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Miles JR, Lu P, Bai S, Aguillón-Durán GP, Rodríguez-Herrera JE, Gunn BM, Restrepo BI, Lu LL. Antigen specificity shapes antibody functions in tuberculosis. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.06.03.597169. [PMID: 38895452 PMCID: PMC11185737 DOI: 10.1101/2024.06.03.597169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/21/2024]
Abstract
Tuberculosis (TB) is the number one infectious disease cause of death worldwide due to an incomplete understanding of immunity. Emerging data highlight antibody functions mediated by the Fc domain as immune correlates. However, the mechanisms by which antibody functions impact the causative agent Mycobacterium tuberculosis (Mtb) are unclear. Here, we examine how antigen specificity determined by the Fab domain shapes Fc effector functions against Mtb. Using the critical structural and secreted virulence proteins Mtb cell wall and ESAT-6 & CFP-10, we observe that antigen specificity alters subclass, antibody post-translational glycosylation, and Fc effector functions in TB patients. Moreover, Mtb cell wall IgG3 enhances disease through opsonophagocytosis of extracellular Mtb . In contrast, polyclonal and a human monoclonal IgG1 we generated targeting ESAT-6 & CFP-10 inhibit intracellular Mtb . These data show that antibodies have multiple roles in TB and antigen specificity is a critical determinant of the protective and pathogenic capacity.
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Arya R, Shakya H, Chaurasia R, Haque MA, Kim JJ. Exploring the Role of Extracellular Vesicles in the Pathogenesis of Tuberculosis. Genes (Basel) 2024; 15:434. [PMID: 38674369 PMCID: PMC11049626 DOI: 10.3390/genes15040434] [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: 03/05/2024] [Revised: 03/27/2024] [Accepted: 03/28/2024] [Indexed: 04/28/2024] Open
Abstract
Tuberculosis (TB) remains a significant global health concern, necessitating accurate diagnosis and treatment monitoring. Extracellular vesicles (EVs), including exosomes, play crucial roles in disease progression, with their associated genes serving as potential biomarkers and therapeutic targets. Leveraging publicly available RNA-Seq datasets of TB patients and healthy controls (HCs), to identify differentially expressed genes (DEGs) and their associated protein-protein interaction networks and immune cell profiles, the common EV-related DEGs were identified and validated in the GSE42830 and GSE40553 datasets. We have identified nine common EV-related DEGs (SERPINA1, TNFAIP6, MAPK14, STAT1, ITGA2B, VAMP5, CTSL, CEACAM1, and PLAUR) upregulated in TB patients. Immune cell infiltration analysis revealed significant differences between TB patients and HCs, highlighting increased proportions of various immune cells in TB patients. These DEGs are involved in crucial cellular processes and pathways related to exocytosis and immune response regulation. Notably, VAMP5 exhibited excellent diagnostic performance (AUC-0.993, sensitivity-93.8%, specificity-100%), with potential as a novel biomarker for TB. The EV-related genes can serve as novel potential biomarkers that can distinguish between TB and HCs. VAMP5, which functions in exosome biogenesis and showed significant upregulation in TB, can be targeted for therapeutic interventions and treatment outcomes.
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Affiliation(s)
- Rakesh Arya
- Department of Biotechnology, Yeungnam University, Gyeongsan 38541, Republic of Korea; (R.A.); (M.A.H.)
| | - Hemlata Shakya
- Department of Biomedical Engineering, Shri G. S. Institute of Technology and Science, Indore 452003, Madhya Pradesh, India;
| | - Reetika Chaurasia
- Department of Internal Medicine, Section of Infectious Diseases, Yale University School of Medicine, New Haven, CT 06519, USA
| | - Md Azizul Haque
- Department of Biotechnology, Yeungnam University, Gyeongsan 38541, Republic of Korea; (R.A.); (M.A.H.)
| | - Jong-Joo Kim
- Department of Biotechnology, Yeungnam University, Gyeongsan 38541, Republic of Korea; (R.A.); (M.A.H.)
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Lyu M, Xu G, Zhou J, Reboud J, Wang Y, Lai H, Chen Y, Zhou Y, Zhu G, Cooper JM, Ying B. Single-Cell Sequencing Reveals Functional Alterations in Tuberculosis. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2024; 11:e2305592. [PMID: 38192178 PMCID: PMC10953544 DOI: 10.1002/advs.202305592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 11/21/2023] [Indexed: 01/10/2024]
Abstract
Despite its importance, the functional heterogeneity surrounding the dynamics of interactions between mycobacterium tuberculosis and human immune cells in determining host immune strength and tuberculosis (TB) outcomes, remains far from understood. This work now describes the development of a new technological platform to elucidate the immune function differences in individuals with TB, integrating single-cell RNA sequencing and cell surface antibody sequencing to provide both genomic and phenotypic information from the same samples. Single-cell analysis of 23 990 peripheral blood mononuclear cells from a new cohort of primary TB patients and healthy controls enables to not only show four distinct immune phenotypes (TB, myeloid, and natural killer (NK) cells), but also determine the dynamic changes in cell population abundance, gene expression, developmental trajectory, transcriptomic regulation, and cell-cell signaling. In doing so, TB-related changes in immune cell functions demonstrate that the immune response is mediated through host T cells, myeloid cells, and NK cells, with TB patients showing decreased naive, cytotoxicity, and memory functions of T cells, rather than their immunoregulatory function. The platform also has the potential to identify new targets for immunotherapeutic treatment strategies to restore T cells from dysfunctional or exhausted states.
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Affiliation(s)
- Mengyuan Lyu
- Department of Laboratory MedicineWest China HospitalSichuan UniversityChengduSichuan610041P. R. China
| | - Gaolian Xu
- School of Biomedical Engineering/Med‐X Research InstituteShanghai Jiao Tong UniversityShanghai200030P. R. China
| | - Jian Zhou
- Department of Thoracic SurgeryWest China HospitalSichuan UniversityChengduSichuan610041P. R. China
| | - Julien Reboud
- Division of Biomedical EngineeringUniversity of GlasgowGlasgowG12 8LTUnited Kingdom
| | - Yili Wang
- Department of Laboratory MedicineWest China HospitalSichuan UniversityChengduSichuan610041P. R. China
| | - Hongli Lai
- Department of Laboratory MedicineWest China HospitalSichuan UniversityChengduSichuan610041P. R. China
| | - Yi Chen
- Department of Laboratory MedicineWest China HospitalSichuan UniversityChengduSichuan610041P. R. China
| | - Yanbing Zhou
- Department of Laboratory MedicineWest China HospitalSichuan UniversityChengduSichuan610041P. R. China
| | - Guiying Zhu
- School of Biomedical Engineering/Med‐X Research InstituteShanghai Jiao Tong UniversityShanghai200030P. R. China
| | - Jonathan M. Cooper
- Division of Biomedical EngineeringUniversity of GlasgowGlasgowG12 8LTUnited Kingdom
| | - Binwu Ying
- Department of Laboratory MedicineWest China HospitalSichuan UniversityChengduSichuan610041P. R. China
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GATECHOMPOL S, KERR SJ, CARDOSO SW, SAMANEKA W, TRIPATHY S, GODBOLE S, GHATE M, KANYAMA C, NYIRENDA M, SUGANDHAVESA P, MACHADO A, VAN LETH F, CAMPBELL TB, SWINDLELLS S, AVIHINGSANON A, COBELENS F. Monocyte to lymphocyte ratio and hemoglobin level to predict tuberculosis after antiretroviral therapy initiation. AIDS 2024; 38:31-38. [PMID: 37696248 PMCID: PMC10811616 DOI: 10.1097/qad.0000000000003713] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2023]
Abstract
OBJECTIVE To determine the performance of the baseline monocyte to lymphocyte ratio (MLR), baseline anemia severity and combination of these biomarkers, to predict tuberculosis (TB) incidence in people with HIV (PWH) after antiretroviral therapy (ART) initiation. DESIGN Multicenter, retrospective cohort study. METHODS We utilized the data from study A5175 (Prospective Evaluation of Antiretroviral Therapy in Resource-limited Settings: PEARLS). We assessed the utility of MLR, anemia severity and in combination, for predicting TB in the first year after ART. Cox regression was used to assess associations of MLR and anemia with incident TB. Harrell's C index was used to describe single model discrimination. RESULTS A total of 1455 participants with a median age of 34 [interquartile range (IQR) 29, 41] were included. Fifty-four participants were diagnosed with TB. The hazard ratio (HR) for incident TB was 1.77 [95% confidence interval (CI) 1.01-3.07]; P = 0.04 for those with MLR ≥0.23. The HR for mild/mod anemia was 3.35 (95% CI 1.78-6.29; P < 0.001) and 18.16 (95% CI 5.17-63.77; P < 0.001) for severe anemia. After combining parameters, there were increases in adjusted HR (aHR) for MLR ≥0.23 to 1.83 (95% CI 1.05-3.18), and degrees of anemia to 3.38 (95% CI 1.80-6.35) for mild/mod anemia and 19.09 (95% CI 5.43-67.12) for severe anemia. CONCLUSIONS MLR and hemoglobin levels which are available in routine HIV care can be used at ART initiation for identifying patients at high risk of developing TB disease to guide diagnostic and management decisions.
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Affiliation(s)
- Sivaporn GATECHOMPOL
- HIV-NAT, Thai Red Cross AIDS Research Center, Bangkok, Thailand
- Center of Excellence in Tuberculosis, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Department of Global Health and Amsterdam Institute for Global Health and Development Amsterdam University Medical Centers location University of Amsterdam, Amsterdam, The Netherlands
| | - Stephen J. KERR
- HIV-NAT, Thai Red Cross AIDS Research Center, Bangkok, Thailand
- Biostatistics Excellence Centre, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Sandra W. CARDOSO
- Evandro Chagas Clinical Research Institute, Fiocruz, Rio de Janeiro, Brazil
| | | | | | | | | | | | - Mulinda NYIRENDA
- College of Medicine- Johns Hopkins Research Project, Blantyre, Malawi
| | | | - Andre MACHADO
- Hospital Nossa Senhora da Conceicao-GHC, Porto Alegre, Brazil
| | - Frank VAN LETH
- Department of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | | | | | - Anchalee AVIHINGSANON
- HIV-NAT, Thai Red Cross AIDS Research Center, Bangkok, Thailand
- Center of Excellence in Tuberculosis, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Frank COBELENS
- Department of Global Health and Amsterdam Institute for Global Health and Development Amsterdam University Medical Centers location University of Amsterdam, Amsterdam, The Netherlands
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Shojaan H, Kalami N, Ghasempour Alamdari M, Emami Alorizy SM, Ghaedi A, Bazrgar A, Khanzadeh M, Lucke-Wold B, Khanzadeh S. Diagnostic value of the neutrophil lymphocyte ratio in discrimination between tuberculosis and bacterial community acquired pneumonia: A meta-analysis. J Clin Tuberc Other Mycobact Dis 2023; 33:100395. [PMID: 37692090 PMCID: PMC10485633 DOI: 10.1016/j.jctube.2023.100395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/12/2023] Open
Abstract
Background We conducted a systematic review and meta-analysis, based on Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, to evaluate current literature on diagnostic value of neutrophil to lymphocyte ratio (NLR) in discrimination between tuberculosis (TB) and bacterial community acquired pneumonia (B-CAP). Methods Literature search was conducted from July 20, 2023 using Scopus, PubMed, and Web of Science databases. STATA software (version 12.0; Stata Corporation) was used for all analyses. Results We found that patients with TB had significantly lower levels of NLR compared to those with B-CAP (SMD = -1.09, 95 %CI = -1.78- -0.40, P = 0.002). In the quality subgroup analysis, we found that patients with TB had significantly lower level of NLR compared to those with B-CAP consistent in moderate (SMD = -0.86, 95 %CI = -2.30, 0.57, P = 0.23) and high-quality studies (SMD = -1.25, 95 %CI = -2.07, -0.42). In the subgroup analysis based on continent, we found that patients with TB had significantly lower level of NLR compared to those with B-CAP in studies performed in Asian populations (SMD = -1.37, 95 %CI = -2.13, -0.61, P < 0.001), but not on African population (SMD = -0.02, 95 %CI = -1.06, 1.02, P = 0.97). The result of this study did not change after execution of sensitivity analysis. The pooled sensitivity of NLR was 0.86 (95% CI = 0.80, 0.91), and the pooled specificity was0.88 (95% CI = 0.69, 0.95). Conclusion Patients with TB had a significantly lower NLR levels compared to those with B-CAP, so we utilized this biomarker for distinguishing between the disorders.
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Affiliation(s)
- Horieh Shojaan
- Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Niusha Kalami
- Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | | | - Arshin Ghaedi
- Student Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Aida Bazrgar
- Student Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Monireh Khanzadeh
- Geriatric & Gerontology Department, Medical School, Tehran University of Medical and Health Sciences, Tehran, Iran
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Mayito J, Meya DB, Miriam A, Dhikusooka F, Rhein J, Sekaggya-Wiltshire C. Monocyte to Lymphocyte ratio is highly specific in diagnosing latent tuberculosis and declines significantly following tuberculosis preventive therapy: A cross-sectional and nested prospective observational study. PLoS One 2023; 18:e0291834. [PMID: 38033005 PMCID: PMC10688757 DOI: 10.1371/journal.pone.0291834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 09/06/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Interferon-gamma release assay and tuberculin skin test use is limited by costly sundries and cross-reactivity with non-tuberculous mycobacteria and Bacille Calmette-Guérin (BCG) vaccination respectively. We investigated the Monocyte to Lymphocyte ratio (MLR) as a biomarker to overcome these limitations and for use in monitoring response to tuberculosis preventive therapy (TPT). METHODS We conducted a cross-sectional and nested prospective observational study among asymptomatic adults living with Human Immuno-deficiency Virus (HIV) in Kampala, Uganda. Complete blood count (CBC) and QuantiFERON-TB® Gold-plus were measured at baseline and CBC repeated at three months. Multivariable logistic regression was performed to identify factors associated with a high MLR and decline in MLR. RESULTS We recruited 110 adults living with HIV and on antiretroviral therapy, of which 82.5% (85/110) had suppressed viral loads, 71.8% (79/110) were female, and 73.6% (81/110) had a BCG scar. The derived MLR diagnostic cut-off was 0.35, based on which the MLR sensitivity, specificity, positive predictive value, and negative predictive value were 12.8%, 91.6%, 45.5%, and 65.7% respectively. The average MLR declined from 0.212 (95% CI: 0.190-0.235) at baseline to 0.182 (95% CI: 0.166-0.198) after three months of TPT. A viral load of >50 copies/ml (aOR, 5.67 [1.12-28.60]) was associated with a high MLR while that of <50 copies/ml (aOR, 0.07 [0.007-0.832]) was associated with a decline in MLR. CONCLUSION MLR was highly specific in diagnosing latent TB and declined significantly following three months of TPT. Implications of a high MLR and decline in MLR after TPT need further evaluation in a larger cohort.
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Affiliation(s)
- Jonathan Mayito
- Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda
| | - David B. Meya
- Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda
| | - Akia Miriam
- Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda
| | - Flavia Dhikusooka
- Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda
| | - Joshua Rhein
- Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis, Minnesota, United States of America
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Shi H, Yang L, Zhang F, Zhou Y, Zhou Y. Diagnostic Value of CD25, CD69, and CD134 on Tuberculosis-Specific Antigen-Stimulated CD4+ T Cells for Tuberculous Pleurisy. J Immunol Res 2023; 2023:5309816. [PMID: 37809012 PMCID: PMC10551431 DOI: 10.1155/2023/5309816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 08/12/2023] [Accepted: 08/18/2023] [Indexed: 10/10/2023] Open
Abstract
Rapid and accurate methods for the diagnosis of tuberculous pleurisy (TP) are urgently needed. Activation markers of tuberculosis (TB)-reactive T cells are considered promising for the diagnosis of active TB (ATB). Different activation indexes may play different roles in the progression of TB, but there are few reports on T cell activation indicators, except for HLA-DR. Hence, we evaluated the expression of early (CD25 and CD69) and late (CD134) activation markers on TB antigen-stimulated CD4+ T cells in populations with different TB infection status and investigated their diagnostic value for ATB, particularly, for TP. Moreover, we compared the differences in the diagnostic efficacy among the indexes from peripheral blood (PB) and pleural fluid (PF) for TP. The expression of each activation marker was significantly increased in TB-infected populations (patients with ATB and latent TB infection vs. healthy individuals; patients with TP vs. non-TP) and was significantly higher in the PF than in the PB of patients with TP. The diagnostic performance of the coexpressed activation markers was superior to that of single expression markers in the differential diagnosis of ATB and non-TB, with CD25+CD134+ showing the best diagnostic efficiency (AUC: 0.93, 95% CI, 0.87-0.99; sensitivity: 86.7%, 95% CI, 72.5%-94.5%; and specificity: 94.0%, 95% CI, 82.5%-98.4%). Except for TB-IGRA, the activation indexes were more accurate than conventional laboratory methods for ATB diagnosis. In addition, the expression of CD25+CD134+ in PB and PF was the best values for differential diagnosis of TP and NTP, with AUCs of 0.87 (95% CI, 0.77-0.96) and 0.95 (95% CI, 0.90-1.00), respectively. Our study provides information on the diagnostic value of different activation markers for TB and shows that the expression of CD25+CD134+ on CD4+ T cells in PF can serve as a potential marker for TP diagnosis.
