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Kumari R, Muni S, Kumar R, Kumar R, Kumar A, Kumar S, Kumari N. Comparison of Cytokines Profiles and Monocyte Response Among Tuberculosis Patients Versus Patients Coinfected With Intestinal Helminth and Tuberculosis. Cureus 2024; 16:e51726. [PMID: 38318585 PMCID: PMC10839430 DOI: 10.7759/cureus.51726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2024] [Indexed: 02/07/2024] Open
Abstract
Background Tuberculosis (TB) and intestinal helminth infections often coexist, posing a significant health challenge. TB, caused by Mycobacterium tuberculosis, and helminths elicit distinct immune responses - Th1 for TB and Th2 for helminths. Co-infection introduces a complex immunological challenge, potentially compromising TB control. This study addresses the research gap by comparing cytokine profiles and monocyte responses in TB patients, helminth-infected individuals, and those with both. Insights gained may enhance diagnosis, treatment, and disease control strategies where TB and helminths prevail. Methods A cross-sectional observational study conducted at Indira Gandhi Institute of Medical Sciences, Patna, Bihar, aimed to compare cytokine profiles and monocyte responses in TB patients and those coinfected with TB and helminths. The study included 150 newly diagnosed active TB individuals aged 18 to 65 years. TB diagnosis was confirmed through clinical assessment, sputum microscopy, and GeneXpert (Cepheid, Sunnyvale, CA, USA) testing. Stool examination employed various methods, including the Kato-Katz technique and formalin-ether concentration. Blood samples were collected for hematological analysis, cytokine profiling, and monocyte isolation. Statistical analysis, using SPSS version 20.0 (IBM Corp., Armonk, NY, USA), included descriptive statistics, and t-test analyses. Results In our study of 150 participants, half (50.0%) showed positive helminth status. The sociodemographic analysis revealed no significant differences in age, gender, education, occupation, marital status, smoking, alcohol, BMI, diabetes, and hypertension between TB patients (n=75) and TB+Helminth patients (n=75), ensuring baseline matching. The prevalence of specific helminth infections in TB+Helminth patients included Ascaris lumbricoides (24.0%), Trichuris trichiura (18.7%), and others. Hematological parameters showed significant differences, with TB+Helminth patients exhibiting higher RBC count, hemoglobin, hematocrit, neutrophil count, and monocyte count; also eosinophil count was more raised in TB+Helminth patients (0.36 x 103/μL) when compared to TB patients (0.25 x 103/μL). Cytokine profiles and monocyte responses varied significantly between the groups, with TB patients having higher IL-4, IL-6, IFN-γ, TNF-α, and IL-1β levels, while TB+Helminth patients had elevated IL-10. Monocyte response time did not differ significantly. Conclusion The observed differences in hematological parameters and cytokine profiles emphasize the need for tailored approaches to diagnosis and treatment in co-infected individuals. These findings suggest that the management of TB patients should consider the potential influence of helminth co-infections.
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Affiliation(s)
- Ritu Kumari
- Microbiology, Indira Gandhi Institute of Medical Sciences, Patna, IND
| | - Sweta Muni
- Microbiology, Indira Gandhi Institute of Medical Sciences, Patna, IND
| | - Randhir Kumar
- Microbiology, Indira Gandhi Institute of Medical Sciences, Patna, IND
| | - Rakesh Kumar
- Microbiology, Indira Gandhi Institute of Medical Sciences, Patna, IND
| | - Abay Kumar
- Microbiology, Indira Gandhi Institute of Medical Sciences, Patna, IND
| | - Shailesh Kumar
- Microbiology, Indira Gandhi Institute of Medical Sciences, Patna, IND
| | - Namrata Kumari
- Microbiology, Indira Gandhi Institute of Medical Sciences, Patna, IND
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2
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Fonte L, Lim BH, Sarmiento ME, Acosta A. Editorial: Expert opinions and perspectives in immunity to worms infection: 2022. Front Immunol 2023; 14:1210743. [PMID: 37215137 PMCID: PMC10196623 DOI: 10.3389/fimmu.2023.1210743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 05/02/2023] [Indexed: 05/24/2023] Open
Affiliation(s)
- Luis Fonte
- Department of Parasitology, Institute of Tropical Medicine “Pedro Kourí”, Havana, Cuba
