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Murugesan H, Sampath P, A VK, R S, Veerasamy A, Ranganathan UD, Paramasivam S, Bethunaickan R. Association of CYP27B1 gene polymorphisms with pulmonary tuberculosis and vitamin D levels. Gene 2024; 927:148679. [PMID: 38876405 DOI: 10.1016/j.gene.2024.148679] [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: 01/25/2024] [Revised: 05/08/2024] [Accepted: 06/10/2024] [Indexed: 06/16/2024]
Abstract
BACKGROUND AND OBJECTIVES Genetic factors are reported to be connected with tuberculosis (TB) infection. Studies have shown that genetic variations in genes involved in the vitamin D pathway influence the levels of vitamin D found in the bloodstream (serum). Cyp27b1 (1α-hydroxylase) is an enzyme that activates the synthesis of bioactive vitamin D3 by hydroxylation of 25(OH)D3.The in vitro studies reported rare gene variants of Cyp27b1 such as rs118204011 and rs118204012, associated with loss of Cyp27b1 function and lower serum vitamin D levels. Globally, a critical gap exists in understanding the link between these gene variants with TB and vitamin D levels. Hence, the study objective is to comprehend the association of Cyp27b1 rs118204009 (G/A), rs118204011 (C/T), and rs118204012 (A/G) with tuberculosis susceptibility/protection and to assess the influence of gene variants on vitamin D levels in both healthy controls (HCs) and those with pulmonary tuberculosis (PTB) in South India. METHODS Genomic DNA extraction was performed by salting-out procedure and subsequently genotyped through polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP) method. Vitamin D level was measured by Enzyme-Linked Immunosorbent Assay (ELISA). RESULTS In rs118204012 (A/G), a substantial association was found with PTB susceptibility in allele 'A' [Odds Ratio (OR): 1.52 (1.02-2.26); p = 0.044] and 'AA' genotype [OR: 1.69 (1.02-2.81); p = 0.040] through the dominant model. Allele 'G' [OR: 0.66 (0.44-0.98); p = 0.044) was found to be associated with protection against TB. Males were associated with increased susceptibility towards TB compared to females in the rs118204011 "CC" [OR: 3.94 (1.94-7.98); p = 0.002] and rs118204012 'AA' [OR: 4.57 (2.13-9.79); p = 0.0001] genotypes. Vitamin D insufficiency (<30 ng/ml) was more prevalent in PTB patients (66.67 %) with the rs118201012 'AA' genotype compared with healthy controls (57.14 %). This genotype was associated with disease susceptible odds ratio of 1.5. CONCLUSION Cyp27b1 rs118204012 'AA' genotype was found to have association with vitamin D insufficiency and TB susceptibility. In terms of gender, our findings suggest that male individuals are correlated with a higher TB risk. This suggest that the gene variants may be involved in the downstream processing of serum Vitamin D levels and its association with the disease.
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Affiliation(s)
- Harishankar Murugesan
- Department of Immunology, ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - Pavithra Sampath
- Department of Immunology, ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - Vamsi Kumar A
- Department of Immunology, ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - Srividhya R
- Department of Immunology, ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - Athikesavan Veerasamy
- Department of Immunology, ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - Uma Devi Ranganathan
- Department of Immunology, ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - Selvaraj Paramasivam
- Department of Immunology, ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - Ramalingam Bethunaickan
- Department of Immunology, ICMR-National Institute for Research in Tuberculosis, Chennai, India.
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Chen Z, Kong X, Ma Q, Chen J, Zeng Y, Liu H, Wang X, Lu S. The impact of Mycobacterium tuberculosis on the macrophage cholesterol metabolism pathway. Front Immunol 2024; 15:1402024. [PMID: 38873598 PMCID: PMC11169584 DOI: 10.3389/fimmu.2024.1402024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Accepted: 05/14/2024] [Indexed: 06/15/2024] Open
Abstract
Mycobacterium tuberculosis (Mtb) is an intracellular pathogen capable of adapting and surviving within macrophages, utilizing host nutrients for its growth and replication. Cholesterol is the main carbon source during the infection process of Mtb. Cholesterol metabolism in macrophages is tightly associated with cell functions such as phagocytosis of pathogens, antigen presentation, inflammatory responses, and tissue repair. Research has shown that Mtb infection increases the uptake of low-density lipoprotein (LDL) and cholesterol by macrophages, and enhances de novo cholesterol synthesis in macrophages. Excessive cholesterol is converted into cholesterol esters, while the degradation of cholesterol esters in macrophages is inhibited by Mtb. Furthermore, Mtb infection suppresses the expression of ATP-binding cassette (ABC) transporters in macrophages, impeding cholesterol efflux. These alterations result in the massive accumulation of cholesterol in macrophages, promoting the formation of lipid droplets and foam cells, which ultimately facilitates the persistent survival of Mtb and the progression of tuberculosis (TB), including granuloma formation, tissue cavitation, and systemic dissemination. Mtb infection may also promote the conversion of cholesterol into oxidized cholesterol within macrophages, with the oxidized cholesterol exhibiting anti-Mtb activity. Recent drug development has discovered that reducing cholesterol levels in macrophages can inhibit the invasion of Mtb into macrophages and increase the permeability of anti-tuberculosis drugs. The development of drugs targeting cholesterol metabolic pathways in macrophages, as well as the modification of existing drugs, holds promise for the development of more efficient anti-tuberculosis medications.
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Affiliation(s)
| | | | | | | | | | | | - Xiaomin Wang
- National Clinical Research Center for Infectious Diseases, Shenzhen Third People’s Hospital, Shenzhen, Guangdong, China
| | - Shuihua Lu
- National Clinical Research Center for Infectious Diseases, Shenzhen Third People’s Hospital, Shenzhen, Guangdong, China
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Argano C, Mirarchi L, Amodeo S, Orlando V, Torres A, Corrao S. The Role of Vitamin D and Its Molecular Bases in Insulin Resistance, Diabetes, Metabolic Syndrome, and Cardiovascular Disease: State of the Art. Int J Mol Sci 2023; 24:15485. [PMID: 37895163 PMCID: PMC10607188 DOI: 10.3390/ijms242015485] [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: 09/04/2023] [Revised: 10/11/2023] [Accepted: 10/18/2023] [Indexed: 10/29/2023] Open
Abstract
In the last decade, an increasing awareness was directed to the role of Vitamin D in non-skeletal and preventive roles for chronic diseases. Vitamin D is an essential hormone in regulating calcium/phosphorous balance and in the pathogenesis of inflammation, insulin resistance, and obesity. The main forms of vitamin D, Cholecalciferol (Vitamin D3) and Ergocalciferol (Vitamin D2) are converted into the active form (1,25-dihydroxyvitamin D) thanks to two hydroxylations in the liver, kidney, pancreas, and immune cells. Some anti-inflammatory cytokines are produced at higher levels by vitamin D, while some pro-inflammatory cytokines are released at lower levels. Toll-Like Receptor (TLR) expression is increased, and a pro-inflammatory state is also linked to low levels of vitamin D. Regardless of how it affects inflammation, various pathways suggest that vitamin D directly improves insulin sensitivity and secretion. The level of vitamin D in the body may change the ratio of pro- to anti-inflammatory cytokines, which would impact insulin action, lipid metabolism, and the development and function of adipose tissue. Many studies have demonstrated an inverse relationship between vitamin D concentrations and pro-inflammatory markers, insulin resistance, glucose intolerance, metabolic syndrome, obesity, and cardiovascular disease. It is interesting to note that several long-term studies also revealed an inverse correlation between vitamin D levels and the occurrence of diabetes mellitus. Vitamin D supplementation in people has controversial effects. While some studies demonstrated improvements in insulin sensitivity, glucose, and lipid metabolism, others revealed no significant effect on glycemic homeostasis and inflammation. This review aims to provide insight into the molecular basis of the relationship between vitamin D, insulin resistance, metabolic syndrome, type 1 and 2 diabetes, gestational diabetes, and cardiovascular diseases.
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Affiliation(s)
- Christiano Argano
- Department of Internal Medicine, National Relevance and High Specialization Hospital Trust ARNAS Civico Di Cristina Benfratelli, 90127 Palermo, Italy; (L.M.); (S.A.); (V.O.); (A.T.); (S.C.)
| | - Luigi Mirarchi
- Department of Internal Medicine, National Relevance and High Specialization Hospital Trust ARNAS Civico Di Cristina Benfratelli, 90127 Palermo, Italy; (L.M.); (S.A.); (V.O.); (A.T.); (S.C.)
| | - Simona Amodeo
- Department of Internal Medicine, National Relevance and High Specialization Hospital Trust ARNAS Civico Di Cristina Benfratelli, 90127 Palermo, Italy; (L.M.); (S.A.); (V.O.); (A.T.); (S.C.)
| | - Valentina Orlando
- Department of Internal Medicine, National Relevance and High Specialization Hospital Trust ARNAS Civico Di Cristina Benfratelli, 90127 Palermo, Italy; (L.M.); (S.A.); (V.O.); (A.T.); (S.C.)
| | - Alessandra Torres
- Department of Internal Medicine, National Relevance and High Specialization Hospital Trust ARNAS Civico Di Cristina Benfratelli, 90127 Palermo, Italy; (L.M.); (S.A.); (V.O.); (A.T.); (S.C.)
| | - Salvatore Corrao
- Department of Internal Medicine, National Relevance and High Specialization Hospital Trust ARNAS Civico Di Cristina Benfratelli, 90127 Palermo, Italy; (L.M.); (S.A.); (V.O.); (A.T.); (S.C.)
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties, [PROMISE], University of Palermo, 90127 Palermo, Italy
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Araujo Z, Camargo M, Moreno Pérez DA, Wide A, Pacheco D, Díaz Arévalo D, Celis Giraldo CT, Salas S, de Waard JH, Patarroyo MA. Differential NRAMP1gene's D543N genotype frequency: Increased risk of contracting tuberculosis among Venezuelan populations. Hum Immunol 2023; 84:484-491. [PMID: 37380553 DOI: 10.1016/j.humimm.2023.06.003] [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: 09/28/2022] [Revised: 05/15/2023] [Accepted: 06/11/2023] [Indexed: 06/30/2023]
Abstract
NRAMP1 and VDR gene polymorphisms have been variably associated with susceptibility to tuberculosis (TB) amongst populations having different genetic background. NRAMP1 and VDR gene variants' association with susceptibility to active infection by Mycobacterium tuberculosis (Mtb) was analyzed in the Warao Amerindian population, an ethnic population from Venezuela's Orinoco delta region. Genomic DNA was extracted from individuals with and without TB to evaluate genetic polymorphism by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Four NRAMP1 gene polymorphisms were analyzed: D543N (rs17235409), 3' UTR (rs17235416), INT4 (rs3731865), and 274C/T (rs2276631), and one VDR gene polymorphism: FokI (rs2228570). The results showed that the genotypes D543N-A/A, 3'UTR-TGTG+/+, INT4-C/C, and 274C/T-T/T of known polymorphism in the NRAMP1 gene, as well as the genotypes FokI-F/f and FokI-f/f in the VDR gene were most often found in indigenous Warao with active TB. Binomial logistic regression was used for evaluating associations between polymorphisms and risk of contracting TB, an association between NRAMP1-D543N-A/A genotype distribution and TB susceptibility was found in Warao Amerindians. Regarding Venezuelan populations having different genetic backgrounds; statistically significant TB associations concerning NRAMP1-D543N-A/A, INT4-C/C and 3'UTR-TGTG+/+ variant genotype distributions in Warao Amerindians (indigenous) compared to Creole (admixed non-indigenous population) individuals were found. In conclusion, the results thus indicated that the association between NRAMP1-D543N-A/A genotype and TB in Warao Amerindians could support such allele's role in host susceptibility to Mtb infection.
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Affiliation(s)
- Zaida Araujo
- Laboratorio de Inmunología de Enfermedades Infecciosas, Instituto de Biomedicina "Dr. Jacinto Convit", Universidad Central de Venezuela, Apartado 4043, Caracas 1010A, Venezuela.
| | - Milena Camargo
- Molecular Biology and Immunology Department, Fundación Instituto de Inmunología de Colombia (FIDIC), Carrera 50 No. 26-20, Bogota, Colombia
| | - Darwin A Moreno Pérez
- Animal Science Faculty, Universidad de Ciencias Aplicadas y Ambientales (U.D.C.A), Calle 222 No. 55-37, Bogotá, Colombia
| | - Albina Wide
- Laboratorio de Biotecnología, Instituto de Medicina Tropical, Universidad Central de Venezuela, Caracas, Venezuela
| | - Dailobivxon Pacheco
- Laboratorio de Inmunología de Enfermedades Infecciosas, Instituto de Biomedicina "Dr. Jacinto Convit", Universidad Central de Venezuela, Apartado 4043, Caracas 1010A, Venezuela
| | - Diana Díaz Arévalo
- Molecular Biology and Immunology Department, Fundación Instituto de Inmunología de Colombia (FIDIC), Carrera 50 No. 26-20, Bogota, Colombia
| | - Carmen T Celis Giraldo
- Animal Science Faculty, Universidad de Ciencias Aplicadas y Ambientales (U.D.C.A), Calle 222 No. 55-37, Bogotá, Colombia
| | - Sandra Salas
- Molecular Biology and Immunology Department, Fundación Instituto de Inmunología de Colombia (FIDIC), Carrera 50 No. 26-20, Bogota, Colombia
| | - Jacobus H de Waard
- Laboratorio de Tuberculosis, Instituto de Biomedicina "Dr. Jacinto Convit", Universidad Central de Venezuela, Apartado 4043, Caracas 1010A, Venezuela
| | - Manuel A Patarroyo
- Molecular Biology and Immunology Department, Fundación Instituto de Inmunología de Colombia (FIDIC), Carrera 50 No. 26-20, Bogota, Colombia; Faculty of Medicine, Universidad Nacional de Colombia, Carrera 45 No. 26-85, Bogotá, Colombia; Health Sciences Division, Main Campus, Universidad Santo Tomás, Carrera 9 No. 51-11, Bogotá, Colombia.
