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Zhan H, Xie Y, Liu Y, Cheng L, Xu Y, Qu X, Li C, Guo X, Li H, Wang Y, Dai E, Wang L, Gao H, Li Y. Omicron BA.4/5 neutralization and cell-mediated immune responses in relation to baseline immune status and breakthrough infection among PLWH: A follow-up cohort study. J Med Virol 2024; 96:e29446. [PMID: 38345110 DOI: 10.1002/jmv.29446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 01/04/2024] [Accepted: 01/21/2024] [Indexed: 02/15/2024]
Abstract
There is a paucity of data on hybrid immunity (vaccination plus breakthrough infection [BI]), especially cell-mediated responses to Omicron among immunosuppressed patients. We aim to investigate humoral and cellular responses to Omicron BA.4/5 among people living with HIV (PLWH) with/without BIs, the most prevalent variant of concern after the reopening of China. Based on our previous study, we enrolled 77 PLWH with baseline immune status of severe acute respiratory syndrome coronavirus 2 specific antibodies after inactivated vaccination. "Correlates of protection," including serological immunoassays, T cell phenotypes and memory B cells (MBC) were determined in PLWH without and with BI, together with 16 PLWH with reinfections. Higher inhibition rate of neutralizing antibodies (NAb) against BA.4/5 was elicited among PLWH with BI than those without. Omicron-reactive IL4+ CD8+ T cells were significantly elevated in PLWH experienced postvaccine infection contrasting with those did not. NAb towards wild type at baseline was associated with prolonged negative conversion time for PLWH whereas intermediate MBCs serve as protecting effectors. We uncovered that hybrid immunity intensified more protection on BA.4/5 than vaccination did. Strengthened surveillance on immunological parameters and timely clinical intervention on PLWH deficient in protection would reduce the severity and mortality in the context of coexistence with new Omicron subvariants.
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Affiliation(s)
- Haoting Zhan
- Department of Clinical Laboratory, State key Laboratory of Complex, Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Yuchen Xie
- School of Public Health, North China University of Science and Technology, Tangshan, China
- Department of Laboratory Medicine, Hebei Key Laboratory of Immune Mechanism of Major Infectious Diseases and New Technology of Diagnosis and Treatment, The Fifth Hospital of Shijiazhuang, North China University of Science and Technology, Tangshan, China
| | - Yongmei Liu
- Department of Clinical Laboratory, State key Laboratory of Complex, Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Linlin Cheng
- Department of Clinical Laboratory, State key Laboratory of Complex, Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Yi Xu
- Department of Laboratory Medicine, Hebei Key Laboratory of Immune Mechanism of Major Infectious Diseases and New Technology of Diagnosis and Treatment, The Fifth Hospital of Shijiazhuang, North China University of Science and Technology, Tangshan, China
| | - Xiaojing Qu
- Department of AIDS, The Fifth Hospital of Shijiazhuang, North China University of Science and Technology, Tangshan, China
| | - Chen Li
- Department of AIDS, The Fifth Hospital of Shijiazhuang, North China University of Science and Technology, Tangshan, China
| | - Xinru Guo
- School of Public Health, North China University of Science and Technology, Tangshan, China
- Department of Laboratory Medicine, Hebei Key Laboratory of Immune Mechanism of Major Infectious Diseases and New Technology of Diagnosis and Treatment, The Fifth Hospital of Shijiazhuang, North China University of Science and Technology, Tangshan, China
| | - Haolong Li
- Department of Clinical Laboratory, State key Laboratory of Complex, Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Yuling Wang
- Department of AIDS, The Fifth Hospital of Shijiazhuang, North China University of Science and Technology, Tangshan, China
| | - Erhei Dai
- Department of Laboratory Medicine, Hebei Key Laboratory of Immune Mechanism of Major Infectious Diseases and New Technology of Diagnosis and Treatment, The Fifth Hospital of Shijiazhuang, North China University of Science and Technology, Tangshan, China
| | - Lijing Wang
- Department of AIDS, The Fifth Hospital of Shijiazhuang, North China University of Science and Technology, Tangshan, China
| | - Huixia Gao
- Department of Laboratory Medicine, Hebei Key Laboratory of Immune Mechanism of Major Infectious Diseases and New Technology of Diagnosis and Treatment, The Fifth Hospital of Shijiazhuang, North China University of Science and Technology, Tangshan, China
| | - Yongzhe Li
- Department of Clinical Laboratory, State key Laboratory of Complex, Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
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Kumar R, Gupta R, Dewan P, Kashyap B, Kotru M. Raised circulatory T regulatory cells in paediatric tuberculosis - An environment for bacterial persistence? Indian J Tuberc 2024; 71:12-18. [PMID: 38296384 DOI: 10.1016/j.ijtb.2023.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 03/15/2023] [Indexed: 02/07/2024]
Abstract
OBJECTIVES T-regulatory cells (Tregs) restrain the Th1-mediated immune response and thus may help in persistence and dissemination of childhood Tuberculosis. This study compared the percentage of Tregs in peripheral blood of paediatric TB patients (severe and non severe) with healthy individuals by flow cytometry. METHODS Study enrolled 40 subjects, less than 12 years along with 20 age matched healthy controls. Cases were further classified as severe TB and non severe TB. Haematological work-up and flow-cytometry for Tregs was done. Tregs were quantified as CD4CD25 high and CD4FoxP3 cells and compared in different groups using the Mann-Whitney U test. RESULTS In cases, CD4CD25 high Tregs (%) ranged from 0.55 to 12.8 with a Mean ± SD of 3.61 ± 2.98 and CD4FoxP3 Tregs (%) ranged from 0.02 to 13.44 with a Mean ± SD of 3.56 ± 2.76. In controls, CD4CD25 high Tregs (%) ranged from 0.3 to 6.5 with a Mean ± SD of 1.29 ± 1.4 and CD4FoxP3 Tregs (%) ranged from 0.33 to 2.59 with a Mean ± SD of 1.57 ± 0.58. Thus the percentage of both CD4CD25 high and CD4FoxP3 Tregs were significantly higher in cases as compared to controls (p value, 0.001 and 0.001 respectively), however the difference was not significant between severe versus non-severe TB (p value, 0.827 and 0.880 respectively). CONCLUSION Children with TB (both pulmonary and extra-pulmonary) demonstrate increased number of T regulatory cells as compared to healthy controls. However, the number of Tregs are not significantly different between cases with severe versus non severe TB.
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Affiliation(s)
- Ranjith Kumar
- Department of Pathology, University College of Medical Sciences and GTB Hospital, Delhi, India
| | - Richa Gupta
- Department of Pathology, University College of Medical Sciences and GTB Hospital, Delhi, India.
| | - Pooja Dewan
- Department of Paediatrics, University College of Medical Sciences and GTB Hospital, Delhi, India
| | - Bineeta Kashyap
- Department of Microbiology, University College of Medical Sciences and GTB Hospital, Delhi, India
| | - Mrinalini Kotru
- Department of Pathology, University College of Medical Sciences and GTB Hospital, Delhi, India
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Djaharuddin I, Amir M, Qanitha A. Exploring the link between cardiovascular risk factors and manifestations in latent tuberculosis infection: a comprehensive literature review. Egypt Heart J 2023; 75:43. [PMID: 37249745 DOI: 10.1186/s43044-023-00370-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 05/20/2023] [Indexed: 05/31/2023] Open
Abstract
BACKGROUND The global burden of tuberculosis (TB) and cardiovascular disease (CVD) is overt, and the prevalence of this double burden disease remains steadily rising, particularly in low- and middle-income countries. This review aims to explore the association between latent tuberculosis infection (LTBI) and the development of cardiovascular diseases and risk factors. Furthermore, we elucidated the underlying pathophysiological mechanisms that contribute to this relationship. MAIN BODY Approximately 25% of the global population carries a dormant form of tuberculosis (TB) infection. During this latent stage, certain subsets of mycobacteria actively reproduce, and recent research suggests that latent TB infection (LTBI) is connected to persistent, long-term low-grade inflammation that can potentially contribute to the development of atherosclerosis and cardiovascular disease (CVD). The presence of LTBI can be confirmed through a positive result on either a tuberculin skin test (TST) or an interferon-gamma release assay (IGRA). Several plausible explanations for the association between LTBI and CVD include increased inflammation, autoimmunity related to heat shock proteins (HSP), and the presence of pathogens within the developing atherosclerotic plaque. The most commonly observed cardiovascular events and risk factors associated with LTBI are acute myocardial infarction, coronary artery stenosis, diabetes mellitus, and hypertension. CONCLUSIONS This article highlights the critical role of LTBI in perpetuating the tuberculosis disease cycle and its association with cardiovascular risk factors. Chronic and persistent low inflammation underlined the association. Identifying high-risk LTBI patients and providing targeted preventive medication are crucial strategies for global TB eradication and interrupting transmission chains.
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Affiliation(s)
- Irawaty Djaharuddin
- Department of Pulmonology and Respirology Medicine, Faculty of Medicine, Universitas Hasanuddin, Makassar, 90245, Indonesia
| | - Muzakkir Amir
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Hasanuddin, Jl. Perintis Kemerdekaan Km. 10, Makassar, 90245, South Sulawesi, Indonesia
| | - Andriany Qanitha
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Hasanuddin, Jl. Perintis Kemerdekaan Km. 10, Makassar, 90245, South Sulawesi, Indonesia.
- Department of Physiology, Faculty of Medicine, Universitas Hasanuddin, Makassar, 90245, Indonesia.
- Doctoral Study Program, Faculty of Medicine, Universitas Hasanuddin, Makassar, 90245, Indonesia.
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Lozano-Ordaz V, Rodriguez-Miguez Y, Ortiz-Cabrera AE, Hernandez-Bazan S, Mata-Espinosa D, Barrios-Payan J, Saavedra R, Hernandez-Pando R. Beneficial or detrimental activity of regulatory T cells, indoleamine 2,3-dioxygenase, and heme oxygenase-1 in the lungs is influenced by the level of virulence of Mycobacterium tuberculosis strain infection. Front Cell Infect Microbiol 2023; 13:1105872. [PMID: 37284503 PMCID: PMC10239976 DOI: 10.3389/fcimb.2023.1105872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 05/02/2023] [Indexed: 06/08/2023] Open
Abstract
Tuberculosis (TB) caused by the complex Mycobacterium tuberculosis (Mtb) is the main cause of death by a single bacterial agent. Last year, TB was the second leading infectious killer after SARS-CoV-2. Nevertheless, many biological and immunological aspects of TB are not completely elucidated, such as the complex process of immunoregulation mediated by regulatory T cells (Treg cells) and the enzymes indoleamine 2,3-dioxygenase (IDO) and heme oxygenase 1 (HO-1). In this study, the contribution of these immunoregulatory factors was compared in mice infected with Mtb strains with different levels of virulence. First Balb/c mice were infected by intratracheal route, with a high dose of mild virulence reference strain H37Rv or with a highly virulent clinical isolate (strain 5186). In the lungs of infected mice, the kinetics of Treg cells during the infection were determined by cytofluorometry and the expression of IDO and HO-1 by RT-PCR and immunohistochemistry. Then, the contribution of immune-regulation mediated by Treg cells, IDO and HO-1, was evaluated by treating infected animals with specific cytotoxic monoclonal antibodies for Treg cells depletion anti-CD25 (PC61 clone) or by blocking IDO and HO-1 activity using specific inhibitors (1-methyl-D,L-tryptophan or zinc protoporphyrin-IX, respectively). Mice infected with the mild virulent strain showed a progressive increment of Treg cells, showing this highest number at the beginning of the late phase of the infection (28 days), the same trend was observed in the expression of both enzymes being macrophages the cells that showed the highest immunostaining. Animals infected with the highly virulent strain showed lower survival (34 days) and higher amounts of Treg cells, as well as higher expression of IDO and HO-1 one week before. In comparison with non-treated animals, mice infected with strain H37Rv with depletion of Treg cells or treated with the enzymes blockers during late infection showed a significant decrease of bacilli loads, higher expression of IFN-g and lower IL-4 but with a similar extension of inflammatory lung consolidation determined by automated morphometry. In contrast, the depletion of Treg cells in infected mice with the highly virulent strain 5186 produced diffuse alveolar damage that was similar to severe acute viral pneumonia, lesser survival and increase of bacillary loads, while blocking of both IDO and HO-1 produced high bacillary loads and extensive pneumonia with necrosis. Thus, it seems that Treg cells, IDO and HO-1 activities are detrimental during late pulmonary TB induced by mild virulence Mtb, probably because these factors decrease immune protection mediated by the Th1 response. In contrast, Treg cells, IDO and HO-1 are beneficial when the infection is produced by a highly virulent strain, by regulation of excessive inflammation that produced alveolar damage, pulmonary necrosis, acute respiratory insufficiency, and rapid death.
