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Jin C, Tao X, Zhang W, Xu H, Wu Y, Chen Q, Li S, Ning A, Wang W, Wu Q, Chu M. Multi-omics and multi-stages integration identified a novel variant associated with silicosis risk. Arch Toxicol 2024:10.1007/s00204-024-03795-2. [PMID: 38811393 DOI: 10.1007/s00204-024-03795-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 05/23/2024] [Indexed: 05/31/2024]
Abstract
Assessing the association between candidate single-nucleotide polymorphisms (SNPs) identified by multi-omics approaches and susceptibility to silicosis. RNA-seq analysis was performed to screen the differentially expressed mRNAs in the fibrotic lung tissues of mice exposed to silica particles. Following this, we integrated the SNPs located in the above human homologenes with the silicosis-related genome-wide association study (GWAS) data to select the candidate SNPs. Then, expression quantitative trait locus (eQTL)-SNPs were identified by the GTEx database. Next, we validated the associations between the functional eQTL-SNPs and silicosis susceptibility by additional case-control study. And the contribution of the identified SNP and its host gene in the fibrosis process was further validated by functional experiments. A total of 12 eQTL-SNPs were identified in the screening stage. The results of the validation stage suggested that the variant T allele of rs419540 located in IL12RB1 significantly increased the risk of developing silicosis [additive model: odds ratio (OR) = 1.78, 95% confidence interval (CI) 1.11-2.85, P = 0.017]. Furthermore, the combination of GWAS and the results of validation stage also indicated that the variant T allele of rs419540 in IL12RB1 was associated with increased silicosis risk (additive model: OR = 2.07, 95% CI 1.38-3.12, P < 0.001). Additionally, after knockdown or overexpression of IL12RB1, the levels of pro-inflammatory factors, such as IL-12, IFN-γ, and other pro-inflammatory factors, were correspondingly decreased or increased. The novel eQTL-SNP, rs419540, might increase the risk of silicosis by modulating the expression levels of IL12RB1.
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Affiliation(s)
- Chunmeng Jin
- School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Xiaobo Tao
- Department of Epidemiology, School of Public Health, Nantong University, Nantong, Jiangsu, China
| | - Wendi Zhang
- Department of Epidemiology, School of Public Health, Nantong University, Nantong, Jiangsu, China
| | - Huiwen Xu
- Department of Epidemiology, School of Public Health, Nantong University, Nantong, Jiangsu, China
| | - Yutong Wu
- Department of Epidemiology, School of Public Health, Nantong University, Nantong, Jiangsu, China
| | - Qiong Chen
- Department of Epidemiology, School of Public Health, Nantong University, Nantong, Jiangsu, China
| | - Siqi Li
- Department of Epidemiology, School of Public Health, Nantong University, Nantong, Jiangsu, China
| | - Anhui Ning
- Department of Epidemiology, School of Public Health, Nantong University, Nantong, Jiangsu, China
| | - Wei Wang
- Department of Occupational Health, Center for Disease Control and Prevention of Wuxi, Wuxi, Jiangsu, China.
| | - Qiuyun Wu
- School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, China.
| | - Minjie Chu
- Department of Epidemiology, School of Public Health, Nantong University, Nantong, Jiangsu, China.
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Li S, Zhao J, Han G, Zhang X, Li N, Zhang Z. Silicon dioxide-induced endoplasmic reticulum stress of alveolar macrophages and its role on the formation of silicosis fibrosis: a review article. Toxicol Res (Camb) 2023; 12:1024-1033. [PMID: 38145097 PMCID: PMC10734631 DOI: 10.1093/toxres/tfad099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 09/01/2023] [Accepted: 10/07/2023] [Indexed: 12/26/2023] Open
Abstract
Silicosis is a chronic lung inflammatory disease induced by long-term inhalation of high concentrations of silicon dioxide (SiO2), characterized by pulmonary fibrosis. Inhalation of silica invades alveolar macrophages (AMs) and changes the micro-environment of the cell, resulting in abnormal morphology and dysfunction of the endoplasmic reticulum (ER). Once beyond the range of cell regulation, the endoplasmic reticulum stress (ERS) will occur, which will lead to cell damage, necrosis, and apoptosis, eventually causing silicosis fibrosis through various mechanisms. This is a complex and delicate process accompanied by various macrophage-derived cytokines. Unfortunately, the details have not been systematically summarized yet. In this review, we systematically introduce the basic two processes: the process of inducing ERS by inhaling SiO2 and the process of inducing pulmonary fibrosis by ERS. Moreover, the underlying mechanism of the above two sequential events is also be discussed. We conclude that the ERS of alveolar macrophages caused by silica dust are involved deeply in the pathogenesis of silicosis. Therefore, changing the states of SiO2-induced ERS of macrophage may be an attractive therapeutic target for silicosis fibrosis.