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Yu J, Liu M, Mijiti X, Liu H, Wang Q, Yin C, Anwaierjiang A, Xu M, Li M, Deng L, Xiao H, Zhao X, Wan K, Li G, Yuan X. Association of Single-Nucleotide Polymorphisms in the VDR Gene with Tuberculosis and Infection of Beijing Genotype Mycobacterium tuberculosis. Infect Drug Resist 2023; 16:3157-3169. [PMID: 37235072 PMCID: PMC10208660 DOI: 10.2147/idr.s407595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 05/03/2023] [Indexed: 05/28/2023] Open
Abstract
Background The aim of the present study was to investigate the association between vitamin D receptor (VDR) gene polymorphism and tuberculosis susceptibility, as well as the potential interaction of host genetic factors with the heterogeneity of Mycobacterium tuberculosis in the population from Xinjiang, China. Methods From January 2019 to January 2020, we enrolled 221 tuberculosis patients as the case group and 363 staff with no clinical symptoms as the control group from four designated tuberculosis hospitals in southern Xinjiang, China. The polymorphisms of Fok I, Taq I, Apa I, Bsm I, rs3847987 and rs739837 in the VDR were detected by sequencing. M. tuberculosis isolates were collected from the case group and identified as Beijing or non-Beijing lineage by multiplex PCR. Propensity score (PS), univariate analysis and multivariable logistic regression models were used to perform the analysis. Results Our results showed that the allele and genotype frequencies of Fok I, Taq I, Apa I, Bsm I, rs3847987 and rs739837 in VDR were not correlated with tuberculosis susceptibility or lineages of M. tuberculosis. Two out of six loci of the VDR gene formed one haplotype block, and none of the haplotypes was found to correlate with tuberculosis susceptibility or lineages of M. tuberculosis infected. Conclusion Polymorphisms in the VDR gene may not indicate susceptibility to tuberculosis. There was also no evidence on the interaction between the VDR gene of host and the lineages of M. tuberculosis in the population from Xinjiang, China. Further studies are nonetheless required to prove our conclusions.
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Affiliation(s)
- Jinjie Yu
- School of Public Health, University of South China, Hengyang, 421001, People’s Republic of China
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, People’s Republic of China
| | - Mengwen Liu
- School of Public Health, Xinjiang Medical University, Urumqi, Xinjiang, 830011, People’s Republic of China
| | - Xiaokaiti Mijiti
- The Eighth Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, 830049, People’s Republic of China
| | - Haican Liu
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, People’s Republic of China
| | - Quan Wang
- The Eighth Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, 830049, People’s Republic of China
| | - Chunjie Yin
- School of Public Health, Xinjiang Medical University, Urumqi, Xinjiang, 830011, People’s Republic of China
| | | | - Miao Xu
- The Eighth Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, 830049, People’s Republic of China
| | - Machao Li
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, People’s Republic of China
| | - Lele Deng
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, People’s Republic of China
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China
| | - Hui Xiao
- School of Public Health, Xinjiang Medical University, Urumqi, Xinjiang, 830011, People’s Republic of China
| | - Xiuqin Zhao
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, People’s Republic of China
| | - Kanglin Wan
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, People’s Republic of China
| | - Guilian Li
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, People’s Republic of China
| | - Xiuqin Yuan
- School of Public Health, University of South China, Hengyang, 421001, People’s Republic of China
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Flores-Villalva S, Reid C, Remot A, Gordon SV, Meade KG. Long term dietary vitamin D 3 supplementation impacts both microbicidal and inflammatory responses to ex-vivo Mycobacterium bovis BCG challenge in dairy calves. Vet Immunol Immunopathol 2023; 258:110575. [PMID: 36848773 DOI: 10.1016/j.vetimm.2023.110575] [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: 09/06/2022] [Accepted: 02/19/2023] [Indexed: 02/22/2023]
Abstract
Vitamin D deficiency (VDD) is associated with enhanced susceptibility to multiple respiratory diseases in humans, including tuberculosis. However, the consequences of VDD for disease susceptibility in calves are unknown. Previously we developed a model to drive divergent circulating 25OHD concentrations in cattle, where animals were supplemented with vitamin D3 (vit D3) from birth to 7 months of age. Calves in the control group (Ctl) received a diet containing a standard vit D3 concentration, whereas the vit D group (VitD) received a diet with the highest vit D3 concentration allowed under EU guidelines. Here, we assessed the microbicidal activity and immunoregulatory effect of divergent 25OHD circulating levels to Mycobacterium bovis BCG challenge ex-vivo. Blood samples from Ctl and VitD calves were taken at 1-, 3- and 7-months of age. 25OHD concentrations were significantly different at 7 months (but not at 1 or 3 months) with animals from the VitD group having higher serum levels. Differences in microbicidal activity followed the same pattern, with no significant differences observed at 1 and 3 months, but at 7 months a significant increase in the percentage of bacteria killed was detected. Furthermore, analysis of the reactive oxygen species (ROS) and nitric oxide (NO) in serum showed a higher production of ROS and NO in VitD-supplemented calves. In contrast, serum concentrations of IL-1β and IL-8 were significantly lower. A similar anti-inflammatory profile was observed after gene expression analysis, with a significant downregulation of a cluster of genes including IL1B, IL1R1, CXCL1, CXCL2, CXCL5, MMP9 and COX2 and an upregulation of CXCR1, CX3CR1 and NCF1, in VitD calves after BCG challenge relative to Ctl animals. Collectively, these results suggest that dietary vit D3 boosts antimicrobial and innate immune responses and thereby could improve host anti-mycobacterial immunity.
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Affiliation(s)
- Susana Flores-Villalva
- School of Agriculture and Food Science, University College Dublin, Belfield, Dublin 4, Ireland; CENID Fisiología, INIFAP. Querétaro, Mexico
| | - Cian Reid
- School of Agriculture and Food Science, University College Dublin, Belfield, Dublin 4, Ireland
| | - Aude Remot
- INRAE, Université de Tours, Nouzilly, France
| | - Stephen V Gordon
- UCD School of Veterinary Medicine, University College Dublin, Belfield, Dublin 4, Ireland
| | - Kieran G Meade
- School of Agriculture and Food Science, University College Dublin, Belfield, Dublin 4, Ireland; Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Belfield, Dublin 4, Ireland; Institute of Food and Health, University College Dublin, Belfield, Dublin 4, Ireland.
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Caliskan M, Dabak M, Tumer KC. The relationship between serum cytokine profile and vitamin D in calves with neonatal diarrhea. Cytokine 2023; 165:156173. [PMID: 36933398 DOI: 10.1016/j.cyto.2023.156173] [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: 01/10/2023] [Revised: 03/02/2023] [Accepted: 03/05/2023] [Indexed: 03/18/2023]
Abstract
It is important to know the characteristics of the immunological response in newborn calf diarrhea, which is often caused by bacterial, viral and protozoal pathogens. Cytokinesare proteins that serve as chemical messengers to regulate theinnate and adaptive arms of theimmune response. Changes in circulatory cytokine levels provide valuable information for understanding the pathophysiological process and monitoring disease progression and inflammation. Vitamin D has important immunomodulatory effects, which include enhancing the innate immune system and inhibiting adaptative immune responses. The objective of this study was to evaluate the relationship between serum cytokine profile and vitamin D level in neonatal calves with diarrhea. The study population was comprised of 40 neonatal calves, 32 of which had diarrhea and 8 of which were healthy calves. The calves with diarrhea were allocated to four groups according to bacterial (Escherichia coli), viral (Rotavirus, Coronavirus) and protozoal (Cryptosporidium parvum) etiologies. Circulatory vitamin D metabolites (25-hydroxyvitamin D, 1,25-dihydroxyvitamin D) and cytokines (TNF-α, IFN-γ, IL-1β, IL-2, IL-4, IL-5, IL-6, IL-10, IL-12, IL-13 and IL-17) in the calves were determined. There was no statistically significant difference among the groups in 25-hydroxyvitamin D levels. 1,25-dihydroxyvitamin D levels were higher in Coronavirus and E. coli groups compared to the controls. Serum levels of all cytokines except for IL-13, were higher in E. coli group than those of the control group. As a result, differences in serum cytokines and vitamin D levels according to etiological factors in calf diarrhea indicate that vitamin D may play a role in the immune response in the disease.
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Affiliation(s)
- Mehmet Caliskan
- Department of Internal Medicine, Veterinary Teaching Hospital, Firat University, 23119 Elazig, Turkey.
| | - Murat Dabak
- Department of Internal Medicine, Veterinary Teaching Hospital, Firat University, 23119 Elazig, Turkey.
| | - Kenan Cagri Tumer
- Department of Internal Medicine, Faculty of Veterinary Medicine, Kastamonu University, 37150 Kastamonu, Turkey.
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Liang W, Hu A, Hu P, Zhu J, Wang Y. Estimating the tuberculosis incidence using a SARIMAX-NNARX hybrid model by integrating meteorological factors in Qinghai Province, China. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2023; 67:55-65. [PMID: 36271168 DOI: 10.1007/s00484-022-02385-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 09/30/2022] [Accepted: 10/06/2022] [Indexed: 06/16/2023]
Abstract
Tuberculosis (TB) is recognized as being a major public health concern owing to its increase in Qinghai, China. In this study, we aimed to estimate the long-term effects of meteorological variables on TB incidence and construct an advanced hybrid model with seasonal autoregressive integrated moving average (SARIMA) and a neural network nonlinear autoregression (SARIMAX-NNARX) by integrating meteorological factors and evaluating the model fitting and prediction effect. During 2005-2017, TB experienced an upward trend with obvious periodic and seasonal characteristics, peaking in spring and winter. The results showed that TB incidence was positively correlated with average relative humidity (ARH) with a 2-month lag (β = 1.889, p = 0.003), but negatively correlated with average atmospheric pressure (AAP) with a 1-month lag (β = - 1.633, p = 0.012), average temperature (AT) with a 2-month lag (β = - 0.093, p = 0.027), and average wind speed (AWS) with a 0-month lag (β = - 13.221, p = 0.033), respectively. The SARIMA (3,1,0)(1,1,1)12, SARIMAX(3,1,0)(1,1,1)12, and SARIMAX(3,1,0)(1,1,1)12-NNARX(15,3) were considered preferred models based on the evaluation criteria. Of them, the SARIMAX-NNARX technique had smaller error values than the SARIMA and SARIMAX models in both fitting and forecasting aspects. The sensitivity analysis also revealed the robustness of the mixture forecasting model. Therefore, the SARIMAX-NNARX model by integrating meteorological variables can be used as an accurate method for forecasting the epidemic trends which would be great importance for TB prevention and control in the coming periods in Qinghai.
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Affiliation(s)
- Wenjuan Liang
- Department of Epidemiology, International School of Public Health and One Health, Hainan Medical University, Haikou, Hainan Province, 571199, People's Republic of China
- Department of Epidemiology and Health Statistics, School of Public Health, The Third Affiliated Hospital, Xinxiang Medical University, No. 601 Jinsui Road, Hongqi District, Xinxiang, Henan Province, 453003, People's Republic of China
| | - Ailing Hu
- Department of Epidemiology and Health Statistics, School of Public Health, The Third Affiliated Hospital, Xinxiang Medical University, No. 601 Jinsui Road, Hongqi District, Xinxiang, Henan Province, 453003, People's Republic of China
| | - Pan Hu
- Department of Epidemiology and Health Statistics, School of Public Health, The Third Affiliated Hospital, Xinxiang Medical University, No. 601 Jinsui Road, Hongqi District, Xinxiang, Henan Province, 453003, People's Republic of China
| | - Jinqin Zhu
- Department of Epidemiology and Health Statistics, School of Public Health, The Third Affiliated Hospital, Xinxiang Medical University, No. 601 Jinsui Road, Hongqi District, Xinxiang, Henan Province, 453003, People's Republic of China
| | - Yongbin Wang
- Department of Epidemiology and Health Statistics, School of Public Health, The Third Affiliated Hospital, Xinxiang Medical University, No. 601 Jinsui Road, Hongqi District, Xinxiang, Henan Province, 453003, People's Republic of China.
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Campbell JR, Chan ED, Falzon D, Trajman A, Keshavjee S, Leung CC, Miller AC, Monedero-Recuero I, Rodrigues DS, Seo H, Baghaei P, Udwadia Z, Viiklepp P, Bastos M, Menzies D. Low Body Mass Index at Treatment Initiation and Rifampicin-Resistant Tuberculosis Treatment Outcomes: An Individual Participant Data Meta-Analysis. Clin Infect Dis 2022; 75:2201-2210. [PMID: 35476134 DOI: 10.1093/cid/ciac322] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 04/08/2022] [Accepted: 04/18/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The impact of low body mass index (BMI) at initiation of rifampicin-resistant tuberculosis (RR-TB) treatment on outcomes is uncertain. We evaluated the association between BMI at RR-TB treatment initiation and end-of-treatment outcomes. METHODS We performed an individual participant data meta-analysis of adults aged ≥18 years with RR-TB whose BMI was documented at treatment initiation. We compared odds of any unfavorable treatment outcome, mortality, or failure/recurrence between patients who were underweight (BMI <18.5 kg/m2) and not underweight. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were estimated using logistic regression, with matching on demographic, clinical, and treatment-related factors. We evaluated effect modification by human immunodeficiency virus (HIV) status and other variables using likelihood ratio tests. We also estimated cumulative incidence of mortality during treatment stratified by HIV. RESULTS Overall, 5148 patients were included; 1702 (33%) were underweight at treatment initiation. The median (interquartile range) age was 37 years (29 to 47), and 455 (9%) had HIV. Compared with nonunderweight patients, the aOR among underweight patients was 1.7 (95% CI, 1.4-1.9) for any unfavorable outcome, 3.1 (2.4-3.9) for death, and 1.6 (1.2-2.0) for failure/recurrence. Significant effect modification was found for World Health Organization region of treatment. Among HIV-negative patients, 24-month mortality was 14.8% (95% CI, 12.7%-17.3%) for underweight and 5.6% (4.5%-7.0%) for not underweight patients. Among patients with HIV, corresponding values were 33.0% (25.6%-42.6%) and 20.9% (14.1%-27.6%). CONCLUSIONS Low BMI at treatment initiation for RR-TB is associated with increased odds of unfavorable treatment outcome, particularly mortality.