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Affiliation(s)
- Hanlu Shi
- Laboratory Medicine Center, Department of Clinical Laboratory, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou 310014, China
- School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou 310053, China
| | - Liping Yang
- The Quzhou Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou 324000, China
| | - Fujie Zhang
- Qian Xi Nan Hospital of Traditional Chinese Medicine, Qian Xi Nan Buyei and Miao Autonomous Prefecture, Guizhou 562499, China
| | - Yu Zhou
- Laboratory Medicine Center, Department of Clinical Laboratory, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou 310014, China
- Key Laboratory of Biomarkers and in vitro Diagnosis Translation of Zhejiang Province, Hangzhou, Zhejiang 310063, China
| | - Yonglie Zhou
- Laboratory Medicine Center, Department of Clinical Laboratory, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou 310014, China
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Ahor HS, Schulte R, Adankwah E, Harelimana JDD, Minadzi D, Acheampong I, Vivekanandan MM, Aniagyei W, Yeboah A, Arthur JF, Lamptey M, Abass MK, Kumbel F, Osei-Yeboah F, Gawusu A, Debrah LB, Owusu DO, Debrah A, Mayatepek E, Seyfarth J, Phillips RO, Jacobsen M. Monocyte pathology in human tuberculosis is due to plasma milieu changes and aberrant STAT signalling. Immunology 2023; 170:154-166. [PMID: 37219921 DOI: 10.1111/imm.13659] [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: 03/15/2023] [Accepted: 04/29/2023] [Indexed: 05/24/2023] Open
Abstract
Monocyte-derived macrophages contribute centrally to immune protection in Mycobacterium tuberculosis infection and changes in monocyte phenotype characterize immunopathology in tuberculosis patients. Recent studies highlighted an important role of the plasma milieu in tuberculosis immunopathology. Here, we investigated monocyte pathology in patients with acute tuberculosis and determined tuberculosis plasma milieu effects on phenotype as well as cytokine signalling of reference monocytes. Patients with tuberculosis (n = 37) and asymptomatic contacts (controls n = 35) were recruited as part of a hospital-based study in the Ashanti region of Ghana. Multiplex flow cytometry phenotyping of monocyte immunopathology was performed and effects of individual blood plasma samples on reference monocytes prior to and during treatment were characterized. Concomitantly, cell signalling pathways were analysed to elucidate underlying mechanisms of plasma effects on monocytes. Multiplex flow cytometry visualization characterized changes in monocyte subpopulations and detected higher expression of CD40, CD64 and PD-L1 in monocytes from tuberculosis patients as compared to controls. Aberrant expression normalized during anti-mycobacterial treatment and also CD33 expression decreased markedly. Notably, higher CD33, CD40 and CD64 expression was induced in reference monocytes when cultured in the presence of plasma samples from tuberculosis patients as compared to controls. STAT signalling pathways were affected by the aberrant plasma milieu and higher levels of STAT3 and STAT5 phosphorylation was found in tuberculosis plasma-treated reference monocytes. Importantly, high pSTAT3 levels were associated with high CD33 expression and pSTAT5 correlated with CD40 as well as CD64 expression. These results suggested plasma milieu effects with potential implications on monocyte phenotype and function in acute tuberculosis.
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Affiliation(s)
- Hubert Senanu Ahor
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, Medical Faculty, University Hospital Duesseldorf, Heinrich-Heine University, Duesseldorf, Germany
| | - Rebecca Schulte
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, Medical Faculty, University Hospital Duesseldorf, Heinrich-Heine University, Duesseldorf, Germany
| | - Ernest Adankwah
- Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), Kumasi, Ghana
| | - Jean De Dieu Harelimana
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, Medical Faculty, University Hospital Duesseldorf, Heinrich-Heine University, Duesseldorf, Germany
| | - Difery Minadzi
- Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), Kumasi, Ghana
| | - Isaac Acheampong
- Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), Kumasi, Ghana
| | | | - Wilfred Aniagyei
- Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), Kumasi, Ghana
| | - Augustine Yeboah
- Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), Kumasi, Ghana
| | - Joseph F Arthur
- Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), Kumasi, Ghana
| | - Millicent Lamptey
- Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), Kumasi, Ghana
| | | | | | | | - Amidu Gawusu
- Sene West Health Directorate, Kwame Danso, Ghana
| | - Linda Batsa Debrah
- Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), Kumasi, Ghana
| | - Dorcas O Owusu
- Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), Kumasi, Ghana
| | - Alexander Debrah
- Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), Kumasi, Ghana
| | - Ertan Mayatepek
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, Medical Faculty, University Hospital Duesseldorf, Heinrich-Heine University, Duesseldorf, Germany
| | - Julia Seyfarth
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, Medical Faculty, University Hospital Duesseldorf, Heinrich-Heine University, Duesseldorf, Germany
| | - Richard O Phillips
- Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), Kumasi, Ghana
- School of Medicine and Dentistry, College of Health Sciences, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
| | - Marc Jacobsen
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, Medical Faculty, University Hospital Duesseldorf, Heinrich-Heine University, Duesseldorf, Germany
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9
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Zhou P, Shen J, Ge X, Ding F, Zhang H, Huang X, Zhao C, Li M, Li Z. Classification and characterisation of extracellular vesicles-related tuberculosis subgroups and immune cell profiles. J Cell Mol Med 2023; 27:2482-2494. [PMID: 37409682 PMCID: PMC10468662 DOI: 10.1111/jcmm.17836] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 06/23/2023] [Accepted: 06/24/2023] [Indexed: 07/07/2023] Open
Abstract
Around the world, tuberculosis (TB) remains one of the most common causes of morbidity and mortality. The molecular mechanism of Mycobacterium tuberculosis (Mtb) infection is still unclear. Extracellular vesicles (EVs) play a key role in the onset and progression of many disease states and can serve as effective biomarkers or therapeutic targets for the identification and treatment of TB patients. We analysed the expression profile to better clarify the EVs characteristics of TB and explored potential diagnostic markers to distinguish TB from healthy control (HC). Twenty EVs-related differentially expressed genes (DEGs) were identified, and 17 EVs-related DEGs were up-regulated and three DEGs were down-regulated in TB samples, which were related to immune cells. Using machine learning, a nine EVs-related gene signature was identified and two EVs-related subclusters were defined. The single-cell RNA sequence (scRNA-seq) analysis further confirmed that these hub genes might play important roles in TB pathogenesis. The nine EVs-related hub genes had excellent diagnostic values and accurately estimated TB progression. TB's high-risk group had significantly enriched immune-related pathways, and there were substantial variations in immunity across different groups. Furthermore, five potential drugs were predicted for TB using CMap database. Based on the EVs-related gene signature, the TB risk model was established through a comprehensive analysis of different EV patterns, which can accurately predict TB. These genes could be used as novel biomarkers to distinguish TB from HC. These findings lay the foundation for further research and design of new therapeutic interventions aimed at treating this deadly infectious disease.
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Affiliation(s)
- Peipei Zhou
- School of Medical LaboratoryWeifang Medical UniversityWeifangChina
| | - Jie Shen
- School of Medical LaboratoryWeifang Medical UniversityWeifangChina
| | - Xiao Ge
- School of Medical LaboratoryWeifang Medical UniversityWeifangChina
| | - Fang Ding
- Respiratory MedicineAffiliated Hospital of Weifang Medical UniversityWeifangChina
| | - Hong Zhang
- School of Public HealthWeifang Medical UniversityWeifangChina
| | - Xinlin Huang
- School of Medical LaboratoryWeifang Medical UniversityWeifangChina
| | - Chao Zhao
- Office of Academic AffairsWeifang Medical UniversityWeifangChina
| | - Meng Li
- School of Medical LaboratoryWeifang Medical UniversityWeifangChina
| | - Zhenpeng Li
- School of Medical LaboratoryWeifang Medical UniversityWeifangChina
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10
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Riou C, du Bruyn E, Kim GHJ, da Costa I, Lee J, Sher A, Wilkinson RJ, Allwood BW, Goldin J. Derivation of a high-resolution CT-based, semi-automated radiographic score in tuberculosis and its relationship to bacillary load and antitubercular therapy. Eur Respir J 2023; 62:2300600. [PMID: 37678952 PMCID: PMC7615118 DOI: 10.1183/13993003.00600-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 07/04/2023] [Indexed: 09/09/2023]
Affiliation(s)
- Catherine Riou
- Wellcome Centre for Infectious Disease Research in Africa and Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Observatory, Cape Town, South Africa
- Division of Medical Virology, Department of Pathology, University of Cape Town, Observatory, Cape Town, South Africa
| | - Elsa du Bruyn
- Wellcome Centre for Infectious Disease Research in Africa and Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Observatory, Cape Town, South Africa
| | - Grace Hyun J. Kim
- Department of Radiology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
- UCLA Center for Computer Vision and Imaging Biomarkers, Los Angeles, CA, USA
| | - Irene da Costa
- Department of Radiology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
- UCLA Center for Computer Vision and Imaging Biomarkers, Los Angeles, CA, USA
| | - Jihey Lee
- Department of Radiology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
- UCLA Center for Computer Vision and Imaging Biomarkers, Los Angeles, CA, USA
| | - Alan Sher
- Immunobiology Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Robert J. Wilkinson
- Wellcome Centre for Infectious Disease Research in Africa and Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Observatory, Cape Town, South Africa
- Department of Medicine, University of Cape Town, Observatory, Cape Town, South Africa
- Department of Infectious Diseases, Imperial College London, W12 0NN, UK
- The Francis Crick Institute, London, NW1 1AT, UK
| | - Brian W. Allwood
- Division of Pulmonology, Department of Medicine, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
| | - Jonathan Goldin
- Department of Radiology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
- UCLA Center for Computer Vision and Imaging Biomarkers, Los Angeles, CA, USA
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11
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Niewold P, Dijkstra DJ, Cai Y, Goletti D, Palmieri F, van Meijgaarden KE, Verreck FAW, Akkerman OW, Hofland RW, Delemarre EM, Nierkens S, Verheul MK, Pollard AJ, van Dissel JT, Ottenhoff THM, Trouw LA, Joosten SA. Identification of circulating monocytes as producers of tuberculosis disease biomarker C1q. Sci Rep 2023; 13:11617. [PMID: 37464009 DOI: 10.1038/s41598-023-38889-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 07/17/2023] [Indexed: 07/20/2023] Open
Abstract
Tuberculosis (TB) is a prevalent disease causing an estimated 1.6 million deaths and 10.6 million new cases annually. Discriminating TB disease from differential diagnoses can be complex, particularly in the field. Increased levels of complement component C1q in serum have been identified as a specific and accessible biomarker for TB disease but the source of C1q in circulation has not been identified. Here, data and samples previously collected from human cohorts, a clinical trial and a non-human primate study were used to identify cells producing C1q in circulation. Cell subset frequencies were correlated with serum C1q levels and combined with single cell RNA sequencing and flow cytometry analyses. This identified monocytes as C1q producers in circulation, with a pronounced expression of C1q in classical and intermediate monocytes and variable expression in non-classical monocytes.
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Affiliation(s)
- Paula Niewold
- Department of Infectious Diseases, Leiden University Medical Center, Leiden, the Netherlands.
| | - Douwe J Dijkstra
- Department of Immunology, Leiden University Medical Center, Leiden, the Netherlands
| | - Yi Cai
- Guangdong Key Laboratory of Regional Immunity and Diseases, Department of Pathogen Biology, Shenzhen University Medical School, Shenzhen, China
| | - Delia Goletti
- Translational Research Unit, Department of Epidemiology and Preclinical Research, National Institute for Infectious Diseases, Rome, Italy
| | - Fabrizio Palmieri
- Respiratory Infectious Diseases Unit, Clinical Department, National Institute for Infectious Diseases, Rome, Italy
| | | | - Frank A W Verreck
- Section of TB Research & Immunology, Department of Parasitology, Biomedical Primate Research Centre (BPRC), Rijswijk, the Netherlands
| | - Onno W Akkerman
- Department of Pulmonary Disease and Tuberculosis, University of Groningen, Groningen, the Netherlands
- Tuberculosis Center Beatrixoord, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Regina W Hofland
- Department of Pulmonary Diseases and Tuberculosis, University Medical Center Utrecht, Utrecht, the Netherlands
| | | | - Stefan Nierkens
- Center for Translational Immunology, UMC Utrecht, Utrecht, the Netherlands
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Marije K Verheul
- Oxford Vaccine Group, Department of Pediatrics, University of Oxford and NIHR Oxford Biomedical Research Centre, Oxford, UK
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, 3720 BA, The Netherlands
| | - Andrew J Pollard
- Oxford Vaccine Group, Department of Pediatrics, University of Oxford and NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Jaap T van Dissel
- Department of Infectious Diseases, Leiden University Medical Center, Leiden, the Netherlands
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, 3720 BA, The Netherlands
| | - Tom H M Ottenhoff
- Department of Infectious Diseases, Leiden University Medical Center, Leiden, the Netherlands
| | - Leendert A Trouw
- Department of Immunology, Leiden University Medical Center, Leiden, the Netherlands
| | - Simone A Joosten
- Department of Infectious Diseases, Leiden University Medical Center, Leiden, the Netherlands
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12
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Nonaka M, Matsuyama M, Sakai C, Matsumura S, Arai N, Nakajima M, Saito T, Hizawa N. Risk factors for clinical progression in patients with pulmonary Mycobacterium avium complex disease without culture-positive sputum: a single-center, retrospective study. Eur J Med Res 2023; 28:186. [PMID: 37291649 DOI: 10.1186/s40001-023-01152-0] [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: 10/28/2022] [Accepted: 05/31/2023] [Indexed: 06/10/2023] Open
Abstract
OBJECTIVES Limited data are available on the progression of pulmonary Mycobacterium avium complex (MAC) disease without culture-positive sputum. The aim of this study was to identify the risk factors associated with clinical progression of pulmonary MAC disease diagnosed by bronchoscopy. METHODS A single-center, retrospective, observational study was conducted. Pulmonary MAC patients diagnosed by bronchoscopy without culture-positive sputum from January 1, 2013, to December 31, 2017 were analyzed. Clinical progression after diagnosis was defined as having culture-positive sputum at least once or initiation of guideline-based therapy. Then, clinical characteristics were compared between clinically progressed patients and stable patients. RESULTS Ninety-three pulmonary MAC patients diagnosed by bronchoscopy were included in the analysis. During the 4-year period after diagnosis, 38 patients (40.9%) started treatment, and 35 patients (37.6%) had new culture-positive sputum. Consequently, 52 patients (55.9%) were classified into the progressed group, and 41 patients (44.1%) were classified into the stable group. There were no significant differences between the progressed and the stable groups in age, body mass index, smoking status, comorbidities, symptoms, or species isolated from bronchoscopy. On multivariate analysis, male sex, monocyte to lymphocyte ratio (MLR) ≥ 0.17, and the presence of combined lesions in the middle (lingula) and lower lobes were risk factors for clinical progression. CONCLUSIONS Some patients with pulmonary MAC disease without culture-positive sputum progress within 4 years. Therefore, pulmonary MAC patients, especially male patients, having higher MLR or lesions in the middle (lingula) and lower lobes might need careful follow-up for a longer time.
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Affiliation(s)
- Mizu Nonaka
- Department of Respiratory Medicine, National Hospital Organization Ibarakihigashi National Hospital, Ibaraki, Japan
- Department of Respiratory Medicine, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Masashi Matsuyama
- Department of Respiratory Medicine, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan.
- Department of Pulmonary Medicine, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Ibaraki, Tsukuba, 305-8575, Japan.
| | - Chio Sakai
- Department of Respiratory Medicine, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Sosuke Matsumura
- Department of Respiratory Medicine, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Naoki Arai
- Department of Respiratory Medicine, National Hospital Organization Ibarakihigashi National Hospital, Ibaraki, Japan
- Department of Respiratory Medicine, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Masayuki Nakajima
- Department of Respiratory Medicine, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Takefumi Saito
- Department of Respiratory Medicine, National Hospital Organization Ibarakihigashi National Hospital, Ibaraki, Japan
| | - Nobuyuki Hizawa
- Department of Respiratory Medicine, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
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13
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Tamene W, Marconi VC, Abebe M, Wassie L, Belay Y, Kebede A, Sack U, Howe R. Differential expression of chemokine receptors on monocytes in TB and HIV S. Heliyon 2023; 9:e17202. [PMID: 37484366 PMCID: PMC10361379 DOI: 10.1016/j.heliyon.2023.e17202] [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: 04/29/2022] [Revised: 06/04/2023] [Accepted: 06/09/2023] [Indexed: 07/25/2023] Open
Abstract
In the present study, we defined multiple chemokine receptors expressed by classical, intermediate and non-classical monocyte subsets in TB, HIV and TB/HIV co-infection and associate it with the perturbation of monocyte subsets due to the diseases. Peripheral blood mononuclear cells from TB+ (n = 34), HIV+ (n = 35), TB + HIV+ (n = 12), as well as TB-HIV- healthy controls (n = 39), were tested for monocyte phenotyping by flow cytometry. Frequencies of intermediate and non-classical monocytes were significantly higher in TB and/or HIV disease relative to healthy controls. CCR2 and CX3CR1 were significantly higher on monocytes in TB disease, whereas CCR4 and CCR5 were present at higher levels in HIV disease. TB/HIV co-infected patients exhibited CCR2, CCR5 and CX3CR1 levels intermediate to TB and HIV subjects, while CCR4 was at a higher level than HIV. Despite the increase in the expression of chemokine receptors due to disease conditions, chemokine receptors maintained their original expression pattern on monocyte subsets. Our data provided new insight into the disease-specific but not monocyte subsets-specific modulation of chemokine receptors in TB and HIV.
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Affiliation(s)
- Wegene Tamene
- TB and HIV Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Vincent C. Marconi
- Emory University School of Medicine and Rollins School of Public Health, Atlanta, Georgia
| | - Meseret Abebe
- Bacterial and Viral Diseases Research Directorate, Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Liya Wassie
- Bacterial and Viral Diseases Research Directorate, Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Yohannes Belay
- TB and HIV Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Amha Kebede
- TB and HIV Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Ulrich Sack
- Institute of Immunology, Leipzig University, Leipzig, Saxony, Germany
| | - Rawleigh Howe
- Bacterial and Viral Diseases Research Directorate, Armauer Hansen Research Institute, Addis Ababa, Ethiopia
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14
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Grifoni A, Alonzi T, Alter G, Noonan DM, Landay AL, Albini A, Goletti D. Impact of aging on immunity in the context of COVID-19, HIV, and tuberculosis. Front Immunol 2023; 14:1146704. [PMID: 37292210 PMCID: PMC10246744 DOI: 10.3389/fimmu.2023.1146704] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 05/11/2023] [Indexed: 06/10/2023] Open
Abstract
Knowledge of aging biology needs to be expanded due to the continuously growing number of elderly people worldwide. Aging induces changes that affect all systems of the body. The risk of cardiovascular disease and cancer increases with age. In particular, the age-induced adaptation of the immune system causes a greater susceptibility to infections and contributes to the inability to control pathogen growth and immune-mediated tissue damage. Since the impact of aging on immune function, is still to be fully elucidated, this review addresses some of the recent understanding of age-related changes affecting key components of immunity. The emphasis is on immunosenescence and inflammaging that are impacted by common infectious diseases that are characterized by a high mortality, and includes COVID-19, HIV and tuberculosis.