| | - Boon Huat Lim
- School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Maria E. Sarmiento
- School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Armando Acosta
- School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
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Piazzesi A, Putignani L. Impact of helminth-microbiome interactions on childhood health and development-A clinical perspective. Parasite Immunol 2023; 45:e12949. [PMID: 36063358 DOI: 10.1111/pim.12949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/26/2022] [Accepted: 09/01/2022] [Indexed: 12/01/2022]
Abstract
Humans have co-existed with parasites for virtually the entirety of our existence as a species. Today, nearly one third of the human population is infected with at least one helminthic species, most of which reside in the intestinal tract, where they have co-evolved alongside the human gut microbiota (GM). Appreciation for the interconnected relationship between helminths and GM has increased in recent years. Here, we review the evidence of how helminths and GM can influence various aspects of childhood development and the onset of paediatric diseases. We discuss the emerging evidence of how many of the changes that parasitic worms inflict on their host is enacted through gut microbes. In this light, we argue that helminth-induced microbiota modifications are of great importance in both facing the global challenge of overcoming parasitic infections, and in replicating helminthic protective effects against inflammatory diseases. We propose that deepening our knowledge of helminth-microbiota interactions will uncover novel, safer and more effective therapeutic strategies in combatting an array of childhood disorders.
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Affiliation(s)
- Antonia Piazzesi
- Multimodal Laboratory Medicine Research Area, Unit of Human Microbiome, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Lorenza Putignani
- Department of Diagnostic and Laboratory Medicine, Unit of Microbiology and Diagnostic Immunology, Unit of Microbiomics and Multimodal Laboratory Medicine Research Area, Unit of Human Microbiome, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
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Baya B, Kone B, Somboro A, Kodio O, Somboro AM, Diarra B, Traore FG, Kone D, Traore MA, Kone M, Togo AG, Sarro YS, Maiga A, Maiga M, Toloba Y, Diallo S, Murphy RL, Doumbia S. Prevalence and Clinical Relevance of Schistosoma mansoni Co-Infection with Mycobacterium tuberculosis: A Systematic Literature Review. OPEN JOURNAL OF EPIDEMIOLOGY 2023; 13:97-111. [PMID: 36910425 PMCID: PMC9997105 DOI: 10.4236/ojepi.2023.131008] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
Tuberculosis disease stands for the second leading cause of death worldwide after COVID-19, most active tuberculosis cases result from the reactivation of latent TB infection through impairment of immune response. Several factors are known to sustain that process. Schistosoma mansoni, a parasite of the helminth genus that possesses switching power from an immune profile type Th1 to Th2 that favors reactivation of latent TB bacteria. The aim of the study was to assess the prevalence of the co-infection between the two endemic infections. Systematic literature was contacted at the University Clinical Research Center at the University of Sciences, Techniques, and Technologies of Bamako in Mali. Original articles were included, and full texts were reviewed to assess the prevalence and better understand the immunological changes that occur during the co-infection. In total, 3530 original articles were retrieved through database search, 53 were included in the qualitative analysis, and data from 10 were included in the meta-analysis. Prevalence of the co-infection ranged from 4% to 34% in the literature. Most of the articles reported that immunity against infection with helminth parasite and more specifically Schistosoma mansoni infection enhances latent TB reactivation through Th1/Th2. In sum, the impact of Schistosoma mansoni co-infection with Mycobacterium tuberculosis is under-investigated. Understanding the role of this endemic tropical parasite as a contributing factor to TB epidemiology and burden could help integrate its elimination as one of the strategies to achieve the END-TB objectives by the year 2035.