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Affiliation(s)
- Jonathon R Campbell
- Department of Epidemiology, Biostatistics, and Occupational Health, Faculty of Medicine, McGill University, Montreal, Canada
| | - Edward D Chan
- Department of Academic Affairs and Medicine, National Jewish Health, Denver, Colorado, USA.,Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA.,Pulmonary Section, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colorado, USA
| | - Dennis Falzon
- Global TB Programme, World Health Organization, Geneva, Switzerland
| | - Anete Trajman
- Departamento de Clínica Médica, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.,Department of Medicine, Division of Respiratory Diseases, McGill University, Montreal, Canada
| | - Salmaan Keshavjee
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Chi C Leung
- Hong Kong Tuberculosis, Chest, and Heart Diseases Association, Hong Kong
| | - Ann C Miller
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Ignacio Monedero-Recuero
- TB-HIV Department, International Union against Tuberculosis and Lung Disease (The Union), Paris, France
| | - Denise S Rodrigues
- The Secretary of Health of The State of Sao Paulo, Instituto Clemente Ferreira, São Paulo, Brazil
| | - Haesook Seo
- Department of Tuberculosis, Seoul Metropolitan Government Seobuk Hospital, Seoul, South Korea
| | - Parvaneh Baghaei
- Clinical Tuberculosis and Epidemiology Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zarir Udwadia
- Pulmonary Department, Hinduja Hospital & Research Center, Mumbai, India
| | - Piret Viiklepp
- Department of Registries, National Institute for Health Development, Tallinn, Estonia
| | - Mayara Bastos
- Department of Epidemiology, Biostatistics, and Occupational Health, Faculty of Medicine, McGill University, Montreal, Canada
| | - Dick Menzies
- Department of Epidemiology, Biostatistics, and Occupational Health, Faculty of Medicine, McGill University, Montreal, Canada
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10
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Al-Jaberi FAH, Crone CG, Lindenstrøm T, Arildsen NS, Lindeløv ES, Aagaard L, Gravesen E, Mortensen R, Andersen AB, Olgaard K, Hjaltelin JX, Brunak S, Bonefeld CM, Kongsbak-Wismann M, Geisler C. Reduced vitamin D-induced cathelicidin production and killing of Mycobacterium tuberculosis in macrophages from a patient with a non-functional vitamin D receptor: A case report. Front Immunol 2022; 13:1038960. [DOI: 10.3389/fimmu.2022.1038960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 10/18/2022] [Indexed: 11/06/2022] Open
Abstract
Tuberculosis (TB) presents a serious health problem with approximately a quarter of the world’s population infected with Mycobacterium tuberculosis (M. tuberculosis) in an asymptomatic latent state of which 5–10% develops active TB at some point in their lives. The antimicrobial protein cathelicidin has broad antimicrobial activity towards viruses and bacteria including M. tuberculosis. Vitamin D increases the expression of cathelicidin in many cell types including macrophages, and it has been suggested that the vitamin D-mediated antimicrobial activity against M. tuberculosis is dependent on the induction of cathelicidin. However, unraveling the immunoregulatory effects of vitamin D in humans is hampered by the lack of suitable experimental models. We have previously described a family in which members suffer from hereditary vitamin D-resistant rickets (HVDRR). The family carry a mutation in the DNA-binding domain of the vitamin D receptor (VDR). This mutation leads to a non-functional VDR, meaning that vitamin D cannot exert its effect in family members homozygous for the mutation. Studies of HVDRR patients open unique possibilities to gain insight in the immunoregulatory roles of vitamin D in humans. Here we describe the impaired ability of macrophages to produce cathelicidin in a HVDRR patient, who in her adolescence suffered from extrapulmonary TB. The present case is a rare experiment of nature, which illustrates the importance of vitamin D in the pathophysiology of combating M. tuberculosis.
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11
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Cubillos-Angulo JM, Nogueira BMF, Arriaga MB, Barreto-Duarte B, Araújo-Pereira M, Fernandes CD, Vinhaes CL, Villalva-Serra K, Nunes VM, Miguez-Pinto JP, Amaral EP, Andrade BB. Host-directed therapies in pulmonary tuberculosis: Updates on anti-inflammatory drugs. Front Med (Lausanne) 2022; 9:970408. [PMID: 36213651 PMCID: PMC9537567 DOI: 10.3389/fmed.2022.970408] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 08/22/2022] [Indexed: 11/26/2022] Open
Abstract
Tuberculosis (TB) is a lethal disease and remains one of the top ten causes of mortality by an infectious disease worldwide. It can also result in significant morbidity related to persistent inflammation and tissue damage. Pulmonary TB treatment depends on the prolonged use of multiple drugs ranging from 6 months for drug-susceptible TB to 6–20 months in cases of multi-drug resistant disease, with limited patient tolerance resulting from side effects. Treatment success rates remain low and thus represent a barrier to TB control. Adjunct host-directed therapy (HDT) is an emerging strategy in TB treatment that aims to target the host immune response to Mycobacterium tuberculosis in addition to antimycobacterial drugs. Combined multi-drug treatment with HDT could potentially result in more effective therapies by shortening treatment duration, improving cure success rates and reducing residual tissue damage. This review explores the rationale and challenges to the development and implementation of HDTs through a succinct report of the medications that have completed or are currently being evaluated in ongoing clinical trials.
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Affiliation(s)
- Juan M. Cubillos-Angulo
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador, BA, Brazil
- Multinational Organization Network Sponsoring Translational and Epidemiological Research Initiative, Salvador, Brazil
| | - Betânia M. F. Nogueira
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador, BA, Brazil
- Multinational Organization Network Sponsoring Translational and Epidemiological Research Initiative, Salvador, Brazil
| | - María B. Arriaga
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador, BA, Brazil
- Multinational Organization Network Sponsoring Translational and Epidemiological Research Initiative, Salvador, Brazil
| | - Beatriz Barreto-Duarte
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
- Multinational Organization Network Sponsoring Translational and Epidemiological Research Initiative, Salvador, Brazil
- Curso de Medicina, Universidade Salvador, Salvador, Brazil
- Programa de Pós-Graduação em Clínica Médica, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Mariana Araújo-Pereira
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador, BA, Brazil
- Multinational Organization Network Sponsoring Translational and Epidemiological Research Initiative, Salvador, Brazil
| | - Catarina D. Fernandes
- Multinational Organization Network Sponsoring Translational and Epidemiological Research Initiative, Salvador, Brazil
| | - Caian L. Vinhaes
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
- Multinational Organization Network Sponsoring Translational and Epidemiological Research Initiative, Salvador, Brazil
- Bahiana School of Medicine and Public Health, Bahia Foundation for the Development of Sciences, Salvador, Brazil
| | - Klauss Villalva-Serra
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador, BA, Brazil
- Multinational Organization Network Sponsoring Translational and Epidemiological Research Initiative, Salvador, Brazil
- Curso de Medicina, Universidade Salvador, Salvador, Brazil
| | | | | | - Eduardo P. Amaral
- Immunobiology Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States
| | - Bruno B. Andrade
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador, BA, Brazil
- Multinational Organization Network Sponsoring Translational and Epidemiological Research Initiative, Salvador, Brazil
- Programa de Pós-Graduação em Clínica Médica, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
- Bahiana School of Medicine and Public Health, Bahia Foundation for the Development of Sciences, Salvador, Brazil
- *Correspondence: Bruno B. Andrade,
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12
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de Oliveira Rezende A, Sabóia RS, da Costa AC, da Silva Monteiro DMP, Zagmignan A, Santiago LÂM, Carvalho RC, Pereira PVS, Junqueira-Kipnis AP, de Sousa EM. Restricted Activation of the NF-κB Pathway in Individuals with Latent Tuberculosis Infection after HIF-1α Blockade. Biomedicines 2022; 10:biomedicines10040817. [PMID: 35453567 PMCID: PMC9024452 DOI: 10.3390/biomedicines10040817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 03/25/2022] [Accepted: 03/28/2022] [Indexed: 11/16/2022] Open
Abstract
Tuberculous granuloma formation is mediated by hypoxia-inducible factor 1 alpha (HIF-1α), and is essential for establishing latent tuberculosis infection (LTBI) and its progression to active tuberculosis (TB). Here, we investigated whether HIF-1α expression and adjacent mechanisms were associated with latent or active TB infection. Patients with active TB, individuals with LTBI, and healthy controls were recruited, and the expression of cytokine genes IL15, IL18, TNFA, IL6, HIF1A, and A20 in peripheral blood mononuclear cells (PBMCs) and serum vitamin D (25(OH)D3) levels were evaluated. Additionally, nuclear factor kappa B (NF-κB) and tumor necrosis factor-alpha (TNF-α) levels were analyzed in PBMC lysates and culture supernatants, respectively, after HIF-1α blockade with 2-methoxyestradiol. We observed that IL-15 expression was higher in individuals with LTBI than in patients with active TB, while IL-18 and TNF-α expression was similar between LTBI and TB groups. Additionally, serum 25(OH)D3 levels and expression of IL-6, HIF1A, and A20 were higher in patients with active TB than in individuals with LTBI. Moreover, PBMCs from individuals with LTBI showed decreased NF-κB phosphorylation and increased TNF-α production after HIF-1α blockade. Together, these results suggest that under hypoxic conditions, TNF-α production and NF-κB pathway downregulation are associated with the LTBI phenotype.
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Affiliation(s)
- Aline de Oliveira Rezende
- Graduate Program in Health Sciences, Federal University of Maranhão—UFMA, São Luís 65080-805, Brazil; (A.d.O.R.); (R.C.C.); (P.V.S.P.)
| | - Rafaella Santos Sabóia
- Graduate Program in Microbial Biology, CEUMA University—UniCEUMA, São Luís 65075-120, Brazil;
| | | | | | - Adrielle Zagmignan
- Graduate Program in Health and Services Management, CEUMA University—UniCEUMA, São Luís 65075-120, Brazil; (D.M.P.d.S.M.); (A.Z.)
| | - Luis Ângelo Macedo Santiago
- Graduate Program in Biodiversity and Biotechnology, Amazônia-BIONORTE, Federal University of Maranhão—UFMA, São Luís 65080-805, Brazil;
| | - Rafael Cardoso Carvalho
- Graduate Program in Health Sciences, Federal University of Maranhão—UFMA, São Luís 65080-805, Brazil; (A.d.O.R.); (R.C.C.); (P.V.S.P.)
| | - Paulo Vitor Soeiro Pereira
- Graduate Program in Health Sciences, Federal University of Maranhão—UFMA, São Luís 65080-805, Brazil; (A.d.O.R.); (R.C.C.); (P.V.S.P.)
| | - Ana Paula Junqueira-Kipnis
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia 74605-050, Brazil;
| | - Eduardo Martins de Sousa
- Graduate Program in Health Sciences, Federal University of Maranhão—UFMA, São Luís 65080-805, Brazil; (A.d.O.R.); (R.C.C.); (P.V.S.P.)
- Graduate Program in Microbial Biology, CEUMA University—UniCEUMA, São Luís 65075-120, Brazil;
- Graduate Program in Biodiversity and Biotechnology, Amazônia-BIONORTE, Federal University of Maranhão—UFMA, São Luís 65080-805, Brazil;
- Correspondence:
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13
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Association between TAP gene polymorphisms and tuberculosis susceptibility in a Han Chinese population in Guangdong. Mol Genet Genomics 2022; 297:779-790. [PMID: 35325275 PMCID: PMC8943507 DOI: 10.1007/s00438-022-01885-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 03/08/2022] [Indexed: 12/02/2022]
Abstract
Tuberculosis (TB) is an important public health problem. Studies indicated that TAP plays a key role in the presentation and transport of antigenic peptides during anti-M.tb infection. Given the important biological role of the TAP gene involved in anti-M.tb infection, a family-based case–control study including 133 tuberculosis patients, 107 healthy household contacts, and 173 healthy controls was conducted to assess the association between TAP gene polymorphisms and TB susceptibility. The basic information of subjects and their blood samples were collected. Four SNPs including rs1135216, rs1057141, rs241447, and rs3819721 were genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR–RFLP). Our results suggested that BMI, residence, bedroom crowding, indoor humidity, fitness activities, history of smoking, and TB exposure history were associated with the occurrence of tuberculosis (P < 0.05). A significant association was observed between the TAP1 rs1135216 CT/CC genotype and increased TB risk, and the ORs were 2.56 (95% CI 1.31–4.99) and 6.73 (95% CI 1.33–34.02), respectively. TAP2 rs3819721 GG genotype carriers also showed an increased risk of TB when compared TB patients to healthy household contacts. Haplotype analysis revealed that the haplotype CT at rs1057141 and rs1135216 (OR = 11.34, 95% CI 1.49–86.56; OR = 7.45, 95% CI 1.43–38.76), as well as TA at rs241447 and rs3819721 (OR = 2.20, 95% CI 1.07–4.56) had a significantly increased risk of TB. The genetic risk scores (GRS) analysis of the four loci indicated that the risk of tuberculosis increased with increasing GRS scores in TB vs HHC (Ptrend = 0.010) and in TB vs HC (Ptrend = 0.001). In conclusion, our findings suggested that the SNPs of rs1135216 and rs3819721 were associated with TB susceptibility among the tuberculosis-prone families in the Chinese Han population and the risk of developing tuberculosis increases with the number of risk alleles, which could help identify high-risk groups in time and take scientific preventive measures. Further cohort studies with large samples are needed to validate the role of TAP gene variants on TB susceptibility.
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14
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Vitamin D Status and Immune Response in Hospitalized Patients with Moderate and Severe COVID-19. Pharmaceuticals (Basel) 2022; 15:ph15030305. [PMID: 35337103 PMCID: PMC8955127 DOI: 10.3390/ph15030305] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 02/22/2022] [Accepted: 02/26/2022] [Indexed: 12/17/2022] Open
Abstract
A low 25-hydroxyvitamin D (25(OH)D) level is considered as an independent risk factor for COVID-19 severity. However, the association between vitamin D status and outcomes in COVID-19 is controversial. In the present study we investigate the association between the serum 25(OH)D level, immune response, and clinical disease course in patients with COVID-19. A total of 311 patients hospitalized with COVID-19 were enrolled. For patients with a vitamin D deficiency/insufficiency, the prevalence of severe COVID-19 was higher than in those with a normal 25(OH)D level (p < 0.001). The threshold of 25(OH)D level associated with mortality was 11.4 ng/mL (p = 0.003, ROC analysis). The frequency of CD3+CD4+ T helper (Th) cells was decreased in patients with 25(OH)D level ≤ 11.4 ng/mL, compared to healthy controls (HCs). There were no differences in the frequency of naive, central memory (CM), effector memory (EM), and terminally differentiated effector memory Th cells in patients with COVID-19 compared to HCs. The frequency of T-follicular helpers was decreased both in patients with 25(OH)D level > 11.4 ng/mL (p < 0.001) and 25(OH)D level ≤ 11.4 ng/mL (p = 0.003) compared to HCs. Patients with 25(OH)D level > 11.4 ng/mL had an increased frequency of Th2 CM (p = 0.010) and decreased Th17 CM (p < 0.001). While the frequency of Th2 EM was significantly increased, the frequency of Th17 EM was significantly decreased in both groups compared to HCs. Thus, 25(OH)D level is an independent risk factor for the disease severity and mortality in patients with COVID-19. We demonstrate that the serum 25(OH)D level ≤ 11.4 ng/mL is associated with the stimulation of Th2 and the downregulation of Th17 cell polarization of the adaptive immunity in patients with COVID-19.