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Affiliation(s)
- Alba Grifoni
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology (LJI), La Jolla, CA, United States
| | - Tonino Alonzi
- Translational Research Unit, National Institute for Infectious Diseases “Lazzaro Spallanzani”-IRCCS, Rome, Italy
| | - Galit Alter
- Ragon Institute of Massachusetts General Hospital (MGH), Massachusetts Institute of Technology (MIT), and Harvard, Cambridge, MA, United States
| | - Douglas McClain Noonan
- Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS) MultiMedica, Milan, Italy
- Immunology and General Pathology Laboratory, Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
| | - Alan L. Landay
- Department of Internal Medicine, Rush Medical College, Chicago, IL, United States
| | | | - Delia Goletti
- Translational Research Unit, National Institute for Infectious Diseases “Lazzaro Spallanzani”-IRCCS, Rome, Italy
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15
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Xie J, Chen Y, Chen S, Long H, Zhang W, Liu G. The potential value of Notch1 and DLL1 in the diagnosis and prognosis of patients with active TB. Front Immunol 2023; 14:1134123. [PMID: 37063841 PMCID: PMC10090694 DOI: 10.3389/fimmu.2023.1134123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 03/13/2023] [Indexed: 03/31/2023] Open
Abstract
ObjectivesThe Notch signaling pathway has been implicated in the pathogenesis of active tuberculosis (TB), and Th1-type cell-mediated immunity is essential for effective control of mycobacterial infection. However, it remains unclear whether Notch signaling molecules (Notch1, DLL1, and Hes1) and Th1-type factors (T-bet and IFN-γ) can serve as biomarkers for tracking the progression of active TB at different stages along with peripheral blood white blood cell (WBC) parameters.MethodsA total of 60 participants were enrolled in the study, including 37 confirmed TB patients (mild (n=17), moderate/severe (n=20)) and 23 healthy controls. The mRNA expression of Notch1, DLL1, Hes1, T-bet and IFN-γ in the peripheral blood mononuclear cells (PBMCs) of the subjects was measured by RT-qPCR, then analyzed for differences. Receiver Operating Characteristic curve (ROC) was used to assess the effectiveness of each factor as a biomarker in identifying lung injury.ResultsWe found that mRNA expression levels of Notch1, DLL1, and Hes1 were upregulated in active TB patients, with higher levels observed in those with moderate/severe TB than those with mild TB or without TB. In contrast, mRNA levels of T-bet and IFN-γ were downregulated and significantly lower in mild and moderate/severe cases. Furthermore, the combiROC analysis of IFN-γ and the percentage of lymphocytes (L%) among WBC parameters showed superior discriminatory ability compared to other factors for identifying individuals with active TB versus healthy individuals. Notably, Notch pathway molecules were more effective than Th1-type factors and WBC parameters in differentiating mild and moderate/severe cases of active TB, particularly in the combiROC model that included Notch1 and Hes1.ConclusionsOur study demonstrated that Notch1, Hes1, IFN-γ, and L% can be used as biomarkers to identify different stages of active TB patients and to monitor the effectiveness of treatment.
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16
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Zanon IDB, Meves R, Klautau GB. The Relative Lymphocyte Count is Lower when the Etiological Agent in Pott Disease is Successfully Isolated
*. Rev Bras Ortop 2023; 58:92-100. [PMID: 36969768 PMCID: PMC10038726 DOI: 10.1055/s-0042-1756638] [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: 10/26/2021] [Accepted: 07/18/2022] [Indexed: 03/26/2023] Open
Abstract
Objective
To describe the clinico-epidemiological, laboratory, and radiological characteristics of tuberculous spondylodiscitis in the Brazilian population, and to assess whether there are differences between patients in whom the etiological agent in Pott disease was isolated or not.
Methods
Patients diagnosed with tuberculosis (TB) of the spine (Pott disease) underwent follow-up between 2009 and 2019 at a quaternary hospital and were divided into 2 groups: successful isolation (SI) of the etiological agent (through bacilloscopy, culture, or positive molecular rapid test) and unsuccessful isolation (UI) of the etiological agent.
Results
From a total of 26 patients diagnosed with TB of the spine, 21 (80.7%) were male, with a mean age of 40 ± 22.5 years. The average lymphocyte counts were higher in the UI group (25.35 ± 13.08;
p
= 0.025) compared to the SI group (14.18 ± 7.48). Moreover, the monocyte/lymphocyte ratio was lower in the UI group (0.39 ± 0.22;
p
= 0.009) than in the SI group (0.89 ± 0.65). Relative lymphocyte counts higher than or equal to 16.7 had a sensitivity of 76.9% and specificity of 62.5% in the UI group. Values higher than or equal to 0.58 for the monocyte/lymphocyte ratio showed a sensitivity of 84.6% and specificity of 75.0% in the UI group.
Conclusion
No differences were observed regarding the clinico-epidemiological and radiological characteristics of the two experimental groups. However, the UI group had higher lymphocyte counts and a lower monocyte/lymphocyte ratio.
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Affiliation(s)
- Igor de Barcellos Zanon
- Grupo de Afecções da Coluna Vertebral, Departamento de Ortopedia e Traumatologia, Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brasil
- Endereço para correspondência Igor de Barcellos Zanon, MD, MSc Rua Doutor Cesário Motta Júnior112, Vila Buarque, São Paulo, SPBrasil
| | - Robert Meves
- Faculdade de Ciências Médicas, Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brasil
| | - Giselle Burlamaqui Klautau
- Grupo de Afecções da Coluna Vertebral, Departamento de Ortopedia e Traumatologia, Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brasil
- Faculdade de Ciências Médicas, Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brasil
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17
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Kissling M, Fritschi N, Baumann P, Buettcher M, Bonhoeffer J, Naranbhai V, Ritz N. Monocyte, Lymphocyte and Neutrophil Ratios - Easy-to-Use Biomarkers for the Diagnosis of Pediatric Tuberculosis. Pediatr Infect Dis J 2023; 42:520-527. [PMID: 36977187 DOI: 10.1097/inf.0000000000003901] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
Abstract
BACKGROUND The neutrophil-to-lymphocyte-ratio (NLR), neutrophil-to-monocyte-plus-lymphocyte-ratio (NMLR) and monocyte-to-lymphocyte-ratio (MLR) may have diagnostic potential for tuberculosis (TB). METHODS Data of two prospective multicenter studies in Switzerland were used, which included children <18 years with TB exposure, infection or disease or with febrile non-TB lower-respiratory-tract infection (nTB-LRTI). RESULTS Of the 389 children included 25 (6.4%) had TB disease, 12 (3.1%) TB infection, 28 (7.2%) were healthy TB exposed and 324 (83.3%) nTB-LRTI. Median (IQR) NLR was highest with 2.0 (1.2, 2.2) in children with TB disease compared to TB exposed [0.8 (0.6, 1.3); P = 0.002] and nTB-LRTI [0.3 (0.1, 1.0); P < 0.001]. Median (IQR) NMLR was highest with 1.4 (1.2, 1.7) in children with TB disease compared to healthy exposed [0.7 (0.6, 1.1); P = 0.003] and children with nTB-LRTI [0.2 (0.1, 0.6); P < 0.001). Receiver operating characteristic curves to detect TB disease compared to nTB-LRTI for NLR and NMLR had an area under the curve of 0.82 and 0.86, the sensitivity of 88% and 88%, and specificity of 71% and 76%, respectively. CONCLUSION NLR and NMLR are promising, easy-to-obtain diagnostic biomarkers to differentiate children with TB disease from other lower respiratory tract infections. These results require validation in a larger study and in settings with high and low TB endemicity.
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Affiliation(s)
- Mirjam Kissling
- From the Department of Clinical Research, Mycobacterial and Migrant Health Research Group, University of Basel, Switzerland
| | - Nora Fritschi
- From the Department of Clinical Research, Mycobacterial and Migrant Health Research Group, University of Basel, Switzerland
- University Children's Hospital Basel, Switzerland
| | - Philipp Baumann
- Department of Intensive Care Medicine and Neonatology, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland
- Infectious Disease and Vaccinology Unit, University Children's Hospital Basel, University of Basel, Basel, Switzerland
| | - Michael Buettcher
- Paediatric Infectious Diseases Unit, Children's Hospital, Lucerne Cantonal Hospital, Lucerne Switzerland
- Paediatric Pharmacology and Pharmacometrics Research Center, University Children's Hospital Basel, University of Basel, Basel, Switzerland
| | | | - Vivek Naranbhai
- Massachusetts General Hospital Cancer Center, Massachusetts General Hospital, Boston
- Dana-Farber Cancer Institute, Boston, Massachusetts
- Center for the AIDS Programme of Research in South Africa, Durban, South Africa
| | - Nicole Ritz
- From the Department of Clinical Research, Mycobacterial and Migrant Health Research Group, University of Basel, Switzerland
- University Children's Hospital Basel, Switzerland
- Paediatric Infectious Diseases Unit, Children's Hospital, Lucerne Cantonal Hospital, Lucerne Switzerland
- Department of Pediatrics, The Royal Children's Hospital Melbourne, The University of Melbourne, Australia
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18
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Thu VTA, Dat LD, Jayanti RP, Trinh HKT, Hung TM, Cho YS, Long NP, Shin JG. Advancing personalized medicine for tuberculosis through the application of immune profiling. Front Cell Infect Microbiol 2023; 13:1108155. [PMID: 36844400 PMCID: PMC9950414 DOI: 10.3389/fcimb.2023.1108155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 01/17/2023] [Indexed: 02/12/2023] Open
Abstract
While early and precise diagnosis is the key to eliminating tuberculosis (TB), conventional methods using culture conversion or sputum smear microscopy have failed to meet demand. This is especially true in high-epidemic developing countries and during pandemic-associated social restrictions. Suboptimal biomarkers have restricted the improvement of TB management and eradication strategies. Therefore, the research and development of new affordable and accessible methods are required. Following the emergence of many high-throughput quantification TB studies, immunomics has the advantages of directly targeting responsive immune molecules and significantly simplifying workloads. In particular, immune profiling has been demonstrated to be a versatile tool that potentially unlocks many options for application in TB management. Herein, we review the current approaches for TB control with regard to the potentials and limitations of immunomics. Multiple directions are also proposed to hopefully unleash immunomics' potential in TB research, not least in revealing representative immune biomarkers to correctly diagnose TB. The immune profiles of patients can be valuable covariates for model-informed precision dosing-based treatment monitoring, prediction of outcome, and the optimal dose prediction of anti-TB drugs.
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Affiliation(s)
- Vo Thuy Anh Thu
- Department of Pharmacology and PharmacoGenomics Research Center, Inje University College of Medicine, Busan, Republic of Korea,Center for Personalized Precision Medicine of Tuberculosis, Inje University College of Medicine, Busan, Republic of Korea
| | - Ly Da Dat
- Department of Pharmacology and PharmacoGenomics Research Center, Inje University College of Medicine, Busan, Republic of Korea,Center for Personalized Precision Medicine of Tuberculosis, Inje University College of Medicine, Busan, Republic of Korea
| | - Rannissa Puspita Jayanti
- Department of Pharmacology and PharmacoGenomics Research Center, Inje University College of Medicine, Busan, Republic of Korea,Center for Personalized Precision Medicine of Tuberculosis, Inje University College of Medicine, Busan, Republic of Korea
| | - Hoang Kim Tu Trinh
- Center for Molecular Biomedicine, University of Medicine and Pharmacy at Ho Chi Minh, Ho Chi Minh City, Vietnam
| | - Tran Minh Hung
- Department of Pharmacology and PharmacoGenomics Research Center, Inje University College of Medicine, Busan, Republic of Korea,Center for Personalized Precision Medicine of Tuberculosis, Inje University College of Medicine, Busan, Republic of Korea
| | - Yong-Soon Cho
- Department of Pharmacology and PharmacoGenomics Research Center, Inje University College of Medicine, Busan, Republic of Korea,Center for Personalized Precision Medicine of Tuberculosis, Inje University College of Medicine, Busan, Republic of Korea
| | - Nguyen Phuoc Long
- Department of Pharmacology and PharmacoGenomics Research Center, Inje University College of Medicine, Busan, Republic of Korea,Center for Personalized Precision Medicine of Tuberculosis, Inje University College of Medicine, Busan, Republic of Korea,*Correspondence: Jae-Gook Shin, ; Nguyen Phuoc Long,
| | - Jae-Gook Shin
- Department of Pharmacology and PharmacoGenomics Research Center, Inje University College of Medicine, Busan, Republic of Korea,Center for Personalized Precision Medicine of Tuberculosis, Inje University College of Medicine, Busan, Republic of Korea,Department of Clinical Pharmacology, Inje University Busan Paik Hospital, Busan, Republic of Korea,*Correspondence: Jae-Gook Shin, ; Nguyen Phuoc Long,
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19
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Liu QX, Tang DY, Xiang X, He JQ. Associations between nutritional and immune status and clinicopathologic factors in patients with tuberculosis: A comprehensive analysis. Front Cell Infect Microbiol 2022; 12:1013751. [PMID: 36506012 PMCID: PMC9731357 DOI: 10.3389/fcimb.2022.1013751] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 10/31/2022] [Indexed: 11/25/2022] Open
Abstract
Objective This study was designed to assess and analyze nutritional status (NS) and immune status in patients with tuberculosis. Methods A retrospective analysis was conducted on 93 TB patients hospitalized in the tuberculosis ward of the West China Hospital of Sichuan University. Subgroup comparisons were made according to age (<65 years and ≥65 years), nutritional risk score 2002 (NRS 2002 <3 and ≥3), tuberculosis location [pulmonary tuberculosis and extrapulmonary tuberculosis (including pulmonary tuberculosis complicated with extrapulmonary tuberculosis)], and prognostic nutrition index (PNI) (<45 vs ≥45). Results Significantly increased weight loss was associated with extrapulmonary tuberculosis (P =0.0010). Serum albumin (P =0.0214), total lymphocyte count (P = 0.0009) and PNI (P = 0.0033) were significantly decreased in older patients. Neutrophils/lymphocytes (NLR) (P =0.0002), monocytes/lymphocytes (MLR) (P < 0.0001), and platelets/lymphocytes (PLR) (P =0.0107) were higher. According to NRS 2002, higher nutritional risk was associated with lower body weight and body mass index (BMI) (P < 0.0001), higher weight loss (P = 0.0012), longer duration of hospitalization (P =0.0100), lower serum albumin level and hemoglobin concentration (P <0.01), lower creatinine level, and lower PNI (P < 0.01). 0.0001), lower total lymphocyte count (P = 0.0004), higher neutrophil and monocyte counts (P <0.05), and higher NLR (P = 0.0002), MLR (P = 0.0006), and PLR (P = 0.0156). Lower PNI was associated with lower body weight (P = 0.0001) and BMI (P =0.0074), lower total protein, albumin, and hemoglobin concentrations (P < 0.0001), and lower total lymphocyte count (P < 0.0001) and creatinine levels (P = 0.0336), higher age (P =0.0002) and NRS 2002 score, P < 0.0001), longer hos-pital stay (P = 0.0003), higher neutrophil count (P = 0.0042), and NLR, MLR, and PLR (P <0.0001) were significantly correlated. In multivariate logistic regression analysis, weight loss (OR: 0.209, 95% CI: 0.060-0.722; p =0.013) was significantly associated with higher nutritional risk (NRS 2002≥3). In multiple linear regression analysis, the NRS 2002 score was higher (B=2.018; p =0.023), and extrapulmonary tuberculosis (B=-6.205; p =0.007) was linked with a longer duration of hos-pitalization. Conclusions Older tuberculosis patients are at nutritional risk, and older patients (≥65 years old) need to pay attention to nutritional monitoring and intervention. Older TB patients and those at risk of malnutrition have increased immune ratio and impaired immune function. Management of TB patients using basic diagnostic tools to assess nutritional and immune status and calculate PNI and immunological indexes (NLR, MLR, PLR) to improve treatment outcomes.
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Affiliation(s)
- Quan-Xian Liu
- Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University, Chengdu, China
- Department of Tuberculosis, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Dao-Yan Tang
- Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University, Chengdu, China
| | - Xi Xiang
- Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University, Chengdu, China
| | - Jian-Qing He
- Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University, Chengdu, China
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Adane T, Melku M, Ayalew G, Bewket G, Aynalem M, Getawa S. Accuracy of monocyte to lymphocyte ratio for tuberculosis diagnosis and its role in monitoring anti-tuberculosis treatment: Systematic review and meta-analysis. Medicine (Baltimore) 2022; 101:e31539. [PMID: 36343023 PMCID: PMC9646665 DOI: 10.1097/md.0000000000031539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND High monocyte to lymphocyte ratio (MLR) values may be associated with the risk of active tuberculosis (TB) infection in adults, infants, and postpartum women with HIV infection. It may also serve as an indicator of the effectiveness of anti-TB treatment. Thus, the main aim of this study is to ascertain the accuracy of MLR for the diagnosis of TB and its role in monitoring the effectiveness of anti-TB therapy. METHODS This systematic review and meta-analysis followed the preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. All statistical analyses were performed using STATA 11 and Meta-DiSc software. The Quality assessment of Diagnostic Accuracy Studies tool was used to evaluate the methodological quality of the included studies. The area under the hierarchical summary receiver-operating characteristic hierarchical summary ROC curve [(HSROC) curve (AUC)] was also calculated as an indicator of diagnostic accuracy. RESULTS A total of 15 articles were included in this study. Accordingly, the result showed that elevated MLR is associated with increased risks of TB disease [odd ratio = 3.11 (95% CI: 1.40-6.93)]. The pooled sensitivity and specificity of MLR for identifying TB were 79.5% (95% CI: 68.5-87.3) and 80.2% (95% CI: 67.3-88.9), respectively. The AUC of HSROC was 0.88 (95% CI: 0.857-0.903), indicating the excellent diagnostic performance of MLR for TB. This study also showed that there is a significant reduction in the MLR value after anti-TB treatment in TB patients (standardized mean difference = 0.68; 95% CI: 0.007, 1.43). CONCLUSIONS Generally, MLR can be considered as a crucial biomarker to identify TB and monitor the effectiveness of anti-TB therapy.
