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Petruccioli E, Chiacchio T, Navarra A, Vanini V, Cuzzi G, Cimaglia C, Codecasa LR, Pinnetti C, Riccardi N, Palmieri F, Antinori A, Goletti D. Effect of HIV-infection on QuantiFERON-plus accuracy in patients with active tuberculosis and latent infection. J Infect 2020; 80:536-546. [PMID: 32097688 DOI: 10.1016/j.jinf.2020.02.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 01/31/2020] [Accepted: 02/17/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE HIV-infection increases the risk to progress to active-tuberculosis (TB). Detection of latent TB infection (LTBI) is needed to eventually propose preventive-therapy and reduce TB reservoir. QuantiFERON-TB Plus (QFT-Plus)-test identifies LTBI. Currently, only two studies on QFT-Plus accuracy in HIV-infected-population are available in high TB-endemic-countries. Therefore we aimed to evaluate the effect of HIV-infection on QFT-Plus accuracy to detect LTBI in a low TB-endemic-country. METHODS We enrolled 465 participants, among the 167 HIV-infected-persons: 32 with active-TB (HIV-TB), 45 remote-LTBI (HIV-LTBI) and 90 at low M. tuberculosis (Mtb)-infection risk. Among the 298 HIV-uninfected-persons: 170 with active-TB, 76 recent-LTBI, 34 remote-LTBI and 18 with low Mtb-infection risk. RESULTS QFT-Plus sensitivity was similar in TB regardless of HIV-status. CD4-count did not influence the distribution of IFN-γ values in HIV-TB and HIV-LTBI. Moreover HIV-LTBI and HIV-uninfected remote LTBI had a similar proportion of results in the uncertain range (IFNγ ≥0.2 ≤ 0.7 IU/ml) differently from those LTBI-persons reporting recent-exposure (p = 0.016). Cytometry results demonstrated that CD8-response was similar in HIV-infected- and -uninfected-persons whereas CD4-response was impaired in HIV-infected-persons (p = 0.011). CONCLUSIONS HIV-infection does not affect QFT-Plus response in active-TB, whereas the time of exposure influences the proportion of uncertain-results in LTBI.
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Affiliation(s)
- Elisa Petruccioli
- Translational Research Unit, Department of Epidemiology and Preclinical Research, "L. Spallanzani" National Institute for Infectious Diseases (INMI), IRCCS, Via Portuense 292, 00149 Rome, Italy
| | - Teresa Chiacchio
- Translational Research Unit, Department of Epidemiology and Preclinical Research, "L. Spallanzani" National Institute for Infectious Diseases (INMI), IRCCS, Via Portuense 292, 00149 Rome, Italy
| | - Assunta Navarra
- Department of Epidemiology and Preclinical Research, "L. Spallanzani" National Institute for Infectious Diseases (INMI) IRCCS, Italy
| | - Valentina Vanini
- Translational Research Unit, Department of Epidemiology and Preclinical Research, "L. Spallanzani" National Institute for Infectious Diseases (INMI), IRCCS, Via Portuense 292, 00149 Rome, Italy
| | - Gilda Cuzzi
- Translational Research Unit, Department of Epidemiology and Preclinical Research, "L. Spallanzani" National Institute for Infectious Diseases (INMI), IRCCS, Via Portuense 292, 00149 Rome, Italy
| | - Claudia Cimaglia
- Department of Epidemiology and Preclinical Research, "L. Spallanzani" National Institute for Infectious Diseases (INMI) IRCCS, Italy
| | - Luigi Ruffo Codecasa
- Regional TB Reference Centre, Istituto Villa Marelli, Ospedale Niguarda, Milan, Italy; StopTB Italia Onlus, Milan, Italy
| | - Carmela Pinnetti
- Department of Clinical and Clinical Research, "L. Spallanzani" National Institute for Infectious Diseases (INMI) IRCCS, Italy
| | - Niccolò Riccardi
- Infectious Diseases and Tropical Medicine Centre, IRCCS Sacro Cuore Don Calabria Hospital (Negrar, Verona, Italy), Italy; StopTB Italia Onlus, Milan, Italy
| | - Fabrizio Palmieri
- Department of Clinical and Clinical Research, "L. Spallanzani" National Institute for Infectious Diseases (INMI) IRCCS, Italy
| | - Andrea Antinori
- Department of Clinical and Clinical Research, "L. Spallanzani" National Institute for Infectious Diseases (INMI) IRCCS, Italy
| | - Delia Goletti
- Translational Research Unit, Department of Epidemiology and Preclinical Research, "L. Spallanzani" National Institute for Infectious Diseases (INMI), IRCCS, Via Portuense 292, 00149 Rome, Italy.