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Affiliation(s)
- Vasti Lozano-Ordaz
- Experimental Pathology Section, Department of Pathology, National Institute of Medical Sciences Nutrition Salvador Zubiran, Mexico City, Mexico
| | - Yadira Rodriguez-Miguez
- Experimental Pathology Section, Department of Pathology, National Institute of Medical Sciences Nutrition Salvador Zubiran, Mexico City, Mexico
| | - Angel E. Ortiz-Cabrera
- Experimental Pathology Section, Department of Pathology, National Institute of Medical Sciences Nutrition Salvador Zubiran, Mexico City, Mexico
| | - Sujhey Hernandez-Bazan
- Experimental Pathology Section, Department of Pathology, National Institute of Medical Sciences Nutrition Salvador Zubiran, Mexico City, Mexico
| | - Dulce Mata-Espinosa
- Experimental Pathology Section, Department of Pathology, National Institute of Medical Sciences Nutrition Salvador Zubiran, Mexico City, Mexico
| | - Jorge Barrios-Payan
- Experimental Pathology Section, Department of Pathology, National Institute of Medical Sciences Nutrition Salvador Zubiran, Mexico City, Mexico
| | - Rafael Saavedra
- Immunology Deparment, Biomedical Research Insitute, National Autonomous University of Mexico (UNAM), Mexico City, Mexico
| | - Rogelio Hernandez-Pando
- Experimental Pathology Section, Department of Pathology, National Institute of Medical Sciences Nutrition Salvador Zubiran, Mexico City, Mexico
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Chen Y, Zhang L, Zhou C, Liu Y, Pan F, Ke Q, Chen Z. Combined Detection of IFN-γ and Lymphocyte Subsets with Activation Indicators in the Clinical Application of Mycobacterium Tuberculosis Infection at Different Times. Curr Microbiol 2023; 80:193. [PMID: 37103584 PMCID: PMC10140100 DOI: 10.1007/s00284-023-03306-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 04/17/2023] [Indexed: 04/28/2023]
Abstract
The immune status of mycobacterium tuberculosis (MTB) infection is essential for the diagnosis and treatment of this disease. In this work, we aim to evaluate the clinical significance of the combination of serum IFN-γ, IGRAs (Interferon-Gamma Release Assay), lymphocyte subset with activation indicators detection in active and latent tuberculosis infection patients. For this study, anticoagulant whole blood were collected from 45 active tuberculosis (AT group), 44 latent tuberculosis (LT group) and 32 healthy controls (HCs group). The serum IFN-γ and IGRAs detected by chemiluminescence, and the percentage of lymphocyte subsets and activated lymphocytes detected by flow cytometry. The results showed combined IGRAs, serum IFN-γ and NKT cells not only has good diagnostic efficiency for the AT, but also provides a laboratory diagnostic method to distinguish AT from LT. Activation indicator of CD3+HLA-DR+T and CD4+HLA-DR+T can effectively distinguish LT from HCs. While combined CD3+T, CD4+T, CD8+CD28+T, Treg and CD16+CD56+CD69+ cells can distinguish AT from HCs. This study showed combined direct detection of serum IFN-γ and IGRAs as well as lymphocyte subsets with activation indicators which may provide laboratory basis for the diagnosis and differential diagnosis of active and latent MTB infection.
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Affiliation(s)
- Yiwen Chen
- Clinical Laboratory Department, Hangzhou Normal University Affiliated Hospital, Zhejiang Province, Hangzhou, 310015, China
| | - Lahong Zhang
- Clinical Laboratory Department, Hangzhou Normal University Affiliated Hospital, Zhejiang Province, Hangzhou, 310015, China
| | - Changjun Zhou
- Clinical Laboratory Department, Hangzhou Normal University Affiliated Hospital, Zhejiang Province, Hangzhou, 310015, China
| | - Yuhua Liu
- Clinical Laboratory Department, Hangzhou Normal University Affiliated Hospital, Zhejiang Province, Hangzhou, 310015, China
| | - Feng Pan
- Clinical Laboratory Department, Hangzhou Normal University Affiliated Hospital, Zhejiang Province, Hangzhou, 310015, China
| | - Qiang Ke
- Hangzhou Normal University Affiliated Hospital (Clinical College), Hangzhou, China
| | - Zhaojun Chen
- Clinical Laboratory Department, Hangzhou Normal University Affiliated Hospital, Zhejiang Province, Hangzhou, 310015, China.
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Civelekoglu O, Wang N, Arifuzzman A, Boya M, Sarioglu AF. Automated lightless cytometry on a microchip with adaptive immunomagnetic manipulation. Biosens Bioelectron 2022; 203:114014. [DOI: 10.1016/j.bios.2022.114014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 12/13/2021] [Accepted: 01/15/2022] [Indexed: 01/08/2023]
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Stringari LL, Covre LP, da Silva FDC, de Oliveira VL, Campana MC, Hadad DJ, Palaci M, Salgame P, Dietze R, Gomes DCDO, Ribeiro-Rodrigues R. Increase of CD4+CD25highFoxP3+ cells impairs in vitro human microbicidal activity against Mycobacterium tuberculosis during latent and acute pulmonary tuberculosis. PLoS Negl Trop Dis 2021; 15:e0009605. [PMID: 34324509 PMCID: PMC8321116 DOI: 10.1371/journal.pntd.0009605] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 06/29/2021] [Indexed: 11/23/2022] Open
Abstract
Background Regulatory T cells (Tregs) play a critical role during Mycobacterium tuberculosis (Mtb) infection, modulating host responses while neutralizing excessive inflammation. However, their impact on regulating host protective immunity is not completely understood. Here, we demonstrate that Treg cells abrogate the in vitro microbicidal activity against Mtb. Methods We evaluated the in vitro microbicidal activity of peripheral blood mononuclear cells (PBMCs) from patients with active tuberculosis (TB), individuals with latent tuberculosis infection (LTBI, TST+/IGRA+) and healthy control (HC, TST-/IGRA-) volunteers. PBMCs, depleted or not of CD4+CD25+ T-cells, were analyzed to determine frequency and influence on microbicidal activity during in vitro Mtb infection with four clinical isolates (S1, S5, R3, and R6) and one reference strain (H37Rv). Results The frequency of CD4+CD25highFoxP3+ cells were significantly higher in Mtb infected whole blood cultures from both TB patients and LTBI individuals when compared to HC. Data from CD4+CD25+ T-cells depletion demonstrate that increase of CD4+CD25highFoxP3+ is associated with an impairment of Th-1 responses and a diminished in vitro microbicidal activity of LTBI and TB groups. Conclusions Tregs restrict host anti-mycobacterial immunity during active disease and latent infection and thereby may contribute to both disease progression and pathogen persistence. Our immune system has an enormous capacity of recognizing and responding to foreign antigens and, likewise, presents an extremely efficient mechanism of controlling these responses. Here, we investigated how a specific cell type with regulatory abilities can interfere in the immunological response against tuberculosis bacillus. For this, we used blood samples from individuals sensitized with the bacillus and patients with active pulmonary tuberculosis to understand how these cells act and their impact on the host/parasite relationship in the development of the disease. We could observe the negative impact that such regulatory cells cause during the immune response against Mycobacterium tuberculosis, decreasing the control/elimination of the bacillus in asymptomatic individuals and patients with tuberculosis. We also observed a recovery in the immune response when Treg cells were removed during in vitro challenge, restoring the capacity of Mtb clearance. Thus, these regulatory cells, when present, may represent a possible facilitator of the asymptomatic permanence of the bacillus, or even of the development of the disease itself. These data allowed us to see latency and tuberculosis from a new angle and thus postulate new approaches to fight tuberculosis.
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Affiliation(s)
- Lorenzzo Lyrio Stringari
- Núcleo de Doenças Infecciosas, Universidade Federal do Espírito Santo, Vitória, Brazil
- * E-mail: (LLS); (RR-R)
| | - Luciana Polaco Covre
- Núcleo de Doenças Infecciosas, Universidade Federal do Espírito Santo, Vitória, Brazil
| | | | | | | | - David Jamil Hadad
- Núcleo de Doenças Infecciosas, Universidade Federal do Espírito Santo, Vitória, Brazil
| | - Moisés Palaci
- Núcleo de Doenças Infecciosas, Universidade Federal do Espírito Santo, Vitória, Brazil
| | - Padmini Salgame
- Center for Emerging Pathogens, Rutgers-New Jersey Medical School, International Center for Public Health, Newark, New Jersey, United States of America
| | - Reynaldo Dietze
- Núcleo de Doenças Infecciosas, Universidade Federal do Espírito Santo, Vitória, Brazil
- Global Health & Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Daniel Cláudio de Oliveira Gomes
- Núcleo de Doenças Infecciosas, Universidade Federal do Espírito Santo, Vitória, Brazil
- Núcleo de Biotecnologia, Universidade Federal do Espírito Santo, Vitória, Brazil
| | - Rodrigo Ribeiro-Rodrigues
- Núcleo de Doenças Infecciosas, Universidade Federal do Espírito Santo, Vitória, Brazil
- * E-mail: (LLS); (RR-R)
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Jiang H, Cui B, Zhang J. Mycobacterium tuberculosis (MTB) antigen-induced upregulation of interleukin-35 expression in patients with MTB infection: In vitro blockade of the effects of interleukin-35 on T lymphocyte subsets. Pathog Dis 2021; 79:6318859. [PMID: 34245560 DOI: 10.1093/femspd/ftab035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 07/08/2021] [Indexed: 11/14/2022] Open
Abstract
Immunosuppressive interleukin-35 (IL-35) serum concentrations were analyzed in patients with active pulmonary Mycobacterium tuberculosis (MTB) infections (PTB), PTB patients after two months treatment (stable PTB) and healthy controls. IL-35 concentrations were highest in active PTB followed by stable PTB cases and lowest in healthy control participants (all P < 0.01). The same trents were found for supernatants of isolated blood mononuclear cells (PBMCs), with additional enhancements after MTB antigen stimulation only for PBMCs of active and stable PTB patients (P < 0.001), for EBI3 and IL-12a transcriptions in PBMCs (P < 0.001) and percentages of EBI3 expressing (CD4 + CD25 + Foxp3+) regulatory T cells (Treg) (P < 0.001). IL-35 antibody applications significantly reversed MTB antigen stimulated IL-35 and IL-10 expression in PBMCs of active and stable PTB patients, and reduced Foxp3 expression in CD4 + CD25 + cells and EBI3 expression in Treg cells, but had no effects on healthy control cells. The percentages of Th1 and Th17 cells in CD4 + cells were enhanced after MTB antigen stimulation of cells taken from active and stable PTB patients, which were partly increased only for Th1 cells after IL-35 antibody exposure. MTB antigen-driven upregulation of IL-35 may lead to reduced immune surveillance in PTB patients.
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Affiliation(s)
- Hongbin Jiang
- Department of Emergency, Shanghai Pulmonary Hospital, Tongji University School of Medicine, No. 507 Zhengmin Road, Yangpu District, Shanghai 200433, China
| | - Beinian Cui
- Department of Laboratory Medicine, Shanghai DeltaHealth Hospital. No. 109 Xule Road, Xujing Town, Qingpu District, Shanghai 201702, China
| | - Jun Zhang
- Department of Laboratory Medicine, Shanghai DeltaHealth Hospital. No. 109 Xule Road, Xujing Town, Qingpu District, Shanghai 201702, China
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Huaman MA, De Cecco CN, Bittencourt MS, Ticona E, Kityo C, Ballena I, Nalukwago S, Nazzinda R, Ticona C, Azañero R, Zhang B, Farquhar C, Hawn TR, Sterling TR, Fichtenbaum CJ, Longenecker CT. Latent Tuberculosis Infection and Subclinical Coronary Atherosclerosis in Peru and Uganda. Clin Infect Dis 2021; 73:e3384-e3390. [PMID: 33388766 DOI: 10.1093/cid/ciaa1934] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Tuberculosis has been linked to an increased risk of atherosclerotic cardiovascular disease (ASCVD). We assessed whether latent tuberculosis infection (LTBI) is associated with subclinical coronary atherosclerosis in two TB-prevalent areas. METHODS We analyzed cross-sectional data from studies conducted in Lima, Peru, and Kampala, Uganda. Individuals ≥40 years old were included. We excluded persons with known history of ASCVD events or active TB. Participants underwent QuantiFERON®-TB (QFT) testing to define LTBI, and computed tomography angiography to examine coronary atherosclerosis. A Coronary Artery Disease-Reporting Data System (CAD-RADS) score ≥3 defined obstructive CAD (plaque causing ≥50% stenosis). RESULTS 113 persons with LTBI and 91 persons without LTBI were included. There were no significant differences between LTBI and non-LTBI participants in terms of age (median [interquartile range]; 56 [51-62] vs. 55 [49-64], p=0.829), male sex (38% vs. 42%; p=0.519), or 10-year ASCVD risk scores (7.1 [3.2-11.7] vs. 6.1 [2.8-10.8]; p=0.533). CAD prevalence (any plaque) was similar between groups (29% vs. 24%; p=0.421). Obstructive CAD was present in 9% of LTBI and 3% of non-LTBI individuals; p=0.095. LTBI was associated with obstructive CAD after adjusting for ASCVD risk score, HIV status, and study site (adjusted odds ratio, 4.96, 95% CI 1.05-23.44; p=0.043). Quantitative QFT TB antigen minus nil interferon-gamma responses were associated with obstructive CAD (adjusted odds ratio, 1.2, 95% CI 1.03-1.41; p=0.022). CONCLUSIONS LTBI was independently associated with an increased likelihood of subclinical obstructive CAD. Our data indicates that LTBI is a non-traditional correlate of ASCVD risk.
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Affiliation(s)
- Moises A Huaman
- Department of Internal Medicine, Division of Infectious Diseases, University of Cincinnati College of Medicine, Ohio, United States of America
| | - Carlo N De Cecco
- Division of Cardiothoracic Imaging, Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, United States of America
| | | | - Eduardo Ticona
- Hospital Nacional Dos de Mayo, Lima, Peru.,Department of Internal Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Cissy Kityo
- Joint Clinical Research Centre, Kampala, Uganda
| | | | | | | | | | | | - Bin Zhang
- Division of Biostatistics and Epidemiology, Cincinnati Children's Medical Center, Ohio, United States of America
| | - Carey Farquhar
- Departments of Medicine and Global Health, University of Washington School of Medicine, Seattle, United States of America
| | - Thomas R Hawn
- Departments of Medicine and Global Health, University of Washington School of Medicine, Seattle, United States of America
| | - Timothy R Sterling
- Department of Medicine, Division of Infectious Diseases, Vanderbilt University School of Medicine, United States of America
| | - Carl J Fichtenbaum
- Department of Internal Medicine, Division of Infectious Diseases, University of Cincinnati College of Medicine, Ohio, United States of America
| | - Chris T Longenecker
- Harrington Heart & Vascular Institute, Case Western Reserve University School of Medicine, Ohio, United States of America
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Abdelaziz MH, Ji X, Wan J, Abouelnazar FA, Abdelwahab SF, Xu H. Mycobacterium-Induced Th1, Helminths-Induced Th2 Cells and the Potential Vaccine Candidates for Allergic Asthma: Imitation of Natural Infection. Front Immunol 2021; 12:696734. [PMID: 34413850 PMCID: PMC8369065 DOI: 10.3389/fimmu.2021.696734] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Accepted: 07/19/2021] [Indexed: 02/05/2023] Open
Abstract
Bronchial asthma is one of the most chronic pulmonary diseases and major public health problems. In general, asthma prevails in developed countries than developing countries, and its prevalence is increasing in the latter. For instance, the hygiene hypothesis demonstrated that this phenomenon resulted from higher household hygienic standards that decreased the chances of infections, which would subsequently increase the occurrence of allergy. In this review, we attempted to integrate our knowledge with the hygiene hypothesis into beneficial preventive approaches for allergic asthma. Therefore, we highlighted the studies that investigated the correlation between allergic asthma and the two different types of infections that induce the two major antagonizing arms of T cells. This elucidation reflects the association between various types of natural infections and the immune system, which is predicted to support the main objective of the current research on investigating of the benefits of natural infections, regardless their immune pathways for the prevention of allergic asthma. We demonstrated that natural infection with Mycobacterium tuberculosis (Mtb) prevents the development of allergic asthma, thus Bacille Calmette-Guérin (BCG) vaccine is suggested at early age to mediate the same prevention particularly with increasing its efficiency through genetic engineering-based modifications. Likewise, natural helminth infections might inhabit the allergic asthma development. Therefore, helminth-derived proteins at early age are good candidates for designing vaccines for allergic asthma and it requires further investigation. Finally, we recommend imitation of natural infections as a general strategy for preventing allergic asthma that increased dramatically over the past decades.