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Affiliation(s)
- Tiruneh Adane
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- *Correspondence: Tiruneh Adane, Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P.O. BOX 196, Gondar, Ethiopia (e-mail: )
| | - Mulugeta Melku
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Getnet Ayalew
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Gezahegn Bewket
- Department of Immunology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Melak Aynalem
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Solomon Getawa
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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21
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Malik AA, Gandhi NR, Marcy O, Walters E, Tejiokem M, Chau GD, Omer SB, Lash TL, Becerra MC, Njuguna IN, LaCourse SM, Maleche-Obimbo E, Wamalwa D, John-Stewart GC, Cranmer LM. Development of a Clinical Prediction Score Including Monocyte-to-Lymphocyte Ratio to Inform Tuberculosis Treatment Among Children With HIV: A Multicountry Study. Open Forum Infect Dis 2022; 9:ofac548. [PMID: 36381621 PMCID: PMC9645646 DOI: 10.1093/ofid/ofac548] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 10/12/2022] [Indexed: 11/13/2022] Open
Abstract
Background Clinical pediatric tuberculosis (TB) diagnosis may lead to overdiagnosis particularly among children with human immunodeficiency virus (CHIV). We assessed the performance of monocyte-lymphocyte ratio (MLR) as a diagnostic biomarker and constructed a clinical prediction score to improve specificity of TB diagnosis in CHIV with limited access to microbiologic testing. Methods We pooled data from cohorts of children aged ≤13 years from Vietnam, Cameroon, and South Africa to validate the use of MLR ≥0.378, previously found as a TB diagnostic marker among CHIV. Using multivariable logistic regression, we created an internally validated prediction score for diagnosis of TB disease in CHIV. Results The combined cohort had 601 children (median age, 1.9 [interquartile range, 0.9-5.3] years); 300 (50%) children were male, and 283 (47%) had HIV. Elevated MLR ≥0.378 had sensitivity of 36% (95% confidence interval [CI], 23%-51%) and specificity of 79% (95% CI, 71%-86%) among CHIV in the validation cohort. A model using MLR ≥0.28, age ≥4 years, tuberculin skin testing ≥5 mm, TB contact history, fever >2 weeks, and chest radiograph suggestive of TB predicted active TB disease in CHIV with an area under the receiver operating characteristic curve of 0.85. A prediction score of ≥5 points had a sensitivity of 94% and specificity of 48% to identify confirmed TB, and a sensitivity of 82% and specificity of 48% to identify confirmed and unconfirmed TB groups combined. Conclusions Our score has comparable sensitivity and specificity to algorithms including microbiological testing and should enable clinicians to rapidly initiate TB treatment among CHIV when microbiological testing is unavailable.
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Affiliation(s)
- Amyn A Malik
- Correspondence: Amyn A. Malik, PhD, Yale Institute for Global Health, 1 Church St, Suite 340, New Haven, CT 06510 ()
| | - Neel R Gandhi
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Olivier Marcy
- Epidemiology and Public Health Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
- Centre INSERM U1219, Bordeaux Population Health, University of Bordeaux, Bordeaux, France
| | - Elisabetta Walters
- Desmond Tutu TB Centre, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- John Walton Muscular Dystrophy Research Centre, Newcastle University, Newcastle-upon-Tyne, United Kingdom
| | | | | | - Saad B Omer
- Yale Institute for Global Health, New Haven, Connecticut, USA
- Yale School of Medicine, New Haven, Connecticut, USA
- Yale School of Public Health, New Haven, Connecticut, USA
| | - Timothy L Lash
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Mercedes C Becerra
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Division of Global Health Equity, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Partners In Health, Boston, Massachusetts, USA
| | - Irene N Njuguna
- Department of Research and Programs, Kenyatta National Hospital, Nairobi, Kenya
- Department of Global Health, University of Washington, Seattle, Washington, USA
| | - Sylvia M LaCourse
- Department of Global Health, University of Washington, Seattle, Washington, USA
| | | | - Dalton Wamalwa
- Department of Paediatrics and Child Health, University of Nairobi, Nairobi, Kenya
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22
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Suryana K, Dharmesti NWW, Rai IBN. High Pretreatment Level of Neutrophil to Lymphocyte Ratio, Monocyte to Lymphocyte Ratio and Other Factors Associated with Delayed Sputum Conversion in Patients with Pulmonary Tuberculosis. Infect Drug Resist 2022; 15:5455-5462. [PMID: 36131811 PMCID: PMC9484577 DOI: 10.2147/idr.s380166] [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] [Received: 07/05/2022] [Accepted: 08/29/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction Patients with delayed intensive phase sputum conversion have a higher risk of multidrug resistant-tuberculosis (MDR-TB) and poorer treatment outcomes. Both, host (immune response and comorbidity) and pathogen factors play important roles in determining sputum conversion after treatment initiation. Impaired host immune response, especially the cellular components, as defined by the increased pre-treatment level of neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR) and other additional factors, were associated with severe active TB. Purpose To evaluate whether impaired immune responses (high pre-treatment level of NLR and MLR) and other factors associate with delayed sputum conversion at the end of the intensive phase treatment. Patients and Methods This was a case–control study from 2016 to 2020, which retrospectively analyzed the pre-treatment level of NLR, MLR and other factors among patients with new cases of pulmonary tuberculosis (PTB). Results A total of 62 patients (31 cases and 31 control). The cut-off value of high pretreatment level of NLR and MLR was 5.065 and 0.585, respectively. Bivariate analysis showed that pretreatment NLR ≥5.065 (OR 8.23, CI 95% 2.48–27.32, p < 0.001), MLR ≥0.585 (OR 10.18, 95% CI 3.13–33.18, p < 0.001) and BMI <18.5 (OR 2.91, 95% CI 1.03–8.20, p = 0.041) were associated with an increased risk of delayed sputum conversion. Multivariate analysis, however, showed that pretreatment NLR ≥5.065 was not significantly associated with delayed sputum conversion (AOR 3.370, 95% CI 0.71–15.91, p value 0.125). A high pretreatment of MLR (AOR 30.802, 95% CI 3.22–287.55, p value 0.003) and lower BMI (AOR 10.942, 95% CI 1.121–98.563, p value 0.033) were significantly associated with an increased risk of delayed intensive phase sputum conversion. Conclusion High MLR pretreatment and a low BMI were significantly associated with an increased risk of delayed sputum conversion at the end of the PTB intensive phase treatment. High NLR pretreatment, smoking, diabetes, and HIV were not associated with sputum conversion.
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Affiliation(s)
- Ketut Suryana
- Division of Clinical Allergy-Immunology, Department of Internal Medicine, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia.,Department of Internal Medicine, Merpati Clinic, Wangaya Hospital, Denpasar, Bali, Indonesia
| | - Ni Wayan Wina Dharmesti
- Department of Internal Medicine, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia
| | - I B Ngurah Rai
- Division of Pulmonology, Department of Internal Medicine, Faculty of Medicine, Udayana University, Sanglah Hospital, Denpasar, Bali, Indonesia
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23
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Impact of Mycobacterium tuberculosis Infection on Human B Cell Compartment and Antibody Responses. Cells 2022; 11:cells11182906. [PMID: 36139482 PMCID: PMC9497247 DOI: 10.3390/cells11182906] [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] [Received: 08/29/2022] [Revised: 09/14/2022] [Accepted: 09/15/2022] [Indexed: 11/30/2022] Open
Abstract
Tuberculosis (TB) remains one of the most important health challenges worldwide. Control of the TB epidemic has not yet been achieved because of the lack of an effective vaccine and rapid and sensitive diagnostic approaches, as well as the emergence of drug-resistant forms of M. tuberculosis. Cellular immunity has a pivotal role against M. tuberculosis infection, but the role of humoral immunity is still controversial. We analyzed the frequency, absolute counts, and phenotypic and functional subsets of B lymphocytes in the peripheral blood of patients with active TB and subjects with latent infection compared to healthy donors. Moreover, we analyzed serum levels of total Ig and their IgA, IgM, and IgG isotypes and the titers of preexisting antibodies against a pool of common viral pathogens. FlowCT and unsupervised clusterization analysis show that patients with active TB and LTBI subjects have modest non-significant reduction in the numbers of circulating B lymphocytes as compared to healthy donors. Moreover, LTBI subjects had high percentages of atypical B cell population and lower percentages of naive and switched memory B cells. These findings were supported by gene expression and GSEA analysis. Moreover, there were no differences between active TB patients, LTBI subjects and HD, either in serum levels of total Ig isotypes or in preexisting IgG antibody titers, to ten different antigens from eight common pathogenic viruses, clearly demonstrating that either active or latent M. tuberculosis infection preserves the antibody production capacity of long-lived plasma cells. Thus, our results agree with previous studies reporting unaltered B cell frequencies in the blood of active TB patients and LTBI individuals as compared to healthy controls.
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Compagno M, Navarra A, Campogiani L, Coppola L, Rossi B, Iannetta M, Malagnino V, Parisi SG, Mariotti B, Cerretti R, Arcese W, Goletti D, Andreoni M, Sarmati L. Latent Tuberculosis Infection in Haematopoietic Stem Cell Transplant Recipients: A Retrospective Italian Cohort Study in Tor Vergata University Hospital, Rome. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191710693. [PMID: 36078409 PMCID: PMC9518118 DOI: 10.3390/ijerph191710693] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/23/2022] [Accepted: 08/24/2022] [Indexed: 05/17/2023]
Abstract
The results of tuberculosis (TB) screening and reactivation in a cohort of 323 adult patients undergoing haematopoietic stem cell transplantation (HSCT) from 2015 to 2019 at the University Hospital of Tor Vergata, Rome, Italy, were reported. A total of 260 patients, 59 (18.3%) autologous and 264 (81.7%) allogeneic transplants, underwent Interferon Release (IFN)-γ (IGRA) test screening: 228 (87.7%) were negative, 11 (4.2%) indeterminate and 21 (8.1%) positive. Most of the IGRA-positive patients were of Italian origin (95.2%) and significantly older than the IGRA-negative (p < 0.001); 22 (8.5%) patients underwent a second IGRA during the first year after transplantation, and 1 tested positive for IGRA. Significantly lower monocyte (p = 0.044) and lymphocyte counts (p = 0.009) were detected in IGRA negative and IGRA indeterminate patients, respectively. All latent TB patients underwent isoniazid prophylaxis, and none of them progressed to active TB over a median follow-up period of 63.4 months. A significant decline in TB screening practices was shown from 2015 to 2019, and approximately 19% of patients were not screened. In conclusion, 8.1% of our HSCT population had LTBI, all received INH treatment, and no reactivation of TB was observed during the follow-up period. In addition, 19% escaped screening and 8% of these came from countries with a medium TB burden, therefore at higher risk of possible development of TB.
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Affiliation(s)
- Mirko Compagno
- Clinical Infectious Diseases Unit, Tor Vergata Hospital, 00133 Rome, Italy
| | - Assunta Navarra
- Clinical Epidemiology Unit, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, 00161 Rome, Italy
| | - Laura Campogiani
- Clinical Infectious Diseases Unit, Tor Vergata Hospital, 00133 Rome, Italy
| | - Luigi Coppola
- Clinical Infectious Diseases Unit, Tor Vergata Hospital, 00133 Rome, Italy
| | - Benedetta Rossi
- Clinical Infectious Diseases, Department of System Medicine, Tor Vergata University, 00133 Rome, Italy
| | - Marco Iannetta
- Clinical Infectious Diseases, Department of System Medicine, Tor Vergata University, 00133 Rome, Italy
| | - Vincenzo Malagnino
- Clinical Infectious Diseases, Department of System Medicine, Tor Vergata University, 00133 Rome, Italy
| | - Saverio G. Parisi
- Department of Molecular Medicine, University of Padova, Via Gabelli, 63, 35100 Padova, Italy
| | - Benedetta Mariotti
- Department of Biomedicine and Prevention, University Tor Vergata of Roma, 00133 Rome, Italy
- Rome Transplant Network, Tor Vergata University Hospital, 00133 Rome, Italy
| | - Raffaella Cerretti
- Department of Biomedicine and Prevention, University Tor Vergata of Roma, 00133 Rome, Italy
- Rome Transplant Network, Tor Vergata University Hospital, 00133 Rome, Italy
| | - William Arcese
- Department of Biomedicine and Prevention, University Tor Vergata of Roma, 00133 Rome, Italy
- Rome Transplant Network, Tor Vergata University Hospital, 00133 Rome, Italy
| | - Delia Goletti
- Translational Research Unit, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, 00161 Rome, Italy
| | - Massimo Andreoni
- Clinical Infectious Diseases, Department of System Medicine, Tor Vergata University, 00133 Rome, Italy
| | - Loredana Sarmati
- Clinical Infectious Diseases, Department of System Medicine, Tor Vergata University, 00133 Rome, Italy
- Correspondence: ; Tel./Fax: +39-0672596873
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25
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Sampath P, Natarajan AP, Moideen K, Kathamuthu GR, Hissar S, Dhanapal M, Jayabal L, Ramesh PM, Tripathy SP, Ranganathan UD, Babu S, Bethunaickan R. Differential Frequencies of Intermediate Monocyte Subsets Among Individuals Infected With Drug-Sensitive or Drug-Resistant Mycobacterium tuberculosis. Front Immunol 2022; 13:892701. [PMID: 35911760 PMCID: PMC9336531 DOI: 10.3389/fimmu.2022.892701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 06/21/2022] [Indexed: 11/13/2022] Open
Abstract
The rampant increase in drug-resistant tuberculosis (TB) remains a major challenge not only for treatment management but also for diagnosis, as well as drug design and development. Drug-resistant mycobacteria affect the quality of life owing to the delayed diagnosis and require prolonged treatment with multiple and toxic drugs. The phenotypic modulations defining the immune status of an individual during tuberculosis are well established. The present study aims to explore the phenotypic changes of monocytes & dendritic cells (DC) as well as their subsets across the TB disease spectrum, from latency to drug-sensitive TB (DS-TB) and drug-resistant TB (DR-TB) using traditional immunophenotypic analysis and by uniform manifold approximation and projection (UMAP) analysis. Our results demonstrate changes in frequencies of monocytes (classical, CD14++CD16-, intermediate, CD14++CD16+ and non-classical, CD14+/-CD16++) and dendritic cells (DC) (HLA-DR+CD11c+ myeloid DCs, cross-presenting HLA-DR+CD14-CD141+ myeloid DCs and HLA-DR+CD14-CD16-CD11c-CD123+ plasmacytoid DCs) together with elevated Monocyte to Lymphocyte ratios (MLR)/Neutrophil to Lymphocyte ratios (NLR) and alteration of cytokine levels between DS-TB and DR-TB groups. UMAP analysis revealed significant differential expression of CD14+, CD16+, CD86+ and CD64+ on monocytes and CD123+ on DCs by the DR-TB group. Thus, our study reveals differential monocyte and DC subset frequencies among the various TB disease groups towards modulating the immune responses and will be helpful to understand the pathogenicity driven by Mycobacterium tuberculosis.
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Affiliation(s)
- Pavithra Sampath
- Department of Immunology, National Institute for Research in Tuberculosis (NIRT), Chennai, India
| | | | - Kadar Moideen
- Indian Council of Medical Research-National Institute for Research in Tuberculosis (ICMR-NIRT)-International Center for Excellence in Research, Chennai, India
| | - Gokul Raj Kathamuthu
- Indian Council of Medical Research-National Institute for Research in Tuberculosis (ICMR-NIRT)-International Center for Excellence in Research, Chennai, India
| | - Syed Hissar
- Department of Clinical Research, National Institute for Research in Tuberculosis (NIRT), Chennai, India
| | - Madhavan Dhanapal
- Department of Immunology, National Institute for Research in Tuberculosis (NIRT), Chennai, India
| | | | | | - Srikanth Prasad Tripathy
- Indian Council of Medical Research-National Institute for Research in Tuberculosis (ICMR-NIRT), Chennai, India
| | - Uma Devi Ranganathan
- Department of Immunology, National Institute for Research in Tuberculosis (NIRT), Chennai, India
| | - Subash Babu
- Indian Council of Medical Research-National Institute for Research in Tuberculosis (ICMR-NIRT)-International Center for Excellence in Research, Chennai, India
| | - Ramalingam Bethunaickan
- Department of Immunology, National Institute for Research in Tuberculosis (NIRT), Chennai, India
- *Correspondence: Ramalingam Bethunaickan, ;
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26
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Factores que afectan la cobertura del programa de tuberculosis en el primer nivel de atención en Honduras. BIOMÉDICA 2022; 42:315-328. [PMID: 35867924 PMCID: PMC9436301 DOI: 10.7705/biomedica.6368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Indexed: 11/21/2022]
Abstract
Introducción. Hay consenso global en que el diagnóstico y el tratamiento precoces de la tuberculosis pueden acelerar su control y mitigar sus consecuencias. En Honduras, la tasa de mortalidad por la enfermedad aumentó gradualmente entre 2014 y 2018, a lo que se suman las reformas en el sistema de salud del 2014 y la implementación parcial de la estrategia “Fin a la TB”.Objetivo. Analizar las barreras y los elementos facilitadores del diagnóstico y el tratamiento que afectan la cobertura del programa nacional de tuberculosis, con el fin de brindar herramientas para la implementación efectiva de la estrategia “Fin a la TB” en San Pedro Sula, Honduras, 2015-2019.Materiales y métodos. Se hizo un estudio mixto secuencial y explicativo de pacientes mayores de 18 años con tuberculosis pulmonar positivos en la baciloscopia. Se revisaron las fichas de notificación de la enfermedad y las historias clínicas en dos establecimientos de salud de primer nivel y se hicieron entrevistas semiestructuradas al personal de salud, los pacientes y los familiares.Resultados. En el 74,6 % (297/398) de los casos no hubo diagnóstico oportuno. En este grupo, se encontró una mayor proporción de hombres (62,3 %; 185/297) y de adultos (80,8 %; 240/297); predominó un nivel de escolaridad inferior a la secundaria (53,7 %; 108/297); el 49,2 % (123/297) de los pacientes tenía alguna ocupación, y el 98,2 % había recibido tratamiento oportuno. Se detectaron las siguientes barreras: condiciones socioeconómicas precarias, desarticulación del sistema de salud público y privado, y límites fronterizos entre maras y pandillas. Los elementos facilitadores fueron la buena atención y la actitud del personal de salud, y la disponibilidad y reserva de tratamiento. Conclusiones. La falta de oportunidad en el diagnóstico de tuberculosis afectó la cobertura del programa nacional como resultado de las barreras culturales y de atención en salud.
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27
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La Manna MP, Orlando V, Badami GD, Tamburini B, Azgomi MS, Presti EL, Del Nonno F, Petrone L, Belmonte B, Falasca L, Carlo PD, Dieli F, Goletti D, Caccamo N. Platelets accumulate in lung lesions of tuberculosis patients and inhibit T-cell responses and Mycobacterium tuberculosis replication in macrophages. Eur J Immunol 2022; 52:784-799. [PMID: 35338775 PMCID: PMC9325462 DOI: 10.1002/eji.202149549] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 12/24/2021] [Accepted: 03/23/2022] [Indexed: 12/05/2022]
Abstract
Platelets regulate human inflammatory responses that lead to disease. However, the role of platelets in tuberculosis (TB) pathogenesis is still unclear. Here, we show that patients with active TB have a high number of platelets in peripheral blood and a low number of lymphocytes leading to a high platelets to lymphocytes ratio (PL ratio). Moreover, the serum concentration of different mediators promoting platelet differentiation or associated with platelet activation is increased in active TB. Immunohistochemistry analysis shows that platelets localise around the lung granuloma lesions in close contact with T lymphocytes and macrophages. Transcriptomic analysis of caseous tissue of human pulmonary TB granulomas, followed by Gene Ontology analysis, shows that 53 platelet activation‐associated genes are highly expressed compared to the normal lung tissue. In vitro activated platelets (or their supernatants) inhibit BCG‐induced T‐ lymphocyte proliferation and IFN‐γ production. Likewise, platelets inhibit the growth of intracellular macrophages of Mycobacterium (M.) tuberculosis. Soluble factors released by activated platelets mediate both immunological and M. tuberculosis replication activities. Furthermore, proteomic and neutralisation studies (by mAbs) identify TGF‐β and PF4 as the factors responsible for inhibiting T‐cell response and enhancing the mycobactericidal activity of macrophages, respectively. Altogether these results highlight the importance of platelets in TB pathogenesis.