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15
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Zhang TP, Chen SS, Zhang GY, Shi SJ, Wei L, Li HM. Association of vitamin D pathway genes polymorphisms with pulmonary tuberculosis susceptibility in a Chinese population. GENES & NUTRITION 2021; 16:6. [PMID: 33882819 PMCID: PMC8061222 DOI: 10.1186/s12263-021-00687-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 04/14/2021] [Indexed: 01/08/2023]
Abstract
OBJECTIVE This study aimed to evaluate the association of single nucleotide polymorphisms (SNPs) of vitamin D metabolic pathway genes with susceptibility to pulmonary tuberculosis (PTB). METHODS Nine hundred seventy-nine patients (490 PTB cases and 489 healthy controls) were included in this study. Seventeen SNPs of vitamin D metabolic pathway genes, including CYP24A1, CYP27A1, CYP27B1, CYP2R1, GC, and DHCR7, were genotyped with improved multiple ligase detection reaction (iMLDR). RESULTS The GC rs3733359 GA, rs16847024 CT genotypes were significantly associated with the reduced risk of PTB, and the rs3733359 A, rs16847024 T alleles were also associated with the decreased PTB susceptibility. The GT genotype of GC rs4588 variant was significantly higher in patients with PTB when compared to controls. Moreover, the increased risk of rs3733359 and rs16847024 variants, and a decreased risk of rs4588, were found under the dominant mode among the PTB patients. However, there was no significant relationship of CYP24A1, CYP27A1, CYP27B1, CYP2R1, and DHCR7 polymorphisms with the risk of PTB. In CYP27A1, the rs17470271 T and rs933994 T alleles were significantly associated with leukopenia, drug resistance in the PTB patients, respectively. In GC gene, the rs7041 and rs3733359 variants were found to be associated with pulmonary infection, fever in the PTB patients, respectively. The increased frequency of rs16847024 TT genotype was found in the PTB patients with fever and drug-induced liver damage. DHCR7 rs12785878 TT genotype, and T allele frequencies were both significantly associated with pulmonary infection in the PTB patients. The haplotype analysis showed that CYP24A1 TACT, CYP2R1 GGCT, GGAT, GC AATG haplotypes were related to PTB susceptibility. CONCLUSION Our study suggested that GC SNPs were associated with the genetic background of PTB. CYP27A1, GC, and DHCR7 genetic variations might contribute to several clinical phenotypes of PTB in Chinese.
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Affiliation(s)
- Tian-Ping Zhang
- The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, 17 Lujiang Road, Hefei, Anhui, 230001, People's Republic of China.
| | - Shuang-Shuang Chen
- Anhui Chest Hospital (Anhui Provincial TB Institute), Clinical College of Chest, Anhui Medical University, 397 Jixi Road, Hefei, Anhui, 230022, People's Republic of China
| | - Gen-You Zhang
- Anhui Chest Hospital (Anhui Provincial TB Institute), Clinical College of Chest, Anhui Medical University, 397 Jixi Road, Hefei, Anhui, 230022, People's Republic of China
| | - Si-Jiu Shi
- Anhui Chest Hospital (Anhui Provincial TB Institute), Clinical College of Chest, Anhui Medical University, 397 Jixi Road, Hefei, Anhui, 230022, People's Republic of China
| | - Li Wei
- Pharmacoepidemiology and Medication Safety Research Cluster, UCL School of Pharmacy, London, UK
| | - Hong-Miao Li
- Anhui Chest Hospital (Anhui Provincial TB Institute), Clinical College of Chest, Anhui Medical University, 397 Jixi Road, Hefei, Anhui, 230022, People's Republic of China.
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Uptake of Vitamins D 2, D 3, D 4, D 5, D 6, and D 7 Solubilized in Mixed Micelles by Human Intestinal Cells, Caco-2, an Enhancing Effect of Lysophosphatidylcholine on the Cellular Uptake, and Estimation of Vitamins D' Biological Activities. Nutrients 2021; 13:nu13041126. [PMID: 33805560 PMCID: PMC8067314 DOI: 10.3390/nu13041126] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 03/26/2021] [Accepted: 03/26/2021] [Indexed: 02/06/2023] Open
Abstract
Vitamins D have various biological activities, as well as intestinal calcium absorption. There has been recent concern about insufficient vitamin D intake. In addition to vitamins D2 and D3, there are lesser-known vitamins D4–D7. We synthesized vitamins D5–D7, which are not commercially available, and then evaluated and compared the mixed micelles-solubilized vitamins D uptake by Caco-2 cells. Except for vitamin D5, the uptake amounts of vitamins D4–D7 by differentiated Caco-2 cells were similar to those of vitamins D2 and D3. The facilitative diffusion rate in the ezetimibe inhibited pathway was approximately 20% for each vitamin D type, suggesting that they would pass through the pathway at a similar rate. Lysophosphatidylcholine enhanced each vitamin D uptake by approximately 2.5-fold. Lysophosphatidylcholine showed an enhancing effect on vitamin D uptake by reducing the intercellular barrier formation of Caco-2 cells by reducing cellular cholesterol, suggesting that increasing the uptakes of vitamins D and/or co-ingesting them with lysophosphatidylcholine, would improve vitamin D insufficiency. The various biological activities in the activated form of vitamins D4–D7 were estimated by Prediction of Activity Spectra for Substances (PASS) online simulation. These may have some biological activities, supporting the potential as nutritional components.
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Sarangi A, Das BS, Patnaik G, Sarkar S, Debnath M, Mohan M, Bhattacharya D. Potent anti-mycobacterial and immunomodulatory activity of some bioactive molecules of Indian ethnomedicinal plants that have the potential to enter in TB management. J Appl Microbiol 2021; 131:1578-1599. [PMID: 33772980 DOI: 10.1111/jam.15088] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 03/01/2021] [Accepted: 03/23/2021] [Indexed: 11/26/2022]
Abstract
Tuberculosis (TB) is one of the deadliest infectious diseases of human civilization. Approximately one-third of global population is latently infected with the TB pathogen Mycobacterium tuberculosis (M.tb). The discovery of anti-TB antibiotics leads to decline in death rate of TB. However, the evolution of antibiotic-resistant M.tb-strain and the resurgence of different immune-compromised diseases re-escalated the death rate of TB. WHO has already cautioned about the chances of pandemic situation in TB endemic countries until the discovery of new anti-tubercular drugs, that is, the need of the hour. Analysing the pathogenesis of TB, it was found that M.tb evades the host by altering the balance of immune response and affects either by killing the cells or by creating inflammation. In the pre-antibiotic era, traditional medicines were only therapeutic measures for different infectious diseases including tuberculosis. The ancient literatures of India or ample Indian traditional knowledge and ethnomedicinal practices are evidence for the treatment of TB using different indigenous plants. However, in the light of modern scientific approach, anti-TB effects of those plants and their bioactive molecules were not established thoroughly. In this review, focus has been given on five bioactive molecules of different traditionally used Indian ethnomedicinal plants for treatment of TB or TB-like symptom. These compounds are also validated with proper identification and their mode of action with modern scientific approaches. The effectiveness of these molecules for sensitive or drug-resistant TB pathogen in clinical or preclinical studies was also evaluated. Thus, our specific aim is to highlight such scientifically validated bioactive compounds having anti-mycobacterial and immunomodulatory activity for future use as medicine or adjunct-therapeutic molecule for TB management.
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Affiliation(s)
- A Sarangi
- Centre for Biotechnology, School of Pharmaceutical Sciences, SOA Deemed to be University, Bhubaneswar, Odisha, India
| | - B S Das
- Centre for Biotechnology, School of Pharmaceutical Sciences, SOA Deemed to be University, Bhubaneswar, Odisha, India
| | - G Patnaik
- Special Centre for Molecular Medicine, Jawaharlal Nehru University, New Delhi, India
| | - S Sarkar
- Barsal High School, Rampurhat, West Bengal, India
| | - M Debnath
- Panskura Banamali College (Autonomous), Vidyasagar University, Panskura, West Bengal, India
| | - M Mohan
- ICMR-National Institute of Malarial Research (NIMR), New Delhi, India
| | - D Bhattacharya
- Centre for Biotechnology, School of Pharmaceutical Sciences, SOA Deemed to be University, Bhubaneswar, Odisha, India
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Hammami F, Koubaa M, Mejdoub Y, Turki M, Ben Ayed H, Chakroun A, Rekik K, Smaoui F, Ben Jemaa M. The association between vitamin D deficiency and extrapulmonary tuberculosis: Case-control study. Tuberculosis (Edinb) 2020; 126:102034. [PMID: 33291025 DOI: 10.1016/j.tube.2020.102034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 11/12/2020] [Accepted: 11/24/2020] [Indexed: 10/22/2022]
Abstract
Tuberculosis remains a public health issue worldwide. Identifying its risk factors, such as vitamin D deficiency, is mandatory so as to target the preventive strategies. We aimed to study the association between vitamin D deficiency and extrapulmonary tuberculosis. We conducted a case-control study including all cases of extrapulmonary tuberculosis hospitalized in the infectious diseases department over a two-year period from April 2017 until April 2019. We included 45 cases of extrapulmonary tuberculosis and 45 controls matched by gender and age. Vitamin D deficiency was significantly more frequent among cases (80% vs 37.7%; p < 0.001), with an odds ratio (OR) of 6.5 (IC95% = 2.5-16). The mean levels of vitamin D were significantly lower among cases (11.9 ± 8.8 vs 22.3 ± 11 ng/mL; p < 0.001). In the multivariate analysis, we found that vitamin D deficiency was an independent predictor of extrapulmonary tuberculosis (OR = 6.13; p < 0.001). The cutoff value of vitamin D predictor of extrapulmonary tuberculosis was 18.5 ng/mL which was associated with a sensitivity of 80% and a specificity of 62%. Our study provides strong evidence that vitamin D deficiency was an independent predictor of extrapulmonary tuberculosis. More studies are needed in order to evaluate the potential preventive role of vitamin D and the benefit of possible supplementation.
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Affiliation(s)
- Fatma Hammami
- Infectious Diseases Department, Extra-pulmonary Tuberculosis Research Unity UR17SP12, Hedi Chaker University Hospital, University of Sfax, Tunisia.
| | - Makram Koubaa
- Infectious Diseases Department, Extra-pulmonary Tuberculosis Research Unity UR17SP12, Hedi Chaker University Hospital, University of Sfax, Tunisia.
| | - Yosra Mejdoub
- Community Health and Epidemiology Department, Hedi Chaker University Hospital, University of Sfax, Tunisia
| | - Mouna Turki
- Biochemistry Laboratory, Habib Bourguiba University Hospital, University of Sfax, Tunisia
| | - Houda Ben Ayed
- Preventive Medicine and Hygiene Department, Hedi Chaker University Hospital, University of Sfax, Tunisia
| | - Amal Chakroun
- Infectious Diseases Department, Extra-pulmonary Tuberculosis Research Unity UR17SP12, Hedi Chaker University Hospital, University of Sfax, Tunisia
| | - Khaoula Rekik
- Infectious Diseases Department, Extra-pulmonary Tuberculosis Research Unity UR17SP12, Hedi Chaker University Hospital, University of Sfax, Tunisia
| | - Fatma Smaoui
- Infectious Diseases Department, Extra-pulmonary Tuberculosis Research Unity UR17SP12, Hedi Chaker University Hospital, University of Sfax, Tunisia
| | - Mounir Ben Jemaa
- Infectious Diseases Department, Extra-pulmonary Tuberculosis Research Unity UR17SP12, Hedi Chaker University Hospital, University of Sfax, Tunisia
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Cheng C, Pan W, Li X, Qu H. Clinical effect of vitamin D supplementation on patients with pulmonary tuberculosis and its influence on the expression of immune cells and inflammatory factors. Exp Ther Med 2020; 20:2236-2244. [PMID: 32765700 PMCID: PMC7401900 DOI: 10.3892/etm.2020.8957] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 05/21/2020] [Indexed: 01/01/2023] Open
Abstract
Tuberculosis is highly infectious and has a high incidence worldwide. Therefore, effective treatment is essential for the disease. The immune function and inflammatory factors can reflect the therapeutic effect of pulmonary tuberculosis to some extent. Thus, the aim of the present study was to investigate the clinical effect of vitamin D supplementation on pulmonary tuberculosis patients and its influence on the expression of immune cells and inflammatory factors in patients. A total of 256 patients with pulmonary tuberculosis who were admitted to our hospital were collected as research participants; 120 patients who were treated with conventional antituberculosis drugs were taken as a control group (CG) and 136 patients who were treated with vitamin D-assisted antituberculosis drugs were taken as the research group (RG). The levels of inflammatory factors (IL-6, MMP-9, IL-4, TNF-α) and T lymphocyte subgroup of patients were measured in both groups before and after treatment. The efficacy was compared in both groups. The disappearance time of wheezing and cough in RG was shorter than that in CG (P<0.001). There was no difference in X-ray chest plain film, sputum examination results and efficacy of patients in both groups (P>0.05). After treatment, CD3+, CD4+, CD4+/CD8+ were upregulated in both groups (P<0.05), while CD3+, CD4+, CD4+/CD8+ in RG were higher than those in CG (P<0.05). After treatment, inflammatory factors in both groups improved compared with those before treatment. Serum inflammatory factors in RG were significantly lower than those in CG (P<0.05). After treatment, surfactant protein in the two groups was lower than that before treatment, while that in RG was significantly lower than that in CG (P<0.05). After treatment, soluble selectins in both groups improved significantly. The level of soluble selectins in RG was slightly lower than that in CG. The incidence of adverse reactions in RG was lower than that in CG. The life quality scores of patients in RG were slightly higher than those in CG (P<0.05). In conclusion, vitamin D-assisted antituberculosis drugs can effectively improve the immune function and expression level of inflammatory factors in pulmonary tuberculosis patients and reduce adverse reactions.
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Affiliation(s)
- Chunxu Cheng
- Department of Infectious Diseases, Changchun Hospital for Infectious Diseases, Changchun, Jilin 130031, P.R. China
| | - Weina Pan
- Department of Infectious Diseases, Changchun Hospital for Infectious Diseases, Changchun, Jilin 130031, P.R. China
| | - Xiang Li
- Department of Radiology, The Third People's Hospital of Gongzhuling City, Siping, Jilin 136105, P.R. China
| | - Hongyan Qu
- Department of Drug-Resistant Tuberculosis, Changchun Hospital for Infectious Diseases, Changchun, Jilin 130031, P.R. China
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20
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Xu P, Gao QL, Wang YJ, Guo CF, Tang MX, Liu SH, Deng A, Wang YX, Li YB, Zhang HQ. rs6127698 polymorphism in the MC3R gene and susceptibility to multifocal tuberculosis in southern Chinese Han population. INFECTION GENETICS AND EVOLUTION 2020; 82:104292. [PMID: 32240798 DOI: 10.1016/j.meegid.2020.104292] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 02/15/2020] [Accepted: 03/19/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To investigate the relationship between melanocortin-3 receptor (MC3R) gene polymorphism and tuberculosis (TB) susceptibility in Han population in southern China. METHODS A total of 341 patients with TB (173 with pulmonary TB and 168 with multifocal TB) and 359 healthy controls were enrolled. Genotyping was performed by PCR and DNA sequencing, and detection of protein was performed by western blot. RESULTS The distributions of genotype and allele frequencies of rs6127698 differed significantly between the pulmonary and multifocal TB groups, and between the multifocal TB and control groups. The GG genotype was significantly more common among multifocal TB patients than among pulmonary TB patients (P = .009) and those in the control group (P = .001) under the recessive model. GG+GT genotype was more common in multifocal TB than in pulmonary TB (P < .01) and control group (P < .01) under the dominant model. G allele was more common in multifocal TB than in pulmonary TB (P < .0167) and control group (P < .0167). Patients with multifocal TB had an increased expression of MC3R protein than healthy controls (P < .05). CONCLUSIONS In the southern Chinese Han population, the MC3R rs6127698 polymorphism, which accompanying an increased expression of MC3R protein,was associated with susceptibility to multifocal TB. Presence of the G allele increased the risk of developing multifocal TB.
