1
|
Mawa PA, Webb EL, Filali-Mouhim A, Nkurunungi G, Sekaly RP, Lule SA, Prentice S, Nash S, Dockrell HM, Elliott AM, Cose S. Maternal BCG scar is associated with increased infant proinflammatory immune responses. Vaccine 2016; 35:273-282. [PMID: 27914741 PMCID: PMC5357573 DOI: 10.1016/j.vaccine.2016.11.079] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 10/19/2016] [Accepted: 11/21/2016] [Indexed: 11/26/2022]
Abstract
Introduction Prenatal exposures such as infections and immunisation may influence infant responses. We had an opportunity to undertake an analysis of innate responses in infants within the context of a study investigating the effects of maternal mycobacterial exposures and infection on BCG vaccine-induced responses in Ugandan infants. Material and methods Maternal and cord blood samples from 29 mother-infant pairs were stimulated with innate stimuli for 24 h and cytokines and chemokines in supernatants were measured using the Luminex® assay. The associations between maternal latent Mycobacterium tuberculosis infection (LTBI), maternal BCG scar (adjusted for each other’s effect) and infant responses were examined using linear regression. Principal Component Analysis (PCA) was used to assess patterns of cytokine and chemokine responses. Gene expression profiles for pathways associated with maternal LTBI and with maternal BCG scar were examined using samples collected at one (n = 42) and six (n = 51) weeks after BCG immunisation using microarray. Results Maternal LTBI was positively associated with infant IP-10 responses with an adjusted geometric mean ratio (aGMR) [95% confidence interval (CI)] of 5.10 [1.21, 21.48]. Maternal BCG scar showed strong and consistent associations with IFN-γ (aGMR 2.69 [1.15, 6.17]), IL-12p70 (1.95 [1.10, 3.55]), IL-10 (1.82 [1.07, 3.09]), VEGF (3.55 [1.07, 11.48]) and IP-10 (6.76 [1.17, 38.02]). Further assessment of the associations using PCA showed no differences for maternal LTBI, but maternal BCG scar was associated with higher scores for principal component (PC) 1 (median level of scores: 1.44 in scar-positive versus −0.94 in scar-negative, p = 0.020) in the infants. PC1 represented a controlled proinflammatory response. Interferon and inflammation response pathways were up-regulated in infants of mothers with LTBI at six weeks, and in infants of mothers with a BCG scar at one and six weeks after BCG immunisation. Conclusions Maternal BCG scar had a stronger association with infant responses than maternal LTBI, with an increased proinflammatory immune profile.
Collapse
Affiliation(s)
- Patrice Akusa Mawa
- MRC/UVRI Uganda Research Unit on AIDS, P.O. Box 49, Entebbe, Uganda; London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK.
| | - Emily L Webb
- London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Abdelali Filali-Mouhim
- Case Western Reserve University School of Medicine, 10900 Euclid Ave., LC4960, Wood Bldg. W200, Cleveland, OH 44106, United States
| | | | - Rafick-Pierre Sekaly
- Case Western Reserve University School of Medicine, 10900 Euclid Ave., LC4960, Wood Bldg. W200, Cleveland, OH 44106, United States
| | | | - Sarah Prentice
- London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Stephen Nash
- London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Hazel M Dockrell
- London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Alison M Elliott
- MRC/UVRI Uganda Research Unit on AIDS, P.O. Box 49, Entebbe, Uganda; London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Stephen Cose
- MRC/UVRI Uganda Research Unit on AIDS, P.O. Box 49, Entebbe, Uganda; London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| |
Collapse
|
2
|
Abstract
Parasitic helminths have co-evolved with the mammalian immune system. Current hypotheses suggest that immunological stimulation in the presence of helminths is balanced by immuno-regulation and by the broad spectrum of mechanisms possessed by helminths for countering the host immune response. The degree to which this balance is perfected, and the mechanisms by which this is achieved, vary between helminth species; we suggest that this is reflected not only in the degree of pathology induced by helminths but also in a variety of relationships with HIV infection and HIV disease. Available epidemiological data regarding interactions between helminths and HIV are largely observational; results are variable and generally inconclusive. Well designed, controlled intervention studies are required to provide definitive information on the species-specific nature of these interactions and on the advantages, disadvantages and optimal timing of de-worming in relation to HIV infection.
Collapse
Affiliation(s)
- M Brown
- London School of Hygiene & Tropical Medicine, London, UK
| | | | | | | |
Collapse
|
3
|
Mawa PA, Pickering JM, Miiro G, Namujju PB, Watera C, Anyaegani G, Whitworth JAG, Elliott AM. The effect of tuberculin skin testing on viral load and anti-mycobacterial immune responses in HIV-1-infected Ugandan adults. Int J Tuberc Lung Dis 2004; 8:586-92. [PMID: 15137535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023] Open
Abstract
OBJECTIVE To determine whether tuberculin skin testing (TST) is associated with an increase in human immunodeficiency virus (HIV) viral load, and to examine the effect of TST on anti-mycobacterial immune responses. DESIGN A nested cohort study of HIV-1-infected adults. METHOD Forty-two participants (21 TST-positive and 21 TST-negative) from a larger cohort were recruited to the study. Blood was collected for CD4+ T-cell count, whole blood was cultured, and plasma saved for viral load. These measurements were taken before, 3 days after, 3 months after, and 3 months plus 3 days after TST. Cytokine responses to culture filtrate proteins (CFP) of Mycobacterium tuberculosis and phytohaemagglutinin (PHA) were examined in the whole blood assay. RESULTS Twenty-nine participants attended all four visits. No statistically significant change in viral load, CD4+ T-cell count, or cytokine response to PHA was observed at any visit. However, TST was associated with a transient increase in the interferon-gamma response to CFP and a lasting increase in the interleukin-5 response to CFP. CONCLUSION There appeared to be a systemic effect of TST on the anti-tuberculosis immune response.
Collapse
Affiliation(s)
- P A Mawa
- MRC Programme on AIDS in Uganda, Uganda Virus Research Institute, Entebbe, Uganda.
| | | | | | | | | | | | | | | |
Collapse
|