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Affiliation(s)
- Marco P La Manna
- Central Laboratory of Advanced Diagnosis and Biomedical Research (CLADIBIOR).,Department of Biomedicine, Neurosciences and Advanced Diagnostic (Bi.N.D.), University of Palermo, Palermo, 90127, Italy
| | - Valentina Orlando
- Central Laboratory of Advanced Diagnosis and Biomedical Research (CLADIBIOR).,Department of Biomedicine, Neurosciences and Advanced Diagnostic (Bi.N.D.), University of Palermo, Palermo, 90127, Italy
| | - Giusto D Badami
- Central Laboratory of Advanced Diagnosis and Biomedical Research (CLADIBIOR).,Department of Biomedicine, Neurosciences and Advanced Diagnostic (Bi.N.D.), University of Palermo, Palermo, 90127, Italy
| | - Bartolo Tamburini
- Central Laboratory of Advanced Diagnosis and Biomedical Research (CLADIBIOR).,Department of Biomedicine, Neurosciences and Advanced Diagnostic (Bi.N.D.), University of Palermo, Palermo, 90127, Italy
| | - Mojtaba Shekarkar Azgomi
- Central Laboratory of Advanced Diagnosis and Biomedical Research (CLADIBIOR).,Department of Biomedicine, Neurosciences and Advanced Diagnostic (Bi.N.D.), University of Palermo, Palermo, 90127, Italy
| | - Elena Lo Presti
- Institute for Biomedical Research and Innovation, National Research Council, Palermo, Italy
| | - Franca Del Nonno
- Pathology Unit, National Institute for Infectious Diseases L. Spallanzani-IRCCS, Rome, Italy
| | - Linda Petrone
- Translational research Unit, National Institute for Infectious Diseases L. Spallanzani-IRCCS, Rome, Italy
| | - Beatrice Belmonte
- Tumor Immunology Unit, Department of Health Science, Human Pathology Section, University of Palermo School of Medicine, Palermo, Italy
| | - Laura Falasca
- Pathology Unit, National Institute for Infectious Diseases L. Spallanzani-IRCCS, Rome, Italy
| | - Paola Di Carlo
- Department of Sciences for Health Promotion and Mother-Child Care "G. D'Alessandro", University of Palermo, Palermo, Italy
| | - Francesco Dieli
- Central Laboratory of Advanced Diagnosis and Biomedical Research (CLADIBIOR).,Department of Biomedicine, Neurosciences and Advanced Diagnostic (Bi.N.D.), University of Palermo, Palermo, 90127, Italy
| | - Delia Goletti
- Translational research Unit, National Institute for Infectious Diseases L. Spallanzani-IRCCS, Rome, Italy
| | - Nadia Caccamo
- Central Laboratory of Advanced Diagnosis and Biomedical Research (CLADIBIOR).,Department of Biomedicine, Neurosciences and Advanced Diagnostic (Bi.N.D.), University of Palermo, Palermo, 90127, Italy
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28
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Lemkus L, Lawrie D, Vaughan J. The utility of extended differential parameters as a biomarker of bacteremia at a tertiary academic hospital in persons with and without HIV infection in South Africa. PLoS One 2022; 17:e0262938. [PMID: 35176042 PMCID: PMC8853519 DOI: 10.1371/journal.pone.0262938] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 01/07/2022] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION Extended differential parameters (EDPs) are generated with the automated differential count by Sysmex XN-series automated hematology analysers, and include the immature granulocyte count (IG%), the neutrophil fluorescent light intensity (NE-SFL) and the neutrophil fluorescent light distribution width (NE-WY). These have been proposed as early biomarkers of bacteremia. This study aimed to evaluate the NE-SFL, NE-WY and IG% in comparison to neutrophil CD64 (nCD64) expression (as a high quality sepsis biomarker) among patients with suspected bacterial sepsis at the Chris Hani Baragwanath Academic Hospital in Johannesburg, South Africa. METHODS A daily search of the laboratory information system identified samples submitted for a blood culture (BC) and a concurrent full blood count (FBC). Automated differential counts using a Sysmex XN-9000 haematology analyser and neutrophil CD64 expression by flow cytometry were assessed on the residual FBC samples. RESULTS A total of 151 samples were collected, of which 83 were excluded due to equivocal results with regards to the presence of bacterial infection. The remaining 68 samples included 23 with bacteremia, 28 with evidence of non-bacteremic bacterial infection, 13 with no evidence of bacterial infection and 4 with Tuberculosis. HIV status was documented in 90 of the patients, with a seropositivity rate of 57.8%. The EDPs were all significantly higher among patients with bacteremia as compared to those without bacterial infection, but on ROC curve analyses, only the NE-SFL showed good performance (AUC>0.8) for discriminating cases with bacteremia from those without bacterial infection at a cut-off value of 49.75. In comparison to the nCD64, the NE-SFL showed moderate agreement (kappa = 0.5). On stratification of the ROC analysis by HIV status, the NE-SFL showed superior performance among persons with HIV infection (AUC = 1), while the automated IG% showed better performance among the patients without HIV infection (AUC = 0.9). CONCLUSION In this study, EDPs showed differential performance as biomarkers for bacteremia according to HIV-status in the South African setting, with the most promising results seen with the NE-SFL and IG% parameters among people with and without HIV infection, respectively. Further assessment of these parameters without pre-selection of patients likely to have infection is required to further determine their clinical utility, particularly among patients with underlying inflammatory conditions or malignancy.
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Affiliation(s)
- Lauren Lemkus
- Department of Molecular Medicine and Haematology, University of the Witwatersrand, Johannesburg, South Africa
- National Health Laboratory Services, Johannesburg, South Africa
| | - Denise Lawrie
- Department of Molecular Medicine and Haematology, University of the Witwatersrand, Johannesburg, South Africa
- National Health Laboratory Services, Johannesburg, South Africa
| | - Jenifer Vaughan
- Department of Molecular Medicine and Haematology, University of the Witwatersrand, Johannesburg, South Africa
- National Health Laboratory Services, Johannesburg, South Africa
- * E-mail:
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Gupta R, Sarkar B, Goel A, Kotru M, Kashyap B. Utility of monocyte parameters in diagnosing Sputum Smear Negative Pulmonary TB. Trop Doct 2022; 52:315-321. [DOI: 10.1177/00494755221074533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background - Smear-negative TB (SNTB) may remain undetected for a long duration and new bio-markers are needed for diagnosis. Our study investigated monocyte parameters in this regard. Thirty cases each of SNTB, sputum positive cases and healthy controls were included. Full blood count and immune-phenotyping for ‘monocyte parameters’ by flow cytometry were performed using CD45, CD16, CD14, CD64 and HLA-DR The percentage of monocyte subsets and MFI of CD64 and HLA- DR noted and data statistically compared. The monocyte to lymphocyte ratio, percentage of intermediate monocytes, expression of CD64 on total as well as intermediate monocytes were significantly elevated in cases with SNTB as compared to healthy controls (p value, 0.07, 0.07, 0.001, 0.001 respectively). The cut off value for MFI CD64 on total and intermediate monocyte was >18 and >19.6 respectively. Thus monocyte parameters can serve as useful biomarkers for diagnosing tuberculosis in the sputum negative group.
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Affiliation(s)
- Richa Gupta
- University College of medical Sciences and GTB Hospital, Delhi, India
| | - Beauty Sarkar
- University College of medical Sciences and GTB Hospital, Delhi, India
| | - Ashish Goel
- University College of medical Sciences and GTB Hospital, Delhi, India
| | - Mrinalini Kotru
- University College of medical Sciences and GTB Hospital, Delhi, India
| | - Binita Kashyap
- University College of medical Sciences and GTB Hospital, Delhi, India
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30
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Hillman H, Khan N, Singhania A, Dubelko P, Soldevila F, Tippalagama R, DeSilva AD, Gunasena B, Perera J, Scriba TJ, Ontong C, Fisher M, Luabeya A, Taplitz R, Seumois G, Vijayanand P, Hedrick CC, Peters B, Burel JG. Single-cell profiling reveals distinct subsets of CD14+ monocytes drive blood immune signatures of active tuberculosis. Front Immunol 2022; 13:1087010. [PMID: 36713384 PMCID: PMC9874319 DOI: 10.3389/fimmu.2022.1087010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 12/12/2022] [Indexed: 01/13/2023] Open
Abstract
Introduction Previous studies suggest that monocytes are an important contributor to tuberculosis (TB)-specific immune signatures in blood. Methods Here, we carried out comprehensive single-cell profiling of monocytes in paired blood samples of active TB (ATB) patients at diagnosis and mid-treatment, and healthy controls. Results At diagnosis, ATB patients displayed increased monocyte-to-lymphocyte ratio, increased frequency of CD14+CD16- and intermediate CD14+CD16+ monocytes, and upregulation of interferon signaling genes that significantly overlapped with previously reported blood TB signatures in both CD14+ subsets. In this cohort, we identified additional transcriptomic and functional changes in intermediate CD14+CD16+ monocytes, such as the upregulation of inflammatory and MHC-II genes, and increased capacity to activate T cells, reflecting overall increased activation in this population. Single-cell transcriptomics revealed that distinct subsets of intermediate CD14+CD16+ monocytes were responsible for each gene signature, indicating significant functional heterogeneity within this population. Finally, we observed that changes in CD14+ monocytes were transient, as they were no longer observed in the same ATB patients mid-treatment, suggesting they are associated with disease resolution. Discussion Together, our study demonstrates for the first time that both intermediate and classical monocytes individually contribute to blood immune signatures of ATB and identifies novel subsets and associated gene signatures that may hold disease relevance.
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Affiliation(s)
- Hannah Hillman
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology, La Jolla, CA, United States
| | - Nabeela Khan
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology, La Jolla, CA, United States
| | - Akul Singhania
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology, La Jolla, CA, United States
| | - Paige Dubelko
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology, La Jolla, CA, United States
| | - Ferran Soldevila
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology, La Jolla, CA, United States
| | - Rashmi Tippalagama
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology, La Jolla, CA, United States
| | - Aruna D DeSilva
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology, La Jolla, CA, United States.,Department of Paraclinical Sciences, Faculty of Medicine, General Sir John Kotelawala Defence University, Colombo, Sri Lanka
| | - Bandu Gunasena
- Medical Unit, National Hospital for Respiratory Diseases, Welisara, Sri Lanka
| | - Judy Perera
- Department of Paraclinical Sciences, Faculty of Medicine, General Sir John Kotelawala Defence University, Colombo, Sri Lanka
| | - Thomas J Scriba
- South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine and Division of Immunology, Department of Pathology, University of Cape Town, Cape Town, South Africa
| | - Cynthia Ontong
- South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine and Division of Immunology, Department of Pathology, University of Cape Town, Cape Town, South Africa
| | - Michelle Fisher
- South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine and Division of Immunology, Department of Pathology, University of Cape Town, Cape Town, South Africa
| | - Angelique Luabeya
- South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine and Division of Immunology, Department of Pathology, University of Cape Town, Cape Town, South Africa
| | - Randy Taplitz
- Department of Medicine, City of Hope National Medical Center, Duarte, CA, United States
| | - Gregory Seumois
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology, La Jolla, CA, United States
| | - Pandurangan Vijayanand
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology, La Jolla, CA, United States.,Department of Medicine, University of California San Diego, La Jolla, CA, United States
| | - Catherine C Hedrick
- Center for Autoimmunity and Inflammation, La Jolla Institute for Immunology, La Jolla, CA, United States
| | - Bjoern Peters
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology, La Jolla, CA, United States.,Department of Medicine, University of California San Diego, La Jolla, CA, United States
| | - Julie G Burel
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology, La Jolla, CA, United States
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Bebeshko VG, Bruslova KM, Lyashenko LO, Pushkariova TI, Tsvetkova NM, Galkina SG, Vasylenko VV, Yaroshenko ZS, Zaitseva AL, Gonchar LO, Yatsemirskyi SM. ASSESSMENT OF QUALITATIVE CHANGES IN PERIPHERAL BLOOD CELLS IN CHILDREN - RESIDENTS OF RADIOLOGICALLY CONTAMINATED TERRITORIES IN THE LATE PERIOD AFTER THE ChNPP ACCIDENT. PROBLEMY RADIATSIINOI MEDYTSYNY TA RADIOBIOLOHII 2021; 26:297-308. [PMID: 34965556 DOI: 10.33145/2304-8336-2021-26-297-308] [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: 03/15/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE to establish the relationship between quantitative and qualitative parameters of peripheral blood cells(lymphocytes, neutrophilic granulocytes, monocytes, platelets) depending on the type of somatic diseases andannual internal radiation doses from 137Cs in children - residents of radiologically contaminated territories in thelate period after the Chornobyl Nuclear Power Plant (ChNPP) accident. MATERIALS AND METHODS There were 175 children included in the study comprising residents of radiologically con-taminated territories (n = 79) aged from 4 to 18 years. Annual internal radiation doses in children from 137Cs rangedfrom 0.004 to 0.067 mSv. Certain blood parameters were assessed in a comparative mode in children having got theradiation doses up to 0.01 mSv and higher. The comparison group (n = 96) included children living in settlementsnot attributed to the radiologically contaminated ones. Incidence and type of somatic diseases and its impact onquantitative and qualitative changes in blood parameters (i.e. lymphocyte, neutrophilic granulocyte, monocyte, andplatelet count) were studied. The cell size, state of nucleus, membranes and cytoplasm, signs of proliferative anddegenerative processes were taken into account. RESULTS Incidence and type of somatic diseases in children did not depend on the annual internal radiation dose.Number of cases of monocytosis was significantly higher among the children exposed to ionizing radiation than inthe comparison group (16.6 % vs. 7.3 %). There were, however, no correlation between these changes and radiationdoses. Number of activated blood monocytes with cytoplasmic basophilia and residues of nucleoli in nuclei washigher in individuals with internal radiation doses > 0.01 mSv. A direct correlation between the qualitative param-eters of monocytes and internal radiation doses was established (rs = 0.60; р < 0.001), as well as a direct correlationof different strength between qualitative parameters of blood cells, indicating their unidirectional pattern depend-ing on the somatic morbid conditions. Regardless of annual internal radiation dose, there was an increase in thenumber of degenerative and aberrant cells vs. the comparison group (р < 0.05), which could be due to the role ofnon-radiation factors. CONCLUSIONS Results of the assessment of quantitative and qualitative parameters of peripheral blood cells reflect-ed the state of morbid conditions in children and are of a diagnostic value. The identified dose-dependent changesin monocyte lineage of hematopoiesis may be the markers of impact of long-term radionuclide incorporation withfood in children living in environmentally unfavorable conditions after the ChNPP accident.
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Affiliation(s)
- V G Bebeshko
- State Institution «National Research Center for Radiation Medicine of the National Academy of MedicalSciences of Ukraine», 53 Yuriia Illienka Str., Kyiv, 04050, Ukraine
| | - K M Bruslova
- State Institution «National Research Center for Radiation Medicine of the National Academy of MedicalSciences of Ukraine», 53 Yuriia Illienka Str., Kyiv, 04050, Ukraine
| | - L O Lyashenko
- State Institution «National Research Center for Radiation Medicine of the National Academy of MedicalSciences of Ukraine», 53 Yuriia Illienka Str., Kyiv, 04050, Ukraine
| | - T I Pushkariova
- State Institution «National Research Center for Radiation Medicine of the National Academy of MedicalSciences of Ukraine», 53 Yuriia Illienka Str., Kyiv, 04050, Ukraine
| | - N M Tsvetkova
- State Institution «National Research Center for Radiation Medicine of the National Academy of MedicalSciences of Ukraine», 53 Yuriia Illienka Str., Kyiv, 04050, Ukraine
| | - S G Galkina
- State Institution «National Research Center for Radiation Medicine of the National Academy of MedicalSciences of Ukraine», 53 Yuriia Illienka Str., Kyiv, 04050, Ukraine
| | - V V Vasylenko
- State Institution «National Research Center for Radiation Medicine of the National Academy of MedicalSciences of Ukraine», 53 Yuriia Illienka Str., Kyiv, 04050, Ukraine
| | - Zh S Yaroshenko
- State Institution «National Research Center for Radiation Medicine of the National Academy of MedicalSciences of Ukraine», 53 Yuriia Illienka Str., Kyiv, 04050, Ukraine
| | - A L Zaitseva
- State Institution «National Research Center for Radiation Medicine of the National Academy of MedicalSciences of Ukraine», 53 Yuriia Illienka Str., Kyiv, 04050, Ukraine
| | - L O Gonchar
- State Institution «National Research Center for Radiation Medicine of the National Academy of MedicalSciences of Ukraine», 53 Yuriia Illienka Str., Kyiv, 04050, Ukraine
| | - S M Yatsemirskyi
- State Institution «National Research Center for Radiation Medicine of the National Academy of MedicalSciences of Ukraine», 53 Yuriia Illienka Str., Kyiv, 04050, Ukraine
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Mohan A, Podin Y, Liew DW, Mahendra Kumar J, Lau PST, Tan YY, Tai YP, Gill RS, Shanmugam R, Chien SL, Tan LS, Mat Sani NA, Manan K, Ooi MH. Fine-needle aspiration to improve diagnosis of melioidosis of the head and neck in children: a study from Sarawak, Malaysia. BMC Infect Dis 2021; 21:1069. [PMID: 34654392 PMCID: PMC8520244 DOI: 10.1186/s12879-021-06754-9] [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: 07/06/2021] [Accepted: 10/01/2021] [Indexed: 11/21/2022] Open
Abstract
Background Melioidosis, the infection caused by Burkholderia pseudomallei, is associated with a high case fatality rate, due in part to difficulties in clinical recognition and diagnostic confirmation of the disease. Although head and neck involvement is common in children, specific disease manifestations differ between geographic regions. The aim of this study was to provide a detailed description of melioidosis of the head and neck among children in Sarawak, Malaysia, and determine if fine-needle aspiration of suspected head or neck lesions could improve melioidosis diagnosis. Methods We conducted a retrospective descriptive study of all children aged < 12 years with culture-confirmed melioidosis presenting with head and neck manifestations and admitted to Bintulu Hospital in Sarawak, Malaysia, from January 2011 until December 2020. Fine-needle aspiration of head and neck lesions suspected to be due to melioidosis with inoculation in blood culture bottles (FNA + BCB) was used from the beginning of 2016. Results Of 34 children with culture-confirmed melioidosis, 20 (59%) had an infection involving one or more sites in the head and neck. Of these, 17 (85%) were diagnosed in or after 2016. Cervical lymph nodes were the most common organ or site affected, involved in 19 (95%) children. Clinical presentations of B. pseudomallei lymph node infections were highly variable. Five (25%) children had salivary gland involvement. Lacrimal gland involvement (dacryocystitis) and skin or soft tissue infection (scalp abscess) were less frequent. B. pseudomallei was isolated from the head or neck using FNA + BCB in 15 (75%) children and by standard culture methods of direct plating of pus on agar following incision and drainage in only 2 (10%) children. B. pseudomallei was isolated from non-head or neck specimens or blood in 3 (15%) children. Conclusions Manifestations of pediatric head and neck melioidosis in Sarawak, Malaysia, differ from those of other regions. Fine-needle aspiration, mainly of affected cervical lymph nodes, facilitates B. pseudomallei detection and enables confirmation of melioidosis infections. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-021-06754-9.
