Allergic sensitisation in tuberculosis patients at the time of diagnosis and following chemotherapy

Antitumor, Anti-Inflammatory and Antiallergic Effects of Agaricus blazei Mushroom Extract and the Related Medicinal Basidiomycetes Mushrooms, Hericium erinaceus and Grifola frondosa: A Review of Preclinical and Clinical Studies

Since the 1980s, medicinal effects have been documented in scientific studies with the related Basidiomycota mushrooms Agaricus blazei Murill (AbM), Hericium erinaceus (HE) and Grifola frondosa (GF) from Brazilian and Eastern traditional medicine. Special focus has been on their antitumor effects, but the mushrooms' anti-inflammatory and antiallergic properties have also been investigated. The antitumor mechanisms were either direct tumor attack, e.g., apoptosis and metastatic suppression, or indirect defense, e.g., inhibited tumor neovascularization and T helper cell (Th) 1 immune response. The anti-inflammatory mechanisms were a reduction in proinflammatory cytokines, oxidative stress and changed gut microbiota, and the antiallergic mechanism was amelioration of a skewed Th1/Th2 balance. Since a predominant Th2 milieu is also found in cancer, which quite often is caused by a local chronic inflammation, the three conditions-tumor, inflammation and allergy-seem to be linked. Further mechanisms for HE were increased nerve and beneficial gut microbiota growth, and oxidative stress regulation. The medicinal mushrooms AbM, HE and GF appear to be safe, and can, in fact, increase longevity in animal models, possibly due to reduced tumorigenesis and oxidation. This article reviews preclinical and clinical findings with these mushrooms and the mechanisms behind them.

IgE-sensitization to food and inhalant allergens in IBD patients compared with normal blood donors at Oslo University Hospital, Norway

Objectives: Crohn's disease (CD) and ulcerative colitis (UC) have been regarded as autoimmune Th-1/Th-17- and Th-2-associated conditions, respectively. The aim of the study was to examine possible differences in allergen sensitization between these diseases and relative to normal blood donors (BD). Materials and methods: Plasma from 29 UC and 37 CD patients with moderate disease activity and 100 healthy age- and gender-matched BD, were analyzed for specific IgE to 22 food- and 28 inhalation allergens using EUROLINE atopy screen. Results: There was significantly higher proportion of allergen sensitized patients in UC compared to BD. Corresponding mean percentages for UC, CD and BD were 8.5, 8.9 (p = .2) and 5.9 (p = .04). There was no intergroup difference in sensitization to food allergens. Most prominent result was the double level of sensitization to inhalants in CD (15%) compared to BD (8%) (p = .03). Overall highest levels of sensitization to inhalants were for grass pollens. Interestingly, the number of allergens (n = 50) the subjects were sensitized to, was significantly lower among UC (n = 20; 40%) (p = .0005) than CD (n = 31; 62%) and BD (n = 38; 76%). Conclusions: The percentage of individuals sensitized to inhalants in CD and to inhalants and foods in UC, were higher than corresponding results in BD. However, whereas allergen positive reactions in CD were comparable to those in BD, they were reduced in UC because of the few UC reactions to food allergens. This contrasts previous data and the study also points to sensitization to inhalants as a potential factor in the complex pathogenesis of IBD.

Allergic Asthma Favors Brucella Growth in the Lungs of Infected Mice

Allergic asthma is a chronic Th2 inflammatory disease of the lower airways affecting a growing number of people worldwide. The impact of infections and microbiota composition on allergic asthma has been investigated frequently. Until now, however, there have been few attempts to investigate the impact of asthma on the control of infectious microorganisms and the underlying mechanisms. In this work, we characterize the consequences of allergic asthma on intranasal (i.n.) infection by Brucella bacteria in mice. We observed that i.n. sensitization with extracts of the house dust mite Dermatophagoides farinae or the mold Alternaria alternata (Alt) significantly increased the number of Brucella melitensis, Brucella suis, and Brucella abortus in the lungs of infected mice. Microscopic analysis showed dense aggregates of infected cells composed mainly of alveolar macrophages (CD11c+ F4/80+ MHCII+) surrounded by neutrophils (Ly-6G+). Asthma-induced Brucella susceptibility appears to be dependent on CD4+ T cells, the IL-4/STAT6 signaling pathway and IL-10, and is maintained in IL-12- and IFN-γR-deficient mice. The effects of the Alt sensitization protocol were also tested on Streptococcus pneumoniae and Mycobacterium tuberculosis pulmonary infections. Surprisingly, we observed that Alt sensitization strongly increases the survival of S. pneumoniae infected mice by a T cell and STAT6 independent signaling pathway. In contrast, the course of M. tuberculosis infection is not affected in the lungs of sensitized mice. Our work demonstrates that the impact of the same allergic sensitization protocol can be neutral, negative, or positive with regard to the resistance of mice to bacterial infection, depending on the bacterial species.