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Affiliation(s)
- Shuang Li
- Department of Public Health and Management, Binzhou Medical University, Guanhai Road 346, Yantai 264003, Shandong Province, China
- Department of Public Health, Jining Medical University, Jianshe South Road 45, Jining 272067, Shandong Province, China
| | - Jiahui Zhao
- Department of Public Health, Jining Medical University, Jianshe South Road 45, Jining 272067, Shandong Province, China
- Department of Public Health, Weifang Medical University, Baotong west Street 7166, Weifang 261053, Shandong Province, China
| | - Guizhi Han
- Department of Public Health, Jining Medical University, Jianshe South Road 45, Jining 272067, Shandong Province, China
| | - Xin Zhang
- Department of Public Health and Management, Binzhou Medical University, Guanhai Road 346, Yantai 264003, Shandong Province, China
| | - Ning Li
- Department of Public Health and Management, Binzhou Medical University, Guanhai Road 346, Yantai 264003, Shandong Province, China
| | - Zhaoqiang Zhang
- Department of Public Health and Management, Binzhou Medical University, Guanhai Road 346, Yantai 264003, Shandong Province, China
- Department of Public Health, Jining Medical University, Jianshe South Road 45, Jining 272067, Shandong Province, China
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Roy P, Bardhan M, Roy S, Singh U, Suresh T, Anand A. Silico-tuberculosis amidst COVID-19 pandemic: global scenario and Indian perspective. Ann Med Surg (Lond) 2023; 85:6083-6090. [PMID: 38098595 PMCID: PMC10718399 DOI: 10.1097/ms9.0000000000001471] [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: 08/07/2023] [Accepted: 10/24/2023] [Indexed: 12/17/2023] Open
Abstract
Inhalation of crystalline silica-rich dust particles can result in the deadly occupational lung disorder called silicosis. The risk of contracting tuberculosis (TB) and the potential for lung cancer increase due to silicosis. This review article aims to bring to light the state of silicosis and TB scenario in the world and India for evaluating hurdles in the present and future to achieve the elimination road map and assess these conditions in the backdrop of the COVID-19 pandemic. A patient with silicosis has a 2.8-2.9 times higher risk of developing pulmonary TB and 3.7 times that of extrapulmonary TB. Incidences of missed cases when TB was misdiagnosed with silicosis due to indifferent clinical manifestations of the two in the initial stages are not uncommon. The duration of silica exposure and silicosis severity are directly related to the propensity to develop TB. As per a study, an average gap of 7.6 years has been noticed in a South African population for silico-tuberculosis to develop post-silicosis. In a study done on mine workers at Jodhpur, Rajasthan, it was seen that there is no definitive relation between patients with silicosis and the possibility of having COVID-19. There is a significant need to integrate the Silicosis control program with the TB elimination program for the government. A few steps can include assessing the workplaces, periodic monitoring of the workers' health, active case surveillance, identification of hotspots, and introducing reforms to curb the spread of dust and particulate matter from industrialised areas be taken in this regard.
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Affiliation(s)
- Priyanka Roy
- Deputy Chief Inspector of Factories/ Deputy Director (Medical) and Certifying Surgeon, Directorate of Factories, Department of Labour, Government of West Bengal, West Bengal
| | - Mainak Bardhan
- Miami Cancer Institute, Baptist Health South Florida, FL, USA
| | - Shubhajeet Roy
- Faculty of Medical Sciences, King George’s Medical University, Lucknow, India
| | - Utkarsh Singh
- Faculty of Medical Sciences, King George’s Medical University, Lucknow, India
| | - Timil Suresh
- Faculty of Medical Sciences, King George’s Medical University, Lucknow, India
| | - Ayush Anand
- BP Koirala Institute of Health Sciences, Dharan, Nepal
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Shichkin VP, Kurchenko OV, Okhotnikova EN, Chopyak VV, Delfino DV. Enterosorbents in complex therapy of food allergies: a focus on digestive disorders and systemic toxicity in children. Front Immunol 2023; 14:1210481. [PMID: 37901242 PMCID: PMC10611465 DOI: 10.3389/fimmu.2023.1210481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 10/03/2023] [Indexed: 10/31/2023] Open
Abstract
The review analyzes mechanisms and concomitant factors in developing IgE-associated allergic diseases provoked by food allergens and discusses clinical symptoms and current approaches for the treatment of food allergies. The expediency of using enterosorbents in complex therapy of food allergies and skin and respiratory manifestations associated with gastroenterological disorders is substantiated. The review summarizes the experience of using enterosorbents in post-Soviet countries to detoxify the human body. In this regard, special attention is paid to the enterosorbent White Coal (Carbowhite) based on silicon dioxide produced by the Ukrainian company OmniFarma.
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Affiliation(s)
| | | | - Elena N. Okhotnikova
- Department of Pediatrics, Children’s Infectious Diseases, Immunology and Allergology, Shupyk National Healthcare University of Ukraine, Kyiv, Ukraine
| | - Valentyna V. Chopyak
- Department of Clinical Immunology and Allergology, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
| | - Domenico V. Delfino
- Master in Musculoskeletal and Rheumatological Physiotherapy, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
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Howlett P, Mousa H, Said B, Mbuya A, Kon OM, Mpagama S, Feary J. Silicosis, tuberculosis and silica exposure among artisanal and small-scale miners: A systematic review and modelling paper. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002085. [PMID: 37733799 PMCID: PMC10513209 DOI: 10.1371/journal.pgph.0002085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 08/30/2023] [Indexed: 09/23/2023]
Abstract
An estimated 44 million artisanal and small-scale miners (ASM), largely based in developing economies, face significant occupational risks for respiratory diseases which have not been reviewed. We therefore aimed to review studies that describe silicosis and tuberculosis prevalence and respirable crystalline silica (RCS) exposures among ASM and use background evidence to better understand the relationship between exposures and disease outcomes. We searched PubMed, Web of Science, Scopus and Embase for studies published before the 24th March 2023. Our primary outcome of interest was silicosis or tuberculosis among ASM. Secondary outcomes included measurements of respirable dust or silica, spirometry and prevalence of respiratory symptoms. A systematic review and narrative synthesis was performed and risk of bias assessed using the Joanna Briggs Prevalence Critical Appraisal Tool. Logistic and Poisson regression models with predefined parameters were used to estimate silicosis prevalence and tuberculosis incidence at different distributions of cumulative silica exposure. We identified 18 eligible studies that included 29,562 miners from 13 distinct populations in 10 countries. Silicosis prevalence ranged from 11 to 37%, despite four of five studies reporting an average median duration of mining of <6 years. Tuberculosis prevalence was high; microbiologically confirmed disease ranged from 1.8 to 6.1% and clinical disease 3.0 to 17%. Average RCS intensity was very high (range 0.19-89.5 mg/m3) and respiratory symptoms were common. Our modelling demonstrated decreases in cumulative RCS are associated with reductions in silicosis and tuberculosis, with greater reductions at higher mean exposures. Despite potential selection and measurement bias, prevalence of silicosis and tuberculosis were high in the studies identified in this review. Our modelling demonstrated the greatest respiratory health benefits of reducing RCS are in those with highest exposures. ASM face a high occupational respiratory disease burden which can be reduced by low-cost and effective reductions in RCS.