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Affiliation(s)
- Anand Mohan
- Department of Pediatrics, Bintulu Hospital, Ministry of Health Malaysia, Bintulu, Sarawak, Malaysia.,Institute of Health and Community Medicine, Universiti Malaysia Sarawak, Kota Samarahan, Sarawak, Malaysia
| | - Yuwana Podin
- Institute of Health and Community Medicine, Universiti Malaysia Sarawak, Kota Samarahan, Sarawak, Malaysia.
| | - Da-Wei Liew
- Department of Pediatrics, Bintulu Hospital, Ministry of Health Malaysia, Bintulu, Sarawak, Malaysia
| | - Jeevithaa Mahendra Kumar
- Department of Pediatrics, Bintulu Hospital, Ministry of Health Malaysia, Bintulu, Sarawak, Malaysia
| | - Peter Sie-Teck Lau
- Department of Pediatrics, Bintulu Hospital, Ministry of Health Malaysia, Bintulu, Sarawak, Malaysia
| | - Yee-Yen Tan
- Department of Pediatrics, Bintulu Hospital, Ministry of Health Malaysia, Bintulu, Sarawak, Malaysia
| | - Yi-Pinn Tai
- Department of Pediatrics, Bintulu Hospital, Ministry of Health Malaysia, Bintulu, Sarawak, Malaysia
| | - Ranveer Singh Gill
- Department of Otorhinolaryngology, Bintulu Hospital, Ministry of Health Malaysia, Bintulu, Sarawak, Malaysia
| | - Ram Shanmugam
- Department of Otorhinolaryngology, Bintulu Hospital, Ministry of Health Malaysia, Bintulu, Sarawak, Malaysia
| | - Su-Lin Chien
- Department of Pathology, Bintulu Hospital, Ministry of Health Malaysia, Bintulu, Sarawak, Malaysia
| | - Lee-See Tan
- Department of Pathology, Bintulu Hospital, Ministry of Health Malaysia, Bintulu, Sarawak, Malaysia
| | - Nurul Asiah Mat Sani
- Department of Pathology, Bintulu Hospital, Ministry of Health Malaysia, Bintulu, Sarawak, Malaysia
| | - Kamilah Manan
- Department of Radiology, Bintulu Hospital, Ministry of Health Malaysia, Bintulu, Sarawak, Malaysia
| | - Mong-How Ooi
- Institute of Health and Community Medicine, Universiti Malaysia Sarawak, Kota Samarahan, Sarawak, Malaysia.,Department of Pediatrics, Sarawak General Hospital, Ministry of Health Malaysia, Kuching, Sarawak, Malaysia
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Sukson P, Liwsrisakun C, Inchai J, Trongtrakul K, Tajarernmuang P. Peripheral Blood Monocyte to Lymphocyte Ratio for Prediction of Tuberculous Pleuritis. Int J Infect Dis 2021; 112:212-216. [PMID: 34547484 DOI: 10.1016/j.ijid.2021.09.033] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 09/08/2021] [Accepted: 09/15/2021] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE To examine the peripheral monocyte to lymphocyte ratio (ML ratio) of patients with tuberculous (TB) pleuritis and the ML ratio changes after treatment. METHODS Clinical and laboratory information were collected from patients with lymphocytic exudative pleural effusion admitted to Chiang Mai University Hospital from 2013 to 2019. This study compared the ML ratios between tuberculous pleuritis and other diagnoses in patients who were followed after treatment. RESULTS A total of 152 patients were included: 57 with tuberculous pleuritis and 95 with other lymphocytic exudates. The majority of non-tuberculous effusion was malignant pleural effusion. The mean ML ratio of each group was 0.72±0.29 and 0.34±0.13 (p<0.001). The Area Under the Receiver Operative Characteristic Curve of the ML ratio for diagnosing tuberculous pleuritis was 0.91. The best cut-off point of the ML ratio for diagnosing tuberculous pleuritis was >0.45, where the sensitivity and specificity were 82.5% and 86.3%, respectively. The ML ratio gradually reduced after the anti-TB treatment. ML ratios at 0, 2, and 6 months after the treatment were 0.72±0.29, 0.40±0.37, and 0.30±0.27, respectively (p<0.001). CONCLUSION The peripheral blood ML ratio is an easy and useful tool for diagnosing and predicting the treatment response in patients with tuberculous pleuritis.
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Affiliation(s)
- Pasa Sukson
- Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Chalerm Liwsrisakun
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Juthamas Inchai
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Konlawij Trongtrakul
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Pattraporn Tajarernmuang
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
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Burel JG, Singhania A, Dubelko P, Muller J, Tanner R, Parizotto E, Dedicoat M, Fletcher TE, Dunbar J, Cunningham AF, Lindestam Arlehamn CS, Catanzaro DG, Catanzaro A, Rodwell T, McShane H, O'Shea MK, Peters B. Distinct blood transcriptomic signature of treatment in latent tuberculosis infected individuals at risk of developing active disease. Tuberculosis (Edinb) 2021; 131:102127. [PMID: 34555657 DOI: 10.1016/j.tube.2021.102127] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 07/28/2021] [Accepted: 09/09/2021] [Indexed: 01/12/2023]
Abstract
Although only a small fraction will ever develop the active form of tuberculosis (ATB) disease, chemoprophylaxis treatment in latent TB infected (LTBI) individuals is an effective strategy to control pathogen transmission. Characterizing immune responses in LTBI upon chemoprophylactic treatment is important to facilitate treatment monitoring, and thus improve TB control strategies. Here, we studied changes in the blood transcriptome in a cohort of 42 LTBI and 8 ATB participants who received anti-TB therapy. Based on the expression of previously published gene signatures of progression to ATB, we stratified the LTBI cohort in two groups and examined if individuals deemed to be at elevated risk of developing ATB before treatment (LTBI-Risk) differed from others (LTBI-Other). We found that LTBI-Risk and LTBI-Other groups were associated with two distinct transcriptomic treatment signatures, with the LTBI-Risk signature resembling that of treated ATB patients. Notably, overlapping genes between LTBI-Risk and ATB treatment signatures were associated with risk of progression to ATB and interferon (IFN) signaling, and were selectively downregulated upon treatment in the LTBI-Risk but not the LTBI-Other group. Our results suggest that transcriptomic reprogramming following treatment of LTBI is heterogeneous and can be used to distinguish LTBI-Risk individuals from the LTBI cohort at large.
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Affiliation(s)
- Julie G Burel
- Vaccine Discovery Division, La Jolla Institute for Immunology, La Jolla, CA, USA
| | - Akul Singhania
- Vaccine Discovery Division, La Jolla Institute for Immunology, La Jolla, CA, USA
| | - Paige Dubelko
- Vaccine Discovery Division, La Jolla Institute for Immunology, La Jolla, CA, USA
| | - Julius Muller
- The Jenner Institute, University of Oxford, Oxford, UK
| | - Rachel Tanner
- The Jenner Institute, University of Oxford, Oxford, UK
| | | | - Martin Dedicoat
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Thomas E Fletcher
- Royal Centre for Defence Medicine, Joint Medical Command, Birmingham, UK; Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - James Dunbar
- Department of Infectious Diseases, The Friarage Hospital, Northallerton, UK
| | - Adam F Cunningham
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
| | | | | | | | - Timothy Rodwell
- Department of Medicine, University of California San Diego, CA, USA
| | - Helen McShane
- The Jenner Institute, University of Oxford, Oxford, UK
| | - Matthew K O'Shea
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK; Royal Centre for Defence Medicine, Joint Medical Command, Birmingham, UK; Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK.
| | - Bjoern Peters
- Vaccine Discovery Division, La Jolla Institute for Immunology, La Jolla, CA, USA; Department of Medicine, University of California San Diego, CA, USA.
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35
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Buttle TS, Hummerstone CY, Billahalli T, Ward RJB, Barnes KE, Marshall NJ, Spong VC, Bothamley GH. The monocyte-to-lymphocyte ratio: Sex-specific differences in the tuberculosis disease spectrum, diagnostic indices and defining normal ranges. PLoS One 2021; 16:e0247745. [PMID: 34460817 PMCID: PMC8405018 DOI: 10.1371/journal.pone.0247745] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 07/19/2021] [Indexed: 11/29/2022] Open
Abstract
Background The monocyte-to-lymphocyte ratio (MLR) has been advocated as a biomarker in tuberculosis. Our objective was to evaluate its clinical value and associations. Methods Blood counts, inflammatory markers and clinical parameters were measured in patients with and those screened for tuberculosis. Complete blood counts (CBCs) from a multi-ethnic population aged 16 to 65 years were evaluated; a sub-group with normal hematological indices was used to define the range of MLRs. Results Multivariate analysis in proven tuberculosis (n = 264) indicated MLR associated with low serum albumin, high white cell counts and a positive culture; values were higher in sputum smear-positive pulmonary tuberculosis (S+PTB). Analysis in S+PTB (n = 296) showed higher MLRs in males and those with high neutrophil counts, low serum albumin and high C-reactive protein. The diagnostic value of MLRs was assessed by comparing notified patients with TB (n = 264) with denotified cases (n = 50), active case-finding in non-contacts (TB n = 111 and LTBI n = 373) and contacts of S+PTB (n = 149) with S+PTB found at screening (n = 75). Sensitivities and specificities ranged from 58.0–62.5% and 50.0–70.0% respectively for optimal cut-off values, defined by ROC curves. In CBCs obtained over one month, ratios correlated with neutrophil counts (ρ = 0.48, P<0.00001, n = 14,573; MLR = 0.45 at 8–8.9 x 109/L) and were higher in males than females (P<0.0001). The MLR range (mean ± 2SD) in those with normal hematological indices (n = 3921: females 0.122–0.474; males 0.136–0.505) paralleled LTBI MLRs. Ratios did not predict death (n = 29) nor response to treatment (n = 178 S+PTB with follow-up CBCs). Ratios were higher in males than female in the 16–45 years age group, where immune differences due to sex hormones are likely greatest. Conclusions Severe tuberculosis and male sex associated with high MLRs; the same variables likely affect the performance of other biomarkers. The ratio performed poorly as a clinical aid.
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Affiliation(s)
- Thomas S. Buttle
- Department of Respiratory Medicine, Homerton University Hospital, London, United Kingdom
| | - Claire Y. Hummerstone
- Department of Respiratory Medicine, Homerton University Hospital, London, United Kingdom
| | - Thippeswamy Billahalli
- Department of Respiratory Medicine, Homerton University Hospital, London, United Kingdom
| | - Richard J. B. Ward
- Department of Respiratory Medicine, Homerton University Hospital, London, United Kingdom
| | - Korina E. Barnes
- Microbiology Department, Homerton University Hospital, London, United Kingdom
| | - Natalie J. Marshall
- Microbiology Department, Homerton University Hospital, London, United Kingdom
| | - Viktoria C. Spong
- Department of Respiratory Medicine, Homerton University Hospital, London, United Kingdom
| | - Graham H. Bothamley
- Department of Respiratory Medicine, Homerton University Hospital, London, United Kingdom
- Department of Immunobiology, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
- Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
- * E-mail:
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White AD, Sibley L, Gullick J, Sarfas C, Clark S, Fagrouch Z, Verschoor E, Salguero FJ, Dennis M, Sharpe S. TB and SIV Coinfection; a Model for Evaluating Vaccine Strategies against TB Reactivation in Asian Origin Cynomolgus Macaques: A Pilot Study Using BCG Vaccination. Vaccines (Basel) 2021; 9:945. [PMID: 34579182 PMCID: PMC8473354 DOI: 10.3390/vaccines9090945] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 08/12/2021] [Accepted: 08/16/2021] [Indexed: 11/17/2022] Open
Abstract
This pilot study aimed to determine the utility of a cynomolgus macaque model of coinfection with simian immunodeficiency virus (SIV) for the assessment of vaccines designed to prevent reactivation of TB. Following infection caused by aerosol exposure to an ultralow dose of Mycobacterium tuberculosis (M. tb), data trends indicated that subsequent coinfection with SIVmac32H perturbed control of M. tb infection as evidenced by the increased occurrence of progressive disease in this group, higher levels of pathology and increased frequency of progressive tuberculous granulomas in the lung. BCG vaccination led to improved control of TB-induced disease and lower viral load in comparison to unvaccinated coinfected animals. The M. tb-specific IFNγ response after exposure to M. tb, previously shown to be associated with bacterial burden, was lower in the BCG-vaccinated group than in the unvaccinated groups. Levels of CD4+ and CD8+ T cells decreased in coinfected animals, with counts recovering more quickly in the BCG-vaccinated group. This pilot study provides proof of concept to support the use of the model for evaluation of interventions against reactivated/exacerbated TB caused by human immunodeficiency virus (HIV) infection.
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Affiliation(s)
- Andrew D. White
- Public Health England, National Infections Service, Porton Down, Salisbury SP4 0JG, UK; (A.D.W.); (J.G.); (C.S.); (S.C.); (F.J.S.); (M.D.); (S.S.)
| | - Laura Sibley
- Public Health England, National Infections Service, Porton Down, Salisbury SP4 0JG, UK; (A.D.W.); (J.G.); (C.S.); (S.C.); (F.J.S.); (M.D.); (S.S.)
| | - Jennie Gullick
- Public Health England, National Infections Service, Porton Down, Salisbury SP4 0JG, UK; (A.D.W.); (J.G.); (C.S.); (S.C.); (F.J.S.); (M.D.); (S.S.)
| | - Charlotte Sarfas
- Public Health England, National Infections Service, Porton Down, Salisbury SP4 0JG, UK; (A.D.W.); (J.G.); (C.S.); (S.C.); (F.J.S.); (M.D.); (S.S.)
| | - Simon Clark
- Public Health England, National Infections Service, Porton Down, Salisbury SP4 0JG, UK; (A.D.W.); (J.G.); (C.S.); (S.C.); (F.J.S.); (M.D.); (S.S.)
| | - Zahra Fagrouch
- Department of Virology, Biomedical Primate Research Centre, Lange Kleiweg 161, 2288 GJ Rijswijk, The Netherlands; (Z.F.); (E.V.)
| | - Ernst Verschoor
- Department of Virology, Biomedical Primate Research Centre, Lange Kleiweg 161, 2288 GJ Rijswijk, The Netherlands; (Z.F.); (E.V.)
| | - Francisco J. Salguero
- Public Health England, National Infections Service, Porton Down, Salisbury SP4 0JG, UK; (A.D.W.); (J.G.); (C.S.); (S.C.); (F.J.S.); (M.D.); (S.S.)
| | - Mike Dennis
- Public Health England, National Infections Service, Porton Down, Salisbury SP4 0JG, UK; (A.D.W.); (J.G.); (C.S.); (S.C.); (F.J.S.); (M.D.); (S.S.)
| | - Sally Sharpe
- Public Health England, National Infections Service, Porton Down, Salisbury SP4 0JG, UK; (A.D.W.); (J.G.); (C.S.); (S.C.); (F.J.S.); (M.D.); (S.S.)
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Petruccioli E, Petrone L, Chiacchio T, Farroni C, Cuzzi G, Navarra A, Vanini V, Massafra U, Lo Pizzo M, Guggino G, Caccamo N, Cantini F, Palmieri F, Goletti D. Mycobacterium tuberculosis Immune Response in Patients With Immune-Mediated Inflammatory Disease. Front Immunol 2021; 12:716857. [PMID: 34447382 PMCID: PMC8382688 DOI: 10.3389/fimmu.2021.716857] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 07/20/2021] [Indexed: 01/09/2023] Open
Abstract
Subjects with immune-mediated inflammatory diseases (IMID), such as rheumatoid arthritis (RA), have an intrinsic higher probability to develop active-tuberculosis (TB) compared to the general population. The risk ranges from 2.0 to 8.9 in RA patients not receiving therapies. According to the WHO, the RA prevalence varies between 0.3% and 1% and is more common in women and in developed countries. Therefore, the identification and treatment of TB infection (TBI) in this fragile population is important to propose the TB preventive therapy. We aimed to study the M. tuberculosis (Mtb) specific T-cell response to find immune biomarkers of Mtb burden or Mtb clearance in patients with different TB status and different risk to develop active-TB disease. We enrolled TBI subjects as example of Mtb-containment, the active-TB as example of a replicating Mtb status, and the TBI-IMID as fragile population. To study the Mtb-specific response in a condition of possible Mtb sterilization, we longitudinally enrolled TBI subjects and active-TB patients before and after TB therapy. Peripheral blood mononuclear cells were stimulated overnight with Mtb peptides contained in TB1- and TB2-tubes of the Quantiferon-Plus kit. Then, we characterized by cytometry the Mtb-specific CD4 and CD8 T cells. In TBI-IMID, the TB therapy did not affect the ability of CD4 T cells to produce interferon-γ, tumor necrosis factor-α, and interleukin-2, their functional status, and their phenotype. The TB therapy determined a contraction of the triple functional CD4 T cells of the TBI subjects and active-TB patients. The CD45RA- CD27+ T cells stood out as a main subset of the Mtb-specific response in all groups. Before the TB-preventive therapy, the TBI subjects had higher proportion of Mtb-specific CD45RA-CD27+CD4+ T cells and the active-TB subjects had higher proportion of Mtb-specific CD45RA-CD27-CD4+ T cells compared to other groups. The TBI-IMID patients showed a phenotype similar to TBI, suggesting that the type of IMID and the IMID therapy did not affect the activation status of Mtb-specific CD4 T cells. Future studies on a larger and better-stratified TBI-IMID population will help to understand the change of the Mtb-specific immune response over time and to identify possible immune biomarkers of Mtb-containment or active replication.