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Affiliation(s)
- Peng Xu
- Department of Spine Surgery, Xiangya Spinal Surgery Center, Xiangya Hospital, Central South University, Changsha 410008, People's Republic of China
| | - Qi-le Gao
- Department of Spine Surgery, Xiangya Spinal Surgery Center, Xiangya Hospital, Central South University, Changsha 410008, People's Republic of China
| | - Yun-Jia Wang
- Department of Spine Surgery, Xiangya Spinal Surgery Center, Xiangya Hospital, Central South University, Changsha 410008, People's Republic of China.
| | - Chao-Feng Guo
- Department of Spine Surgery, Xiangya Spinal Surgery Center, Xiangya Hospital, Central South University, Changsha 410008, People's Republic of China
| | - Ming-Xing Tang
- Department of Spine Surgery, Xiangya Spinal Surgery Center, Xiangya Hospital, Central South University, Changsha 410008, People's Republic of China
| | - Shao-Hua Liu
- Department of Spine Surgery, Xiangya Spinal Surgery Center, Xiangya Hospital, Central South University, Changsha 410008, People's Republic of China
| | - Ang Deng
- Department of Spine Surgery, Xiangya Spinal Surgery Center, Xiangya Hospital, Central South University, Changsha 410008, People's Republic of China
| | - Yu-Xiang Wang
- Department of Spine Surgery, Xiangya Spinal Surgery Center, Xiangya Hospital, Central South University, Changsha 410008, People's Republic of China
| | - Yan-Bing Li
- Department of Clinical Laboratory, Xiangya Hospital, Central South University, Changsha 410008, People's Republic of China
| | - Hong-Qi Zhang
- Department of Spine Surgery, Xiangya Spinal Surgery Center, Xiangya Hospital, Central South University, Changsha 410008, People's Republic of China
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21
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Association between multivitamin supplementation and mortality among patients with Ebola virus disease: An international multisite cohort study. Afr J Emerg Med 2020; 10:23-29. [PMID: 32161708 PMCID: PMC7058859 DOI: 10.1016/j.afjem.2019.11.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 10/30/2019] [Accepted: 11/01/2019] [Indexed: 01/26/2023] Open
Abstract
INTRODUCTION Micronutrient supplementation is recommended in Ebola Virus Disease (EVD) care; however, there is limited data on its therapeutic effects. METHODS This retrospective cohort study included patients with EVD admitted to five Ebola Treatment Units (ETU) in Sierra Leone and Liberia during September 2014 to December 2015. A uniform protocol was used to guide ETU care, however, due to supply limitations, only a subset of patients received multivitamins. Data on demographics, clinical characteristics, and laboratory testing was collected. The outcome of interest was facility-based mortality and the primary predictor was multivitamin supplementation initiated within 48 h of admission. The multivitamin formulations included: thiamine, riboflavin, niacin and vitamins A, C, and D3. Propensity score models (PSM) were used to match patients based on covariates associated with multivitamin administration and mortality. Mortality between cases treated and untreated within 48 h of admission were compared using generalized estimating equations to calculate relative risk with bootstrap methods employed to assess statistical significance. RESULTS There were 424 patients with EVD who had sufficient treatment data for analysis, of which 261 (61.6%) had daily multivitamins initiated within 48 h of admission. The mean age of the cohort was 30.5 years and 59.4% were female. In the propensity score matched analysis, mortality was 53.5% among patients receiving multivitamins and 66.2% among patients not receiving multivitamins, resulting in a relative risk for mortality of 0.81 (p = 0.03) for patients receiving multivitamins. CONCLUSION Early multivitamin supplementation was associated with lower overall mortality. Further research on the impact of micronutrient supplementation in EVD is warranted.
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Host-Directed Therapy as a Novel Treatment Strategy to Overcome Tuberculosis: Targeting Immune Modulation. Antibiotics (Basel) 2020; 9:antibiotics9010021. [PMID: 31936156 PMCID: PMC7168302 DOI: 10.3390/antibiotics9010021] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Revised: 12/25/2019] [Accepted: 01/04/2020] [Indexed: 12/12/2022] Open
Abstract
Tuberculosis (TB) is one of the leading causes of mortality and morbidity, particularly in developing countries, presenting a major threat to the public health. The currently recommended long term treatment regimen with multiple antibiotics is associated with poor patient compliance, which in turn, may contribute to the emergence of multi-drug resistant TB (MDR-TB). The low global treatment efficacy of MDR-TB has highlighted the necessity to develop novel treatment options. Host-directed therapy (HDT) together with current standard anti-TB treatments, has gained considerable interest, as HDT targets novel host immune mechanisms. These immune mechanisms would otherwise bypass the antibiotic bactericidal targets to kill Mycobacterium tuberculosis (Mtb), which may be mutated to cause antibiotic resistance. Additionally, host-directed therapies against TB have been shown to be associated with reduced lung pathology and improved disease outcome, most likely via the modulation of host immune responses. This review will provide an update of host-directed therapies and their mechanism(s) of action against Mycobacterium tuberculosis.
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23
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Risalde MA, Roy Á, Bezos J, Pineda C, Casal C, Díez-Guerrier A, Lopez-Villalba I, Fernández-Manzano Á, Moreno I, De Juan L, Domínguez L, Gortazar C. Hypervitaminosis D has no positive effects on goat tuberculosis and may cause chronic renal lesions. Vet Rec 2019; 185:759. [PMID: 31690642 DOI: 10.1136/vr.105411] [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: 02/11/2019] [Revised: 08/12/2019] [Accepted: 10/18/2019] [Indexed: 11/03/2022]
Abstract
BACKGROUND There is evidence for a link between vitamin D deficiency and active tuberculosis (TB). In human beings, several trials have evaluated the role of vitamin D supplementation in TB treatment with conflicting results. However, the role of vitamin D supplementation in animal TB control has received less attention. The authors evaluated the benefit of vitamin D supplementation for preventing mycobacterial infection or reducing TB lesions (TBL) in a controlled trial with goats naturally exposed to Mycobacterium caprae. METHODS Two groups of goats, a vitamin D-supplemented group and a non-supplemented control group, were housed for 10 months in direct contact with M caprae-infected adult goats. Upon contact with the infected adult goats, all animals were TB-tested every two months. RESULTS No experimental evidence of a protective effect of vitamin D supplementation based on M caprae culture prevalence, TBL prevalence, median TBL score or the proportion of single versus multiple organs presenting TBL was observed. CONCLUSION The results indicate that, in the conditions used in this study, vitamin D supplementation in goats does not reduce TB infection risk nor the diffusion and severity of TBL. In addition, vitamin D-supplemented goats presented hyperphosphataemia and renal injury with calcifications suggestive of vitamin D intoxication.
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Affiliation(s)
- Maria Angeles Risalde
- Department of Comparative Pathology, University of Córdoba-Agrifood Campus of International Excellence (ceiA3), Cordoba, Spain.,Infectious Diseases Unit. Instituto Maimonides de Investigación Biomédica de Córdoba (IMIBIC). Hospital Universitario Reina Sofía de Córdoba - Universidad de Córdoba, Córdoba, Spain
| | - Álvaro Roy
- Centro de Vigilancia Sanitaria Veterinaria (VISAVET), Universidad Complutense, Madrid, Spain.,CZ Vaccines, Porriño, Pontevedra, Spain
| | - Javier Bezos
- Centro de Vigilancia Sanitaria Veterinaria (VISAVET), Universidad Complutense, Madrid, Spain.,Dpto. de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense de Madrid, Madrid, Spain
| | - Carmen Pineda
- Departamento de Medicina y Cirugía Animal, Universidad de Córdoba, Córdoba, Spain
| | - Carmen Casal
- Laboratorios SYVA S.A.U. Technological Park, León, Spain
| | - Alberto Díez-Guerrier
- Dpto. de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense de Madrid, Madrid, Spain.,MAEVA SERVET S.L, Alameda del Valle, Madrid, Spain
| | | | | | - Inmaculada Moreno
- Servicio de Inmunología Microbiana, Centro Nacional de Microbiología, Instituto de Investigación Carlos III, Majadahonda, Madrid
| | - Lucía De Juan
- Centro de Vigilancia Sanitaria Veterinaria (VISAVET), Universidad Complutense, Madrid, Spain.,Dpto. de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense de Madrid, Madrid, Spain
| | - Lucas Domínguez
- Centro de Vigilancia Sanitaria Veterinaria (VISAVET), Universidad Complutense, Madrid, Spain.,Dpto. de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense de Madrid, Madrid, Spain
| | - Christian Gortazar
- SaBio (Health and Biotechnology), Instituto de Investigación en Recursos Cinegéticos IREC (CSIC-UCLM), Ciudad Real, Spain
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Abstract
Background: Tuberculosis is a leading cause of morbidity and mortality in humans worldwide. There is an urgent need for new and effective drugs to treat tuberculosis and shorten the duration of tuberculosis therapy. 1, 25-dihydroxy vitamin D3 (1,25 (OH)2D3) has been reported to have a synergistic effect with pyrazinamide (PZA) in killing tubercle bacilli in vitro. The addition of 1,25 (OH)2D3 to standard tuberculosis treatment should benefit patients if the adjunctive drug has a synergistic effect in vivo. Thus, in this study, calcitriol (bioactive 1,25 (OH)2D3) was administered to mice undergoing treatment for Mycobacterium tuberculosis (M.tb) infection with PZA, a first-line anti-tuberculosis drug, to determine whether vitamin D3 enhances the therapeutic effect. Methods: C57BL/6 female mice were infected with the M.tb H37Rv strain through aerosol exposure. Calcitriol and PZA, either alone or in combination, were orally administered to the M.tb infected mice. The effect of calcitriol on PZA activity was determined by evaluating the bacterial burden and analyzing the histopathological lesions in the lungs and spleen. To investigate the expression of inflammatory cytokines and anti-microbial peptide genes, we determined the transcriptional levels of interferon-γ (IFN-γ), interleukin-4 (IL-4), mouse β-defensin-2 (mBD2), and cathelicidin LL-37 through real-time quantitative polymerase chain reaction. The protein levels of IFN-γ were detected by enzyme-linked immunosorbent assay. Differences between groups were analyzed with independent samples t-test or one-way analysis of variance. Results: Calcitriol alone had little effect on tuberculosis infection, whereas PZA, compared with saline control treatment, decreased the bacterial burden (spleens: PZA vs. saline, 4.82 ± 0.22 vs. 5.22 ± 0.40 Log10 colony-forming units [CFU]/gram, t = 2.13, P < 0.05; lungs: PZA vs. saline, 5.55 ± 0.15 vs. 6.83 ± 0.46 Log10 CFU/gram, t = 6.56, P < 0.01) and pathological lesions in the lungs. Simultaneous administration of calcitriol with PZA, compared with PZA alone, decreased the bacterial load (spleen: calcitriol + PZA vs. PZA, 4.37 ± 0.13 vs. 4.82 ± 0.22 Log10 CFU/gram, t = 4.36, P < 0.01; lung: calcitriol + PZA vs. PZA, 5.03 ± 0.32 vs. 5.55 ± 0.15 Log10 CFU/gram, t = 3.58, P < 0.01) and attenuated the lung lesions (gross pathological score: calcitriol + PZA vs. PZA, 3.25 ± 0.50 vs. 2.50 ± 0.58, t = 1.96, P < 0.05; affected area of total lung area: calcitriol + PZA vs. PZA, 30.75% ± 6.50% vs. 21.55% ± 2.99%, t = 2.66, P < 0.05). Further studies demonstrated calcitriol significantly increased the expression of anti-inflammatory cytokine IL-4 but suppressed production of the pro-inflammatory cytokine IFN-γ (IL-4: calcitriol vs. saline, 5.69 ± 0.50 vs. 2.80 ± 0.56 fold of control, t = 6.74, P < 0.01; IFN-γ: calcitriol vs. saline, 1.36 ± 0.11 vs. 4.13 ± 0.83 fold of control, t = 5.77, P < 0.01). In addition, calcitriol alone or in combination with PZA significantly enhanced the transcriptional level of anti-microbial peptides (cathelicidin LL-37: calcitriol vs. saline, 10.59 ± 1.03 vs. 2.80 ± 0.90 fold of control, t = 9.85, P < 0.01; mBD2: calcitriol vs. saline, 7.92 ± 0.62 vs. 1.79 ± 0.45 fold of control, t = 13.82, P < 0.01), whereas PZA exerted a negative effect on anti-microbial peptide gene expression. Conclusions: Calcitriol as adjunctive treatment can result in beneficial treatment outcomes in M.tb infection by suppressing the inflammatory response and up-regulating the expression of anti-microbial peptides. These results indicate the feasibility of using calcitriol adjunctively with standard chemotherapy for the treatment of M.tb infection.
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Cai L, Li Z, Guan X, Cai K, Wang L, Liu J, Tong Y. The Research Progress of Host Genes and Tuberculosis Susceptibility. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2019; 2019:9273056. [PMID: 31485302 PMCID: PMC6710736 DOI: 10.1155/2019/9273056] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 05/05/2019] [Accepted: 05/29/2019] [Indexed: 02/05/2023]
Abstract
BACKGROUND/AIMS Nucleotide diversity may affect the immune regulation of tuberculosis (TB) patients, leading to the individual susceptibility to TB. In recent years, there are a lot of researches on the association of host genetic factors and TB susceptibility which has attracted increasing attention, and the in-depth study of its mechanism is gradually clear. MATERIALS We made a minireview on the association of many candidate genes with TB based on recent research studies systematically, such as the human leukocyte antigen (HLA) gene, the solute carrier family 11 member 1 (SLC11A1) gene system, the vitamin D receptor (VDR) gene, the mannan-binding lectin (MBL) gene, the nitric oxide synthase 2A (NOS2A) gene, the speckled 110 (SP110) gene, and the P2X7 receptor (P2X7) gene. The discovery of these candidate genes could reveal the pathogenesis of TB comprehensively and is crucial to provide scientific evidence for formulating the related measures of prevention and cure. DISCUSSION The host genes play important roles in the development of TB, and the host genes may become new targets for the prevention and treatment of TB. Effective regulation of host genes may help prevent or even treat TB. CONCLUSION This minireview focuses on the association of host genes with the development of TB, which may supply some clues for future therapies and novel drug targets for TB.