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Affiliation(s)
- Mohamed Hamed Abdelaziz
- International Genomics Research Center (IGRC), Institute of Immunology, Jiangsu University, Zhenjiang, China
- Department of Microbiology and Immunology, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
| | - Xiaoyun Ji
- International Genomics Research Center (IGRC), Institute of Immunology, Jiangsu University, Zhenjiang, China
| | - Jie Wan
- International Genomics Research Center (IGRC), Institute of Immunology, Jiangsu University, Zhenjiang, China
- Department of Neuroimmunology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
| | - Fatma A. Abouelnazar
- Department of Clinical Laboratory Diagnostics, School of Medicine, Jiangsu University, Zhenjiang, China
| | - Sayed F. Abdelwahab
- Division of Pharmaceutical Microbiology, Department of Pharmaceutics and Industrial Pharmacy, College of Pharmacy, Taif University, Taif, Saudi Arabia
- *Correspondence: Huaxi Xu, ; orcid.org/0000-0002-2568-7393; Sayed F. Abdelwahab, ; ; orcid.org/0000-0002-9636-7485
| | - Huaxi Xu
- International Genomics Research Center (IGRC), Institute of Immunology, Jiangsu University, Zhenjiang, China
- *Correspondence: Huaxi Xu, ; orcid.org/0000-0002-2568-7393; Sayed F. Abdelwahab, ; ; orcid.org/0000-0002-9636-7485
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11
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Sharan R, Bucşan AN, Ganatra S, Paiardini M, Mohan M, Mehra S, Khader SA, Kaushal D. Chronic Immune Activation in TB/HIV Co-infection. Trends Microbiol 2020; 28:619-632. [PMID: 32417227 PMCID: PMC7390597 DOI: 10.1016/j.tim.2020.03.015] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 03/03/2020] [Accepted: 03/25/2020] [Indexed: 12/27/2022]
Abstract
HIV co-infection is the most critical risk factor for the reactivation of latent tuberculosis (TB) infection (LTBI). While CD4+ T cell depletion has been considered the major cause of HIV-induced reactivation of LTBI, recent work in macaques co-infected with Mycobacterium tuberculosis (Mtb)/simian immunodeficiency virus (SIV) suggests that cytopathic effects of SIV resulting in chronic immune activation and dysregulation of T cell homeostasis correlate with reactivation of LTBI. This review builds on compelling data that the reactivation of LTBI during HIV co-infection is likely to be driven by the events of HIV replication and therefore highlights the need to have optimum translational interventions directed at reactivation due to co-infection.
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Affiliation(s)
- Riti Sharan
- Southwest National Primate Research Center, Texas Biomedical Research Institute, San Antonio, TX 78227, USA
| | - Allison N Bucşan
- Department of Microbiology and Immunology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| | - Shashank Ganatra
- Southwest National Primate Research Center, Texas Biomedical Research Institute, San Antonio, TX 78227, USA
| | - Mirko Paiardini
- Yerkes National Primate Research Center, Emory University School of Medicine, Atlanta, GA 30329, USA
| | - Mahesh Mohan
- Southwest National Primate Research Center, Texas Biomedical Research Institute, San Antonio, TX 78227, USA
| | - Smriti Mehra
- Tulane National Primate Research Center, Tulane University School of Medicine, Covington, LA 70433, USA
| | - Shabaana A Khader
- Department of Molecular Microbiology, Washington University in St Louis School of Medicine, St Louis, MO 63110, USA
| | - Deepak Kaushal
- Southwest National Primate Research Center, Texas Biomedical Research Institute, San Antonio, TX 78227, USA.
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12
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LaVergne S, Umlauf A, McCutchan A, Heaton R, Benson C, Kumarasamy N, Bharti AR. Impact of Latent Tuberculosis Infection on Neurocognitive Functioning and Inflammation in HIV-Infected and Uninfected South Indians. J Acquir Immune Defic Syndr 2020; 84:430-436. [PMID: 32282443 PMCID: PMC7321856 DOI: 10.1097/qai.0000000000002368] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND HIV-associated neurocognitive disorder persists in some people living with HIV despite optimal antiretroviral therapy. Latent tuberculosis infection (LTBI) may cause systemic inflammation and immune activation that may impair brain function. We assessed cognition and biomarkers of inflammation in both HIV+ and HIV- South Indians with and without LTBI. METHODS Adults (≥18 years old) with and without HIV infection were screened for LTBI by interferon-gamma release assays, completed comprehensive neurocognitive assessments, and underwent measurement of serum inflammatory biomarker levels. RESULTS The participants (n = 119) were HIV+/LTBI+ (n = 15), HIV+/LTBI- (n = 50), HIV-/LTBI+ (n = 26), and HIV-/LTBI- (n = 28). HIV+ participants, regardless of LTBI status, had more impaired global deficit scores than HIV- participants (odds ratio = 3.42, P = 0.028, adjusted for sex and education differences). Neither global deficit scores nor impairment rates differed in the LTBI+ group compared with the LTBI- group (P = 0.79 and P = 0.41, respectively). The mean log10 interleukin (IL)-6 and monocyte chemoattractant protein-1 values were significantly higher and high sensitivity C-reactive protein lower in the LTBI+ group than the LTBI- group (P = 0.044, 0.023, and 0.03, respectively, adjusting for HIV status and sex). CONCLUSIONS In this cross-sectional study of South Indians, HIV infection, but not LTBI, was associated with increased neurocognitive impairment. Proinflammatory biomarkers (IL-6 and monocyte chemoattractant protein-1, but not tumor necrosis factor-α) were elevated in the LTBI+ groups compared with the LTBI- groups. Biomarkers of immune activation (interferon-γ, macrophage inflammatory protein-1β, IL-2, interferon gamma inducible protein-10, RANTES, and IL-22) did not differ between these groups. Larger longitudinal studies should be conducted to confirm our findings that the effect of LTBI on systemic inflammation or neurocognitive impairment is likely small.
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Affiliation(s)
- Stephanie LaVergne
- Department of Medicine and Psychiatry, University of California, San Diego, CA, USA, Infectious Diseases Medical Centre, Voluntary Health Services (VHS), Chennai, India
| | - Anya Umlauf
- Department of Medicine and Psychiatry, University of California, San Diego, CA, USA, Infectious Diseases Medical Centre, Voluntary Health Services (VHS), Chennai, India
| | - Allen McCutchan
- Department of Medicine and Psychiatry, University of California, San Diego, CA, USA, Infectious Diseases Medical Centre, Voluntary Health Services (VHS), Chennai, India
| | - Robert Heaton
- Department of Medicine and Psychiatry, University of California, San Diego, CA, USA, Infectious Diseases Medical Centre, Voluntary Health Services (VHS), Chennai, India
| | - Constance Benson
- Department of Medicine and Psychiatry, University of California, San Diego, CA, USA, Infectious Diseases Medical Centre, Voluntary Health Services (VHS), Chennai, India
| | - Nagalingeswaran Kumarasamy
- CART Clinical Research Site, Infectious Diseases Medical Centre, Voluntary Health Services (VHS), Chennai, India
| | - Ajay R. Bharti
- Department of Medicine and Psychiatry, University of California, San Diego, CA, USA, Infectious Diseases Medical Centre, Voluntary Health Services (VHS), Chennai, India
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13
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Keikha M, Soleimanpour S, Eslami M, Yousefi B, Karbalaei M. The mystery of tuberculosis pathogenesis from the perspective of T regulatory cells. Meta Gene 2020. [DOI: 10.1016/j.mgene.2019.100632] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
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14
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Cardona P, Cardona PJ. Regulatory T Cells in Mycobacterium tuberculosis Infection. Front Immunol 2019; 10:2139. [PMID: 31572365 PMCID: PMC6749097 DOI: 10.3389/fimmu.2019.02139] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 08/27/2019] [Indexed: 12/11/2022] Open
Abstract
Anti-inflammatory regulatory T cells have lately attracted attention as part of the immune response to Mycobacterium tuberculosis infection, where they counterbalance the protective but pro-inflammatory immune response mediated by Th17 cells and especially by the better-known Th1 cells. In chronic infectious diseases there is a delicate balance between pro- and anti-inflammatory responses. While Th1 and Th17 are needed in order to control infection by Mycobacterium tuberculosis, the inflammatory onset can ultimately become detrimental for the host. In this review, we assess current information on the controversy over whether counterbalancing regulatory T cells are promoting pathogen growth or protecting the host.
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Affiliation(s)
- Paula Cardona
- Unitat de Tuberculosi Experimental, Fundació Institut Germans Trias i Pujol, CIBER Enfermedades Respiratorias, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Pere-Joan Cardona
- Unitat de Tuberculosi Experimental, Fundació Institut Germans Trias i Pujol, CIBER Enfermedades Respiratorias, Universitat Autònoma de Barcelona, Badalona, Spain
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15
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Zhang Z, Liu Y, Wang W, Xing Y, Jiang N, Zhang H, Zhang H, He L, Yue W, Jiang L, Wang K. Identification of Differentially Expressed Genes Associated with Lymph Node Tuberculosis by the Bioinformatic Analysis Based on a Microarray. J Comput Biol 2019; 27:121-130. [PMID: 31460784 DOI: 10.1089/cmb.2019.0161] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
To identify candidate key genes and pathways associated with lymph node tuberculosis (LNTB) and reveal the potential molecular mechanisms of LNTB development. Gene expression profile of GSE63548 was downloaded from the Gene Expression Omnibus (GEO) database. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichments of differentially expressed genes (DEGs) were analyzed by DAVID, and the protein-protein interaction (PPI) network was performed from STRING database. Furthermore, Cytoscape was used to integrate the network of transcription factor (TF) target and miRNA target. A total of 239 DEGs were screened out. Based on the DEGs, a miRNA of hsa-miR-4536 and 28 TFs, such as GATA1, JUND, NR2F1, POU1F1, and RELB, were obtained. Pathway enrichment analyses revealed that DEGs were mainly enriched in the pathways of regulation of lipolysis in adipocytes, vascular smooth muscle contraction, fat digestion and absorption, NOD-like receptor, and TNF signaling pathway. Furthermore, 53 nodes and 241 interactions were identified in the PPI network. In addition, the integrated regulatory network showed that CXCL9, CD36, LEP, ACACB, ALDH1A3, GPX3, STAT1, and LPL were the target genes of hsa-miR-4536. This study revealed the candidate key genes and pathways that are involved in the pathogenesis of LNTB, which will provide potential therapeutic targets for the treatment of LNTB.