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Affiliation(s)
- Elisa Petruccioli
- Translational Research Unit, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy
| | - Linda Petrone
- Translational Research Unit, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy
| | - Teresa Chiacchio
- Translational Research Unit, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy
| | - Chiara Farroni
- Translational Research Unit, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy
| | - Gilda Cuzzi
- Translational Research Unit, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy
| | - Assunta Navarra
- Clinical Epidemiology Unit, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy
| | - Valentina Vanini
- Translational Research Unit, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy
- UOS Professioni Sanitarie Tecniche, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy
| | - Umberto Massafra
- Department of Internal Medicine, S. Pietro Fatebenefratelli Hospital, Rome, Italy
| | - Marianna Lo Pizzo
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Rheumatology Section-University of Palermo, Palermo, Italy
| | - Giuliana Guggino
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Rheumatology Section-University of Palermo, Palermo, Italy
| | - Nadia Caccamo
- Central Laboratory of Advanced Diagnosis and Biomedical Research, University of Palermo, Palermo, Italy
- Department of Biomedicine, Neurosciences and Advanced Diagnostic, University of Palermo, Palermo, Italy
| | - Fabrizio Cantini
- Rheumatology Department, Hospital of Prato, Azienda USL Toscana Centro, Prato, Italy
| | - Fabrizio Palmieri
- Respiratory Infectious Diseases Unit, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy
| | - Delia Goletti
- Translational Research Unit, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy
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Tamburini B, Badami GD, Azgomi MS, Dieli F, La Manna MP, Caccamo N. Role of hematopoietic cells in Mycobacterium tuberculosis infection. Tuberculosis (Edinb) 2021; 130:102109. [PMID: 34315045 DOI: 10.1016/j.tube.2021.102109] [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: 12/16/2020] [Revised: 07/05/2021] [Accepted: 07/20/2021] [Indexed: 10/20/2022]
Abstract
Tuberculosis remains one of the most significant causes of mortality worldwide and the current situation shows a re-emergence of TB due to the emergence of new antibiotic-resistant strains and the widespread of disease caused by immunodeficiencies. For these reasons, a big effort is made to improve the therapeutic strategies against Mycobacterium tuberculosis and to perform new therapeutic and diagnostic strategies. This review analyzes the various hematopoietic populations, their role and the different changes they undergo during Mycobacterium tuberculosis infection or disease. We have examined the population of lymphocytes, monocytes, neutrophils, eosinophils and platelets, in orderto understand how each of them is modulated during the course of infection/disease. In this way it will be possible to highlight the correlations between these cell populations and the different stages of tubercular infection. In fact, Mycobacterium tuberculosis is able to influence both proliferation and differentiation of hematopoietic stem cells. Several studies have highlighted that Mycobacterium tuberculosis can also infect progenitor cells in the bone marrow during active disease driving towards an increase of myeloid differentiation. This review focuses how the different stages of tubercular infection could impact on the different hematopoietic populations, with the aim to correlate the changes of different populations as biomarkers useful to discriminate infection from disease and to evaluate the effectiveness of new therapies.
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Affiliation(s)
- Bartolo Tamburini
- Central Laboratory of Advanced Diagnosis and Biomedical Research (CLADIBIOR), Italy; Department of Biomedicine, Neurosciences and Advanced Diagnostic (Bi.N.D.); University of Palermo, Palermo 90127, Italy
| | - Giusto Davide Badami
- Central Laboratory of Advanced Diagnosis and Biomedical Research (CLADIBIOR), Italy; Department of Biomedicine, Neurosciences and Advanced Diagnostic (Bi.N.D.); University of Palermo, Palermo 90127, Italy
| | - Mojtaba Shekarkar Azgomi
- Central Laboratory of Advanced Diagnosis and Biomedical Research (CLADIBIOR), Italy; Department of Biomedicine, Neurosciences and Advanced Diagnostic (Bi.N.D.); University of Palermo, Palermo 90127, Italy
| | - Francesco Dieli
- Central Laboratory of Advanced Diagnosis and Biomedical Research (CLADIBIOR), Italy; Department of Biomedicine, Neurosciences and Advanced Diagnostic (Bi.N.D.); University of Palermo, Palermo 90127, Italy
| | - Marco Pio La Manna
- Central Laboratory of Advanced Diagnosis and Biomedical Research (CLADIBIOR), Italy; Department of Biomedicine, Neurosciences and Advanced Diagnostic (Bi.N.D.); University of Palermo, Palermo 90127, Italy
| | - Nadia Caccamo
- Central Laboratory of Advanced Diagnosis and Biomedical Research (CLADIBIOR), Italy; Department of Biomedicine, Neurosciences and Advanced Diagnostic (Bi.N.D.); University of Palermo, Palermo 90127, Italy.
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Van Ginderdeuren E, Bassett J, Hanrahan CF, Van Rie A. Association between monocyte-to-lymphocyte ratio and tuberculin skin test positivity in HIV-positive adults. PLoS One 2021; 16:e0253907. [PMID: 34270562 PMCID: PMC8284817 DOI: 10.1371/journal.pone.0253907] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 06/15/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The tuberculin skin test (TST) identifies individuals at high risk of developing tuberculosis (TB) but poses many challenges. The blood monocyte-to-lymphocyte ratio (MLR) could be an alternative, as extremes in MLR have been associated with increased risk of TB disease. METHODS At a primary care clinic in Johannesburg, a differential white blood cell count and TST was performed in adults starting antiretroviral treatment (ART) without symptoms suggestive of active TB. RESULTS Of 259 participants, 171 had valid results of whom 30% (51/171) were TST positive and the median MLR was 0.18 (IQR 0.13-0.28). The MLR distribution differed between CD4 count categories (p < 0.01), with a broader range of values in TST negative participants with a low CD4 count (≤ 250 cells/mm3), likely reflecting HIV immunosuppression. MLR was associated with a positive TST (OR 0.78 per 0.1 increase, 95% CI 0.59, 0.97) in bivariate analysis but not in multivariate regression analysis (aOR 0.83 for every 0.1 increase, 95% CI 0.60, 1.08). CONCLUSION In ART-naïve adults without symptoms suggestive of active TB, MLR was not independently associated with TST positivity and is thus unlikely to be a useful alternative to TST. Future research should focus on development of a cheap, simple and accurate biomarker to identify those people benefiting most from preventive TB therapy.
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Affiliation(s)
- Eva Van Ginderdeuren
- Witkoppen Clinic, Johannesburg, South Africa
- Faculty of Medicine and Health Sciences, Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium
- * E-mail:
| | | | - Colleen F. Hanrahan
- Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Annelies Van Rie
- Faculty of Medicine and Health Sciences, Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium
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Pan SW, Su WJ, Chan YJ, Chuang FY, Feng JY, Chen YM. Mycobacterium tuberculosis-derived circulating cell-free DNA in patients with pulmonary tuberculosis and persons with latent tuberculosis infection. PLoS One 2021; 16:e0253879. [PMID: 34166477 PMCID: PMC8224927 DOI: 10.1371/journal.pone.0253879] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 06/14/2021] [Indexed: 01/15/2023] Open
Abstract
Objectives The timely diagnosis of pulmonary tuberculosis (PTB) is challenging. Although pathogen-derived circulating cell-free DNA (cfDNA) has been detected in humans, the significance of Mycobacterium tuberculosis (MTB)-cfDNA detection in patients with PTB remains unclear. Methods This study enrolled patients with PTB and persons with latent tuberculosis infection (LTBI) as the study and control groups, respectively, from 2018 to 2020. We measured interferon-γ levels and calculated blood monocyte-to-lymphocyte ratio (MLR). We conducted plasma cfDNA extraction, quantitative polymerase chain reaction (qPCR), and droplet digital PCR targeting the IS6110 gene of MTB. We calculated the sensitivity and specificity of using MTB-cfDNA to identify PTB and analyzed the factors associated with PTB diagnosis and MTB-cfDNA positivity. Results We enrolled 24 patients with PTB and 57 LTBI controls. The sensitivity of using MTB-cfDNA to identify PTB was 54.2%(13/24) in total and 46.2%(6/13) in smear-negative cases. Two LTBI controls (3.5%) tested positive for MTB-cfDNA, indicating a specificity of 96.5%(55/57). By using MTB-cfDNA positivity and an MLR ≥0.42 to identify PTB, sensitivity increased to 79.2%(19/24). Among patients with PTB, MTB-specific interferon-γ levels were higher in MTB-cfDNA positive participants than in those who tested negative (7.0 ±2.7 vs 2.7±3.0 IU/mL, p<0.001). MTB-cfDNA levels declined after 2 months of anti-tuberculosis therapy (p<0.001). Conclusion The sensitivity of using MTB-cfDNA to identify PTB in participants was 54.2%, which increased to 79.2% after incorporating an MLR ≥0.42 into the analysis. MTB-cfDNA positivity was associated with MTB-specific immune response, and MTB-cfDNA levels declined after treatment. The clinical value of MTB-cfDNA in PTB management necessitates further investigation.
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Affiliation(s)
- Sheng-Wei Pan
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan
- * E-mail: (JYF); (SWP)
| | - Wei-Juin Su
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yu-Jiun Chan
- Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Division of Microbiology, Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Fan-Yi Chuang
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Jia-Yih Feng
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- * E-mail: (JYF); (SWP)
| | - Yuh-Min Chen
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
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Liang T, Chen J, Xu G, Zhang Z, Xue J, Zeng H, Jiang J, Chen T, Qin Z, Li H, Ye Z, Nie Y, Liu C, Zhan X. Immune status changing helps diagnose osteoarticular tuberculosis. PLoS One 2021; 16:e0252875. [PMID: 34129634 PMCID: PMC8205131 DOI: 10.1371/journal.pone.0252875] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 05/24/2021] [Indexed: 01/06/2023] Open
Abstract
Objective This study is aimed to develop a new nomogram for the clinical diagnosis of osteoarticular tuberculosis (TB). Methods xCell score estimation to obtained the immune cell type abundance scores. We downloaded the expression profile of GSE83456 from GEO and proceed xCell score estimation. The routine blood examinations of 326 patients were collected for further validation. We analyzed univariate and multivariate logistic regression to identified independent predicted factor for developing the nomogram. The performance of the nomogram was assessed using the receiver operating characteristic (ROC) curves. The correlation of ESR with lymphocytes, monocytes, and ML ratio was performed and visualized in osteoarticular TB patients. Results Compared with the healthy control group in the dataset GSE83456, the xCell score of basophils, monocytes, neutrophils, and platelets was higher, while lymphoid was lower in the EPTB group. The clinical data showed that the cell count of monocytes were much higher, while the cell counts of lymphocytes were lower in the osteoarticular TB group. AUCs of the nomogram was 0.798 for the dataset GSE83456, and 0.737 for the clinical data. We identified the ML ratio, BMI, and ESR as the independent predictive factors for osteoarticular TB diagnosis and constructed a nomogram for the clinical diagnosis of osteoarticular TB. AUCs of this nomogram was 0.843. Conclusions We demonstrated a significant change between the ML ratio of the EPTB and non-TB patients. Moreover, we constructed a nomogram for the clinical diagnosis of the osteoarticular TB diagnosis, which works satisfactorily.
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Affiliation(s)
- Tuo Liang
- Spine and Osteopathy Ward, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
| | - Jiarui Chen
- Spine and Osteopathy Ward, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
| | - GuoYong Xu
- Spine and Osteopathy Ward, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
| | - Zide Zhang
- Spine and Osteopathy Ward, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
| | - Jiang Xue
- Spine and Osteopathy Ward, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
| | - Haopeng Zeng
- Spine and Osteopathy Ward, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
| | - Jie Jiang
- Spine and Osteopathy Ward, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
| | - Tianyou Chen
- Spine and Osteopathy Ward, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
| | - Zhaojie Qin
- Spine and Osteopathy Ward, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
| | - Hao Li
- Spine and Osteopathy Ward, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
| | - Zhen Ye
- Spine and Osteopathy Ward, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
| | - Yunfeng Nie
- Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
| | - Chong Liu
- Spine and Osteopathy Ward, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
| | - Xinli Zhan
- Spine and Osteopathy Ward, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
- * E-mail:
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Zanon IDB, Tsai VL, Ribeiro TC, Astur N, Mendonça RGMD, Gotfryd AO, Salles MJC, Caffaro MFS, Klautau GB, Meves R. THE PROFILE OF POTT’S DISEASE IN A SOUTH AMERICAN REFERENCE SERVICE. COLUNA/COLUMNA 2021. [DOI: 10.1590/s1808-185120212002234844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: Tuberculosis (TB) represents one of the top ten causes of death in the world. Its insidious onset and nonspecific symptoms usually result in delayed diagnosis. The objective is to evaluate the characteristics of patients with tuberculous spondylodiscitis in follow-up at a South American reference hospital. Method: Retrospective evaluation of the medical records of patients of both sexes and between 0 and 80 years of age diagnosed with tuberculosis of the spine between 2009 and 2018. The variables were analyzed based on groups: epidemiological, clinical, laboratorial, microbiological, imaging tests and treatment. Results: Total of 26 cases, about 80.8% male, mean age 41.6 ± 22.46 years. Axial pain was the most prevalent symptom (84.6%), the VAS score was 6.85 ± 2.87. The mean time between symptom onset and diagnosis was 23.8 ± 24.1 weeks (4-96). The most affected region was the thoracic spine (50% of the cases). Most participants (61.4%) had no change in neurological function (Frankel D and E) at the beginning of treatment and after 6 months, and 84.5% improved. During treatment 34.6% required surgery and the main indication was isolated neurological deficit (55.5%). The most frequently performed procedure was decompression and arthrodesis (55.5%). The average time to cure was 12.0 ± 8.8 months (8-48). Conclusion: Disease with insidious onset, nonspecific symptoms, high frequency of negative microbiological tests in cases with the disease. A small number of the cases required surgical treatment and most of them achieved good neurological recovery. Level of evidence IV; Case series.
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Cerig S, Geyikoglu F. Oxidative stress and cyto-genotoxicity induced by poly-d-glucosamine in human blood cells in vitro. ACTA ACUST UNITED AC 2021; 77:43-55. [PMID: 34036758 DOI: 10.1515/znc-2021-0080] [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: 03/18/2021] [Accepted: 05/02/2021] [Indexed: 11/15/2022]
Abstract
Poly-N-acetyl-d-glucosamine (CH; chitin) is the main component of the insect skeleton, fungal cell wall, and many crustaceans, including crab and shrimp. CH is the most abundant in nature after cellulose, and it has a complex and hardly soluble structure. Poly-d-glucosamine (CHO; chitosan) is a soluble derivative of CH produced by deacetylation used in many fields, including human health. This study carried out the cytotoxic, genotoxic, and oxidative effects of CHO on human whole blood (hWB) and lymphocytes (LYMs) in dose ranges 6.25-2000 μg/mL, in vitro. Total antioxidant capacity (TAC) and total oxidant status (TOS) analyzes were performed on plasma to appreciate oxidative stress. 3-(4,5-Dimethylthiazol-2-yl)-2,5 diphenyltetrazolium bromide (MTT) and lactate dehydrogenase (LDH) assays were applied to understand the cytotoxicity. Chromosomal aberration (CA) and micronucleus (MN) methods were practiced to evaluate genotoxicity. 6.25-150 μg/mL doses increased TAC and decreased TOS. A decreasing and increasing curve from 200 to 2000 μg/mL on TAC and TOS values were determined, respectively. 0-250 μg/mL doses did not provide any cytotoxic data. However, 500-2000 μg/mL doses showed increasing cytotoxicity and genotoxicity. The study results showed that CHO does not pose a toxic risk to human health at low doses but may pose a threat at high doses.
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Affiliation(s)
- Salim Cerig
- First and Emergency Aid Program, Medical Services and Techniques Department, Vocational School of Health Services, Ibrahim Cecen University, Agri, Turkey
| | - Fatime Geyikoglu
- Department of Biology, Faculty of Science, Ataturk University, Erzurum, Turkey
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Grassi G, Vanini V, De Santis F, Romagnoli A, Aiello A, Casetti R, Cimini E, Bordoni V, Notari S, Cuzzi G, Mosti S, Gualano G, Palmieri F, Fraziano M, Goletti D, Agrati C, Sacchi A. PMN-MDSC Frequency Discriminates Active Versus Latent Tuberculosis and Could Play a Role in Counteracting the Immune-Mediated Lung Damage in Active Disease. Front Immunol 2021; 12:594376. [PMID: 33981297 PMCID: PMC8107479 DOI: 10.3389/fimmu.2021.594376] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 04/06/2021] [Indexed: 01/02/2023] Open
Abstract
Tuberculosis (TB), due to Mycobacterium tuberculosis infection, is still the principal cause of death caused by a single infectious agent. The balance between the bacillus and host defense mechanisms reflects the different manifestations of the pathology. Factors defining this variety are unclear and likely involve both mycobacterial and immunological components. Myeloid derived suppressor cells (MDSC) have been shown to be expanded during TB, but their role in human TB pathogenesis is not clear. We evaluated the frequency of circulating MDSC by flow-cytometry in 19 patients with active TB, 18 with latent TB infection (LTBI), and 12 healthy donors (HD) as control. Moreover, we investigated the capacity of MDSC to modulate the mycobactericidal activity of monocytes. The association between MDSC level and TB chest X-ray severity score was analyzed. We observed that, unlike active TB, polymorphonuclear (PMN)-MDSC are not expanded in LTBI patients, and, by performing a receiver operating characteristic (ROC) curve analysis, we found that PMN-MDSC frequency supported the discrimination between active disease and LTBI. Interestingly, we observed an association between PMN-MDSC levels and the severity of TB disease evaluated by chest X-ray. Specifically, PMN-MDSC frequency was higher in those classified with a low/mild severity score compared to those classified with a high severity score. Moreover, PMN-MDSC can impact mycobacterial growth by inducing ROS production in Bacillus Calmette et Guerin (BCG)-infected monocytes. This effect was lost when tested with M. tuberculosis (MTB), In conclusion, our data indicate that the elevated frequency of PMN-MDSC in IGRA-positive individuals is associated with active TB. Our findings also pointed out a beneficial role of PMN-MDSC during human active TB, most likely associated with the limitation of inflammation-induced tissue damage.