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Affiliation(s)
- Bocar Baya
- University Clinical Research Center (UCRC) of the University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali.,Service of Pneumopthisiology of the University Teaching Hospital of Point G, Bamako, Mali
| | - Bourahima Kone
- University Clinical Research Center (UCRC) of the University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Amadou Somboro
- University Clinical Research Center (UCRC) of the University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Ousmane Kodio
- University Clinical Research Center (UCRC) of the University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Anou Moise Somboro
- University Clinical Research Center (UCRC) of the University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Bassirou Diarra
- University Clinical Research Center (UCRC) of the University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Fah Gaoussou Traore
- University Clinical Research Center (UCRC) of the University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Drissa Kone
- Clinical Laboratory of the University Teaching Hospital of Point G, Bamako, Mali
| | - Mama Adama Traore
- Clinical Laboratory of the University Teaching Hospital of Point G, Bamako, Mali
| | - Mahamadou Kone
- University Clinical Research Center (UCRC) of the University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Antieme Georges Togo
- University Clinical Research Center (UCRC) of the University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Yeya Sadio Sarro
- University Clinical Research Center (UCRC) of the University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Almoustapha Maiga
- University Clinical Research Center (UCRC) of the University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Mamoudou Maiga
- Clinical Laboratory of the University Teaching Hospital of Point G, Bamako, Mali.,Havey Institute for Global Health (Havey IGH), Northwestern University (NU), Chicago, USA
| | - Yacouba Toloba
- Service of Pneumopthisiology of the University Teaching Hospital of Point G, Bamako, Mali
| | - Souleymane Diallo
- University Clinical Research Center (UCRC) of the University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Robert L Murphy
- Havey Institute for Global Health (Havey IGH), Northwestern University (NU), Chicago, USA
| | - Seydou Doumbia
- University Clinical Research Center (UCRC) of the University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
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Kiflie A, Bewket G, Tajebe F, Abate E, Schӧn T, Blomgran R. Helminth species-specific effects on IFN-γ producing T cells during active and latent tuberculosis. PLoS Negl Trop Dis 2023; 17:e0011094. [PMID: 36662839 PMCID: PMC9891516 DOI: 10.1371/journal.pntd.0011094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 02/01/2023] [Accepted: 01/11/2023] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Interferon-γ (IFN-γ) is a key cytokine inducing protective immune responses during tuberculosis (TB) infection. Helminth-induced immune responses may affect IFN-γ production by T cells, although its connection with disease severity and immune recovery during treatment is unexplored. We investigated the species-specific effect of helminths on the IFN-γ production by T cells in relation to disease severity during active and latent TB infection (LTBI). METHODS In this study, 69 active pulmonary TB patients (PTB), 28 with LTBI and 66 healthy controls were included. Active TB was diagnosed using GenXpert MTB/RIF while QuantiFERON test (QFT) was used for the screening of healthy community controls (CCs) and for the diagnosis of LTBI. Helminth infection was identified by routine diagnosis whereas clinical disease severity was evaluated by the TB score. Intracellular IFN-γ production of T cells in stimulated peripheral blood mononuclear cells (PBMCs) was analyzed by flow cytometry using TB antigens (PPD), the polyclonal T cell activator staphylococcal enterotoxin B (SEB), or medium as unstimulated control. RESULTS Helminth infected CCs and LTBI subjects showed a significant reduction of IFN-γ+ CD4+ T cells by PPD-stimulation compared to non-helminth infected control groups. The significant reduction in the frequency of IFN-γ+ T cells in both latent and active PTB patients following SEB stimulation was mostly attributed to Schistosoma mansoni infection, whereas Ascaris lumbricoides, Schistosoma mansoni, and hookworm infection contributed equally in CCs. Following anti-helminthic and anti-TB treatment for 2 months, the frequency of IFN-γ+ CD4 T cells in helminth coinfected PTB was restored to levels of helminth negative PTB before treatment. Helminth coinfected PTB patients with an intermediate and severe clinical course had reduced capacity for production of IFN-γ+ T cells compared to the corresponding non-helminth infected PTB. CONCLUSION We found a reduction in IFN-γ producing T cells by helminth coinfection which was restored following anti-helminthic treatment. This reduction was helminth species-dependent in an exploratory sub-analysis and correlated to increased disease severity.