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Affiliation(s)
- Li Cai
- Wuhan Center for Disease Control and Prevention, Wuhan 430015, China
- School of Health Sciences, Wuhan University, Wuhan 430071, China
| | - Zhan Li
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xuhua Guan
- Hubei Center for Disease Control and Prevention, 430079, China
| | - Kun Cai
- Hubei Center for Disease Control and Prevention, 430079, China
| | - Lei Wang
- Hubei Center for Disease Control and Prevention, 430079, China
| | - Jiafa Liu
- School of Health Sciences, Wuhan University, Wuhan 430071, China
- Hubei Center for Disease Control and Prevention, 430079, China
| | - Yeqing Tong
- Hubei Center for Disease Control and Prevention, 430079, China
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Golpour A, Bereswill S, Heimesaat MM. Antimicrobial and Immune-Modulatory Effects of Vitamin D Provide Promising Antibiotics-Independent Approaches to Tackle Bacterial Infections - Lessons Learnt from a Literature Survey. Eur J Microbiol Immunol (Bp) 2019; 9:80-87. [PMID: 31662886 PMCID: PMC6798578 DOI: 10.1556/1886.2019.00014] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 07/24/2019] [Indexed: 12/19/2022] Open
Abstract
Antimicrobial multidrug-resistance (MDR) constitutes an emerging threat to global health and makes the effective prevention and treatment of many, particularly severe infections challenging, if not impossible. Many antibiotic classes have lost antimicrobial efficacy against a plethora of infectious agents including bacterial species due to microbial acquisition of distinct resistance genes. Hence, the development of novel anti-infectious intervention strategies including antibiotic-independent approaches is urgently needed. Vitamins such as vitamin D and vitamin D derivates might be such promising molecular candidates to combat infections caused by bacteria including MDR strains. Using the Pubmed database, we therefore performed an in-depth literature survey, searching for publications on the antimicrobial effect of vitamin D directed against bacteria including MDR strains. In vitro and clinical studies between 2009 and 2019 revealed that vitamin D does, in fact, possess antimicrobial properties against both Gram-positive and Gram-negative bacterial species, whereas conflicting results could be obtained from in vivo studies. Taken together, the potential anti-infectious effects for the antibiotic-independent application of vitamin D and/or an adjunct therapy in combination with antibiotic compounds directed against infectious diseases such as tuberculosis, H. pylori infections, or skin diseases, for instance, should be considered and further investigated in more detail.
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Affiliation(s)
- Ainoosh Golpour
- Institute of Microbiology, Infectious Diseases and Immunology Charité - University Medicine Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Stefan Bereswill
- Institute of Microbiology, Infectious Diseases and Immunology Charité - University Medicine Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Markus M Heimesaat
- Institute of Microbiology, Infectious Diseases and Immunology Charité - University Medicine Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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Ostadmohammadi V, Milajerdi A, Ghayour-Mobarhan M, Ferns G, Taghizadeh M, Badehnoosh B, Mirzaei H, Asemi Z. The Effects of Vitamin D Supplementation on Glycemic Control, Lipid Profiles and C-Reactive Protein Among Patients with Cardiovascular Disease: a Systematic Review and Meta-Analysis of Randomized Controlled Trials. Curr Pharm Des 2019; 25:201-210. [DOI: 10.2174/1381612825666190308152943] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 03/04/2019] [Indexed: 12/21/2022]
Abstract
Background:
Insulin resistance, dyslipidemia and chronic inflammation are important risk factors for
cardiovascular diseases (CVD). Hence, vitamin D supplementation might be an appropriate approach to decrease
the complications of CVD. This systematic review and meta-analysis aimed to determine the effects of vitamin D
supplementation on glycemic control, lipid profiles, and C-reactive protein among patients with coronary artery
disease.
Methods:
Two independent authors systematically searched online databases including EMBASE, Scopus, Pub-
Med, Cochrane Library, and Web of Science until 20th September 2018. Cochrane Collaboration risk of bias tool
was applied to assess the methodological quality of included trials. The heterogeneity among the included studies
was assessed using Cochran’s Q test and I-square (I2) statistic. Data were pooled using a random-effects model
and weighted mean difference (WMD) was considered as the overall effect size.
Results:
A total of eight trials (305 participants in the intervention group and 325 in placebo group) were included
in the current meta-analysis. Pooling effect sizes from studies revealed a significant reduction in fasting glucose
(WMD): -15.67; 95% CI: -29.32, -2.03), insulin concentrations (WMD: -3.53; 95% CI: -4.59, -2.46) and homeostatic
model assessment of insulin resistance (WMD: -1.07; 95% CI: -1.49, -0.66), and significant increase in the
quantitative insulin-sensitivity check index (WMD: 0.02; 95% CI: 0.01, 0.03) following the administration of
vitamin D. In addition, pooled analysis revealed a significant increase in serum HDL-cholesterol concentrations
following vitamin D therapy (WMD: 3.08; 95% CI: 1.42, 4.73). Additionally, vitamin D supplementation significantly
reduced C-reactive protein (CRP) levels (WMD: -0.75; 95% CI: -1.28, -0.23).
Conclusion:
This meta-analysis demonstrated the beneficial effects of vitamin D supplementation on improving
glycemic control, HDL-cholesterol and CRP levels among patients with CVD, though it did not affect triglycerides,
total- and LDL-cholesterol levels.
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Affiliation(s)
- Vahidreza Ostadmohammadi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
| | - Alireza Milajerdi
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Majid Ghayour-Mobarhan
- Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Gordon Ferns
- Brighton & Sussex Medical School, Division of Medical Education, Falmer, Brighton, Sussex BN1 9PH, United Kingdom
| | - Mohsen Taghizadeh
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
| | - Bita Badehnoosh
- Department of Gynecology and Obstetrics, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Hamed Mirzaei
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
| | - Zatollah Asemi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
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Zhang Y, Liu M, Wu SS, Jiang H, Zhang J, Wang S, Ma W, Li Q, Ma Y, Liu Y, Feng W, Amsalu E, Li X, Wang W, Li W, Guo X. Spatial distribution of tuberculosis and its association with meteorological factors in mainland China. BMC Infect Dis 2019; 19:379. [PMID: 31053104 PMCID: PMC6500018 DOI: 10.1186/s12879-019-4008-1] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Accepted: 04/22/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The incidence of tuberculosis (TB) remains high worldwide. Current strategies will not eradicate TB by 2035; instead, by 2182 is more likely. Therefore, it is urgent that new risk factors be identified. METHODS An ecological study was conducted in 340 prefectures in China from 2005 to 2015. The spatial distribution of TB incidence was shown by clustering and hotspot analysis. The relationship between the distribution patterns and six meteorological factors was evaluated by the geographically weighted regression (GWR) model. RESULTS During the 11 years of the study period, TB incidence was persistently low in the east and high in the west. Local coefficients from the GWR model showed a positive correlation between TB incidence and yearly average rainfall (AR) but a negative correlation with other meteorological factors. Average relative humidity (ARH) was negatively correlated with the incidence of TB in all prefectures (p < 0.05). CONCLUSION Meteorological factors may play an important role in the prevention and control of TB.
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Affiliation(s)
- Yingjie Zhang
- Chinese Center for Disease Control and Prevention, Beijing, 102206 China
| | - Mengyang Liu
- School of Public Health, Capital Medical University, Beijing, 100069 China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, 100069 China
| | - Samuel S. Wu
- Department of Statistics, University of Florida, Gainesville, FL 32610-7450 USA
| | - Hui Jiang
- National Tuberculosis Clinical Lab of China, Beijing Chest Hospital, Capital Medical University, Beijing, 101149 China
- Beijing Key Laboratory of Drug Resistance Tuberculosis, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, 101149 China
| | - Junjie Zhang
- School of life sciences, Beijing Normal University, Beijing, 100875 China
| | - Songwang Wang
- Chinese Center for Disease Control and Prevention, Beijing, 102206 China
| | - Wei Ma
- Institute of statistics and big data, Renmin University of China, Beijing, 100872 China
| | - Qihuan Li
- School of Public Health, Capital Medical University, Beijing, 100069 China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, 100069 China
| | - Yuan Ma
- School of Public Health, Capital Medical University, Beijing, 100069 China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, 100069 China
| | - Yue Liu
- School of Public Health, Capital Medical University, Beijing, 100069 China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, 100069 China
| | - Wei Feng
- School of Public Health, Capital Medical University, Beijing, 100069 China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, 100069 China
| | - Endawoke Amsalu
- School of Public Health, Capital Medical University, Beijing, 100069 China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, 100069 China
| | - Xia Li
- Department of Mathematics and Statistics, La Trobe University, Bundoora, Victoria 3086 Australia
| | - Wei Wang
- School of Medical Sciences and Health, Edith Cowan University, WA6027, Perth, Australia
| | - Weimin Li
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, 100069 China
- National Tuberculosis Clinical Lab of China, Beijing Chest Hospital, Capital Medical University, Beijing, 101149 China
- Beijing Key Laboratory of Drug Resistance Tuberculosis, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, 101149 China
| | - Xiuhua Guo
- School of Public Health, Capital Medical University, Beijing, 100069 China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, 100069 China
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Rajatanavin N, Kanokrungsee S, Aekplakorn W. Vitamin D status in Thai dermatologists and working-age Thai population. J Dermatol 2018; 46:206-212. [PMID: 30592077 DOI: 10.1111/1346-8138.14742] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 11/13/2018] [Indexed: 02/02/2023]
Abstract
This study aimed to determine the prevalence of vitamin D insufficiency among Thai dermatologists compared with the general working-age population in Bangkok. A cross-sectional study was conducted in healthy Thai physicians who had at least 1 years' experience in dermatology practise and a subsample of the general Thai population from the Fourth National Health Survey. Serum 25-hydroxyvitamin D (25[OH]D), a combination of 25(OH)D2 and 25(OH)D3, levels in both groups were measured using liquid chromatography coupled with mass spectrometry. The majority of dermatologists were of Fitzpatrick skin type III (n = 61, 61.3%) or IV (n = 32, 33.3%). The mean serum 25(OH)D and 25(OH)D3 levels were 18.9 and 18.2 ng/mL, respectively, whereas the corresponding levels in the general population were 26.5 and 25.8 ng/mL. None of the dermatologist had serum 25(OH)D sufficiency (>30 ng/mL), 38 (38.78%) had vitamin D insufficiency (20-30 ng/mL) and 60 (61.22%) had vitamin D deficiency (<20 ng/mL). The frequency of vitamin D deficiency in dermatologists was significantly higher than in the general population (61.2% vs 19.2%, P < 0.001). Ninety percent of dermatologists used sunscreen daily and spent time mostly indoors. Dermatologists used physical sun-protection more than half of the time when outdoors, for example, a book or paper as a sunshade (70.3%), an umbrella (48.4%), a long-sleeved shirt (20.4%) or a hat (9.7%). In conclusion, dermatologists showed a remarkably high prevalence of vitamin D deficiency which may be due to inadequate exposure to sunlight, regular use of sunscreen and practicing various sun-protection activities.
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Affiliation(s)
- Natta Rajatanavin
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Silada Kanokrungsee
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Wichai Aekplakorn
- Department of Community Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Wang M, Kong W, He B, Li Z, Song H, Shi P, Wang J. Vitamin D and the promoter methylation of its metabolic pathway genes in association with the risk and prognosis of tuberculosis. Clin Epigenetics 2018; 10:118. [PMID: 30208925 PMCID: PMC6136159 DOI: 10.1186/s13148-018-0552-6] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 09/04/2018] [Indexed: 12/24/2022] Open
Abstract
Background A variety of abnormalities in vitamin D metabolism have been reported in patients with active tuberculosis. However, intervention trials have produced inconsistent results. We hypothesized that genetic and epigenetic changes in the key genes of the vitamin D metabolic pathway may partly explain the differences between studies. Methods We performed a case-control study followed by a prospective cohort study. We recruited 122 patients with pulmonary tuberculosis and 118 healthy controls. The serum 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D levels were measured. The methylation of the promoter regions of key genes in the vitamin D metabolic pathway (CYP24A1, CYP27A1, CYP27B1, CYP2R1, and VDR) was detected using the Illumina MiSeq platform. The specific methylation profiles were examined as epigenetic biomarkers. The sensitivity, specificity, and receiver operating characteristic (ROC) curves were used to estimate the predictive value of the biomarkers. Results The baseline serum 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D concentrations in the cases were significantly lower than those in the controls (51.60 ± 27.25 nmol/L vs. 117.50 ± 75.50 nmol/L, Z = − 8.515, P < 0.001; 82.63 ± 51.43 pmol/L vs. 94.02 ± 49.26 pmol/L, Z = − 2.165, P = 0.03). We sequenced 310 CpG sites in five candidate genes. After Bonferroni correction, there were 55 differentially methylated CpG sites between cases and controls; 41.5% were in the CYP27B1 gene, 31.7% were in the CYP24A1 gene, 14.7% were in the VDR gene, and 12.3% were in the CYP27A1 gene. When we designated the CpG sites that remained significant after the Bonferroni correction as the biomarkers, the area under the curve (AUC) for the cumulative methylation was 0.810 (95% CI 0.754–0.866). There was an interaction between CYP27A1 methylation level and 1,25-dihydroxyvitamin D concentration associated with the risk of TB (ORinteraction = 4.11, 95% CI 1.26–13.36, P = 0.019). The serum 1,25-dihydroxyvitamin D concentration at the end of the intensive treatment stage was related to a patient’s prognosis (P = 0.008). There were 23 CpG sites that were individually related to the treatment outcomes, but the relationships were not significant after the Bonferroni correction. Conclusion Both serum vitamin D concentrations and the methylation levels of key genes in the vitamin D metabolic pathway are related to the risk and prognosis of tuberculosis. Electronic supplementary material The online version of this article (10.1186/s13148-018-0552-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Min Wang
- Department of Epidemiology, School of Public Health, Nanjing Medical University, 101 Longmian Ave, Nanjing, 211166, People's Republic of China.,Department of Preventive Health Care, People's Hospital of Suzhou High-tech Zone, Suzhou, People's Republic of China
| | - Weimin Kong
- Department of Nursing, The First People's Hospital of Yancheng City, Yancheng, People's Republic of China
| | - Biyu He
- Department of Epidemiology, School of Public Health, Nanjing Medical University, 101 Longmian Ave, Nanjing, 211166, People's Republic of China
| | - Zhongqi Li
- Department of Epidemiology, School of Public Health, Nanjing Medical University, 101 Longmian Ave, Nanjing, 211166, People's Republic of China
| | - Huan Song
- Department of Epidemiology, School of Public Health, Nanjing Medical University, 101 Longmian Ave, Nanjing, 211166, People's Republic of China
| | - Peiyi Shi
- Department of Epidemiology, School of Public Health, Nanjing Medical University, 101 Longmian Ave, Nanjing, 211166, People's Republic of China
| | - Jianming Wang
- Department of Epidemiology, School of Public Health, Nanjing Medical University, 101 Longmian Ave, Nanjing, 211166, People's Republic of China. .,Key Laboratory of Infectious Diseases, School of Public Health, Nanjing Medical University, Nanjing, People's Republic of China.