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Affiliation(s)
- Zhenan Zhang
- Department of Surgery, Infectious Disease Hospital of Heilongjiang Province, Harbin, China
| | - Yuqin Liu
- Department of Internal Medicine, Infectious Disease Hospital of Heilongjiang Province, Harbin, China
| | - Wei Wang
- Department of Surgery, Infectious Disease Hospital of Heilongjiang Province, Harbin, China
| | - Yue Xing
- Department of Internal Medicine, Infectious Disease Hospital of Heilongjiang Province, Harbin, China
| | - Nanyang Jiang
- Department of Surgery, Infectious Disease Hospital of Heilongjiang Province, Harbin, China
| | - Hongrui Zhang
- Department of Anesthesiology, and Infectious Disease Hospital of Heilongjiang Province, Harbin, China
| | - Hanwen Zhang
- Department of Critical Care Medicine, Infectious Disease Hospital of Heilongjiang Province, Harbin, China
| | - Lei He
- Department of Surgery, Infectious Disease Hospital of Heilongjiang Province, Harbin, China
| | - Wei Yue
- Department of Surgery, Infectious Disease Hospital of Heilongjiang Province, Harbin, China
| | - Lianju Jiang
- Department of Surgery, Infectious Disease Hospital of Heilongjiang Province, Harbin, China
| | - Kaili Wang
- Department of Surgery, Infectious Disease Hospital of Heilongjiang Province, Harbin, China
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16
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Sahmoudi K, Abbassi H, Bouklata N, El Alami MN, Sadak A, Burant C, Henry Boom W, El Aouad R, Canaday DH, Seghrouchni F. Immune activation and regulatory T cells in Mycobacterium tuberculosis infected lymph nodes. BMC Immunol 2018; 19:33. [PMID: 30409122 PMCID: PMC6225640 DOI: 10.1186/s12865-018-0266-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 10/11/2018] [Indexed: 11/26/2022] Open
Abstract
Background Lymph node tuberculosis (LNTB) is the most frequent extrapulmonary form of tuberculosis (TB). Studies of human tuberculosis at sites of disease are limited. LNTB provides a unique opportunity to compare local in situ and peripheral blood immune response in active Mycobacterium tuberculosis (Mtb) disease. The present study analysed T regulatory cells (Treg) frequency and activation along with CD4+ T cell function in lymph nodes from LNTB patients. Results Lymph node mononuclear cells (LNMC) were compared to autologous peripheral blood mononuclear cells (PBMC). LNMC were enriched for CD4+ T cells with a late differentiated effector memory phenotype. No differences were noted in the frequency and mutifunctional profile of memory CD4+ T cells specific for Mtb. The proportion of activated CD4+ and Tregs in LNMC was increased compared to PBMC. The correlation between Tregs and activated CD4+ T cells was stronger in LNMC than PBMC. Tregs in LNMC showed a strong positive correlation with Th1 cytokine production (IL2, IFNγ and TNFα) as well as MIP-1α after Mtb antigen stimulation. A subset of Tregs in LNMC co-expressed HLA-DR and CD38, markers of activation. Conclusion Further research will determine the functional relationship between Treg and activated CD4+ T cells at lymph node sites of Mtb infection. Electronic supplementary material The online version of this article (10.1186/s12865-018-0266-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Karima Sahmoudi
- Laboratory of Cellular Immunology, National Institute of Hygiene, 27, Avenue Ibn Batouta, PB 769, 11400, Rabat, Morocco.,Faculty of Sciences, University Mohammed V Agdal, Rabat, Morocco
| | - Hassan Abbassi
- Department of ENT, Maxillo- facial, Reconstructive and Plastic Surgery, University Hospital Hassan II, Fes, Morocco
| | - Nada Bouklata
- National Reference Laboratory of Mycobacteriology, the National Institute of Hygiene, Rabat, Morocco
| | - Mohamed Nouredine El Alami
- Department of ENT, Maxillo- facial, Reconstructive and Plastic Surgery, University Hospital Hassan II, Fes, Morocco
| | | | | | - W Henry Boom
- TB Research Unit and Division of Infectious Diseases, Case Western Reserve University, University Hospitals of Cleveland and Cleveland VA, Cleveland, OH, USA
| | - Rajae El Aouad
- Laboratory of Cellular Immunology, National Institute of Hygiene, 27, Avenue Ibn Batouta, PB 769, 11400, Rabat, Morocco
| | - David H Canaday
- TB Research Unit and Division of Infectious Diseases, Case Western Reserve University, University Hospitals of Cleveland and Cleveland VA, Cleveland, OH, USA
| | - Fouad Seghrouchni
- Laboratory of Cellular Immunology, National Institute of Hygiene, 27, Avenue Ibn Batouta, PB 769, 11400, Rabat, Morocco.
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17
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Ferrian S, Ross M, Conradie F, Vally Omar S, Ismail N, Little F, Kaplan G, Fallows D, Gray CM. Frequency of Circulating CD4 +Ki67 +HLA-DR - T Regulatory Cells Prior to Treatment for Multidrug Resistant Tuberculosis Can Differentiate the Severity of Disease and Predict Time to Culture Conversion. Front Immunol 2018; 9:2438. [PMID: 30410488 PMCID: PMC6209685 DOI: 10.3389/fimmu.2018.02438] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Accepted: 10/02/2018] [Indexed: 12/13/2022] Open
Abstract
Identifying a blood circulating cellular biomarker that can be used to assess severity of disease and predict the time to culture conversion (TCC) in patients with multidrug resistant tuberculosis (MDR-TB) would facilitate monitoring response to treatment and may be of value in the design of future drug trials. We report on the frequency of blood Ki67+HLA-DR- CD4+ T regulatory (Treg) cells in predicting microbiological outcome before initiating second-line treatment for MDR-TB. Fifty-one patients with MDR-TB were enrolled and followed over 18 months; a subset of patients was sputum culture (SC) negative at baseline (n = 9). SC positive patients were divided into two groups, based on median TCC: rapid responders (≤71 days TCC; n = 21) and slow responders (>71 days TCC; n = 21). Whole blood at baseline, months 2 and 6 was stimulated with M tuberculosis (Mtb) antigens and Treg cells were then identified as CD3+CD4+CD25hiFoxP3+CD127-CD69- and further delineated as Ki67+HLA-DR- Treg. The frequency of these cells was significantly enlarged at baseline in SC positive relative to SC negative and smear positive relative to smear negative patients and in those with lung cavitation. This difference was further supported by unsupervised hierarchical clustering showing a significant grouping at baseline of total and early differentiated memory Treg cells in slow responders. Conversely, there was a clustering of a lower proportion of Treg cells and activated IFNγ-expressing T cells at baseline in the rapid responders. Examining changes over time revealed a more gradual reduction of Treg cells in slow responders relative to rapid responders to treatment. Receiver operating curve analysis showed that baseline Mtb-stimulated Ki67+HLA-DR- Treg cells could predict the TCC of MDR-TB treatment response with 81.2% sensitivity and 85% specificity (AUC of 0.87, p < 0.0001), but this was not the case after 2 months of treatment. In conclusion, our data show that the frequency of a highly defined Mtb-stimulated blood Treg cell population at baseline can discriminate MDR-TB disease severity and predict time to culture clearance.
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Affiliation(s)
- Selena Ferrian
- Division of Immunology, Department of Pathology, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - Melinda Ross
- Department of Statistical Sciences, University of Cape Town, Cape Town, South Africa
| | - Francesca Conradie
- Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Shaheed Vally Omar
- Centre for Tuberculosis, National Institute of Communicable Diseases, Johannesburg, South Africa
| | - Nazir Ismail
- Centre for Tuberculosis, National Institute of Communicable Diseases, Johannesburg, South Africa.,Department of Medical Microbiology, University of Pretoria, Pretoria, South Africa
| | - Francesca Little
- Department of Statistical Sciences, University of Cape Town, Cape Town, South Africa
| | - Gilla Kaplan
- Public Health Research Institute, Rutgers University, Newark, NJ, United States
| | - Dorothy Fallows
- Public Health Research Institute, Rutgers University, Newark, NJ, United States
| | - Clive M Gray
- Division of Immunology, Department of Pathology, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa.,National Health Laboratory Services, Cape Town, South Africa
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18
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Ahmed A, Adiga V, Nayak S, Uday Kumar JAJ, Dhar C, Sahoo PN, Sundararaj BK, Souza GD, Vyakarnam A. Circulating HLA-DR+CD4+ effector memory T cells resistant to CCR5 and PD-L1 mediated suppression compromise regulatory T cell function in tuberculosis. PLoS Pathog 2018; 14:e1007289. [PMID: 30231065 PMCID: PMC6166982 DOI: 10.1371/journal.ppat.1007289] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 10/01/2018] [Accepted: 08/22/2018] [Indexed: 12/13/2022] Open
Abstract
Chronic T cell activation is a hallmark of pulmonary tuberculosis (PTB). The mechanisms underpinning this important phenomenon are however, poorly elucidated, though known to rely on control of T effector cells (Teff) by regulatory T cells (Treg). Our studies show that circulating natural Treg cells in adults with PTB preserve their suppressive potential but Teff cells from such subjects are resistant to Treg-mediated suppression. We found this to be due to expansion of an activated Teff subset identified by Human Leukocyte Antigen (HLA)-DR expression. Sensitivity to suppression was restored to control levels by depletion of this subset. Comparative transcriptome analysis of Teff cells that contain HLA-DR+ cells versus the fraction depleted of this population identified putative resistance mechanisms linked to IFNG, IL17A, IL22, PD-L1 and β-chemokines CCL3L3, CCL4 expression. Antibody blocking experiments confirmed HLA-DR+ Teff cells, but not the fraction depleted of HLA-DR+ effectors, to be resistant to Treg suppression mediated via CCR5 and PD-L1 associated pathways. In the presence of HLA-DR+ Teff cells, activation of NFκB downstream of CCR5 and PD-L1 was perturbed. In addition, HLA-DR+ Teff cells expressed significantly higher levels of Th1/Th17 cytokines that may regulate Treg function through a reciprocal counter-balancing relationship. Taken together, our study provides novel insight on how activated HLA-DR+CD4+ T cells may contribute to disease associated inflammation by compromising Treg-mediated suppression in PTB. An important marker of progression to PTB following Mycobacterium tuberculosis (Mtb) infection in humans is elevated frequencies of HLA-DR+CD4+ T cells, reflecting chronic T cell activation. However, the mechanisms by which activated HLA-DR+CD4+ T cells contribute to disease process is not known. We show that CD25- HLA-DR+CD4+ memory Teff from PTB patients are resistant to suppression mediated by Treg cells. An unbiased transcriptome analysis identified several key pathways that contribute to this resistance. Specifically, presence of HLA-DR+CD4+ T cells renders the effector population resistant to CCR5 and PD-L1 mediated suppression by Treg cells. In addition, the HLA-DR+CD4+ memory Teff cells express elevated levels of Th1/Th17 cytokines known to counter-regulate and dampen Treg suppression. These findings provide fresh insight to disease process in TB and identify HLA-DR+ Teff resistant to Treg suppression as a potential functional marker of disease.
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Affiliation(s)
- Asma Ahmed
- Laboratory of Immunology of HIV-TB co-infection, Centre for Infectious Disease Research, Indian Institute of Science, Bangalore, India
| | - Vasista Adiga
- Laboratory of Immunology of HIV-TB co-infection, Centre for Infectious Disease Research, Indian Institute of Science, Bangalore, India
| | - Soumya Nayak
- Laboratory of Immunology of HIV-TB co-infection, Centre for Infectious Disease Research, Indian Institute of Science, Bangalore, India
| | | | - Chirag Dhar
- Division of Infectious Diseases, St John’s Research Institute, Bangalore, India
| | - Pravat Nalini Sahoo
- Laboratory of Immunology of HIV-TB co-infection, Centre for Infectious Disease Research, Indian Institute of Science, Bangalore, India
| | - Bharath K. Sundararaj
- Laboratory of Immunology of HIV-TB co-infection, Centre for Infectious Disease Research, Indian Institute of Science, Bangalore, India
| | - George D. Souza
- Dept. of Pulmonary Medicine & Division of Infectious Diseases, St John’s Research Institute, Bangalore, India
| | - Annapurna Vyakarnam
- Laboratory of Immunology of HIV-TB co-infection, Centre for Infectious Disease Research, Indian Institute of Science, Bangalore, India
- Department of Infectious Diseases, King’s College London, London, School of Immunology & Microbial Sciences, Faculty of Life Sciences & Medicine, Guy's Campus, London, United Kingdom
- * E-mail: ,
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19
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Huaman MA, Ticona E, Miranda G, Kryscio RJ, Mugruza R, Aranda E, Rondan PL, Henson D, Ticona C, Sterling TR, Fichtenbaum CJ, Garvy BA. The Relationship Between Latent Tuberculosis Infection and Acute Myocardial Infarction. Clin Infect Dis 2018; 66:886-892. [PMID: 29069328 PMCID: PMC5850031 DOI: 10.1093/cid/cix910] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 10/19/2017] [Indexed: 01/04/2023] Open
Abstract
Background Tuberculosis has been associated with an increased risk of cardiovascular disease (CVD), including acute myocardial infarction (AMI). We investigated whether latent tuberculosis infection (LTBI) is associated with AMI. Methods We conducted a case-control study in 2 large national public hospital networks in Lima, Peru, between July 2015 and March 2017. Case patients were patients with a first time diagnosis of type 1 (spontaneous) AMI. Controls were patients without a history of AMI. We excluded patients with known human immunodeficiency virus infection, tuberculosis disease, or prior LTBI treatment. We used the QuantiFERON-TB Gold In-Tube assay to identify LTBI. We used logistic regression modeling to estimate the odds ratio (OR) of LTBI in AMI case patients versus non-AMI controls. Results We enrolled 105 AMI case patients and 110 non-AMI controls during the study period. Overall, the median age was 62 years (interquartile range, 56-70 years); 69% of patients were male; 64% had hypertension, 40% dyslipidemia, and 39% diabetes mellitus; 30% used tobacco; and 24% were obese. AMI case patients were more likely than controls to be male (80% vs 59%; P < .01) and tobacco users (41% vs 20%; P < .01). LTBI was more frequent in AMI case patients than in controls (64% vs 49% [P = .03]; OR, 1.86; 95% confidence interval [CI], 1.08-3.22). After adjustment for age, sex, hypertension, dyslipidemia, diabetes mellitus, tobacco use, obesity, and family history of coronary artery disease, LTBI remained independently associated with AMI (adjusted OR, 1.90; 95% CI, 1.05-3.45). Conclusions LTBI was independently associated with AMI. Our results suggest a potentially important role of LTBI in CVD.