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Affiliation(s)
- Patrick Howlett
- National Heart & Lung Institute, Imperial College London, London, United Kingdom
| | - Hader Mousa
- Centre for Occupational and Environmental Health, Kigali, Rwanda
| | - Bibie Said
- Kibong’oto Infectious Disease Hospital, Kilimanjaro, Tanzania
| | - Alexander Mbuya
- Kibong’oto Infectious Disease Hospital, Kilimanjaro, Tanzania
| | - Onn Min Kon
- National Heart & Lung Institute, Imperial College London, London, United Kingdom
| | - Stellah Mpagama
- Kibong’oto Infectious Disease Hospital, Kilimanjaro, Tanzania
| | - Johanna Feary
- National Heart & Lung Institute, Imperial College London, London, United Kingdom
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D’Sa L, Pezzuto F, Lunardi F, Scalvenzi F, Tinè M, Comacchio G, Giraudo C, Calabrese F. A Complex Case of Pulmonary Silico-Tuberculosis and Review of Literature. Diagnostics (Basel) 2023; 13:2728. [PMID: 37685266 PMCID: PMC10486577 DOI: 10.3390/diagnostics13172728] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/18/2023] [Accepted: 08/18/2023] [Indexed: 09/10/2023] Open
Abstract
Silicosis caused by the inhalation/deposition of free silica particles is characterized by pulmonary inflammation/fibrosis. Among the clinical disorders associated with silicosis, tuberculosis is by far the most prominent. A 66-year-old male non-smoker, originally from North Africa, reported a dry cough and significant weight loss. He was a foundry worker. He had a medical history of bladder carcinoma associated with schistosomiasis. Computed tomography (CT) and positron emission tomography (PET)/CT showed bilateral multiple hypermetabolic lung nodules, some with cavitation. The patient underwent surgical resection of the largest nodule, which was highly suspicious of lung metastasis. The histological examination revealed multiple nodular formations. Several lesions showed the characteristic features of silicotic nodules. There were also adjacent well-formed granulomas, some with central caseous necrosis. A real-time polymerase chain reaction, performed for the identification and quantification of the DNA of the Mycobacterium tuberculosis complex, was positive. Pulmonary silico-tuberculosis is often encountered in patients with a history of silica exposure in tuberculosis-endemic areas. This case serves as a reminder to never underestimate patient occupational exposure and geographic origin. A careful histological diagnosis and molecular investigation are mandatory when approaching difficult cases, especially patients with a prior cancer history and clinical/radiological features suggestive of tumour recurrence/metastasis.
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Affiliation(s)
- Lauren D’Sa
- Department of Histopathology, Addenbrooke’s Hospital, Cambridge CB20QQ, UK;
| | - Federica Pezzuto
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, 35128 Padova, Italy; (F.P.); (F.L.); (F.S.); (M.T.); (G.C.)
| | - Francesca Lunardi
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, 35128 Padova, Italy; (F.P.); (F.L.); (F.S.); (M.T.); (G.C.)
| | - Francesca Scalvenzi
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, 35128 Padova, Italy; (F.P.); (F.L.); (F.S.); (M.T.); (G.C.)
| | - Mariaenrica Tinè
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, 35128 Padova, Italy; (F.P.); (F.L.); (F.S.); (M.T.); (G.C.)
| | - Giovanni Comacchio
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, 35128 Padova, Italy; (F.P.); (F.L.); (F.S.); (M.T.); (G.C.)
| | - Chiara Giraudo
- Department of Medicine, University of Padova, 35128 Padova, Italy;
| | - Fiorella Calabrese
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, 35128 Padova, Italy; (F.P.); (F.L.); (F.S.); (M.T.); (G.C.)
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7
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Jamshidi P, Danaei B, Arbabi M, Mohammadzadeh B, Khelghati F, Akbari Aghababa A, Nayebzade A, Shahidi Bonjar AH, Centis R, Sotgiu G, Nasiri MJ, Migliori GB. Silicosis and tuberculosis: A systematic review and meta-analysis. Pulmonology 2023:S2531-0437(23)00092-2. [PMID: 37349198 DOI: 10.1016/j.pulmoe.2023.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 05/03/2023] [Accepted: 05/03/2023] [Indexed: 06/24/2023] Open
Abstract
INTRODUCTION Silicosis mostly happens in workers with high silica exposure and may accompany the development of various diseases like tuberculosis, cancer, or autoimmune diseases. The term silico-tuberculosis describes a condition in which an individual is affected by both silicosis and tuberculosis at the same time. This systematic review and meta-analysis study was conducted to evaluate the risk of tuberculosis in silicosis patients and individuals exposed to silica dust. METHODS We performed a systematic search for relevant studies up to 6 September 2022 using PubMed/ Medline, and Embase with the following keywords in titles or abstracts: "silicosis" OR "silicoses" OR "pneumoconiosis" OR "pneumoconioses" AND "tuberculosis". Cohort and case-control studies containing relevant and original information about tuberculosis infection in silicosis patients were included for further analysis. Pooled estimates and 95% confidence intervals (CI) for the relative risk of tuberculosis in individuals with silicosis compared to those without; these were evaluated using the random effects model due to the estimated heterogeneity of the true effect sizes. RESULTS Out of 5352 potentially relevant articles, 7 studies were eligible for systematic review, of which 4 cohort studies were included for meta-analysis. The total population of all studies was 5884, and 90.63% were male. The mean age of participants was 47.7 years. Our meta-analysis revealed a pooled risk ratio of 1.35 (95%CI 1.18-1.53, I 2: 94.30%) which means an increased risk of silicosis patients and silica-exposed individuals to tuberculosis infection. CONCLUSION Silicosis and silica dust exposure increase the risk of tuberculosis. Therefore, we suggest that individuals with long-time silica exposure, like mine workers, be routinely considered for both silicosis and tuberculosis screening programs.