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Jarrett P, Scragg R. A short history of phototherapy, vitamin D and skin disease. Photochem Photobiol Sci 2018; 16:283-290. [PMID: 27892584 DOI: 10.1039/c6pp00406g] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The earliest record between sun exposure and skin disease goes back five millennia to the ancient Egyptians. The modern scientific era of medical light therapy and skin diseases started in 1877 when Downs and Blunt reported that exposure to light inhibited fungal growth in test tubes. Continuing research generated a growing medical interest in the potential the effects of light to treat and cure skin diseases considered as parasitic. This culminated in the awarding of the 1903 Nobel Prize in Medicine to Niels Finsen for his pioneering work showing that light could successfully treat cutaneous mycobacterium tuberculosis (lupus vulgaris), a disfiguring disorder common at the time. Cod liver oil was used as a folk remedy to treat rickets prior to 1789 in Manchester, UK and sunlight was published as the cure for this disease in 1921. The work by Hess and Weinstock in 1925 showed that food irradiated with ultraviolet (UV) light prevented rickets in rats, which paved the way for the discovery of vitamin D. The range of skin diseases treated by light therapy increased in the following years, to the point where a 1932 review by the American Medical Association on the use of UV therapy in dermatology listed 34 skin conditions for which UV radiation may be useful. This period coincided with the development of sanatoria in Europe and North America which used heliotherapy for the treatment of tuberculosis. UV therapy and vitamin D continued to be used successfully for the treatment of tuberculosis up to the 1950s when it was superseded by more effective antibiotics. Modern phototherapy developed in the 1980s with the discovery of the action spectrum for psoriasis leading to the development of narrow band UVB. Subsequently a biological mechanism by which UV light and vitamin D treated tuberculosis was identified in 2006. This involves activation of human macrophages via toll-like receptors to upregulate the vitamin D receptor gene resulting in induction of the antimicrobial peptide cathelicidin. The role of UV light and vitamin D in the treatment of skin diseases is currently an active area of research.
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Affiliation(s)
- Paul Jarrett
- Department of Dermatology, Middlemore Hospital, Auckland, New Zealand. and Department of Medicine, The University of Auckland, Auckland, New Zealand and Department of Epidemiology and Biostatistics, The University of Auckland, Auckland, New Zealand
| | - Robert Scragg
- Department of Epidemiology and Biostatistics, The University of Auckland, Auckland, New Zealand
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Zenata O, Vrzal R. Fine tuning of vitamin D receptor (VDR) activity by post-transcriptional and post-translational modifications. Oncotarget 2018; 8:35390-35402. [PMID: 28427151 PMCID: PMC5471063 DOI: 10.18632/oncotarget.15697] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Accepted: 02/08/2017] [Indexed: 12/31/2022] Open
Abstract
Vitamin D receptor (VDR) is a member of the nuclear receptor (NR) superfamily of ligand-activated transcription factors. Activated VDR is responsible for maintaining calcium and phosphate homeostasis, and is required for proper cellular growth, cell differentiation and apoptosis. The expression of both phases I and II drug-metabolizing enzymes is also regulated by VDR, therefore it is clinically important. Post-translational modifications of NRs have been known as an important mechanism modulating the activity of NRs and their ability to drive the expression of target genes. The aim of this mini review is to summarize the current knowledge about post-transcriptional and post-translational modifications of VDR.
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Affiliation(s)
- Ondrej Zenata
- Department of Cell Biology and Genetics, Faculty of Science, Palacky University, Olomouc, Czech Republic
| | - Radim Vrzal
- Department of Cell Biology and Genetics, Faculty of Science, Palacky University, Olomouc, Czech Republic
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Musteikienė G, Miliauskas S, Zaveckienė J, Žemaitis M, Vitkauskienė A. Factors associated with sputum culture conversion in patients with pulmonary tuberculosis. MEDICINA-LITHUANIA 2018; 53:386-393. [PMID: 29496377 DOI: 10.1016/j.medici.2018.01.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 11/04/2017] [Accepted: 01/22/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to determine what factors are associated with sputum culture conversion after 1 month of tuberculosis (TB) treatment. MATERIALS AND METHODS A total of 52 patients with new drug susceptible pulmonary TB were included in the study. Patients completed St. George respiratory questionnaire (SGRQ), they were asked about smoking, alcohol use, living conditions and education. Body mass index (BMI) measurements, laboratory tests (C reactive protein [CRP], vitamin D, albumin) were performed, and chest X-ray was done. After 1 month of treatment sputum culture was repeated. RESULTS Culture conversion after 1 month of treatment was found in 38.5% cases. None of investigated social factors appeared to have an effect on conversion, but worse overall health status (as reported in SGRQ) and longer duration of tobacco smoking were detected in the "no conversion" group. Concentrations of albumin, CRP, X-ray score and the time it took Mycobacterium tuberculosis culture to grow also differed. Patients who scored 30 or more on SGRQ were more than 7 times as likely to have no conversion. However, the most important factor predicting sputum culture conversion was sputum smear grade at the beginning of treatment: patients with grade of 2+ or more had more than 20-fold higher relative risk for no conversion. Using receiver operating characteristic curve analysis, we also developed a risk score for no conversion. CONCLUSIONS The most important factors in predicting sputum culture conversion after 1 month of treatment were grades of acid-fast bacilli in sputum smears at time of diagnosis and scores of SGRQ.
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Affiliation(s)
- Greta Musteikienė
- Department of Pulmonology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
| | - Skaidrius Miliauskas
- Department of Pulmonology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Jurgita Zaveckienė
- Department of Radiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Marius Žemaitis
- Department of Pulmonology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Astra Vitkauskienė
- Department of Laboratory Medicine, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
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Maceda EB, Gonçalves CCM, Andrews JR, Ko AI, Yeckel CW, Croda J. Serum vitamin D levels and risk of prevalent tuberculosis, incident tuberculosis and tuberculin skin test conversion among prisoners. Sci Rep 2018; 8:997. [PMID: 29343733 PMCID: PMC5772514 DOI: 10.1038/s41598-018-19589-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 01/03/2018] [Indexed: 01/09/2023] Open
Abstract
Poor vitamin D status has been associated with tuberculosis (TB); whether poor status is cause or consequence of disease is uncertain. We conducted a case-control study and two nested case-control studies to determine whether vitamin D levels were associated with active TB, tuberculin skin test (TST) conversion, and risk of progression to the active TB in prisoners in Brazil. In multivariable conditional logistic regression, subnormal vitamin D levels (OR, 3.77; 95% CI, 1.04–13.64) were more likely in prisoners with active TB. In contrast, vitamin D was not found to be a risk factor for either TST conversion (OR, 2.49; 95% CI, 0.64–9.66) or progression to active disease (OR, 0.59; 95% CI, 0.13–2.62). Black race (OR, 11.52; 95% CI, 2.01–63.36), less than 4 years of schooling (OR, 2.70; 95% CI, 0.90–8.16), cigarette smoking (OR, 0.23; 95% CI, 0.06–0.79) were identified as risk factors for TST conversion. Risk of progression to active TB was found to be associated with cigarette smoking (OR, 7.42; 95% CI, 1.23–44.70). Our findings in the prison population show that poor vitamin D status is more common in individuals with active TB, but is not a risk factor for acquisition of latent TB or progression to active TB.
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Affiliation(s)
- Elisangela B Maceda
- Faculty of Health Sciences, Federal University of Grande Dourados, Dourados, Brazil
| | | | - Jason R Andrews
- Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Albert I Ko
- Department of Epidemiology of Microbial Disease, Yale School of Public Health, New Haven, CT, USA.,Oswaldo Cruz Foundation, Salvador, Brazil
| | - Catherine W Yeckel
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Julio Croda
- Faculty of Health Sciences, Federal University of Grande Dourados, Dourados, Brazil. .,School of Medicine, Federal University of Mato Grosso do Sul, Campo Grande, Brazil. .,Oswaldo Cruz Foundation, Campo Grande, Brazil.
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Chandrasekaran P, Saravanan N, Bethunaickan R, Tripathy S. Malnutrition: Modulator of Immune Responses in Tuberculosis. Front Immunol 2017; 8:1316. [PMID: 29093710 PMCID: PMC5651251 DOI: 10.3389/fimmu.2017.01316] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Accepted: 09/29/2017] [Indexed: 11/13/2022] Open
Abstract
Nutrition plays a major role in the management of both acute and chronic diseases, in terms of body’s response to the pathogenic organism. An array of nutrients like macro- and micro-nutrients, vitamins, etc., are associated with boosting the host’s immune responses against intracellular pathogens including mycobacterium tuberculosis (M.tb). These nutrients have an immunomodulatory effects in controlling the infection and inflammation process and nutritional deficiency of any form, i.e., malnutrition may lead to nutritionally acquired immunodeficiency syndrome, which greatly increases an individual’s susceptibility to progression of infection to disease. This narrative review looks at the various mechanisms by which nutrition or its deficiency leads to impaired cell mediated and humoral immune responses, which in turn affects the ability of an individual to fight M.tb infection or disease. There is very little evidence in the literature that any specific food on its own or a specific quantity can alter the course of TB disease or be effective in the treatment of malnutrition. Further clinical trials or studies will be needed to recommend and to better understand the link between malnutrition, tuberculosis, and impaired immunity.
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Affiliation(s)
| | - Natarajan Saravanan
- Department of Biochemistry and Clinical Pharmacology, National Institute for Research in Tuberculosis, Chennai, India
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Mirhosseini N, Vatanparast H, Mazidi M, Kimball SM. The Effect of Improved Serum 25-Hydroxyvitamin D Status on Glycemic Control in Diabetic Patients: A Meta-Analysis. J Clin Endocrinol Metab 2017; 102:3097-3110. [PMID: 28957454 DOI: 10.1210/jc.2017-01024] [Citation(s) in RCA: 83] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 06/28/2017] [Indexed: 02/08/2023]
Abstract
BACKGROUND Type 2 diabetes is a global health concern, with an increased prevalence and high cost of treatment. OBJECTIVE The aim of this systematic review and meta-analysis was to determine the effect of vitamin D supplementation and improved vitamin D status on glycemia and insulin resistance in type 2 diabetic patients. DATA SOURCE We searched PUBMED/Medline, Cumulative Index to Nursing and Allied Health, and Cochrane Library (until January 2017). STUDY SELECTION Prospective clinical trials were selected evaluating the impact of vitamin D supplementation on glycosylated hemoglobin (HbA1c), serum fasting plasma glucose (FPG), and homeostatic model assessment of insulin resistance (HOMA-IR) in diabetic patients. DATA EXTRACTION AND SYNTHESIS We used a random-effects model to synthesize quantitative data, followed by a leave-one-out method for sensitivity analysis. The systematic review registration was CRD42017059555. From a total of 844 entries identified via literature search, 24 controlled trials (1528 individuals diagnosed with type 2 diabetes) were included. The meta-analysis indicated a significant reduction in HbA1c [mean difference: -0.30%; 95% confidence interval (CI): -0.45 to -0.15, P < 0.001], FPG [mean difference: -4.9 mg/dL (-0.27 mmol/L); 95% CI: -8.1 to -1.6 (-0.45 to -0.09 mmol/L), P = 0.003], and HOMA-IR (mean difference: -0.66; 95% CI: -1.06 to -0.26, P = 0.001) following vitamin D supplementation and significant increase in serum 25-hydroxyvitamin D levels [overall increase of 17 ± 2.4 ng/mL (42 ± 6 nmol/L)]. CONCLUSIONS Vitamin D supplementation, a minimum dose of 100 µg/d (4000 IU/d), may significantly reduce serum FPG, HbA1c, and HOMA-IR index, and helps to control glycemic response and improve insulin sensitivity in type 2 diabetic patients.
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Affiliation(s)
| | - Hassanali Vatanparast
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan S7N 5A2, Canada
| | - Mohsen Mazidi
- Key State Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing 100101, China
- Institute of Genetics and Developmental Biology, International College, University of Chinese Academy of Sciences, Beijing 100101, China
| | - Samantha M Kimball
- Pure North S'Energy Foundation, Calgary, Alberta T2R 0C5, Canada
- St. Mary's University, Calgary, Alberta T2X 1Z4, Canada
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Lactoferricin Peptides Increase Macrophages' Capacity To Kill Mycobacterium avium. mSphere 2017; 2:mSphere00301-17. [PMID: 28875176 PMCID: PMC5577653 DOI: 10.1128/msphere.00301-17] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 08/04/2017] [Indexed: 01/15/2023] Open
Abstract
The genus Mycobacterium comprises several pathogenic species, including M. tuberculosis, M. leprae, M. avium, etc. Infections caused by these bacteria are particularly difficult to treat due to their intrinsic impermeability, low growth rate, and intracellular localization. Antimicrobial peptides are increasingly acknowledged as potential treatment tools, as they have a high spectrum of activity, low tendency to induce bacterial resistance, and immunomodulatory properties. In this study, we show that peptides derived from bovine lactoferricin (LFcin) improve the antimicrobial activity of ethambutol against Mycobacterium avium growing inside macrophages. Moreover, the d-enantiomer of a short version of lactoferricin containing amino acids 17 to 30 (d-LFcin17–30) causes intramacrophagic death of M. avium by increasing the formation of lysosomes and autophagosomes. This work opens the way to the use of lactoferricin-derived peptides to treat infections caused by mycobacteria and highlights important modulatory effects of d-FLcin17–30 on macrophages, which may be useful under other conditions in which macrophage activation is needed. Mycobacterial infections cause a significant burden of disease and death worldwide. Their treatment is long, toxic, costly, and increasingly prone to failure due to bacterial resistance to currently available antibiotics. New therapeutic options are thus clearly needed. Antimicrobial peptides represent an important source of new antimicrobial molecules, both for their direct activity and for their immunomodulatory potential. We have previously reported that a short version of the bovine antimicrobial peptide lactoferricin with amino acids 17 to 30 (LFcin17–30), along with its variants obtained by specific amino acid substitutions, killed Mycobacterium avium in broth culture. In the present work, those peptides were tested against M. avium living inside its natural host cell, the macrophage. We found that the peptides increased the antimicrobial action of the conventional antibiotic ethambutol inside macrophages. Moreover, the d-enantiomer of the lactoferricin peptide (d-LFcin17–30) was more stable and induced significant killing of intracellular mycobacteria by itself. Interestingly, d-LFcin17–30 did not localize to M. avium-harboring phagosomes but induced the production of proinflammatory cytokines and increased the formation of lysosomes and autophagosome-like vesicles. These results lead us to conclude that d-LFcin17–30 primes macrophages for intracellular microbial digestion through phagosomal maturation and/or autophagy, culminating in mycobacterial killing. IMPORTANCE The genus Mycobacterium comprises several pathogenic species, including M. tuberculosis, M. leprae, M. avium, etc. Infections caused by these bacteria are particularly difficult to treat due to their intrinsic impermeability, low growth rate, and intracellular localization. Antimicrobial peptides are increasingly acknowledged as potential treatment tools, as they have a high spectrum of activity, low tendency to induce bacterial resistance, and immunomodulatory properties. In this study, we show that peptides derived from bovine lactoferricin (LFcin) improve the antimicrobial activity of ethambutol against Mycobacterium avium growing inside macrophages. Moreover, the d-enantiomer of a short version of lactoferricin containing amino acids 17 to 30 (d-LFcin17–30) causes intramacrophagic death of M. avium by increasing the formation of lysosomes and autophagosomes. This work opens the way to the use of lactoferricin-derived peptides to treat infections caused by mycobacteria and highlights important modulatory effects of d-FLcin17–30 on macrophages, which may be useful under other conditions in which macrophage activation is needed.