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Affiliation(s)
- Moises A Huaman
- Department of Internal Medicine, Division of Infectious Diseases, University of Cincinnati College of Medicine, Ohio
- Department of Medicine, Division of Infectious Diseases, University of Kentucky College of Medicine, Lexington
| | - Eduardo Ticona
- Department of Infectious Diseases and Tropical Medicine, Hospital Nacional Dos de Mayo
- Department of Internal Medicine, Universidad Nacional Mayor de San Marcos
| | - Gustavo Miranda
- Department of Cardiology, Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru
| | - Richard J Kryscio
- Departments of Biostatistics and Statistics, University of Kentucky Colleges of Public Health and Arts & Sciences, Lexington
| | - Raquel Mugruza
- Department of Infectious Diseases and Tropical Medicine, Hospital Nacional Dos de Mayo
| | - Ernesto Aranda
- Department of Cardiology, Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru
- Department of Internal Medicine, Division of Infectious Diseases, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Paola L Rondan
- Department of Infectious Diseases and Tropical Medicine, Hospital Nacional Dos de Mayo
| | - David Henson
- Department of Medicine, Division of Infectious Diseases, University of Kentucky College of Medicine, Lexington
| | - Cesar Ticona
- Department of Infectious Diseases and Tropical Medicine, Hospital Nacional Dos de Mayo
| | - Timothy R Sterling
- Department of Medicine, Division of Infectious Diseases, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Carl J Fichtenbaum
- Department of Internal Medicine, Division of Infectious Diseases, University of Cincinnati College of Medicine, Ohio
| | - Beth A Garvy
- Department of Medicine, Division of Infectious Diseases, University of Kentucky College of Medicine, Lexington
- Department of Microbiology, Immunology and Molecular Genetics, University of Kentucky College of Medicine, Lexington
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IFN-γ decreased the suppressive function of CD33+HLA-DRlow myeloid cells through down-regulation of PD-1/PD-L2 signaling pathway. Mol Immunol 2018; 94:107-120. [DOI: 10.1016/j.molimm.2017.10.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 09/11/2017] [Accepted: 10/11/2017] [Indexed: 11/21/2022]
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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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Immune Activation by Mycobacterium tuberculosis in HIV-Infected and -Uninfected Subjects. J Acquir Immune Defic Syndr 2017; 74:103-111. [PMID: 27532475 DOI: 10.1097/qai.0000000000001157] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
INTRODUCTION This study investigates the influence of Mycobacterium tuberculosis infection on immune activation biomarkers, both in HIV-infected and -uninfected subjects. METHODS Forty-eight treatment-naive HIV-infected patients and 74 HIV-uninfected subjects were recruited and divided into groups according to their M. tuberculosis infection status: latent tuberculosis infection (LTBI), active tuberculosis (TB), and no evidence of M. tuberculosis infection. The expression of cellular markers CD38 and HLA-DR on circulating CD8 T lymphocytes and the plasmatic levels of soluble markers interleukin-6, sCD14, and D-Dimer were measured and compared between groups. The HIV-infected patients with no evidence of M. tuberculosis or with LTBI who initiated antiretroviral treatment were tested again for these biomarkers once viral suppression was reached. RESULTS In both HIV-infected and -uninfected groups, patients with TB had higher levels of immune activation markers than subjects with LTBI and with no evidence of M. tuberculosis. Among the HIV-uninfected subjects, no significant difference in biomarker level was found between those presenting LTBI and those with no evidence of M. tuberculosis. The effect of LTBI on activation biomarkers in the HIV-infected groups was inconclusive because of the small number of individuals in the HIV+/LTBI group. sCD14 and D-Dimer levels were significantly higher in the TB-only group than in the HIV-only group. DISCUSSION Although TB is associated with an increase in biomarkers of immune activation, the effect of LTBI is less evident. Further investigation is warranted, and according to our results, soluble markers may offer greater sensitivity for the evaluation of M. tuberculosis-associated immune activation than cellular markers.
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Feruglio SL, Kvale D, Dyrhol-Riise AM. T Cell Responses and Regulation and the Impact of In Vitro IL-10 and TGF-β Modulation During Treatment of Active Tuberculosis. Scand J Immunol 2017; 85:138-146. [PMID: 27862137 DOI: 10.1111/sji.12511] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2016] [Accepted: 11/14/2016] [Indexed: 01/20/2023]
Abstract
Mycobacterium tuberculosis (Mtb) is particularly challenging for the immune system being an intracellular pathogen, and a variety of T cell subpopulations are activated by the host defence mechanism. In this study, we investigated T cell responses and regulation in active TB patients with drug-sensitive Mtb (N = 18) during 24 weeks of efficient anti-TB therapy. T cell activation, differentiation, regulatory T cell (Treg) subsets, Mtb-induced T cell proliferation and in vitro IL-10 and TGF-β modulation were analysed by flow cytometry at baseline and after 8 and 24 weeks of therapy, while soluble cytokines in culture supernatants were analysed by a 9-plex Luminex assay. Successful treatment resulted in significantly reduced co-expression of HLA-DR/CD38 and PD-1/CD38 on both CD4+ and CD8+ T cells, while the fraction of CD4+ CD25high CD127low Tregs (P = 0.017) and CD4+ CD25high CD127low CD147+ Tregs (P = 0.029) showed significant transient increase at week 8. In vitro blockade of IL-10/TGF-β upon Mtb antigen stimulation significantly lowered the fraction of ESAT-6-specific CD4+ CD25high CD127low Tregs at baseline (P = 0.047), while T cell proliferation and cytokine production were unaffected. Phenotypical and Mtb-specific T cell signatures may serve as markers of effective therapy, while the IL-10/TGF-β pathway could be a target for early inhibition to facilitate Mtb clearance. However, larger clinical studies are needed for verification before concluding.
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Affiliation(s)
- S L Feruglio
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Norwegian Institute of Public Health, Oslo, Norway
| | - D Kvale
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Infectious Diseases, Oslo University Hospital, Oslo, Norway.,K. G. Jebsen Inflammation Research Center, University of Oslo, Oslo, Norway
| | - A M Dyrhol-Riise
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Infectious Diseases, Oslo University Hospital, Oslo, Norway.,K. G. Jebsen Inflammation Research Center, University of Oslo, Oslo, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway
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Jayashankar L, Hafner R. Adjunct Strategies for Tuberculosis Vaccines: Modulating Key Immune Cell Regulatory Mechanisms to Potentiate Vaccination. Front Immunol 2016; 7:577. [PMID: 28018344 PMCID: PMC5159487 DOI: 10.3389/fimmu.2016.00577] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 11/23/2016] [Indexed: 12/22/2022] Open
Abstract
Tuberculosis (TB) remains a global health threat of alarming proportions, resulting in 1.5 million deaths worldwide. The only available licensed vaccine, Bacillus Calmette–Guérin, does not confer lifelong protection against active TB. To date, development of an effective vaccine against TB has proven to be elusive, and devising newer approaches for improved vaccination outcomes is an essential goal. Insights gained over the last several years have revealed multiple mechanisms of immune manipulation by Mycobacterium tuberculosis (Mtb) in infected macrophages and dendritic cells that support disease progression and block development of protective immunity. This review provides an assessment of the known immunoregulatory mechanisms altered by Mtb, and how new interventions may reverse these effects. Examples include blocking of inhibitory immune cell coreceptor checkpoints (e.g., programed death-1). Conversely, immune mechanisms that strengthen immune cell effector functions may be enhanced by interventions, including stimulatory immune cell coreceptors (e.g., OX40). Modification of the activity of key cell “immunometabolism” signaling pathway molecules, including mechanistic target of rapamycin, glycogen synthase kinase-3β, wnt/β-catenin, adenosine monophosophate-activated protein kinase, and sirtuins, related epigenetic changes, and preventing induction of immune regulatory cells (e.g., regulatory T cells, myeloid-derived suppressor cells) are powerful new approaches to improve vaccine responses. Interventions to favorably modulate these components have been studied primarily in oncology to induce efficient antitumor immune responses, often by potentiation of cancer vaccines. These agents include antibodies and a rapidly increasing number of small molecule drug classes that have contributed to the dramatic immune-based advances in treatment of cancer and other diseases. Because immune responses to malignancies and to Mtb share many similar mechanisms, studies to improve TB vaccine responses using interventions based on “immuno-oncology” are needed to guide possible repurposing. Understanding the regulation of immune cell functions appropriated by Mtb to promote the imbalance between protective and pathogenic immune responses may guide the development of innovative drug-based adjunct approaches to substantially enhance the clinical efficacy of TB vaccines.
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Affiliation(s)
- Lakshmi Jayashankar
- Columbus Technologies, Inc., Contractor to the National Institute of Allergy and Infectious Diseases, National Institutes of Health , Bethesda, MD , USA
| | - Richard Hafner
- Division of AIDS, National Institute of Allergy and Infectious Diseases, National Institutes of Health , Bethesda, MD , USA
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25
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Huaman MA, Deepe GS, Fichtenbaum CJ. Elevated Circulating Concentrations of Interferon-Gamma in Latent Tuberculosis Infection. Pathog Immun 2016; 1:291-303. [PMID: 27853753 PMCID: PMC5108047 DOI: 10.20411/pai.v1i2.149] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Latent tuberculosis infection (LTBI) has been associated with increased immune activation. We assessed circulating concentrations of interferon-gamma in persons with LTBI. METHODS We used the 2011-2012 National Health Nutritional Examination Survey (NHANES) to identify adults with and without LTBI by QuantiFERON®-TB Gold In-Tube (QFT) results. Non-LTBI persons were 1:1 age-, gender-, and race-matched to LTBI persons using propensity scores. We compared the plasma concentrations of interferon-gamma measured from the unstimulated, negative control QFT tube between LTBI and non-LTBI persons. We used Mann-Whitney tests and ordered logistic regressions for comparisons. RESULTS There were 430 LTBI and 430 non-LTBI matched persons included in the analysis. LTBI was associated with higher circulating concentrations of interferon-gamma (median, 3 pg/mL; IQR, 2 - 5) compared to non-LTBI (median, 2.5 pg/mL; IQR, 1.5 - 3.5); P < 0.001. LTBI remained associated with higher interferon-gamma concentrations after adjusting for age, gender, race, diabetes, hypertension, tobacco use, HIV status, body mass index, lipid profile, and lymphocyte count (odds ratio, 1.79, 95% CI, 1.26 - 2.53). Results remained similar when tuberculin skin testing defined LTBI. CONCLUSIONS LTBI was associated with increased circulating interferon-gamma concentrations. Future studies are needed to further characterize immune activation in LTBI and its potential long-term consequences.
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Affiliation(s)
- Moises A. Huaman
- Division of Infectious Diseases, Department of Internal Medicine, University of Cincinnati, Cincinnati, Ohio
| | - George S. Deepe
- Division of Infectious Diseases, Department of Internal Medicine, University of Cincinnati, Cincinnati, Ohio
| | - Carl J. Fichtenbaum
- Division of Infectious Diseases, Department of Internal Medicine, University of Cincinnati, Cincinnati, Ohio
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26
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Fletcher HA, Snowden MA, Landry B, Rida W, Satti I, Harris SA, Matsumiya M, Tanner R, O'Shea MK, Dheenadhayalan V, Bogardus L, Stockdale L, Marsay L, Chomka A, Harrington-Kandt R, Manjaly-Thomas ZR, Naranbhai V, Stylianou E, Darboe F, Penn-Nicholson A, Nemes E, Hatherill M, Hussey G, Mahomed H, Tameris M, McClain JB, Evans TG, Hanekom WA, Scriba TJ, McShane H. T-cell activation is an immune correlate of risk in BCG vaccinated infants. Nat Commun 2016; 7:11290. [PMID: 27068708 PMCID: PMC4832066 DOI: 10.1038/ncomms11290] [Citation(s) in RCA: 179] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 02/22/2016] [Indexed: 01/23/2023] Open
Abstract
Vaccines to protect against tuberculosis (TB) are urgently needed. We performed a case-control analysis to identify immune correlates of TB disease risk in Bacille Calmette-Guerin (BCG) immunized infants from the MVA85A efficacy trial. Among 53 TB case infants and 205 matched controls, the frequency of activated HLA-DR(+) CD4(+) T cells associates with increased TB disease risk (OR=1.828, 95% CI=1.25-2.68, P=0.002, FDR=0.04, conditional logistic regression). In an independent study of Mycobacterium tuberculosis-infected adolescents, activated HLA-DR(+) CD4(+) T cells also associate with increased TB disease risk (OR=1.387, 95% CI=1.068-1.801, P=0.014, conditional logistic regression). In infants, BCG-specific T cells secreting IFN-γ associate with reduced risk of TB (OR=0.502, 95% CI=0.29-0.86, P=0.013, FDR=0.14). The causes and impact of T-cell activation on disease risk should be considered when designing and testing TB vaccine candidates for these populations.
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Affiliation(s)
- Helen A. Fletcher
- Jenner Institute, Nuffield Department of Medicine, University of Oxford, Oxford OX3 7DQ, UK
- Department of Immunology and Infection, London School of Hygiene and Tropical Medicine, London W1CE7HT, UK
| | | | | | - Wasima Rida
- Biostatistics Consultant, 1129 N. Illinois Street, Arlington, Virginia 22205, USA
| | - Iman Satti
- Jenner Institute, Nuffield Department of Medicine, University of Oxford, Oxford OX3 7DQ, UK
| | - Stephanie A. Harris
- Jenner Institute, Nuffield Department of Medicine, University of Oxford, Oxford OX3 7DQ, UK
| | - Magali Matsumiya
- Jenner Institute, Nuffield Department of Medicine, University of Oxford, Oxford OX3 7DQ, UK
| | - Rachel Tanner
- Jenner Institute, Nuffield Department of Medicine, University of Oxford, Oxford OX3 7DQ, UK
| | - Matthew K. O'Shea
- Jenner Institute, Nuffield Department of Medicine, University of Oxford, Oxford OX3 7DQ, UK
| | | | | | - Lisa Stockdale
- Jenner Institute, Nuffield Department of Medicine, University of Oxford, Oxford OX3 7DQ, UK
- Department of Immunology and Infection, London School of Hygiene and Tropical Medicine, London W1CE7HT, UK
| | - Leanne Marsay
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford OX3 7LE, UK
| | - Agnieszka Chomka
- Kennedy Institute, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford OX3 7LF, UK
| | | | | | - Vivek Naranbhai
- Wellcome Trust Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford OX37BN, UK
| | - Elena Stylianou
- Jenner Institute, Nuffield Department of Medicine, University of Oxford, Oxford OX3 7DQ, UK
| | - Fatoumatta Darboe
- South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine, Department of Paediatrics and Child Health, University of Cape Town, Cape Town 7935, South Africa
| | - Adam Penn-Nicholson
- South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine, Department of Paediatrics and Child Health, University of Cape Town, Cape Town 7935, South Africa
| | - Elisa Nemes
- South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine, Department of Paediatrics and Child Health, University of Cape Town, Cape Town 7935, South Africa
| | - Mark Hatherill
- South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine, Department of Paediatrics and Child Health, University of Cape Town, Cape Town 7935, South Africa
| | - Gregory Hussey
- South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine, Department of Paediatrics and Child Health, University of Cape Town, Cape Town 7935, South Africa
| | - Hassan Mahomed
- South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine, Department of Paediatrics and Child Health, University of Cape Town, Cape Town 7935, South Africa
| | - Michele Tameris
- South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine, Department of Paediatrics and Child Health, University of Cape Town, Cape Town 7935, South Africa
| | | | | | - Willem A. Hanekom
- South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine, Department of Paediatrics and Child Health, University of Cape Town, Cape Town 7935, South Africa
| | - Thomas J. Scriba
- South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine, Department of Paediatrics and Child Health, University of Cape Town, Cape Town 7935, South Africa
| | - Helen McShane
- Jenner Institute, Nuffield Department of Medicine, University of Oxford, Oxford OX3 7DQ, UK
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Abstract
Epigenetic mechanisms are pivotal in regulating gene expression during cellular response to extracellular stimuli. Bacterial infections have a profound effect on the host epigenome, which triggers susceptibility to diseases. Recent studies suggest that Mycobacterium tuberculosis (Mtb) can alter the host epigenome to modulate the transcriptional machinery and plays a major role in immunomodulation of the host immune response. However, the mechanism of epigenetic alterations during Mtb infection has not yet been fully understood. Thus, Mtb-induced epigenetic changes may affect the host cell by either activation or suppression of key immune genes involved in immune response or pathogen persistence. In this review, we discuss the principles of epigenetics, recent advances in Mtb-induced alterations in the host epigenetic landscape and their role in the host immune response.