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Affiliation(s)
- Amare Kiflie
- Department of Immunology and Molecular Biology, University of Gondar, Gondar, Ethiopia
| | - Gezahegn Bewket
- Department of Immunology and Molecular Biology, University of Gondar, Gondar, Ethiopia
| | - Fitsumbrhan Tajebe
- Department of Immunology and Molecular Biology, University of Gondar, Gondar, Ethiopia
| | - Ebba Abate
- The Ohio State, Global One Health, Addis Ababa, Ethiopia
| | - Thomas Schӧn
- Division of Inflammation and Infection, Department of Biomedical and Clinical Sciences, Faculty of Medicine and Health Sciences, Linkӧping University, Linkӧping, Sweden
- Department of Infectious Diseases, Kalmar County Hospital, Linkӧping University, Linkӧping, Sweden
- Department of Infectious Diseases, County of Östergötland, Linkӧping University Hospital, Linkӧping University, Linkӧping, Sweden
| | - Robert Blomgran
- Division of Inflammation and Infection, Department of Biomedical and Clinical Sciences, Faculty of Medicine and Health Sciences, Linkӧping University, Linkӧping, Sweden
- * E-mail:
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Chin KL, Fonte L, Lim BH, Sarmiento ME, Acosta A. Immunomodulation resulting of helminth infection could be an opportunity for immunization against tuberculosis and mucosal pathogens. Front Immunol 2023; 14:1091352. [PMID: 37020538 PMCID: PMC10067736 DOI: 10.3389/fimmu.2023.1091352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 03/08/2023] [Indexed: 04/07/2023] Open
Affiliation(s)
- Kai Ling Chin
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
- *Correspondence: Kai Ling Chin, ; Luis Fonte, ; Armando Acosta,
| | - Luis Fonte
- Department of Parasitology, Institute of Tropical Medicine “Pedro Kourí”, Havana, Cuba
- *Correspondence: Kai Ling Chin, ; Luis Fonte, ; Armando Acosta,
| | - Boon Huat Lim
- School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Maria E. Sarmiento
- School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Armando Acosta
- School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
- *Correspondence: Kai Ling Chin, ; Luis Fonte, ; Armando Acosta,
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7
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Fonte L, Acosta A, Sarmiento ME, Norazmi MN, Ginori M, de Armas Y, Calderón EJ. Overlapping of Pulmonary Fibrosis of Postacute COVID-19 Syndrome and Tuberculosis in the Helminth Coinfection Setting in Sub-Saharan Africa. Trop Med Infect Dis 2022; 7:tropicalmed7080157. [PMID: 36006249 PMCID: PMC9416620 DOI: 10.3390/tropicalmed7080157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 07/26/2022] [Accepted: 07/27/2022] [Indexed: 12/25/2022] Open
Abstract
There is an increasing attention to the emerging health problem represented by the clinical and functional long-term consequences of SARS-CoV-2 infection, referred to as postacute COVID-19 syndrome. Clinical, radiographic, and autopsy findings have shown that a high rate of fibrosis and restriction of lung function are present in patients who have recovered from COVID-19. Patients with active TB, or those who have recovered from it, have fibrotic scarred lungs and, consequently, some degree of impaired respiratory function. Helminth infections trigger predominantly type 2 immune responses and the release of regulatory and fibrogenic cytokines, such as TGF-β. Here, we analyze the possible consequences of the overlapping of pulmonary fibrosis secondary to COVID-19 and tuberculosis in the setting of sub-Saharan Africa, the region of the world with the highest prevalence of helminth infection.
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Affiliation(s)
- Luis Fonte
- Department of Parasitology, Institute of Tropical Medicine “Pedro Kourí”, Havana 11400, Cuba
- Correspondence: (L.F.); (E.J.C.)
| | - Armando Acosta
- School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia; (A.A.); (M.E.S.); (M.N.N.)
| | - María E. Sarmiento
- School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia; (A.A.); (M.E.S.); (M.N.N.)
| | - Mohd Nor Norazmi
- School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia; (A.A.); (M.E.S.); (M.N.N.)
| | - María Ginori
- Department of Teaching, Polyclinic “Plaza de la Revolución”, Havana 11300, Cuba;
| | - Yaxsier de Armas
- Department of Clinical Microbiology Diagnostic, Hospital Center of Institute of Tropical Medicine “Pedro Kourí”, Havana 11400, Cuba;
- Department of Pathology, Hospital Center of Institute of Tropical Medicine “Pedro Kourí”, Havana 11400, Cuba
| | - Enrique J. Calderón
- Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío, Consejo Superior de Investigaciones Científicas, Universidad de Sevilla, 41013 Sevilla, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
- Depatamento de Medicina, Facultad de Medicina, Universidad de Sevilla, 41009 Sevilla, Spain
- Correspondence: (L.F.); (E.J.C.)