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Affiliation(s)
- P Jamshidi
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Center of Public Health, Environmental and Occupational Hazards Control, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - B Danaei
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - M Arbabi
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - B Mohammadzadeh
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - F Khelghati
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - A Akbari Aghababa
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - A Nayebzade
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - A H Shahidi Bonjar
- Researcher at the National Institute for Medical Research Development (NIMAD), Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran; Clinician Scientist of Dental Materials and Restorative Dentistry, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - R Centis
- Servizio di Epidemiologia Clinica delle Malattie Respiratorie, Istituti Clinici Scientifici Maugeri IRCCS, Tradate, Italy
| | - G Sotgiu
- Clinical Epidemiology and Medical Statistics Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, Italy.
| | - M J Nasiri
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - G B Migliori
- Servizio di Epidemiologia Clinica delle Malattie Respiratorie, Istituti Clinici Scientifici Maugeri IRCCS, Tradate, Italy.
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Maboso B, Te Water Naude J, Rees D, Goodman H, Ehrlich R. Difficulties in distinguishing silicosis and pulmonary tuberculosis in silica-exposed gold miners: A report of four cases. Am J Ind Med 2023; 66:339-348. [PMID: 36714961 DOI: 10.1002/ajim.23460] [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: 10/10/2022] [Revised: 12/25/2022] [Accepted: 01/16/2023] [Indexed: 01/31/2023]
Abstract
Silicosis and tuberculosis (TB) are both global health concerns, with high prevalence among miners from the South African gold mines. Although knowledge has accumulated about these two conditions as distinct diseases since the early 20th century, and despite progress in technology with multiple diagnostic tools and treatment options available for TB, the challenge of distinguishing and therefore efficiently managing these two conditions in this population remains as current as it was 100 years ago. To illustrate the diagnostic and health service problems of distinguishing TB and silicosis clinically and radiologically in former gold miners from the South African mines living in resource-poor areas, we discuss four cases reviewed for this report by a panel of experts. For each case, occupational history, past and current medical history, physical examination, radiological and laboratory findings are described. Common themes are: (1) poor agreement between radiological and clinical presentation; (2) poor agreement between radiology findings and detection of active TB on sputum Xpert MTB/RIF testing; and (3) difficulty in distinguishing the clinical and radiological presentations of silicosis and tuberculosis. Possible consequences at the population level are undertreatment or overtreatment of TB, and underdiagnosis or overdiagnosis of silicosis. There is a need for training of practitioners who are screening or attending to former gold miners in the clinical and radiological features of combined disease, using a curated database of miners' chest X-ray images. Investment in protocols for management of both acute and chronic silicotuberculosis in ex-miners is needed, as is clinical, epidemiologic, and operations research.
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Affiliation(s)
- Botembetume Maboso
- Division of Occupational Medicine, School of Public Health and Family Medicine, University of Cape Town, Rondebosch, South Africa
| | | | - David Rees
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Rodney Ehrlich
- Division of Occupational Medicine, School of Public Health and Family Medicine, University of Cape Town, Rondebosch, South Africa
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Widajati N, Martiana T, Utami TN, Jalaludin J, Hamedon TR. Lung Function Analysis of Marble Home Industry Workers in Tulungagung Regency. PERTANIKA JOURNAL OF SCIENCE AND TECHNOLOGY 2023. [DOI: 10.47836/pjst.31.2.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
Abstract
This study analyzes the effect of dust exposure and worker characteristics on lung function. This type of research was observational with a cross-sectional design. The population was 20 marble home industry workers in Tulungagung. The total population technique determined the sample. Data analysis was carried out using Smart PLS software. The study results found that sociodemography, including age, nutritional status, and years of service, affected lung function with a t-statistic of 2.604. Dust exposure, which includes respirable dust content and duration of exposure, impacted lung function with a t-statistic of 2.522. Marble artisans in Tulungagung with the age of >35 years and a long working period of >5 years with a level of exposure to silica dust >3 mg/m3 and supported by a long working period of >7 hours had great potential for lung function. The recommendation was for home industry entrepreneurs to provide masks according to standards. The role of public health center officers was to monitor the work environment and regularly check home industry workers’ health.
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Mycobacterium tuberculosis Infection among 1,659 Silicosis Patients in Zhejiang Province, China. Microbiol Spectr 2022; 10:e0145122. [PMID: 36453892 PMCID: PMC9784764 DOI: 10.1128/spectrum.01451-22] [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] [Indexed: 12/05/2022] Open
Abstract
Silicosis is a well-established risk factor for Mycobacterium tuberculosis infection. This study aimed to estimate the burden and risk factors of M. tuberculosis infection. Silicosis patients from Zhejiang Province were screened for M. tuberculosis by sputum culture, chest radiographs, whole-blood gamma interferon (IFN-γ) release assay (QuantiFERON-TB Gold In-Tube [QFT-GIT]), and tuberculin skin test (TST). Potential risk factors for M. tuberculosis were identified. Data for 1,659 patients were obtained from 1,684 participants. Of these, 1,656 (99.8%) were men, and the average age was 58 (54 to 63) years. The prevalence of active tuberculosis (ATB) was 6,340/100,000 (6.34%) people; the proportion of patients with latent tuberculosis infection (LTBI) was 50.6%. Age (odds ratio [OR] = 1.059, 95% confidence interval [CI] = 1.020 to 1.099, P = 0.003), being underweight (OR = 2.320, 95% CI = 1.057 to 5.089, P = 0.036), and having a history of exposure to TB patients (OR = 4.329, 95% CI = 1.992 to 9.434, P < 0.001) were associated with ATB; BCG vaccination could reduce ATB risk in silicosis patients (OR = 0.541, 95% CI = 0.307 to 0.954, P = 0.034). Among patients without ATB, the QFT-GIT positivity rate was 40.5%, which was affected by silicosis severity, while that of TST was 57.2%. BCG vaccination was an independent factor for LTBI risk reduction (OR = 0.612, 95% CI = 0.468 to 0.801, P < 0.001). The quantitative results of QFT-GIT decreased with silicosis stage (H = 6.037; P = 0.048). In conclusion, M. tuberculosis prevalence was high in silicosis patients. BCG vaccination reduced the risk of both ATB and LTBI in silicosis patients. IMPORTANCE This study evaluated the prevalence of Mycobacterium tuberculosis infection in silicosis patients in mainland China and identified the potential risk factors for both active tuberculosis (ATB) and latent tuberculosis infection (LTBI). We believe that our study makes a significant contribution to the literature because we demonstrated that M. tuberculosis prevalence was high among silicosis patients. BCG vaccination was an independent factor that reduced the risk of M. tuberculosis infection in patients with silicosis. Furthermore, we show that the prevalence of LTBI in patients with silicosis may have been underestimated by immunological detection methods. This study can help to identify targeted subgroups prioritized for M. tuberculosis control and to reduce the risk of disease development.