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Affiliation(s)
- Maruthai Kathirvel
- Department of Paediatrics, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry-605 006, India
| | - Subramanian Mahadevan
- Department of Paediatrics, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry-605 006, India
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28
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Abstract
T regulatory cells (Treg) constitute a specialized subset of T cells that play a pivotal role in preventing the occurrence of autoimmune diseases by suppressing deleterious activities of immune cells. Contrarily, they can have adverse effect on immune response against infectious diseases where Treg weaken the host immunity leading to enhanced microbial load and thereby increase in severity of the disease. Here, we have attempted to review plethora of information documenting prevalence of Treg in tuberculosis (TB) and their involvement in progression and immunopathogenesis of the disease. Further, we have laid emphasis on the possible use of Treg as a biomarker for determining the TB treatment efficacy. Also, we have discussed the probable contribution of Treg in dampening the efficacy of BCG, the anti-TB vaccine. Finally, we have speculated some of the possible strategies which might be explored by exploiting Treg for enhancing the efficacy of TB management.
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Jaafar RM, Chettri JK, Dalsgaard I, Al-Jubury A, Kania PW, Skov J, Buchmann K. Effects of adjuvant Montanide™ ISA 763 A VG in rainbow trout injection vaccinated against Yersinia ruckeri. FISH & SHELLFISH IMMUNOLOGY 2015; 47:797-806. [PMID: 26492991 DOI: 10.1016/j.fsi.2015.10.023] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 10/13/2015] [Accepted: 10/15/2015] [Indexed: 05/04/2023]
Abstract
Enteric redmouth disease (ERM) caused by the fish pathogen Yersinia ruckeri is a major threat to freshwater production of rainbow trout (Oncorhynchus mykiss) throughout all life stages. Injection vaccination of rainbow trout against Y. ruckeri infection has been shown to confer better protection compared to the traditionally applied immersion vaccination. It may be hypothesized, based on experience from other vaccines, that adjuvants may increase the protective level of ERM injection vaccines even more. Controlled comparative vaccination studies have been performed to investigate effects of the oil adjuvant Montanide™ ISA 763 A VG (Seppic) when added to an experimental Y. ruckeri bacterin (containing both biotype 1 and 2 of serotype O1). A total of 1000 fish with mean weight 19 g was divided into five different groups (in duplicated tanks 2 × 100 fish per group) 1) non-vaccinated control fish (NonVac), 2) fish injected with a commercial vaccine (AquaVac(®) Relera™) (ComVac), 3) fish injected with an experimental vaccine (ExpVac), 4) fish injected with an experimental vaccine + adjuvant (ExpVacAdj) and 5) fish injected with adjuvant alone (Adj). Injection of the experimental vaccine (both adjuvanted and non-adjuvanted) induced a significantly higher antibody (IgM) level, increased occurrence of IgM(+) cells in spleen tissue and significant up-regulation of several immune genes. Additional experiments using a higher challenge dosage suggested an immune enhancing effect of the adjuvant as the challenge produced 100% mortality in the NonVac group, 60% mortality in both of ComVac and Adj groups and only 13 and 2.5% mortalities in the ExpVac and the ExpVacAdj groups, respectively.
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Affiliation(s)
- Rzgar M Jaafar
- Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg C, Denmark.
| | - Jiwan K Chettri
- Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg C, Denmark
| | - Inger Dalsgaard
- National Veterinary Institute, Technical University of Denmark, Frederiksberg C, Denmark
| | - Azmi Al-Jubury
- Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg C, Denmark
| | - Per W Kania
- Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg C, Denmark
| | - Jakob Skov
- Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg C, Denmark
| | - Kurt Buchmann
- Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg C, Denmark
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Escalante P, Peikert T, Van Keulen VP, Erskine CL, Bornhorst CL, Andrist BR, McCoy K, Pease LR, Abraham RS, Knutson KL, Kita H, Schrum AG, Limper AH. Combinatorial Immunoprofiling in Latent Tuberculosis Infection. Toward Better Risk Stratification. Am J Respir Crit Care Med 2015; 192:605-17. [PMID: 26030344 DOI: 10.1164/rccm.201412-2141oc] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
RATIONALE Most immunocompetent patients diagnosed with latent tuberculosis infection (LTBI) will not progress to tuberculosis (TB) reactivation. However, current diagnostic tools cannot reliably distinguish nonprogressing from progressing patients a priori, and thus LTBI therapy must be prescribed with suboptimal patient specificity. We hypothesized that LTBI diagnostics could be improved by generating immunomarker profiles capable of categorizing distinct patient subsets by a combinatorial immunoassay approach. OBJECTIVES A combinatorial immunoassay analysis was applied to identify potential immunomarker combinations that distinguish among unexposed subjects, untreated patients with LTBI, and treated patients with LTBI and to differentiate risk of reactivation. METHODS IFN-γ release assay (IGRA) was combined with a flow cytometric assay that detects induction of CD25(+)CD134(+) coexpression on TB antigen-stimulated T cells from peripheral blood. The combinatorial immunoassay analysis was based on receiver operating characteristic curves, technical cut-offs, 95% bivariate normal density ellipse prediction, and statistical analysis. Risk of reactivation was estimated with a prediction formula. MEASUREMENTS AND MAIN RESULTS Sixty-five out of 150 subjects were included. The combinatorial immunoassay approach identified at least four different T-cell subsets. The representation of these immune phenotypes was more heterogeneous in untreated patients with LTBI than in treated patients with LTBI or unexposed groups. Patients with IGRA(+) CD4(+)CD25(+)CD134(+) T-cell phenotypes had the highest estimated reactivation risk (4.11 ± 2.11%). CONCLUSIONS These findings suggest that immune phenotypes defined by combinatorial assays may potentially have a role in identifying those at risk of developing TB; this potential role is supported by risk of reactivation modeling. Prospective studies will be needed to test this novel approach.
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Affiliation(s)
- Patricio Escalante
- 1 Division of Pulmonary and Critical Care Medicine, Department of Medicine.,2 Public Health Department, Olmsted County Tuberculosis Clinic, Rochester, Minnesota; and.,3 Mayo Clinic Center for Tuberculosis, Rochester, Minnesota
| | - Tobias Peikert
- 1 Division of Pulmonary and Critical Care Medicine, Department of Medicine.,4 Department of Immunology, and
| | | | | | - Cathy L Bornhorst
- 1 Division of Pulmonary and Critical Care Medicine, Department of Medicine
| | - Boleyn R Andrist
- 1 Division of Pulmonary and Critical Care Medicine, Department of Medicine
| | - Kevin McCoy
- 2 Public Health Department, Olmsted County Tuberculosis Clinic, Rochester, Minnesota; and.,3 Mayo Clinic Center for Tuberculosis, Rochester, Minnesota
| | | | - Roshini S Abraham
- 5 Department of Laboratory Medicine, Mayo Clinic, Rochester, Minnesota
| | | | | | | | - Andrew H Limper
- 1 Division of Pulmonary and Critical Care Medicine, Department of Medicine
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31
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Lieske NV, Tonby K, Kvale D, Dyrhol-Riise AM, Tasken K. Targeting Tuberculosis and HIV Infection-Specific Regulatory T Cells with MEK/ERK Signaling Pathway Inhibitors. PLoS One 2015; 10:e0141903. [PMID: 26544592 PMCID: PMC4636186 DOI: 10.1371/journal.pone.0141903] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2015] [Accepted: 10/14/2015] [Indexed: 02/02/2023] Open
Abstract
Human regulatory T cells (Tregs) are essential in maintaining immunological tolerance and suppress effector T cells. Tregs are commonly up-regulated in chronic infectious diseases such as tuberculosis (TB) and human immunodeficiency virus (HIV) infection and thereby hamper disease-specific immune responses and eradication of pathogens. The MEK/ERK signaling pathway is involved in regulation of the FoxP3 transcription factor, which directs a lineage-specific transcriptional program to define Tregs and control their suppressive function. Here, we aimed to target activation of disease-specific Tregs by inhibition of the MEK/ERK signaling pathway based on the hypothesis that this would improve anti-HIV and anti-TB immunity. Stimulation of T cells from untreated TB (n = 12) and HIV (n = 8) patients with disease-specific antigens in vitro in the presence of the MEK inhibitor (MEKI) trametinib (GSK1120212) resulted in significant down-regulation of both FoxP3 levels (MFI) and fractions of resting (CD45RA+FoxP3+) and activated (CD45RA−FoxP3++) Tregs. MEKI also reduced the levels of specific T effector cells expressing the pro-inflammatory cytokines (IFN-γ, TNF-α and IL-2) in both HIV and TB patients. In conclusion, MEKIs modulate disease antigen-specific Treg activation and may have potential application in new treatment strategies in chronic infectious diseases where reduction of Treg activity would be favorable. Whether MEKIs can be used in current HIV or TB therapy regimens needs to be further investigated.
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Affiliation(s)
- Nora V. Lieske
- Centre for Molecular Medicine Norway, Nordic EMBL Partnership, University of Oslo, Oslo, Norway
| | - Kristian Tonby
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Infectious Diseases, Oslo University Hospital, Oslo, Norway
| | - Dag Kvale
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Infectious Diseases, Oslo University Hospital, Oslo, Norway
- Kristian Gerhard Jebsen Inflammation Research Centre, University of Oslo, Oslo, Norway
| | - Anne M. Dyrhol-Riise
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Infectious Diseases, Oslo University Hospital, Oslo, Norway
- Kristian Gerhard Jebsen Inflammation Research Centre, University of Oslo, Oslo, Norway
| | - Kjetil Tasken
- Centre for Molecular Medicine Norway, Nordic EMBL Partnership, University of Oslo, Oslo, Norway
- Department of Infectious Diseases, Oslo University Hospital, Oslo, Norway
- Kristian Gerhard Jebsen Inflammation Research Centre, University of Oslo, Oslo, Norway
- Biotechnology Centre, University of Oslo, Oslo, Norway
- * E-mail:
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32
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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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Gong P, Li Y, Tan YP, Li H. Pretreatment With Inactivated Bacillus Calmette-Guerin Increases CD4+CD25+ Regulatory T Cell Function and Decreases Functional and Structural Effects of Asthma Induction in a Rat Asthma Model. Artif Organs 2015; 40:360-7. [PMID: 26495900 DOI: 10.1111/aor.12566] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Bacillus Calmette-Guerin (BCG) has been shown to have therapeutic effects on asthma through CD4+CD25+ regulatory T cells (Tregs). We sought to assess pretreatment with inactivated BCG on CD4+CD25+ Tregs and its functional and structural effects in rat asthma model. The rat asthma model was established using ovalbumin (OVA) sensitization and challenge. Ten rats were pretreated with BCG prior to OVA and received continued BCG injections during OVA challenge (BCG+OVA group), 10 rats were treated with OVA alone (OVA group), and 10 rats were treated with saline (control group). After 9 weeks, histamine dihydrochloride effect on airway resistance was measured. Number of CD4+CD25+ Tregs was measured by flow cytometry, expression of Foxp3 and CTLA-4 mRNA was measured, and serum TGF-β levels were determined. Differential cell count in bronchoalveolar lavage fluid (BALF) was determined, and lung tissue was processed and stained with hematoxylin and eosin, Masson's trichrome, and alcine blue and periodic acid Schiff's reaction to evaluate inflammatory cell infiltration, collagen deposition, and presence of goblet cells, respectively. BCG treatment led to an increase in CD4+CD25+ Tregs, as well as an increase in Foxp3 and CTLA-4 expression and serum TGF-β levels. In addition, we observed a decrease in histamine dihydrochloride-induced airway resistance, a decrease in inflammatory leukocytes in BALF, and a decrease in airway remodeling indicators in BCG+OVA-treated rats compared with OVA-treated rats. Intradermally injected inactivated BCG has the potential to improve airway inflammation, airway resistance, and airway remodeling through a mechanism that may involve CD4+CD25+ Tregs.
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Affiliation(s)
- Ping Gong
- Department of Pediatrics, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, Hunan, China
| | - Yun Li
- Department of Pediatrics, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, Hunan, China
| | - Yu-Pin Tan
- Department of Pediatrics, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, Hunan, China
| | - Hong Li
- Department of Pediatrics, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, Hunan, China
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Richert-Spuhler LE, Lund JM. The Immune Fulcrum: Regulatory T Cells Tip the Balance Between Pro- and Anti-inflammatory Outcomes upon Infection. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2015; 136:217-43. [PMID: 26615099 DOI: 10.1016/bs.pmbts.2015.07.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Regulatory T cells (Tregs) are indispensable for immune homeostasis and the prevention of autoimmunity. In the context of infectious diseases, Tregs are multidimensional. Here, we describe how they may potentiate effector responses by assisting in recruitment of T cells into the infection site to resolve infection, facilitate accelerated antigen-specific memory responses, limit pathology, and contribute to disease resolution and healing, to the great benefit of the host. We also explore the villainous functions of Tregs during infection by reviewing several diseases in which the depletion or reduction in Treg frequency allows for better generation of effector memory, and results in acute resolution of infection, as opposed to chronicity or severe long-term outcomes. We describe findings generated using mouse models of infection as well as experiments performed using human cells and tissues. We propose that Tregs represent an immunologic fulcrum, promoting both pathogen clearance and damage control by preventing excessive destruction of infected tissues though unchecked immune responses.