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Shinde SR, Inamdar SN, Obakachi VA, Shinde M, Kajee A, Ghai M, Karpoormath R. Discovery of oxazole-dehydrozingerone based hybrid molecules as potential anti-tubercular agents and their docking for Mtb DNA gyrase. RESULTS IN CHEMISTRY 2022. [DOI: 10.1016/j.rechem.2022.100374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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9
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Mouhoub E, Domenech P, Ndao M, Reed MB. The Diverse Applications of Recombinant BCG-Based Vaccines to Target Infectious Diseases Other Than Tuberculosis: An Overview. Front Microbiol 2021; 12:757858. [PMID: 34745066 PMCID: PMC8566895 DOI: 10.3389/fmicb.2021.757858] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 09/30/2021] [Indexed: 11/13/2022] Open
Abstract
Live attenuated Bacillus Calmette-Guérin (BCG) is the world's most widely used vaccine which is mainly administered for its protection against tuberculosis (TB), particularly in young children. However, since its initial use over 100years ago, it has also proven to offer a level of protection against various other pathogens, as a consequence of its non-specific immune enhancing effects. Thus, over the past few decades, recombinant BCG (rBCG) technology has been used as a vector to create rBCG vaccines expressing heterologous antigens that elicit immunity against a range of bacterial, viral, and parasitic diseases. Our goal with this mini-review is to provide an up-to-date survey of the various techniques, approaches, and applications of rBCG-based vaccines for targeting infectious diseases other than TB.
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Affiliation(s)
- Esma Mouhoub
- The Department of Microbiology & Immunology, McGill University, Montreal, QC, Canada
- The Infectious Diseases and Immunity in Global Health Program, Research Institute of the McGill University Health Centre, Montreal, QC, Canada
- The McGill International TB Centre, McGill University, Montreal, QC, Canada
| | - Pilar Domenech
- The Infectious Diseases and Immunity in Global Health Program, Research Institute of the McGill University Health Centre, Montreal, QC, Canada
- The McGill International TB Centre, McGill University, Montreal, QC, Canada
| | - Momar Ndao
- The Department of Microbiology & Immunology, McGill University, Montreal, QC, Canada
- The Infectious Diseases and Immunity in Global Health Program, Research Institute of the McGill University Health Centre, Montreal, QC, Canada
- The McGill International TB Centre, McGill University, Montreal, QC, Canada
- The Department of Medicine, McGill University, Montreal, QC, Canada
- National Reference Centre for Parasitology, Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - Michael B. Reed
- The Department of Microbiology & Immunology, McGill University, Montreal, QC, Canada
- The Infectious Diseases and Immunity in Global Health Program, Research Institute of the McGill University Health Centre, Montreal, QC, Canada
- The McGill International TB Centre, McGill University, Montreal, QC, Canada
- The Department of Medicine, McGill University, Montreal, QC, Canada
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10
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Effect of Helicobacter pylori and Helminth Coinfection on the Immune Response to Mycobacterium tuberculosis. Curr Microbiol 2021; 78:3351-3371. [PMID: 34251513 DOI: 10.1007/s00284-021-02604-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 06/30/2021] [Indexed: 02/07/2023]
Abstract
Tuberculosis remains one of the main causes of morbidity and mortality worldwide despite decades of efforts to eradicate the disease. Although the immune response controls the infection in most infected individuals (90%), the ability of the bacterium to persist throughout the host's life leads to a risk of reactivation. Underlying conditions including human immunodeficiency virus (HIV) infection, organ transplantation, and immunosuppressive therapies are considered risk factors for progression to active disease. However, many individuals infected with Mycobacterium tuberculosis may develop clinical disease in the absence of underlying immunosuppression. It is also possible that unknown conditions may drive the progression to disease. The human microbiota can be an important modulator of the immune system; it can not only trigger inflammatory disorders, but also drive the response to other infectious diseases. In developing countries, chronic mucosal infections with Helicobacter pylori and helminths may be particularly important, as these infections frequently coexist throughout the host's life. However, little is known about the interactions of these pathogens with the immune system and their effects on M. tuberculosis clinical disease, if any. In this review, we discuss the potential effects of H. pylori and helminth co-infections on the immune response to M. tuberculosis. This may contribute to our understanding of host-pathogen interactions and in designing new strategies for the prevention and control of tuberculosis.