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Ganesan N, Ronsmans S, Hoet P. Differential immunological effects of silica nanoparticles on peripheral blood mononuclear cells of silicosis patients and controls. Front Immunol 2022; 13:1025028. [PMID: 36311760 PMCID: PMC9606771 DOI: 10.3389/fimmu.2022.1025028] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 09/21/2022] [Indexed: 11/29/2022] Open
Abstract
Silicosis is a fibrotic disease caused by the inhalation of respirable silica particles, which are typically engulfed by alveolar macrophages and subsequently induce the release of inflammatory cytokines. Various animal experimental and human studies have focused on modeling silicosis, to assess the interactions of macrophages and other cell types with silica particles. There is still, however, limited knowledge on the differential response upon silica-exposure between silicosis patients and controls. We focused on studying the responsiveness of peripheral blood mononuclear cells (PBMCs) to silica nanoparticles (SiNPs) - Ludox and NM-200 - of silicosis patients and controls. The proliferative capacity of T- CD3+ and B- CD19+ cells, were evaluated via Carboxyfluorescein succinimidyl ester (CFSE) assay. The activation status of lymphocyte subsets and response to silica were also evaluated by comparing the extent of micro-granuloma or aggregate formation with the cytokine secretion profiles between both groups of individuals. The proliferative capacity of CD19+ cells was elevated in silicotic patients as opposed to controls. Subsets of regulatory T cells (CD4+ CD25+ and CD8+ CD25+) and immunoglobulins IgM and IgG were also significantly increased in patients. The number and the size of aggregates formed were higher with SiNPs stimulation in patients compared to controls. Multivariable analysis also elucidated the role of key cytokines like interleukin-1β (IL-1β), IL-6 and interferon-gamma (IFN-γ), which were upregulated in SiNP-stimulated PBMCs of patients compared to controls. Our ex vivo model thus has potential to provide insights into the immunological effects of silica particles in lymphocytes of silicosis patients and controls.
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Affiliation(s)
- Nirosha Ganesan
- Laboratory of Toxicology, Unit of Environment & Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
- Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), KU Leuven, Leuven, Belgium
| | - Steven Ronsmans
- Laboratory of Toxicology, Unit of Environment & Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
- Clinic for Occupational and Environmental Medicine, Department of Respiratory Diseases, University Hospitals Leuven, Leuven, Belgium
| | - Peter Hoet
- Laboratory of Toxicology, Unit of Environment & Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
- Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), KU Leuven, Leuven, Belgium
- *Correspondence: Peter Hoet,
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12
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Vanka KS, Shukla S, Gomez HM, James C, Palanisami T, Williams K, Chambers DC, Britton WJ, Ilic D, Hansbro PM, Horvat JC. Understanding the pathogenesis of occupational coal and silica dust-associated lung disease. Eur Respir Rev 2022; 31:31/165/210250. [PMID: 35831008 DOI: 10.1183/16000617.0250-2021] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 04/20/2022] [Indexed: 01/15/2023] Open
Abstract
Workers in the mining and construction industries are at increased risk of respiratory and other diseases as a result of being exposed to harmful levels of airborne particulate matter (PM) for extended periods of time. While clear links have been established between PM exposure and the development of occupational lung disease, the mechanisms are still poorly understood. A greater understanding of how exposures to different levels and types of PM encountered in mining and construction workplaces affect pathophysiological processes in the airways and lungs and result in different forms of occupational lung disease is urgently required. Such information is needed to inform safe exposure limits and monitoring guidelines for different types of PM and development of biomarkers for earlier disease diagnosis. Suspended particles with a 50% cut-off aerodynamic diameter of 10 µm and 2.5 µm are considered biologically active owing to their ability to bypass the upper respiratory tract's defences and penetrate deep into the lung parenchyma, where they induce potentially irreversible damage, impair lung function and reduce the quality of life. Here we review the current understanding of occupational respiratory diseases, including coal worker pneumoconiosis and silicosis, and how PM exposure may affect pathophysiological responses in the airways and lungs. We also highlight the use of experimental models for better understanding these mechanisms of pathogenesis. We outline the urgency for revised dust control strategies, and the need for evidence-based identification of safe level exposures using clinical and experimental studies to better protect workers' health.
