and new effective drugs are urgently needed. Information on the genome of Mycobacterium tuberculosis (MTB) and various mycobacterial virulence genes is leading to the identification of genes that code for new drug targets. Mycobacterium tuberculosis (MTB) is resistant to the antimicrobial mechanisms of host macrophages and can survive and replicate in macrophages for long periods, resulting in a persistent infection. Mycobacterial virulence factors suppress macrophage bactericidal functions partly via their downregulatory effects on the host antimicrobial cytokine networks, consisting of proinflammatory, immunopotentiating, and Th1-inducing cytokines. Thus, for the development of unique drugs that exhibit antimycobacterial action through novel mechanisms, it is reasonable to search for targets among bacterial genes encoding virulence factors which interfere with the host cytokine responses protective to mycobacterial pathogens. In this review, we discuss the profiles of cytokine networks related to host resistance to mycobacteria, including the mechanisms of downregulation of host antimycobacterial immunity due to immunosuppressive cytokines, which are occasionally induced in the advanced stages of TB. We also highlight the development of antituberculous drugs based on bacterial virulence factors interfering with the host antimycobacterial cytokine network.
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Affiliation(s)
- Haruaki Tomioka
- Department of Microbiology and Immunology, Faculty of Medicine, Shimane University, Izumo, Shimane 693-8501, Japan.
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Regulatory T cell frequency and modulation of IFN-gamma and IL-17 in active and latent tuberculosis. Tuberculosis (Edinb) 2010; 90:252-61. [PMID: 20594914 DOI: 10.1016/j.tube.2010.05.003] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2010] [Revised: 05/05/2010] [Accepted: 05/20/2010] [Indexed: 11/24/2022]
Abstract
Regulatory T cells (Tregs) play an essential role in immune homeostasis. In infectious diseases Tregs may inhibit protective responses facilitating pathogen multiplication and dissemination, but they may also limit the inflammatory response diminishing tissue damage. Although there is experimental and clinical evidence that Tregs are induced during Mycobacterium tuberculosis infection, their role in the immunopathogenesis of tuberculosis is still not completely understood. In this study, the phenotype, frequency and activity of circulating Tregs in active and latent tuberculosis were evaluated. Phenotypic analysis showed that Tregs were CD4(+)CD25(high)FOXP3(+)CD45RO(+)CD127(-). High levels of circulating Tregs were found in patients with active pulmonary tuberculosis, compared to individuals with latent infection. Treg activity was evaluated by ELISPOT by determining the effect of CD25(+) cell depletion on the frequency of IFN-gamma and IL-17 producing cells after in vitro stimulation with ESAT-6, CFP-10 and PPD. Treg depletion increased the frequency of IFN-gamma producing cells, without affecting the frequency of IL-17 producing cells, in both active and latent tuberculosis, irrespective of the antigen used. Neutralization of IL-10 did not have any effect on the frequency of IFN-gamma and IL-17 producing cells. Altogether, these results suggest that during active tuberculosis Tregs inhibit protective Th1 responses, but not the proinflammatory Th17 responses, facilitating mycobacterial replication and tissue damage.
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