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11
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Taghipour A, Malih N, Köksal F, Jokelainen P, Ghaffarifar F. Toxoplasma gondii seroprevalence among tuberculosis patients: A systematic review and meta-analysis. Microb Pathog 2021; 159:105083. [PMID: 34246749 DOI: 10.1016/j.micpath.2021.105083] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 06/27/2021] [Accepted: 07/02/2021] [Indexed: 11/26/2022]
Abstract
Toxoplasma gondii and Mycobacterium tuberculosis are intracellular pathogens, both infecting a substantial proportion of human population. We conducted a systematic review and meta-analysis to estimate the pooled T. gondii seroprevalence in tuberculosis patients. Three international databases were systematically searched for literature on prevalence of T. gondii in tuberculosis patients. A total of 1389 documents were identified, and eight papers were eligible to be included in the systematic review and meta-analysis. Geographical data gaps were evident, as no studies were identified from many countries where both infections are important. The pooled seroprevalence of IgG, IgM, and both IgG and IgM antibodies against T. gondii in tuberculosis patients were estimated to be 35.9% (95% confidence interval [CI], 19.3-56.7%), 35.0% (95% CI, 3.0-90.3%), and 13.4% (95% CI, 2.4-49.0%), respectively. In the included case-control studies, the pooled T. gondii seroprevalence (proportion anti- T. gondii IgG antibody positive) was higher in tuberculosis patients than in their controls, with an odds ratio by random effects model of 1.63 (95% CI, 1.28-2.08). The results of our work suggest an association between T. gondii seropositivity and being a tuberculosis patient, which should however be interpreted with caution because the timeline of the infections and the disease process are not accounted for. Our work showed that T. gondii seropositivity, indicating chronic infection with the zoonotic parasite, was relatively common among tuberculosis patients.
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Affiliation(s)
- Ali Taghipour
- Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Narges Malih
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatih Köksal
- Department of Clinical Bacteriology, Faculty of Medicine, Çukurova University, Adana, Turkey; TR Ministry of Health Regional Tuberculosis Laboratories and the Director of the Tropical Diseases Research and Application Center, Turkey
| | - Pikka Jokelainen
- Department of Bacteria, Parasites & Fungi, Infectious Disease Preparedness, Statens Serum Institut, Copenhagen, Denmark.
| | - Fatemeh Ghaffarifar
- Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
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12
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Syal A, Arya Y, Hapani NN, Gupta M, Gaba S. Helminthic Infection in the Background of Active Pulmonary Tuberculosis: An Underreported Co-infection. Cureus 2021; 13:e13741. [PMID: 33842119 PMCID: PMC8022635 DOI: 10.7759/cureus.13741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Helminthic infections are widely prevalent in resource-poor countries. Tuberculosis, a disease contributing significantly to morbidity and mortality in endemic areas, often co-exists with helminthic infections. Poor living standards predispose to both of them. Moreover, untreated helminthic infection enhances the deleterious impact of tuberculosis, largely through immunological alteration. We are reporting the case of a 22-year-old male who presented with a month-long history of abdominal pain, nausea, vomiting, fever and cough complicated by hemoptysis, along with an episode of the passage of a worm in the vomitus. A thorough workup revealed active pulmonary tuberculosis co-existing with intestinal ascariasis. Anti-helminthic therapy was initiated along with anti-tubercular therapy, leading to significant improvement.
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Affiliation(s)
- Arshi Syal
- Internal Medicine, Government Medical College and Hospital, Chandigarh, IND
| | - Yajur Arya
- Internal Medicine, Government Medical College and Hospital, Chandigarh, IND
| | - Nikita N Hapani
- Internal Medicine, Government Medical College and Hospital, Chandigarh, IND
| | - Monica Gupta
- Internal Medicine, Government Medical College and Hospital, Chandigarh, IND
| | - Saurabh Gaba
- Internal Medicine, Government Medical College and Hospital, Chandigarh, IND
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