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Affiliation(s)
- Kanth Swaroop Vanka
- School of Biomedical Sciences and Pharmacy, The University of Newcastle/Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, The University of Newcastle, Newcastle, NSW, Australia.,Division of Pulmonary, Allergy, and Critical Care Medicine, Dept of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Lung Biology Institute, University of Pennsylvania, Philadelphia, PA, USA
| | - Shakti Shukla
- Discipline of Pharmacy, Graduate School of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Henry M Gomez
- School of Biomedical Sciences and Pharmacy, The University of Newcastle/Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, The University of Newcastle, Newcastle, NSW, Australia
| | - Carole James
- School of Health Sciences, The University of Newcastle, Newcastle, NSW, Australia
| | - Thava Palanisami
- Global Innovative Centre for Advanced Nanomaterials, College of Engineering, Science and Environment (CERSE), The University of Newcastle, Newcastle, NSW, Australia
| | - Kenneth Williams
- Newcastle Institute for Energy and Resources (NIER), School of Engineering, The University of Newcastle, Newcastle, NSW, Australia
| | - Daniel C Chambers
- School of Clinical Medicine, The University of Queensland, Brisbane, QLD, Australia.,Queensland Lung Transplant Program, The Prince Charles Hospital, Brisbane, QLD, Australia
| | - Warwick J Britton
- Centenary Institute, The University of Sydney, Sydney, NSW, Australia.,Dept of Clinical Immunology, Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | - Dusan Ilic
- Newcastle Institute for Energy and Resources (NIER), School of Engineering, The University of Newcastle, Newcastle, NSW, Australia
| | - Philip Michael Hansbro
- School of Biomedical Sciences and Pharmacy, The University of Newcastle/Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, The University of Newcastle, Newcastle, NSW, Australia.,Centre for Inflammation, Centenary Institute, Sydney, NSW, Australia.,School of Life Sciences, Faculty of Science, University of Technology Sydney, Sydney, NSW, Australia.,P.M. Hansbro and J.C. Horvat have equally contributed as senior authors
| | - Jay Christopher Horvat
- School of Biomedical Sciences and Pharmacy, The University of Newcastle/Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, The University of Newcastle, Newcastle, NSW, Australia .,P.M. Hansbro and J.C. Horvat have equally contributed as senior authors
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13
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Huaux F. Interpreting Immunoregulation in Lung Fibrosis: A New Branch of the Immune Model. Front Immunol 2021; 12:690375. [PMID: 34489937 PMCID: PMC8417606 DOI: 10.3389/fimmu.2021.690375] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 07/06/2021] [Indexed: 12/24/2022] Open
Abstract
Immunostimulation is recognized as an important contribution in lung fibrosis in some animal models and patient subsets. With this review, we illustrate an additional scenario covering the possible implication of immunoregulation during fibrogenesis. Available animal and human data indicate that pulmonary fibrosis also includes diverse and discrete immunoregulating populations comprising regulatory lymphocytes (T and B regs) and myeloid cells (immunosuppressive macrophages and myeloid-derived suppressive cells; MDSC). They are initially recruited to limit the establishment of deleterious inflammation but participate in the development of lung fibrosis by producing immunoregulatory mediators (mainly TGF-β1 and IL-10) that directly or indirectly stimulate fibroblasts and matrix protein deposition. The existence of this silent immunoregulatory environment sustains an alternative mechanism of fibrosis that explains why in some conditions neither pro-inflammatory cytokine deficiency nor steroid and immunosuppressive therapies limit lung fibrosis. Therefore, the persistent presence of immunoregulation is an important parameter to consider for refining therapeutical strategies in lung fibrotic disorders under non-immunostimulatory conditions.
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Affiliation(s)
- François Huaux
- Louvain Centre for Toxicology and Applied Pharmacology (LTAP), Institut de Recherche Experimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium
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14
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Ehrlich R, Akugizibwe P, Siegfried N, Rees D. The association between silica exposure, silicosis and tuberculosis: a systematic review and meta-analysis. BMC Public Health 2021; 21:953. [PMID: 34016067 PMCID: PMC8136154 DOI: 10.1186/s12889-021-10711-1] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 03/25/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND While the association between occupational inhalation of silica dust and pulmonary tuberculosis has been known for over a century, there has never been a published systematic review, particularly of experience in the current era of less severe silicosis and treatable tuberculosis. We undertook a systematic review of the evidence for the association between (1) silicosis and pulmonary tuberculosis, and (2) silica exposure and pulmonary tuberculosis controlling for silicosis, and their respective exposure-response gradients. METHODS We searched PUBMED and EMBASE, and selected studies according to a priori inclusion criteria. We extracted, summarised and pooled the results of published case-control and cohort studies of silica exposure and/or silicosis and incident active tuberculosis. Study quality was assessed on the Newcastle-Ottawa Scale. Where meta-analysis was possible, effect estimates were pooled using inverse-variance weighted random-effects models. Otherwise narrative and graphic synthesis was undertaken. Confidence regarding overall effect estimates was assessed using the GRADE schema. RESULTS Nine studies met the inclusion criteria. Meta-analysis of eight studies of silicosis and tuberculosis yielded a pooled relative risk of 4.01 (95% confidence interval (CI) 2.88, 5.58). Exposure-response gradients were strong with a low silicosis severity threshold for increased risk. Our GRADE assessment was high confidence in a strong association. Meta-analysis of five studies of silica exposure controlling for or excluding silicosis yielded a pooled relative risk of 1.92 (95% CI 1.36, 2.73). Exposure-response gradients were observable in individual studies but not finely stratified enough to infer an exposure threshold. Our GRADE assessment was low confidence in the estimated effect owing to inconsistency and use of proxies for silica exposure. CONCLUSIONS The evidence is robust for a strongly elevated risk of tuberculosis with radiological silicosis, with a low disease severity threshold. The effect estimate is more uncertain for silica exposure without radiological silicosis. Research is needed, particularly cohort studies measuring silica exposure in different settings, to characterise the effect more accurately as well as the silica exposure threshold that could be used to prevent excess tuberculosis risk.