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Affiliation(s)
- Laura E Richert-Spuhler
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Jennifer M Lund
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA; Department of Global Health, University of Washington, Seattle, Washington, USA.
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Feruglio SL, Tonby K, Kvale D, Dyrhol-Riise AM. Early dynamics of T helper cell cytokines and T regulatory cells in response to treatment of active Mycobacterium tuberculosis infection. Clin Exp Immunol 2015; 179:454-65. [PMID: 25313008 PMCID: PMC4337678 DOI: 10.1111/cei.12468] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2014] [Indexed: 02/07/2023] Open
Abstract
Biomarkers that can identify tuberculosis (TB) disease and serve as markers for efficient therapy are requested. We have studied T cell cytokine production [interferon (IFN)-γ, interleukin (IL)-2, tumour necrosis factor (TNF)-α] and degranulation (CD107a) as well as subsets of CD4(+) T regulatory cells (Tregs ) after in-vitro Mycobacterium tuberculosis (Mtb) antigen stimulation [early secretory antigenic target (ESAT)-6, culture filtrate protein (CFP)-10, antigen 85 (Ag85)] in 32 patients with active tuberculosis (TB) disease throughout 24 weeks of effective TB treatment. A significant decline in the fraction of Mtb-specific total IFN-γ and single IFN-γ-producing T cells was already observed after 2 weeks of treatment, whereas the pool of single IL-2(+) cells increased over time for both CD4(+) and CD8(+) T cells. The Treg subsets CD25(high) CD127(low) , CD25(high) CD147(++) and CD25(high) CD127(low) CD161(+) expanded significantly after Mtb antigen stimulation in vitro at all time-points, whereas the CD25(high) CD127(low) CD39(+) Tregs remained unchanged. The fraction of CD25(high) CD127(low) Tregs increased after 8 weeks of treatment. Thus, we revealed an opposing shift of Tregs and intracellular cytokine production during treatment. This may indicate that functional signatures of the CD4(+) and CD8(+) T cells can serve as immunological correlates of early curative host responses. Whether such signatures can be used as biomarkers in monitoring and follow-up of TB treatment needs to be explored further.
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Affiliation(s)
- S L Feruglio
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Norwegian Institute of Public Health, Oslo, Norway
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Sullivan ZA, Wong EB, Ndung'u T, Kasprowicz VO, Bishai WR. Latent and Active Tuberculosis Infection Increase Immune Activation in Individuals Co-Infected with HIV. EBioMedicine 2015; 2:334-340. [PMID: 26114158 PMCID: PMC4476549 DOI: 10.1016/j.ebiom.2015.03.005] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
In recent years, chronic immune activation and systemic inflammation have emerged as hallmarks of HIV disease progression and mortality. Several studies indicate that soluble inflammatory biomarkers (sCD14, IL-6, IL-8, CRP and hyaluronic acid), as well as surface markers of T-cell activation (CD38, HLA-DR) independently predict progression to AIDS and mortality in HIV-infected individuals. While co-infections have been shown to contribute to immune activation, the impact of latent tuberculosis infection (LTBI), which is widely endemic in the areas most affected by the global AIDS epidemic, has not been evaluated. We hypothesized that both active and latent states of Mycobacterium tuberculosis co-infection contribute to elevated immune activation as measured by these markers. In HIV-infected individuals with active, but not latent TB, we found elevated levels of soluble markers associated with monocyte activation. Interestingly, T-cell activation was elevated individuals with both latent and active TB. These results suggest that in the highly TB- and HIV-endemic settings of southern Africa, latent TB-associated T-cell activation may contribute to HIV disease progression and exacerbate the HIV epidemic. In addition, our findings indicate that aggressive campaigns to treat LTBI in HIV-infected individuals in high-burden countries will not only impact TB rates, but may also slow HIV progression. Significance Latent tuberculosis, which affects an estimated 1/3 of the world's population, has long been thought to be a relatively benign, quiescent state of M. tuberculosis infection. While HIV co-infection is known to exacerbate M. tuberculosis infection and increase the risk of developing active TB, little is known about the potential effect of latent TB infection on HIV disease. This study shows that HIV-infected individuals with both active and latent TB have elevated levels of inflammation and immune activation, biomarkers of HIV disease progression and elevated risk of mortality. These results suggest that, in the context of HIV, latent TB infection may be associated with increased risk of progression to AIDS and mortality. While HIV co-infection is known to exacerbate TB, little is known about the effect of latent TB infection on HIV disease. In HIV-infected individuals, active and latent TB elevate immunological biomarkers of HIV morbidity and mortality. In the context of HIV, latent TB infection may be associated with increased risk of progression to AIDS and mortality. In addition to reducing TB transmission, aggressive treatment of latent TB infection may also reduce the progression of HIV.
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Affiliation(s)
- Zuri A Sullivan
- KwaZulu-Natal Research Institute for Tuberculosis and HIV, Durban, South Africa ; Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Emily B Wong
- KwaZulu-Natal Research Institute for Tuberculosis and HIV, Durban, South Africa ; Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA
| | - Thumbi Ndung'u
- KwaZulu-Natal Research Institute for Tuberculosis and HIV, Durban, South Africa ; HIV Pathogenesis Programme, University of KwaZulu-Natal, Durban, South Africa ; The Ragon Institute of MGH, MIT, and Harvard, Harvard Medical School, Cambridge, MA ; Max Planck Institute for Infection Biology, Berlin, Germany
| | - Victoria O Kasprowicz
- KwaZulu-Natal Research Institute for Tuberculosis and HIV, Durban, South Africa ; HIV Pathogenesis Programme, University of KwaZulu-Natal, Durban, South Africa ; The Ragon Institute of MGH, MIT, and Harvard, Harvard Medical School, Cambridge, MA
| | - William R Bishai
- KwaZulu-Natal Research Institute for Tuberculosis and HIV, Durban, South Africa ; Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD
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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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Urdahl KB. Understanding and overcoming the barriers to T cell-mediated immunity against tuberculosis. Semin Immunol 2014; 26:578-87. [PMID: 25453230 PMCID: PMC4314386 DOI: 10.1016/j.smim.2014.10.003] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Revised: 10/02/2014] [Accepted: 10/03/2014] [Indexed: 12/13/2022]
Abstract
Despite the overwhelming success of immunization in reducing, and even eliminating, the global threats posed by a wide spectrum of infectious diseases, attempts to do the same for tuberculosis (TB) have failed to date. While most effective vaccines act by eliciting neutralizing antibodies, T cells are the primary mediators of adaptive immunity against TB. Unfortunately, the onset of the T cell response after aerosol infection with Mycobacterium tuberculosis (Mtb), the bacterium that causes TB, is exceedingly slow, and systemically administered vaccines only modestly accelerate the recruitment of effector T cells to the lungs. This delay seems to be orchestrated by Mtb itself to prolong the period of unrestricted bacterial replication in the lung that characterizes the innate phase of the response. When T cells finally arrive at the site of infection, multiple layers of regulation have been established that limit the ability of T cells to control or eradicate Mtb. From this understanding, emerges a strategy for achieving immunity. Lung resident memory T cells may recognize Mtb-infected cells shortly after infection and confer protection before regulatory networks are allowed to develop. Early studies using vaccines that elicit lung resident T cells by targeting the lung mucosa have been promising, but many questions remain. Due to the fundamental nature of these questions, and the need to understand and manipulate the early events in the lung after aerosol infection, only coordinated approaches that utilize tractable animal models to inform human TB vaccine trials will move the field toward its goal.
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Affiliation(s)
- Kevin B Urdahl
- Seattle Biomedical Research Institute, Seattle, WA, USA; Department of Immunology, University of Washington School of Medicine, Seattle, WA, USA; Department of Global Health, University of Washington School of Medicine, Seattle, WA, USA; Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA.
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Grant CR, Liberal R, Mieli-Vergani G, Vergani D, Longhi MS. Regulatory T-cells in autoimmune diseases: challenges, controversies and--yet--unanswered questions. Autoimmun Rev 2014; 14:105-16. [PMID: 25449680 DOI: 10.1016/j.autrev.2014.10.012] [Citation(s) in RCA: 202] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Accepted: 09/26/2014] [Indexed: 02/07/2023]
Abstract
Regulatory T cells (Tregs) are central to the maintenance of self-tolerance and tissue homeostasis. Markers commonly used to define human Tregs in the research setting include high expression of CD25, FOXP3 positivity and low expression/negativity for CD127. Many other markers have been proposed, but none unequivocally identifies bona fide Tregs. Tregs are equipped with an array of mechanisms of suppression, including the modulation of antigen presenting cell maturation and function, the killing of target cells, the disruption of metabolic pathways and the production of anti-inflammatory cytokines. Treg impairment has been reported in a number of human autoimmune conditions and includes Treg numerical and functional defects and conversion into effector cells in response to inflammation. In addition to intrinsic Treg impairment, resistance of effector T cells to Treg control has been described. Discrepancies in the literature are common, reflecting differences in the choice of study participants and the technical challenges associated with investigating this cell population. Studies differ in terms of the methodology used to define and isolate putative regulatory cells and to assess their suppressive function. In this review we outline studies describing Treg frequency and suppressive function in systemic and organ specific autoimmune diseases, with a specific focus on the challenges faced when investigating Tregs in these conditions.
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Affiliation(s)
- Charlotte R Grant
- Division of Transplantation Immunology and Mucosal Biology, MRC Centre for Transplantation, King's College London, London, United Kingdom; Faculty of Life Sciences and Medicine, King's College Hospital, London, United Kingdom.
| | - Rodrigo Liberal
- Division of Transplantation Immunology and Mucosal Biology, MRC Centre for Transplantation, King's College London, London, United Kingdom; Faculty of Life Sciences and Medicine, King's College Hospital, London, United Kingdom.
| | - Giorgina Mieli-Vergani
- Division of Transplantation Immunology and Mucosal Biology, MRC Centre for Transplantation, King's College London, London, United Kingdom; Faculty of Life Sciences and Medicine, King's College Hospital, London, United Kingdom.
| | - Diego Vergani
- Division of Transplantation Immunology and Mucosal Biology, MRC Centre for Transplantation, King's College London, London, United Kingdom; Faculty of Life Sciences and Medicine, King's College Hospital, London, United Kingdom.
| | - Maria Serena Longhi
- Division of Transplantation Immunology and Mucosal Biology, MRC Centre for Transplantation, King's College London, London, United Kingdom; Faculty of Life Sciences and Medicine, King's College Hospital, London, United Kingdom.
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Upregulation of plasmacytoid dendritic cells in glioma. Tumour Biol 2014; 35:9661-6. [PMID: 24969556 DOI: 10.1007/s13277-014-2211-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Accepted: 06/06/2014] [Indexed: 12/20/2022] Open
Abstract
The immune system fails to eradicate established tumors partly due to the induction of immune tolerance within tumor microenvironment. Plasmacytoid dendritic cells (pDCs) play critical roles in regulating immune system. In this study, we investigated pDC in the peripheral blood of glioma. CD4 + CD123 + BDCA2+ pDCs were tested from peripheral blood mononuclear cells in 40 glioma patients and 40 healthy controls by flow cytometry. The results revealed that proportion of pDCs was significantly increased in cases than in controls (0.52 ± 0.07 versus 0.21 ± 0.02 %, p < 0.001), whereas myeloid dendritic cells (mDCs) did not present any obvious difference between patients and healthy donors (0.25 ± 0.04 versus 0.18 ± 0.02 %, p = 0.217). We further studied pDCs in glioma patients with different clinical stages. Data showed that cases with smoking history had elevated level of pDCs than those non-smoker patients (0.91 ± 0.16 versus 0.48 ± 0.06 %, p = 0.004). Interestingly, we observed that patients with aphasia presented significantly elevated pDCs than those without aphasia (0.93 ± 0.12 versus 0.41 ± 0.07 %, p < 0.001). These data suggested that pDCs may be closely involved in the pathogenesis of glioma and may play roles in certain symptoms of the disease.