Evaluation of TNF-α, IL-10 and IL-6 Cytokine Production and Their Correlation with Genotype Variants amongst Tuberculosis Patients and Their Household Contacts

BACKGROUND

Household contacts of diagnostically established tuberculosis (TB) patients are highly susceptible to disease development. It is surmised that cytokines perhaps play a synergistic and a prognostic role in the activation of the otherwise latent infection in these house hold contacts. Evaluation of the cytokines and any of their inherent polymorphisms might provide a useful diagnostic tool in evaluating the immune regulation and the progression of the disease. The cytokines thus released in a paracrine manner in serum may also provide an indirect measure of the cytokine function.

OBJECTIVE

The present study was aimed to evaluate the levels of TNF-α, IL-10 & IL-6 cytokines and their correlation with genotype variants amongst tuberculosis patients and their household contacts.

METHODS

The cytokine levels were estimated in serum by enzyme-linked immunosorbent assay (ELISA) and their polymorphisms were studied by amplification refractory mutation system polymerase chain reaction (ARMs PCR) in active pulmonary tuberculosis patients (APTB = 150), household contacts (HHC = 190), and healthy controls (HC = 150).

RESULTS

The median values of TNF-α cytokine were significantly high among APTB and HHC compared to HCs (P< 0.0001 and 0.0001). IL-6 levels also were elevated among APTB compared to HHC and HC, and a significant difference was observed between APTB and HHC at P<0.0001; APTB & HC at P< 0.04; HHC & HC at P< 0.01. The IL-10 levels were low in APTB compared to HHC and HCs and no significant difference was observed. TNF-α/IL-10 ratio was significant and indicated Th1 predominance in APTB and HHC. IL-6/IL-10 showed pronounced Th1 expression in APTB and Th2 in HHC and HC. The ROC analysis indicated that both IL-10 and IL-6 can be used to decide the risk of exposed individual to a disease. The results of multivariate analysis indicate that IL-10 (-1082) GA genotype was significantly associated with p<0.028 in APTB. No significant association was observed between genotypes, other serum cytokine levels and clinical characteristics between APTB, HHC and HCs.

CONCLUSION

Large sample size with follow-up at different time points may further illuminate the role of IL-10 and IL-6 cytokines as a prognostic marker in house hold contacts.

The impact of pulmonary tuberculosis treatment on the prevalence of allergic rhinitis

Atopy is a syndrome characterized by immediate hypersensitivity reactions to common environmental antigens. The "hygiene hypothesis" stipulates that childhood infections are associated with a lower risk of allergies. Not much has been published about the effects that the treatment of pulmonary tuberculosis (TB) has on allergies, specifically allergic rhinitis. We conducted a study to investigate the prevalence of allergic rhinitis in patients with pulmonary TB before and after treatment of their TB. Our initial study group was made up of 121 patients with confirmed pulmonary TB who were followed up by questionnaire. In addition to demographic data, they provided information about their personal and family history of atopy and their current status with regard to allergic rhinitis. After providing informed consent, all patients underwent skin-prick testing with Dermatophagoides pteronyssinus, Dermatophagoides farinae, and Blomia tropicalis allergens before and after TB treatment. Stool samples were obtained to identify patients with worm infestation, and they were excluded from the study. In all, 94 patients completed treatment and follow-up, and their data were included in the final analysis. Of this group, 31 patients (33.0%) exhibited symptoms of allergic rhinitis prior to TB treatment, and 26 (27.7%) had a positive skin-prick test. Following treatment, only 12 patients (12.8%) reported allergic rhinitis symptoms (p = 0.004), but there was no significant reduction in the number of patients with a positive skin-prick test (n = 20 [21.3%]; p = 0.555). We conclude that the treatment of pulmonary TB results in significant relief of atopy, particularly allergic rhinitis symptoms.