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Affiliation(s)
- Rodney Ehrlich
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Paula Akugizibwe
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Nandi Siegfried
- Independent Clinical Epidemiologist, Cape Town, South Africa
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - David Rees
- National Institute for Occupational Health, Johannesburg, South Africa
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
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15
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Mycobactericidal Effects of Different Regimens Measured by Molecular Bacterial Load Assay among People Treated for Multidrug-Resistant Tuberculosis in Tanzania. J Clin Microbiol 2021; 59:JCM.02927-20. [PMID: 33536294 PMCID: PMC8092737 DOI: 10.1128/jcm.02927-20] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 01/28/2021] [Indexed: 12/17/2022] Open
Abstract
Rifampin or multidrug-resistant tuberculosis (RR/MDR-TB) treatment has largely transitioned to regimens free of the injectable aminoglycoside component, despite the drug class’ purported bactericidal activity early in treatment. We tested whether Mycobacterium tuberculosis Rifampin or multidrug-resistant tuberculosis (RR/MDR-TB) treatment has largely transitioned to regimens free of the injectable aminoglycoside component, despite the drug class’ purported bactericidal activity early in treatment. We tested whether Mycobacterium tuberculosis killing rates measured by tuberculosis molecular bacterial load assay (TB-MBLA) in sputa correlate with composition of the RR/MDR-TB regimen. Serial sputa were collected from patients with RR/MDR- and drug-sensitive TB at days 0, 3, 7, and 14, and then monthly for 4 months of anti-TB treatment. TB-MBLA was used to quantify viable M. tuberculosis 16S rRNA in sputum for estimation of colony forming units per ml (eCFU/ml). M. tuberculosis killing rates were compared among regimens using nonlinear-mixed-effects modeling of repeated measures. Thirty-seven patients produced 296 serial sputa and received treatment as follows: 13 patients received an injectable bedaquiline-free reference regimen, 9 received an injectable bedaquiline-containing regimen, 8 received an all-oral bedaquiline-based regimen, and 7 patients were treated for drug-sensitive TB with conventional rifampin/isoniazid/pyrazinamide/ethambutol (RHZE). Compared to the adjusted M. tuberculosis killing of −0.17 (95% confidence interval [CI] −0.23 to −0.12) for the injectable bedaquiline-free reference regimen, the killing rates were −0.62 (95% CI −1.05 to −0.20) log10 eCFU/ml for the injectable bedaquiline-containing regimen (P = 0.019), −0.35 (95% CI −0.65 to −0.13) log10 eCFU/ml for the all-oral bedaquiline-based regimen (P = 0.054), and −0.29 (95% CI −0.78 to +0.22) log10 eCFU/ml for the RHZE regimen (P = 0.332). Thus, M. tuberculosis killing rates from sputa were higher among patients who received bedaquiline but were further improved with the addition of an injectable aminoglycoside.
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16
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Abstract
PURPOSE OF REVIEW Mineworkers in South Africa experience a triple burden of disease due to their distinct work experience. Silicosis increases their risk of tuberculosis (TB), exacerbated by the HIV epidemic. Work-related factors are likely to increase transmission, severity, and post infection sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Understanding these relationships is important to control the impact of the epidemic. RECENT FINDINGS SARS-CoV-2 infection rates among mineworkers exceed the population rates in the provinces in which those mines are located. Migrant work, living in crowded hostels, working in narrow poorly ventilated shafts mainly underground constitute important factors that increase transmission risk. Mineworkers continue to experience high levels of silica exposure. The prevalences of silicosis, HIV and pulmonary TB, remain high. Interstitial lung disease, pulmonary TB, and HIV have all been associated with poorer outcomes of SARS-CoV-2 infections. Mineworkers with post infection respiratory sequelae are likely to lose their jobs or lose income, due to the physically demanding nature of underground minework. SUMMARY Further research into the unique work-related risk factors in mining that influence the COVID-19 epidemic is crucial for optimizing current interventions. Reducing SARS-CoV-2 infection transmission, health monitoring of infected and vulnerable workers, and following up of postinfection outcomes is essential to protect the respiratory health of miners.
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Affiliation(s)
- Rajen N. Naidoo
- Discipline of Occupational and Environmental Health, College of Health Sciences, University of KwaZulu-Natal, Durban
| | - Mohamed F. Jeebhay
- Occupational Medicine Division and Centre for Environmental & Occupational Health Research (CEOHR), University of Cape Town, Cape Town, South Africa
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17
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Ehrlich R. Commentary: Silica-A Multisystem Hazard. Int J Epidemiol 2021; 50:1226-1228. [PMID: 33570131 DOI: 10.1093/ije/dyab020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 01/29/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Rodney Ehrlich
- Division of Occupational Medicine, School of Public Health and Family Medicine, University of Cape Town, Anzio Rd, Cape Town, South Africa 7925
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18
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Abstract
Silicosis continues to be a serious health issue in many countries and its elimination by 2030 (a target set by WHO and the International Labour Organization in 1995) is virtually impossible. The risk to develop pulmonary tuberculosis for silicosis patients is higher than for non-silicosis people, and there is also an increased risk of both pulmonary and extrapulmonary tuberculosis in individuals exposed to silica. HIV coinfection adds further to the risk, and in some countries, such as South Africa, miners living with HIV are a considerable number. The diagnosis of active tuberculosis superimposed on silicosis is often problematic, especially in initial phases, and chest X-ray and smear examination are particularly important for the diagnosis of pulmonary tuberculosis. Treatment is difficult; directly observed therapy is recommended, a duration of at least eight months is probably needed, drug reactions are frequent and the risk of relapse higher than in non-silicosis patients. TB prevention in silicosis patients is essential and include active surveillance of the workers, periodic chest X-rays, tuberculin skin test or interferon-gamma releasing assay testing, and, importantly, adoption of measures to reduce the exposure to silica dust. Chemoprophylaxis is possible with different regimens and needs to be expanded around the world, but efficacy is unfortunately limited. Silico-tuberculosis is still a challenging health problem in many countries and deserves attention worldwide.