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Affiliation(s)
- Germana Grassi
- Laboratory of Cellular Immunology and Pharmacology, National Institute for infectious Diseases "Lazzaro Spallanzani"-IRCCS, Rome, Italy
| | - Valentina Vanini
- Laboratory of Translational Research, National Institute for infectious Diseases "Lazzaro Spallanzani"-IRCCS, Rome, Italy.,UOS Professioni Sanitarie Tecniche National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy
| | | | - Alessandra Romagnoli
- Department of Epidemiology, Preclinical Research, and Advanced Diagnostics, National Institute for Infectious Diseases 'Lazzaro Spallanzani'-IRCCS, Rome, Italy
| | - Alessandra Aiello
- Laboratory of Translational Research, National Institute for infectious Diseases "Lazzaro Spallanzani"-IRCCS, Rome, Italy
| | - Rita Casetti
- Laboratory of Cellular Immunology and Pharmacology, National Institute for infectious Diseases "Lazzaro Spallanzani"-IRCCS, Rome, Italy
| | - Eleonora Cimini
- Laboratory of Cellular Immunology and Pharmacology, National Institute for infectious Diseases "Lazzaro Spallanzani"-IRCCS, Rome, Italy
| | - Veronica Bordoni
- Laboratory of Cellular Immunology and Pharmacology, National Institute for infectious Diseases "Lazzaro Spallanzani"-IRCCS, Rome, Italy
| | - Stefania Notari
- Laboratory of Cellular Immunology and Pharmacology, National Institute for infectious Diseases "Lazzaro Spallanzani"-IRCCS, Rome, Italy
| | - Gilda Cuzzi
- Laboratory of Translational Research, National Institute for infectious Diseases "Lazzaro Spallanzani"-IRCCS, Rome, Italy
| | - Silvia Mosti
- Respiratory Infectious Diseases Unit, National Institute for infectious Diseases "Lazzaro Spallanzani"-IRCCS, Rome, Italy
| | - Gina Gualano
- Respiratory Infectious Diseases Unit, National Institute for infectious Diseases "Lazzaro Spallanzani"-IRCCS, Rome, Italy
| | - Fabrizio Palmieri
- Respiratory Infectious Diseases Unit, National Institute for infectious Diseases "Lazzaro Spallanzani"-IRCCS, Rome, Italy
| | - Maurizio Fraziano
- Department of Biology, University of Rome "Tor Vergata", Rome, Italy
| | - Delia Goletti
- Laboratory of Translational Research, National Institute for infectious Diseases "Lazzaro Spallanzani"-IRCCS, Rome, Italy
| | - Chiara Agrati
- Laboratory of Cellular Immunology and Pharmacology, National Institute for infectious Diseases "Lazzaro Spallanzani"-IRCCS, Rome, Italy
| | - Alessandra Sacchi
- Laboratory of Cellular Immunology and Pharmacology, National Institute for infectious Diseases "Lazzaro Spallanzani"-IRCCS, Rome, Italy
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Gersh JK, Barnabas RV, Matemo D, Kinuthia J, Feldman Z, Lacourse SM, Mecha J, Warr AJ, Kamene M, Horne DJ. Pulmonary tuberculosis screening in anti-retroviral treated adults living with HIV in Kenya. BMC Infect Dis 2021; 21:218. [PMID: 33632173 PMCID: PMC7908695 DOI: 10.1186/s12879-021-05916-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 02/11/2021] [Indexed: 11/25/2022] Open
Abstract
Background People living with HIV (PLHIV) who reside in high tuberculosis burden settings remain at risk for tuberculosis disease despite treatment with anti-retroviral therapy and isoniazid preventive therapy (IPT). The performance of the World Health Organization (WHO) symptom screen for tuberculosis in PLHIV receiving anti-retroviral therapy is sub-optimal and alternative screening strategies are needed. Methods We enrolled HIV-positive adults into a prospective study in western Kenya. Individuals who were IPT-naïve or had completed IPT > 6 months prior to enrollment were eligible. We evaluated tuberculosis prevalence overall and by IPT status. We assessed the accuracy of the WHO symptom screen, GeneXpert MTB/RIF (Xpert), and candidate biomarkers including C-reactive protein (CRP), hemoglobin, erythrocyte sedimentation rate (ESR), and monocyte-to-lymphocyte ratio for identifying pulmonary tuberculosis. Some participants were evaluated at 6 months post-enrollment for tuberculosis. Results The study included 383 PLHIV, of whom > 99% were on antiretrovirals and 88% had received IPT, completed a median of 1.1 years (IQR 0.8–1.55) prior to enrollment. The prevalence of pulmonary tuberculosis at enrollment was 1.3% (n = 5, 95% CI 0.4–3.0%): 4.3% (0.5–14.5%) among IPT-naïve and 0.9% (0.2–2.6%) among IPT-treated participants. The sensitivity of the WHO symptom screen was 0% (0–52%) and specificity 87% (83–90%). Xpert and candidate biomarkers had poor to moderate sensitivity; the most accurate biomarker was CRP ≥ 3.3 mg/L (sensitivity 80% (28–100) and specificity 72% (67–77)). Six months after enrollment, the incidence rate of pulmonary tuberculosis following IPT completion was 0.84 per 100 person-years (95% CI, 0.31–2.23). Conclusions In Kenyan PLHIV treated with IPT, tuberculosis prevalence was low at a median of 1.4 years after IPT completion. WHO symptoms screening, Xpert, and candidate biomarkers were insensitive for identifying pulmonary tuberculosis in antiretroviral-treated PLHIV.
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Affiliation(s)
- Jill K Gersh
- Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA, USA
| | - Ruanne V Barnabas
- Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA, USA.,Department of Global Health, University of Washington, 325 9th Ave, Box 359762, Seattle, WA, 98102, USA.,Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Daniel Matemo
- Department of Obstetrics and Gynaecology, Kenyatta National Hospital, Nairobi, Kenya.,School of Public Health and Community Development Maseno University, Kisumu, Kenya
| | - John Kinuthia
- Department of Global Health, University of Washington, 325 9th Ave, Box 359762, Seattle, WA, 98102, USA.,Department of Obstetrics and Gynaecology, Kenyatta National Hospital, Nairobi, Kenya
| | - Zachary Feldman
- Albers School of Business and Economics, Seattle University, Seattle, WA, USA
| | - Sylvia M Lacourse
- Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA, USA.,Department of Global Health, University of Washington, 325 9th Ave, Box 359762, Seattle, WA, 98102, USA
| | - Jerphason Mecha
- Department of Obstetrics and Gynaecology, Kenyatta National Hospital, Nairobi, Kenya
| | - Alex J Warr
- Department of Pediatrics, Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Maureen Kamene
- National Tuberculosis, Leprosy, and Lung Disease Program, Nairobi, Kenya
| | - David J Horne
- Department of Global Health, University of Washington, 325 9th Ave, Box 359762, Seattle, WA, 98102, USA. .,Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, University of Washington, Harborview Medical Center, Seattle, WA, USA.
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46
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Ferreiro Iglesias R, Barreiro-de Acosta M, López J, Bastón Rey I, Domínguez-Muñoz JE. USEFULNESS OF PERIPHERAL BLOOD MONOCYTE COUNT TO PREDICT RELAPSE IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE: A PROSPECTIVE LONGITUDINAL COHORT STUDY. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2021; 114:10-15. [PMID: 33486959 DOI: 10.17235/reed.2021.7683/2020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Monocytes play an important role in the pathogenesis of inflammatory bowel disease but data are scarce as a biomarker of activity, above all, in patients under biologic therapies. The aim was to evaluate the value of monocyte measurements in predicting flares in inflammatory bowel disease patients under maintenance treatment with anti-TNF. A prospective, observational cohort study was designed. Relapse was defined as a Harvey-Bradshaw score >4 in Crohn's disease and a partial Mayo score ≥2 in ulcerative colitis. Monocytes concentration was quantified at 4-month intervals for twelve months. 95 consecutive patients were included. The median age was 42 years, 50.5% female and 75% with Crohn's disease. 65 (68.4%) patients remained in clinical remission. Mean monocyte concentration preceding the relapse was 563 (standard deviation 144) compared to 405 (standard deviation 177) in patients who kept in remission. Final monocytes concentration significantly differentiated between relapse and remission in Crohn's disease (AUC 0.82; 95% CI: 0.71-0.90; P <0.005). In the multivariate analysis, only monocytes and fecal calprotectin related to more relapses. In conclusion, in inflammatory bowel disease patients under anti-TNF therapy, repeated monocytes concentration could help in order to monitoring patients, at least, in Crohn's disease.
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Affiliation(s)
| | | | - Javier López
- Servicio de Aparato Digestivo, Hospital Clinico Universitario de Santiago
| | - Iria Bastón Rey
- Servicio de Digestivo, Hospital Clínico Universitario de Santiago
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Nore KG, Jørgensen MJ, Dyrhol-Riise AM, Jenum S, Tonby K. Elevated Levels of Anti-Inflammatory Eicosanoids and Monocyte Heterogeneity in Mycobacterium tuberculosis Infection and Disease. Front Immunol 2020; 11:579849. [PMID: 33304347 PMCID: PMC7693556 DOI: 10.3389/fimmu.2020.579849] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 10/19/2020] [Indexed: 12/21/2022] Open
Abstract
Eicosanoids modulate both innate and adaptive immune responses in Mycobacterium tuberculosis (Mtb) infection and have been suggested as possible Host Directed Therapy (HDT) targets, but more knowledge of eicosanoid dynamics in Mtb infection is required. We investigated the levels and ratios of eicosanoid mediators and their cellular sources, monocyte subsets and CD4 T cells in Tuberculosis (TB) patients with various clinical states of Mtb infection. Patients consenting to prospective enrolment in a TB quality registry and biorepository, 16 with pulmonary TB (before and at-end-of treatment), 14 with extrapulmonary TB and 17 latently infected (LTBI) were included. Plasma levels of Prostaglandin E2 (PGE2), Lipoxin A4 (LXA4), and Leukotriene B4 (LTB4) were measured by enzyme-linked immunosorbent assay. Monocyte subsets and CD4 T cells and their expression of Cyclooxygenase-2 (COX-2), Prostaglandin receptor EP2 (EP2), and 5-Lipoxygenase (5-LOX) were analyzed by flow cytometry with and without Purified Protein Derivate (PPD)-stimulation. Pulmonary TB patients had elevated levels of the anti-inflammatory mediator LXA4 at diagnosis compared to LTBI (p < 0.01), while levels of PGE2 and LTB4 showed no difference between clinical states of Mtb infection. LTB4 was the only mediator to be reduced upon treatment (p < 0.05), along with the ratio LTB4/LXA4 (p < 0.01). Pulmonary TB patients had higher levels of total monocytes at diagnosis compared to end-of-treatment and LTBI (both p < 0.05), and a relative increase in the classical monocyte subset. All monocyte subsets had low basal expression of COX-2 and 5-LOX, which were markedly increased upon PPD stimulation. By contrast, the expression of EP2 was reduced upon stimulation. CD4 T cells expressed low basal COX-2 activity that increased modestly upon stimulation, whereas their basal expression of 5-LOX was considerable. In conclusion, the level of eicosanoids in plasma seem to vary between clinical states of Mtb infection. Mediators in the eicosanoid system are present in monocytes and CD4 T cells. The expression of eicosanoids in monocytes are responsive to mycobacterial stimulation independent of Mtb disease state, but subsets are heterogeneous with regard to eicosanoid-mediator expression. Further exploration of eicosanoid mediators as targets for HDT in TB are warranted.
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Affiliation(s)
- Kristin Grotle Nore
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Marthe Jøntvedt Jørgensen
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Infectious Diseases, Oslo University Hospital, Oslo, Norway
| | - Anne Ma Dyrhol-Riise
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Infectious Diseases, Oslo University Hospital, Oslo, Norway
| | - Synne Jenum
- Department of Infectious Diseases, Oslo University Hospital, Oslo, Norway
| | - Kristian Tonby
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Infectious Diseases, Oslo University Hospital, Oslo, Norway
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Mayito J, Meya DB, Rhein J, Sekaggya-Wiltshire C. Utility of the monocyte to lymphocyte ratio in diagnosing latent tuberculosis among HIV-infected individuals with a negative tuberculosis symptom screen. PLoS One 2020; 15:e0241786. [PMID: 33166312 PMCID: PMC7652277 DOI: 10.1371/journal.pone.0241786] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 10/20/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Latent Tuberculosis Infection (LTBI) remains a major driver of the TB epidemic, and individuals with Human Immuno-deficiency Virus (HIV) are particularly at a heightened risk of developing LTBI. However, LTBI screening among HIV-infected individuals in resource limited setting is largely based on a negative symptom screen, which has low specificity. METHODS In a cross sectional diagnostic study, 115 HIV infected participants with a negative symptom screen will be consented and enrolled. They will be requested to donate 5 ml of blood for complete blood count (CBC) and interferon gamma release assay (IGRA) testing. In a nested prospective study, the 115 participants will be initiated on Tuberculosis Preventive Therapy and the CBC testing repeated after 3 months. In the analysis of study finding, the monocyte to lymphocyte ratio (MLR) will be derived from the dividend of the absolute monocyte and lymphocyte counts. The optimal MLR positivity cut-off for elevated or normal MLR will be the highest value of Youden's index, J (sensitivity + specificity-1). The MLR will be cross tabulated with the IGRA status to determine the sensitivity, specificity, negative and positive predictive values of the MLR. The area under the receiver operating characteristic (ROC) curve will be determined to give the overall diagnostic accuracy of MLR. The baseline and 3 month CBC will be used to determine the change in MLR, and a random effect logistic regression will be used to determine factors associated with the change in the MLR. DISCUSSION If positive results are realized from this study, the MLR could become an inexpensive alternative biomarker with potential to improve the specificity of the negative symptom screen in identifying individuals that should be targeted for TB preventive therapy.
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Affiliation(s)
- Jonathan Mayito
- Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda
| | - David B. Meya
- Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda
| | - Joshua Rhein
- Division of Infectious Diseases and International Medicine, University of Minnesota, USA Department of Research, Minneapolis, Minnesota, United States of America
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49
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The potential of CBC-derived ratios (monocyte-to-lymphocyte, neutrophil-to-lymphocyte, and platelet-to-lymphocyte) to predict or diagnose incident TB infection in Tanzanian adolescents. BMC Infect Dis 2020; 20:609. [PMID: 32811463 PMCID: PMC7433160 DOI: 10.1186/s12879-020-05331-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 08/09/2020] [Indexed: 12/21/2022] Open
Abstract
Background Ratios of different immune cell populations (i.e., monocyte-to-lymphocyte, neutrophil-to-lymphocyte, and platelet-to-lymphocyte ratios) have been studied as a means of predicting future tuberculosis (TB) disease risk or to assist in the diagnosis of incident TB disease. No studies to-date, however, have evaluated the potential of these ratios to predict or assist in the diagnosis of incident TB infection - the first step in the natural history of TB disease. Methods In this prospective study, we evaluated the complete blood count (CBC)-derived metrics of monocyte-to-lymphocyte ratio (MLR), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) as predictors of future TB infection risk or aids in the diagnosis of TB infection among 145 Tanzanian adolescents enrolled in the DAR-901 vaccine trial, using paired CBCs and interferon-gamma release assays (IGRAs) obtained at 0, 60 and 720 days after study enrollment. Results At baseline, there were no significant differences between study participants who remained persistently IGRA negative throughout the study period and those who subsequently converted to IGRA positive with respect to MLR (0.18 vs 0.17, p = 0.10), NLR (0.88 vs 1.02, p = 0.08), or PLR (115 vs 120, p = 0.28). Similarly, no significant differences were noted with respect to MLR, NLR, and PLR between IGRA converters and time-matched negative controls at the time of IGRA conversion. With respect to other blood cell measures, however, there were modest but significant differences between IGRA negatives and IGRA converters with respect to red blood cell count (4.8 vs 4.6 × 106 cells/mcL, p = 0.008), hemoglobin (12.6 vs 12.3 g/dL, p = 0.01), and hematocrit (38.8 vs 37.8%, p = 0.005). Conclusions In contrast to prior studies that have suggested that the ratios of different immune cell populations are associated with development of TB disease, our present findings do not demonstrate an association between these ratios and the development of TB infection. However, decreased red blood cell measures were associated with the subsequent development of TB infection, suggesting either that dysregulation of iron metabolism may play a role in TB pathogenesis or that following TB infection, iron dysregulation may precede IGRA positivity. Trial registration Clinicaltrials.gov NCT02712424. Date of registration: March 14, 2016.
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50
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Habtamu M, Abrahamsen G, Aseffa A, Andargie E, Ayalew S, Abebe M, Spurkland A. High-throughput analysis of T cell-monocyte interaction in human tuberculosis. Clin Exp Immunol 2020; 201:187-199. [PMID: 32348546 PMCID: PMC7366737 DOI: 10.1111/cei.13447] [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: 07/30/2019] [Revised: 03/06/2020] [Accepted: 04/19/2020] [Indexed: 12/17/2022] Open
Abstract
The lack of efficient tools for identifying immunological correlates of tuberculosis (TB) protection or risk of disease progression impedes the development of improved control strategies. To more clearly understand the host response in TB, we recently established an imaging flow cytometer‐based in‐vitro assay, which assesses multiple aspects of T cell–monocyte interaction. Here, we extended our previous work and characterized communication between T cells and monocytes using clinical samples from individuals with different TB infection status and healthy controls from a TB endemic setting. To identify T cell–monocyte conjugates, peripheral blood mononuclear cells (PBMC) were stimulated with ds‐Red‐expressing Mycobacterium bovis bacille Calmette–Guérin or 6‐kDa early secreted antigenic target (ESAT 6) peptides for 6 h, and analyzed by imaging flow cytometer (IFC). We then enumerated T cell–monocyte conjugates using polarization of T cell receptor (TCR) and F‐actin as markers for synapse formation, and nuclear factor kappa B (NF‐κB) nuclear translocation in the T cells. We observed a reduced frequency of T cell–monocyte conjugates in cells from patients with active pulmonary tuberculosis (pTB) compared to latent TB‐infected (LTBI) and healthy controls. When we monitored NF‐κB nuclear translocation in T cells interacting with monocytes, the proportion of responding cells was significantly higher in active pTB compared with LTBI and controls. Overall, these data underscore the need to consider multiple immunological parameters against TB, where IFC could be a valuable tool.
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Affiliation(s)
- M Habtamu
- Department of Molecular Medicine, Institute of Basic Medical Sciences, University of Oslo, Olso, Norway.,Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - G Abrahamsen
- Department of Molecular Medicine, Institute of Basic Medical Sciences, University of Oslo, Olso, Norway
| | - A Aseffa
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - E Andargie
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - S Ayalew
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - M Abebe
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - A Spurkland
- Department of Molecular Medicine, Institute of Basic Medical Sciences, University of Oslo, Olso, Norway
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