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Bobosha K, Wilson L, van Meijgaarden KE, Bekele Y, Zewdie M, van der Ploeg- van Schip JJ, Abebe M, Hussein J, Khadge S, Neupane KD, Hagge DA, Jordanova ES, Aseffa A, Ottenhoff THM, Geluk A. T-cell regulation in lepromatous leprosy. PLoS Negl Trop Dis 2014; 8:e2773. [PMID: 24722473 PMCID: PMC3983090 DOI: 10.1371/journal.pntd.0002773] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Accepted: 02/19/2014] [Indexed: 12/12/2022] Open
Abstract
Regulatory T (Treg) cells are known for their role in maintaining self-tolerance and balancing immune reactions in autoimmune diseases and chronic infections. However, regulatory mechanisms can also lead to prolonged survival of pathogens in chronic infections like leprosy and tuberculosis (TB). Despite high humoral responses against Mycobacterium leprae (M. leprae), lepromatous leprosy (LL) patients have the characteristic inability to generate T helper 1 (Th1) responses against the bacterium. In this study, we investigated the unresponsiveness to M. leprae in peripheral blood mononuclear cells (PBMC) of LL patients by analysis of IFN-γ responses to M. leprae before and after depletion of CD25+ cells, by cell subsets analysis of PBMC and by immunohistochemistry of patients' skin lesions. Depletion of CD25+ cells from total PBMC identified two groups of LL patients: 7/18 (38.8%) gained in vitro responsiveness towards M. leprae after depletion of CD25+ cells, which was reversed to M. leprae-specific T-cell unresponsiveness by addition of autologous CD25+ cells. In contrast, 11/18 (61.1%) remained anergic in the absence of CD25+ T-cells. For both groups mitogen-induced IFN-γ was, however, not affected by depletion of CD25+ cells. In M. leprae responding healthy controls, treated lepromatous leprosy (LL) and borderline tuberculoid leprosy (BT) patients, depletion of CD25+ cells only slightly increased the IFN-γ response. Furthermore, cell subset analysis showed significantly higher (p = 0.02) numbers of FoxP3+ CD8+CD25+ T-cells in LL compared to BT patients, whereas confocal microscopy of skin biopsies revealed increased numbers of CD68+CD163+ as well as FoxP3+ cells in lesions of LL compared to tuberculoid and borderline tuberculoid leprosy (TT/BT) lesions. Thus, these data show that CD25+ Treg cells play a role in M. leprae-Th1 unresponsiveness in LL. Leprosy is a curable infectious disease caused by Mycobacterium leprae (M. leprae) that affects the skin and peripheral nerves. It is manifested in different forms ranging from self-healing, tuberculoid leprosy (TT) with low bacillary load and high cellular immunity against M. leprae, to lepromatous leprosy (LL) with high bacillary load and high antibody titers to M. leprae antigens. However, LL patients have poor cell mediated response against M. leprae leading to delayed clearance of the bacilli. A possible explanation for this bacterial persistence could lie in the presence of more regulatory cells at infection sites and in peripheral blood. This study shows the recovery of the cell mediated response by depletion of CD25+ cells in a subset of LL patients, while another patient subset was not affected similarly. Moreover, an increased frequency of FoxP3+ T cells together with anti-inflammatory macrophages was observed in LL patients' skin biopsies. Thus, these data show that CD25+ Treg cells play a role in M. leprae-unresponsiveness in leprosy patients.
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Affiliation(s)
- Kidist Bobosha
- The Dept. of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands
- Armauer Hansen Research Institute and ALERT hospital, Addis Ababa, Ethiopia
- * E-mail:
| | - Louis Wilson
- The Dept. of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Yonas Bekele
- Armauer Hansen Research Institute and ALERT hospital, Addis Ababa, Ethiopia
| | - Martha Zewdie
- Armauer Hansen Research Institute and ALERT hospital, Addis Ababa, Ethiopia
| | | | - Markos Abebe
- Armauer Hansen Research Institute and ALERT hospital, Addis Ababa, Ethiopia
| | - Jemal Hussein
- Armauer Hansen Research Institute and ALERT hospital, Addis Ababa, Ethiopia
| | - Saraswoti Khadge
- Mycobacterial Research Laboratory, Anandaban Hospital, Kathmandu, Nepal
| | - Kapil D. Neupane
- Mycobacterial Research Laboratory, Anandaban Hospital, Kathmandu, Nepal
| | - Deanna A. Hagge
- Mycobacterial Research Laboratory, Anandaban Hospital, Kathmandu, Nepal
| | - Ekaterina S. Jordanova
- The Dept. of Obstetrics and Gynaecology, Free University Amsterdam, Center for Gynaecologic Oncology, Amsterdam, The Netherlands
| | - Abraham Aseffa
- Armauer Hansen Research Institute and ALERT hospital, Addis Ababa, Ethiopia
| | - Tom H. M. Ottenhoff
- The Dept. of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands
| | - Annemieke Geluk
- The Dept. of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands
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Labib S, El-Maraghi N, Younes S, Metwally L, Dessouki O, Nemr N. Study of some T regulatory cell subsets in patients with multi-drug resistant pulmonary tuberculosis. EGYPTIAN JOURNAL OF CHEST DISEASES AND TUBERCULOSIS 2013. [DOI: 10.1016/j.ejcdt.2013.07.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Semple PL, Binder AB, Davids M, Maredza A, van Zyl-Smit RN, Dheda K. Regulatory T cells attenuate mycobacterial stasis in alveolar and blood-derived macrophages from patients with tuberculosis. Am J Respir Crit Care Med 2013; 187:1249-58. [PMID: 23590266 DOI: 10.1164/rccm.201210-1934oc] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
RATIONALE There are hardly any data about the frequency of CD4(+)CD25(+)Foxp3(+) regulatory T cells (T-Regs) in the lungs of patients with active tuberculosis (TB). OBJECTIVES To obtain data about the frequency of CD4(+)CD25(+)Foxp3(+) T-Regs, and their impact on mycobacterial containment, in the lungs of patients with active TB. METHODS Patients with pulmonary TB (n = 49) and healthy volunteers with presumed latent TB infection (LTBI; n = 38) donated blood and/or bronchoalveolar lavage (BAL) cells obtained by bronchoscopy. T-cell phenotype (Th1/Th2/Th17/T-Reg) and functional status was evaluated using flow-cytometry and (3)H-thymidine proliferation assays, respectively. H37Rv-infected alveolar and monocyte-derived macrophages were cocultured with autologous T-Regs and purified protein derivative (PPD) preprimed T-Reg-depleted effector cells. Mycobacterial containment was evaluated by counting CFUs. MEASUREMENTS AND MAIN RESULTS In blood and BAL T-Reg levels were higher in TB versus LTBI (P < 0.04), and in TB the frequency of T-Regs was significantly higher in BAL versus blood (P < 0.001). T-Reg-mediated suppression of T-cell proliferation in blood and BAL was concentration-dependent. Restriction of mycobacterial growth in infected alveolar and monocyte-derived macrophages was significantly diminished, and by up to 50%, when T-Regs were cocultured with PPD-primed CD4(+) effector T cells. The levels of CD8(+) T-Regs (CD8(+)CD25(+)Foxp3(+)), IL-17-producing T-Regs (IL-17(+)CD4(+)CD25(+)Foxp3(+)), and IL-17-producing T cells were similar in BAL-TB versus BAL-LTBI. Within the TB group compartmentalization of responses was prominent (T-Reg, IFN-γ, tumor necrosis factor-α, IL-17, and IL-22 significantly higher in BAL vs. blood). CONCLUSIONS In patients with TB the alveolar compartment is enriched for CD4(+) T-Regs. Peripheral blood-derived T-Regs decrease the ability of alveolar and monocyte-derived macrophages to restrict the growth of Mycobacterium tuberculosis in the presence of effector cells. Collectively, these data suggest that CD4(+)CD25(+)FoxP3(+) T-Regs subvert antimycobacterial immunity in human TB.
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Affiliation(s)
- Patricia L Semple
- Division of Pulmonology and UCT Lung Institute, Department of Medicine, University of Cape Town, Cape Town, South Africa
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Foxp3(+) regulatory T cells in tuberculosis. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2013; 783:165-80. [PMID: 23468109 DOI: 10.1007/978-1-4614-6111-1_9] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The immune response to Mycobacterium tuberculosis (Mtb) must be tightly regulated to mount a sufficient response to limit bacterial growth and dissemination while avoiding excessive inflammation that could damage host tissues. A wide variety of cell types, cell surface molecules, and cytokines are likely to contribute to this regulation, but recent studies have revealed that a subset of CD4 T cells expressing the transcription factor Foxp3, called regulatory T (reg) cells, play a critical role [1-3]. Although the first reports of T reg cells in tuberculosis (TB) occurred only recently (i.e., 2006) [4, 5], we have already gained many insights into their activity during TB. While it is likely that T reg cells do play some beneficial roles by preventing inflammation-mediated damage to host tissues during TB, this aspect of their function has not been well studied to date. What is clear, however, is that during the initial T cell response to Mtb infection, Mtb induces the expansions of T reg cells that delay the onset of adaptive immunity, suggesting that Mtb has hijacked T reg cell-mediated immune suppression to allow it to replicate unabated in the lung until T cells finally arrive [6]. In this chapter, we will first provide an overview of the delayed T cell response to Mtb and a brief introduction to regulatory T cells. We will then review what is known about T reg cells from observations in human populations, discuss mechanistic insights revealed in the mouse model, and speculate about the relevance of this understanding for future efforts to prevent and treat TB.
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Sun Q, Zhang Q, Xiao H, Cui H, Su B. Significance of the frequency of CD4+CD25+CD127- T-cells in patients with pulmonary tuberculosis and diabetes mellitus. Respirology 2013; 17:876-82. [PMID: 22524702 DOI: 10.1111/j.1440-1843.2012.02184.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND AND OBJECTIVE Pulmonary tuberculosis and diabetes mellitus (DM) are closely associated. The objective of this study was to determine whether the expression of CD4+CD25+CD127- T-cells (regulatory T-cells (Treg)) is associated with diabetic pulmonary tuberculosis. METHODS Flow cytometry was used to determine the frequencies of CD4+CD25+ and CD4+CD25+CD127- T-cells in peripheral blood, bronchoalveolar lavage fluid (BALF) and pleural effusions from 120 patients (30 with pulmonary tuberculosis and DM (TBDM), 30 with pulmonary tuberculosis without DM (TB), 30 with tuberculous pleurisy without DM (TBP) and 30 healthy volunteers). The concentrations of interferon (IFN)-γ and interleukin (IL)-10 in BALF and pleural effusions were determined by enzyme-linked immunosorbent assay. RESULTS Treg frequencies in peripheral blood were significantly higher in patients with TBDM, TB and TBP than in the control group, with the frequency in TBDM being the highest (P < 0.01 for all). In TBP patients, Treg frequencies were significantly lower in pleural effusions than in peripheral blood. In TB patients, Treg frequencies in BALF and peripheral blood were not significantly different. However, in TBDM patients, Treg frequencies were significantly higher in BALF than in peripheral blood. IL-10 expression was significantly higher, and IFN-γ expression was significantly lower in BALF of TBDM patients compared with BALF and pleural effusions of TB patients. CONCLUSIONS In patients with pulmonary tuberculosis and DM, the imbalance between Treg and effector T-cells at pathological sites may be associated with weakened immunity and clinical manifestations of TB.
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Affiliation(s)
- Qin Sun
- Departments of Tuberculosis, Shanghai Pulmonary Hospital Affiliated with Tongji University, Tongji University School of Medicine, Shanghai, China
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de Almeida AS, Fiske CT, Sterling TR, Kalams SA. Increased frequency of regulatory T cells and T lymphocyte activation in persons with previously treated extrapulmonary tuberculosis. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2012; 19:45-52. [PMID: 22038848 PMCID: PMC3255960 DOI: 10.1128/cvi.05263-11] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2011] [Accepted: 10/22/2011] [Indexed: 02/08/2023]
Abstract
Extrapulmonary tuberculosis may be due to underlying immune compromise. Immunosuppressive regulatory T cells (Treg cells), and CD4(+) T lymphocytes in general, are important in the host immune response to Mycobacterium tuberculosis. We evaluated T lymphocytes from patients after recovery from extrapulmonary tuberculosis, which may reflect conditions before M. tuberculosis infection. A case-control study was conducted among HIV-uninfected adults with previously treated extrapulmonary tuberculosis and 3 sets of controls: (i) subjects with previously treated pulmonary tuberculosis, (ii) close tuberculosis contacts with M. tuberculosis infection, and (iii) close tuberculosis contacts with no infection. Monocyte-depleted peripheral blood mononuclear cells (PBMC-M) were stained for CD4(+) CD25(hi) CD127(low) FoxP3(+) cell (Treg cell) and T lymphocyte activation. Both characteristics were compared as continuous variables between groups with the Kruskal-Wallis test. There were 7 extrapulmonary tuberculosis cases, 18 pulmonary tuberculosis controls, 17 controls with M. tuberculosis infection, and 18 controls without M. tuberculosis infection. The median Treg cell proportion was highest among persons with previous extrapulmonary tuberculosis (1.23%) compared to subjects with pulmonary tuberculosis (0.56%), latent M. tuberculosis infection (0.14%), or no M. tuberculosis infection (0.20%) (P = 0.001). The median proportion of CD4(+) T lymphocytes that expressed the activation markers HLA-DR and CD38 was highest for CD4(+) T lymphocytes from persons with previous extrapulmonary tuberculosis (0.79%) compared to subjects with pulmonary tuberculosis (0.44%), latent M. tuberculosis infection (0.14%), or no M. tuberculosis infection (0.32%) (P = 0.005). Compared with controls, persons with previously treated extrapulmonary tuberculosis had the highest Treg cell frequency, but also the highest levels of CD4(+) T lymphocyte activation. Immune dysregulation may be a feature of individuals at risk for extrapulmonary tuberculosis.
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Affiliation(s)
- Alexandre S. de Almeida
- Division of Infectious Diseases, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Christina T. Fiske
- Division of Infectious Diseases, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Timothy R. Sterling
- Division of Infectious Diseases, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
- Center for Health Services Research, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Spyros A. Kalams
- Division of Infectious Diseases, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
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Esmail H, Barry CE, Wilkinson RJ. Understanding latent tuberculosis: the key to improved diagnostic and novel treatment strategies. Drug Discov Today 2011; 17:514-21. [PMID: 22198298 DOI: 10.1016/j.drudis.2011.12.013] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2011] [Revised: 12/04/2011] [Accepted: 12/13/2011] [Indexed: 12/12/2022]
Abstract
Treatment of latent tuberculosis (LTBI) is a vital component of tuberculosis (TB) elimination but is not efficiently implemented with currently available diagnostics and therapeutics. The tuberculin skin test and interferon-γ release assays can inform that infection has occurred, but do not prove that it persists. Treatment of LTBI with isoniazid targets actively replicating bacilli but not non-replicating populations, prolonging treatment duration. Developing more predictive diagnostic tests and treatments of shorter duration requires a greater understanding of the biology of LTBI, from both host and bacillary perspectives. In this article, we discuss the basis of current diagnosis and treatment of LTBI and review recent developments in understanding the biology of latency that might enable future improved diagnostic and treatment strategies.
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Affiliation(s)
- Hanif Esmail
- Clinical Infectious Diseases Research Initiative, Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Observatory 7925, South Africa.
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