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Affiliation(s)
- Massimiliano Lanzafame
- Diagnosis and Treatment of HIV Infection Unit, "G.B. Rossi University Hospital", Verona, Italy
| | - Sandro Vento
- Faculty of Medicine, University of Puthisastra, Phnom Penh, Cambodia
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19
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Plasma membrane damage causes NLRP3 activation and pyroptosis during Mycobacterium tuberculosis infection. Nat Commun 2020; 11:2270. [PMID: 32385301 PMCID: PMC7210277 DOI: 10.1038/s41467-020-16143-6] [Citation(s) in RCA: 147] [Impact Index Per Article: 36.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Accepted: 04/14/2020] [Indexed: 12/11/2022] Open
Abstract
Mycobacterium tuberculosis is a global health problem in part as a result of extensive cytotoxicity caused by the infection. Here, we show how M. tuberculosis causes caspase-1/NLRP3/gasdermin D-mediated pyroptosis of human monocytes and macrophages. A type VII secretion system (ESX-1) mediated, contact-induced plasma membrane damage response occurs during phagocytosis of bacteria. Alternatively, this can occur from the cytosolic side of the plasma membrane after phagosomal rupture in infected macrophages. This damage causes K+ efflux and activation of NLRP3-dependent IL-1β release and pyroptosis, facilitating the spread of bacteria to neighbouring cells. A dynamic interplay of pyroptosis with ESCRT-mediated plasma membrane repair also occurs. This dual plasma membrane damage seems to be a common mechanism for NLRP3 activators that function through lysosomal damage. Inflammasome activation is a response to bacterial infection but can cause damage and spread infection. Here, the authors use live single-cell imaging to show two mechanisms by which M. tuberculosis causes damage to human macrophage cell plasma membranes, resulting in activation of the NLRP3 inflammasome, pyroptosis and release of infectious particles.
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20
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Mezouar S, Diarra I, Roudier J, Desnues B, Mege JL. Tumor Necrosis Factor-Alpha Antagonist Interferes With the Formation of Granulomatous Multinucleated Giant Cells: New Insights Into Mycobacterium tuberculosis Infection. Front Immunol 2019; 10:1947. [PMID: 31475008 PMCID: PMC6702871 DOI: 10.3389/fimmu.2019.01947] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 08/01/2019] [Indexed: 12/21/2022] Open
Abstract
More than half of tuberculosis cases in the world are due to resuscitation of dormant Mycobacterium tuberculosis (Mtb) sequestered into cell-derived structures called granulomas. It is fairly admitted that cytokines and more particularly Tumor Necrosis Factor (TNF)-α is critical in the control of Mtb infections and that anti-TNF-α drugs constitute one of the main risk factors for reactivation of latent Mtb infection. The aim of this study was to evaluate the role of etanercept, a dimeric fusion protein consisting of the extracellular ligand-binding portion of the human p75 TNF receptor linked to the Fc portion of human IgG1, in an in vitro model of human tuberculous granuloma. We showed that etanercept slightly delayed the formation of granuloma and reduced the generation of multinuclear giant cells (MGCs). In addition, etanercept exacerbated the expression of M1 polarization genes but also induced interleukin (IL)-10 release. In addition, our results indicated that etanercept inhibited cell fusion in an IL-10-dependent manner. Moreover, adalimumab, a human monoclonal anti-TNF-α IgG1 inhibited MGC formation in granuloma, without altering IL-10 secretion and induced macrophage apoptosis. Taken together, our data provides new insights into the role of TNF-α blockers in MGCs formation and the impact of such immunomodulatory drugs on tuberculous granuloma maturation.
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Affiliation(s)
- Soraya Mezouar
- Aix-Marseille Université, IRD, APHM, MEPHI, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
| | - Issa Diarra
- Aix-Marseille Université, IRD, APHM, MEPHI, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
| | - Jean Roudier
- Department of Rheumatology, Institut du Mouvement et de l'appareil Locomoteur, APHM, Marseille, France
| | - Benoit Desnues
- Aix-Marseille Université, IRD, APHM, MEPHI, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
| | - Jean-Louis Mege
- Aix-Marseille Université, IRD, APHM, MEPHI, Marseille, France.,IHU-Méditerranée Infection, Marseille, France.,APHM, IHU Méditerranée Infection, UF Immunologie, Marseille, France
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21
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Shrestha U, Naik C, Huen A, Marshall K, Arivarasan K, McDyer J. Disseminated blastomycosis in coalworkers' pneumoconiosis. Proc (Bayl Univ Med Cent) 2019; 32:619-621. [PMID: 31656442 DOI: 10.1080/08998280.2019.1635412] [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: 05/02/2019] [Revised: 06/14/2019] [Accepted: 06/20/2019] [Indexed: 10/26/2022] Open
Abstract
Blastomyces dermatitidis is a thermally dimorphic fungus that can cause pulmonary, extrapulmonary, or disseminated infections. Though it can infect both immune-competent and immunocompromised hosts, the disease can be severe in immunocompromised hosts. Exposure to silica dust is associated with silicosis, and this is associated with impaired immunity and an increased risk of mycobacterial and fungal infections. The fungal infections commonly associated with pneumoconiosis are pulmonary aspergillosis, histoplasmosis, coccidioidomycosis, and cryptococcosis. However, there is a dearth of data on the association of pneumoconiosis and blastomycosis. Clinical deterioration and new cavitary lesions in patients with pneumoconiosis should alert clinicians of new pulmonary infection. Traditional sputum sampling may lead to poor diagnostic yield, because the organism is frequently surrounded by a fibrotic wall. Aggressive diagnostic testing with lung or skin biopsies may be warranted. We present the first reported case of disseminated blastomycosis in a patient with coalworkers' pneumoconiosis.
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Affiliation(s)
- Utsav Shrestha
- Department of Internal Medicine, University of Pittsburgh Medical Center, McKeesport ProgramPittsburghPennsylvania
| | - Chetan Naik
- Department of Pulmonary, Allergy and Critical Care, University of Pittsburgh Medical CenterPittsburghPennsylvania.,Center for Advanced Heart and Lung Disease, Baylor University Medical CenterDallasTexas
| | - Arthur Huen
- Department of Dermatology, University of Pittsburgh Medical CenterPittsburghPennsylvania
| | - Keely Marshall
- Department of Dermatology, University of Pittsburgh Medical CenterPittsburghPennsylvania
| | | | - John McDyer
- Department of Pulmonary, Allergy and Critical Care, University of Pittsburgh Medical CenterPittsburghPennsylvania
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22
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Sterile Lung Inflammation Induced by Silica Exacerbates Mycobacterium tuberculosis Infection via STING-Dependent Type 2 Immunity. Cell Rep 2019; 27:2649-2664.e5. [DOI: 10.1016/j.celrep.2019.04.110] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 03/17/2019] [Accepted: 04/26/2019] [Indexed: 12/18/2022] Open
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