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Rode AKO, Kongsbak M, Hansen MM, Lopez DV, Levring TB, Woetmann A, Ødum N, Bonefeld CM, Geisler C. Vitamin D Counteracts Mycobacterium tuberculosis-Induced Cathelicidin Downregulation in Dendritic Cells and Allows Th1 Differentiation and IFNγ Secretion. Front Immunol 2017; 8:656. [PMID: 28620394 PMCID: PMC5450038 DOI: 10.3389/fimmu.2017.00656] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 05/18/2017] [Indexed: 01/21/2023] Open
Abstract
Tuberculosis (TB) presents a serious health problem with approximately one-third of the world's population infected with Mycobacterium tuberculosis in a latent state. Experience from the pre-antibiotic era and more recent clinical studies have established a beneficial role of sunlight and vitamin D in patients with TB. At the same time, experimental data have shown that Th1 cells through production of IFNγ are crucial for cathelicidin release by macrophages, bacterial killing, and containment of M. tuberculosis in granulomas. Paradoxically, vitamin D has repeatedly been ascribed an immune-suppressive function inhibiting Th1 differentiation and production of IFNγ in T cells. The aim of this study was to investigate this apparent paradox. We studied naïve human CD4+ T cells activated either with CD3 and CD28 antibodies or with allogeneic dendritic cells (DC) stimulated with heat-killed M. tuberculosis (HKMT) or purified toll-like receptor (TLR) ligands. We show that vitamin D does not block differentiation of human CD4+ T cells to Th1 cells and that interleukin (IL)-12 partially counteracts vitamin D-mediated inhibition of IFNγ production promoting production of equal amounts of IFNγ in Th1 cells in the presence of vitamin D as in T cells activated in the absence of vitamin D and IL-12. Furthermore, we show that HKMT and TLR2 ligands strongly downregulate cathelicidin expression in DC and that vitamin D counteracts this by upregulating cathelicidin expression. In conclusion, we demonstrate that vitamin D counteracts M. tuberculosis-induced cathelicidin downregulation and allows Th1 differentiation and IFNγ secretion.
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Affiliation(s)
- Anna K O Rode
- Faculty of Health and Medical Sciences, Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
| | - Martin Kongsbak
- Faculty of Health and Medical Sciences, Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
| | - Marie M Hansen
- Faculty of Health and Medical Sciences, Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
| | - Daniel Villalba Lopez
- Faculty of Health and Medical Sciences, Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
| | - Trine B Levring
- Faculty of Health and Medical Sciences, Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
| | - Anders Woetmann
- Faculty of Health and Medical Sciences, Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
| | - Niels Ødum
- Faculty of Health and Medical Sciences, Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
| | - Charlotte M Bonefeld
- Faculty of Health and Medical Sciences, Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
| | - Carsten Geisler
- Faculty of Health and Medical Sciences, Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
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Sharma V, Mandavdhare HS, Kumar A, Sharma R, Sachdeva N, Prasad KK, Rana SS. Prevalence and clinical impact of vitamin D deficiency on abdominal tuberculosis. Ther Adv Infect Dis 2017. [PMID: 28634538 DOI: 10.1177/2049936117709722] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Vitamin D is recognised to have multiple actions, including role in immune modulation. The prevalence and impact of vitamin D deficiency (VDD) in abdominal tuberculosis is unknown. METHODS We report the prevalence and clinical impact of VDD in patients with abdominal tuberculosis. The patients were divided into two groups: VDD (<20 ng/ml) or vitamin D sufficient (VDS) (⩾20 ng/ml). Groups were compared for extent (abdominal alone or extra-abdominal also) of disease and pattern of involvement (intestinal, peritoneal or both) and inflammatory response [serum C-reactive protein (CRP)]. RESULTS Of 63 patients, 53 had complete data (mean age: 36.3 ± 14.43, 31 males). Fourty-five (84.9%) patients had VDD and mean VD levels were 11.1 ± 10.1 ng/ml. Of 8 patients with VDS, 1 (12.5%) had extra-abdominal involvement while 13 (28.9%) with VDD had extra-abdominal involvement (p = 0.066). The mean CRP in patients with VDD was 42.9 ± 34.9 mg/dl vis-a-vis 105.38 ± 64.8 in VDS (p ⩽ 0.05). All seven patients with both intestinal and peritoneal involvement had VDD. CONCLUSION VDD is common in abdominal tuberculosis and may be associated with more extensive involvement albeit a reduced inflammatory response.
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Affiliation(s)
- Vishal Sharma
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Harshal S Mandavdhare
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Amit Kumar
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ravi Sharma
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Naresh Sachdeva
- Department of Endocrinology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Kaushal K Prasad
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Surinder S Rana
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Abstract
Tuberculosis (TB) is still a major global health problem. A third of the world’s population is infected with Mycobacterium tuberculosis. Only ~10% of infected individuals develop TB but there are 9 million TB cases with 1.5 million deaths annually. The standard prophylactic treatment regimens for latent TB infection take 3–9 months, and new cases of TB require at least 6 months of treatment with multiple drugs. The management of latent TB infection and TB has become more challenging because of the spread of multidrug-resistant and extremely drug-resistant TB. Intensified efforts to find new TB drugs and immunotherapies are needed. Immunotherapies could modulate the immune system in patients with latent TB infection or active disease, enabling better control of M. tuberculosis replication. This review describes several types of potential immunotherapies with a focus on those which have been tested in humans.
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Affiliation(s)
- Getahun Abate
- Department of Internal Medicine, Division of Infectious Diseases, Allergy and Immunology
| | - Daniel F Hoft
- Department of Internal Medicine, Division of Infectious Diseases, Allergy and Immunology; Department of Molecular Microbiology and Immunology, Saint Louis University, St. Louis, MO, USA
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Barogui YT, Klis SA, Johnson RC, Phillips RO, van der Veer E, van Diemen C, van der Werf TS, Stienstra Y. Genetic Susceptibility and Predictors of Paradoxical Reactions in Buruli Ulcer. PLoS Negl Trop Dis 2016; 10:e0004594. [PMID: 27097163 PMCID: PMC4838240 DOI: 10.1371/journal.pntd.0004594] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Accepted: 03/09/2016] [Indexed: 01/23/2023] Open
Abstract
Introduction Buruli ulcer (BU) is the third most frequent mycobacterial disease in immunocompetent persons after tuberculosis and leprosy. During the last decade, eight weeks of antimicrobial treatment has become the standard of care. This treatment may be accompanied by transient clinical deterioration, known as paradoxical reaction. We investigate the incidence and the risks factors associated with paradoxical reaction in BU. Methods The lesion size of participants was assessed by careful palpation and recorded by serial acetate sheet tracings. For every time point, surface area was compared with the previous assessment. All patients received antimicrobial treatment for 8 weeks. Serum concentration of 25-hydroxyvitamin D, the primary indicator of vitamin D status, was determined in duplex for blood samples at baseline by a radioimmunoassay. We genotyped four polymorphisms in the SLC11A1 gene, previously associated with susceptibility to BU. For testing the association of genetic variants with paradoxical responses, we used a binary logistic regression analysis with the occurrence of a paradoxical response as the dependent variable. Results Paradoxical reaction occurred in 22% of the patients; the reaction was significantly associated with trunk localization (p = .039 by Χ2), larger lesions (p = .021 by Χ2) and genetic factors. The polymorphisms 3’UTR TGTG ins/ins (OR 7.19, p < .001) had a higher risk for developing paradoxical reaction compared to ins/del or del/del polymorphisms. Conclusions Paradoxical reactions are common in BU. They are associated with trunk localization, larger lesions and polymorphisms in the SLC11A1 gene. Buruli ulcer is an infectious disease of skin, subcutaneous fat and sometimes bone, mainly affecting children in West Africa. It is considered as one of the Neglected Tropical Diseases but the disease occurs also in moderate climates like South East Australia and Japan where it may also affect adults. Once a patient has started antibiotic treatment, lesions may increase in size even if the antimicrobial treatment is effective; this is highly confusing for doctors and patients as they may think that treatment actually fails. The cause of Buruli ulcer is Mycobacterium ulcerans, related to other mycobacteria that cause disease in man, like leprosy and tuberculosis. Using data from two different studies in West Africa, we show that these paradoxical reactions are associated with trunk localization and that they occur more often in larger lesions. The chance to develop these reactions appeared partly inherited: carrying the homozygous ins/ins genotype of 3’UTR TGTG 285 polymorphism in the SLC11A1 gene increased the risk of paradoxical reactions. Vitamin D is important for the immune defense against infections by mycobacteria. Vitamin D blood concentrations were not associated with paradoxical reactions; patients generally did well, and we did not need corticosteroid immune suppression to overcome these reactions.
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Affiliation(s)
- Yves Thierry Barogui
- Centre de Dépistage et de Traitement de l’Ulcère de Buruli de Lalo, Ministère de la Santé, Cotonou, Bénin
- Department of Internal Medicine, Infectious Diseases Service, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Sandor-Adrian Klis
- Department of Internal Medicine, Infectious Diseases Service, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Roch Christian Johnson
- Centre Interfacultaire de Formation et de Recherche en Environnement pour le Développement Durable, Université d’Abomey-Calavi, Abomey-Calavi, Bénin
| | | | - Eveline van der Veer
- Department of Laboratory Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Cleo van Diemen
- Department of Genetics, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Tjip S. van der Werf
- Department of Internal Medicine, Infectious Diseases Service, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Department of Pulmonary Diseases & Tuberculosis, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
- * E-mail:
| | - Ymkje Stienstra
- Department of Internal Medicine, Infectious Diseases Service, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Panwar A, Garg RK, Malhotra HS, Jain A, Singh AK, Prakash S, Kumar N, Garg R, Mahdi AA, Verma R, Sharma PK. 25-Hydroxy Vitamin D, Vitamin D Receptor and Toll-like Receptor 2 Polymorphisms in Spinal Tuberculosis: A Case-Control Study. Medicine (Baltimore) 2016; 95:e3418. [PMID: 27124026 PMCID: PMC4998689 DOI: 10.1097/md.0000000000003418] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Vitamin D deficiency and vitamin D receptor (VDR) gene abnormalities confer susceptibility to tuberculosis. Toll-like receptors (TLRs), such asTLR-2, are also important mediators of inflammatory response against Mycobacterium tuberculosis. We evaluated serum vitamin D, and VDR and TLR-2 gene polymorphisms in patients with spinal tuberculosis.This study comprised of 3 groups: spinal tuberculosis, pulmonary tuberculosis, and controls (each with 106 subjects). Enzyme-linked immunosorbent assay was used to measure vitamin D levels, and polymerase chain reaction-sequencing method was used to analyze VDR and TLR-2 gene polymorphisms. Patients were followed up for 6 months.Vitamin D deficiency was significantly more prevalent in patients with spinal tuberculosis (P < 0.001) and pulmonary tuberculosis (P = 0.011), versus controls. The heterozygous and mutant genotypes of VDR TaqI gene were significantly associated with spinal tuberculosis (P < 0.001; odds ratio [OR] 4.74 [2.45-9.18]) and pulmonary tuberculosis (P < 0.001; OR 3.52 [1.80-6.88]) when compared with controls. The heterozygous and mutant variants of VDR ApaI gene were significantly more common in patients with spinal tuberculosis in comparison with patients with pulmonary tuberculosis (P < 0.001; OR 2.90 [1.65-5.10]) and controls (P < 0.001; OR 6.56 [3.41-12.61]). We did not observe any significantly different results for TLR-2 gene polymorphisms. Vitamin D deficiency, VDR, and TLR-2 polymorphisms did not affect the 6-month disability.Vitamin D deficiency and VDR gene polymorphisms are significantly more prevalent in people with pulmonary and spinal tuberculosis. They may, in isolation or collectively, confer susceptibility to pulmonary and spinal tuberculosis.
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Affiliation(s)
- Ajay Panwar
- From the Department of Neurology (AP, RKG, HSM, NK, RV, PKS); Department of Microbiology (AJ, AKS, SP); Department of Pulmonary Medicine (RG); and Department of Biochemistry (AAM), King George Medical University, Uttar Pradesh, Lucknow, India
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Effect of vitamin D3 on maturation and antigen-presenting function of dendritic cells treated with Mycobacterium tuberculosis. ASIAN PAC J TROP MED 2015; 9:54-7. [PMID: 26851787 DOI: 10.1016/j.apjtm.2015.12.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 11/20/2015] [Accepted: 12/03/2015] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To investigate the phenotypic characteristics and functional capability differences of mouse bone marrow-derived dendritic cells after stimulation with Mycobacterium tuberculosis in the presence or absence of vitamin D3. METHODS Mouse bone marrow-derived cells were cultured with GM-CSF (20 ng/mL). Then, one was added with 100 nmol/L of 25(OH)D3, while the other did not. On day 6, 5 μg/mL of BCG was added to stimulate the cells for 24 h. On day 7, suspension cells were harvested for phenotypic and functional analyses. RESULTS The percentages of CD86 dendritic cells (DCs) in the control group and 25(OH)D3 group were 66.97% ± 8.29% and 52.18% ± 8.52%, respectively; the mean fluorescence intensities of MHC-II in the control group and 25(OH)D3 group were 1 102.16 ± 371.02 and 681.62 ± 292.71. The expression levels of MHC- II and CD86 on the surface of the DCs in 25(OH)D3 group were significantly lower than those of the control group. The ability of the DCs to stimulate proliferation of T-lymphocytes was also significantly lower than that of the control group. CONCLUSIONS These findings suggest that 25(OH)D3 modulates the immune response by affecting the maturation and function of DCs in Mycobacterium tuberculosis period.
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