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Parida SK, Madansein R, Singh N, Padayatchi N, Master I, Naidu K, Zumla A, Maeurer M. Cellular therapy in tuberculosis. Int J Infect Dis 2015; 32:32-8. [PMID: 25809753 DOI: 10.1016/j.ijid.2015.01.016] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 01/16/2015] [Accepted: 01/16/2015] [Indexed: 01/04/2023] Open
Abstract
Cellular therapy now offer promise of potential adjunct therapeutic options for treatment of drug-resistant tuberculosis (TB). We review here the role of Mesenchymal stromal cells, (MSCs), as well as other immune effector cells in the therapy of infectious diseases with a focus on TB. MSCs represent a population of tissue-resident non-hematopoietic adult progenitor cells which home into injured tissues increase the proliferative potential of broncho-alveolar stem cells and restore lung epithelium. MSCs have been shown to be immune-modulatory and anti-inflammatory mediated via cell-cell contacts as well as soluble factors. We discuss the functional profile of MSCs and their potential use for adjunct cellular therapy of multi-drug resistant TB, with the aim of limiting tissue damage, and to convert unproductive inflammatory responses into effective anti-pathogen directed immune responses. Adjunct cellular therapy could potentially offer salvage therapy options for patients with drug-resistant TB, increase clinically relevant anti-M.tuberculosis directed immune responses and possibly shorten the duration of anti-TB therapy.
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WEN YF, JIANG C, CHENG XF, ZHANG ZP, Chen BF, ZHU Y. Predictive Power of ETRE Polymorphism and Katg463 Mutation to INH-Resistance of M.tuberculosis. Iran J Public Health 2015; 44:263-8. [PMID: 25905061 PMCID: PMC4401885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Accepted: 12/04/2014] [Indexed: 11/11/2022]
Abstract
BACKGROUND The MIRU-VNTR polymorphism and katG463 mutation are used to genotype the mycobacterium tuberculosis, but the correlation between them and INH-resistance were unknown. This study was aimed to explore whether ETRE polymorphism and katG463 mutation could predict the INH-resistance, and the relationship between ETRE polymorphism and katG463 mutation. METHODS The ETRE, katG463 mutation and drug resistance information of 109 M. tuberculosis strains were collected from online public database. We constructed the predictive diagnostic tool of ETRE polymorphism and katG463 mutation. Chi-square test was used to analyze the relationship between ETRE polymorphism, katG463 mutation and INH-resistance. ROC curve analysis and Z-test were used to evaluate the predictive ability of ETRE and katG463. The relationship between ETRE polymorphism and katG463 mutation was analyzed with Spearman correlation analysis. RESULTS The mutation rate of katG463 was 27.50%, and the h value of ETRE polymorphism was 0.67. KatG463 mutation was associated with INH resistance (OR=3.72). The INH drug resistance rate in VNTR≧5 group was 3.43 times higher than that in VNTR≦3 group (χ(2) =24.77, P<0.01), and there was no significant difference of INH resistance between the VNTR=4 group and VNTR≦3 group. The areas under the ROC curve of two loci prediction diagnostic tools were 0.64 and 0.70 respectively. The katG463 mutation was significantly related to the ETRE polymorphism (r=0.79, P<0.01). CONCLUSION Both katG463 mutation and the ETRE polymorphism can predict the INH-resistance of tuberculosis. The katG463 mutation was associated with ETRE VNTR polymorphism.
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Affiliation(s)
- Yu-feng WEN
- School of Public Health, Wan Nan Medical College, Wuhu, China,Corresponding Author:
| | - Chao JIANG
- School of Public Health, Wan Nan Medical College, Wuhu, China
| | - Xian-feng CHENG
- School of Public Health, Wan Nan Medical College, Wuhu, China
| | - Zhi-ping ZHANG
- Centre for Disease Prevention and Control of Anqing City, Anqing, China
| | - Bai-feng Chen
- School of Public Health, Wan Nan Medical College, Wuhu, China
| | - Yu ZHU
- School of Public Health, Wan Nan Medical College, Wuhu, China
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Biadglegne F, Tessema B, Rodloff AC, Sack U. Magnitude of gene mutations conferring drug resistance in mycobacterium tuberculosis isolates from lymph node aspirates in ethiopia. Int J Med Sci 2013; 10:1589-94. [PMID: 24046537 PMCID: PMC3775120 DOI: 10.7150/ijms.6806] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Accepted: 08/12/2013] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE Resistance to drugs is due to particular genomic mutations in the specific genes of Mycobacterium tuberculosis. Timely genetic characterization will allow identification of resistance mutations that will optimize an effective antibiotic treatment regimen. We determine the magnitude of gene mutations conferring resistance to isoniazid (INH), rifampicin (RMP) and ethambutol (EMB) among tuberculosis (TB) lymphadenitis patients. METHODS A cross sectional prospective study was conducted among 226 M.tuberculosis isolates from culture positive lymph node aspirates collected from TB lymphadenitis patients between April 2012 and May 2012. Detection of mutations conferring resistance to drugs was carried out using GenoType(®) MTBDRplus and GenoType® MTBDRsl assay. RESULTS Out of the 226 strains, mutations conferring resistance to INH, RMP, multidrug resistance tuberculosis (MDR-TB) and EMB were 8, 3, 2 and 2 isolates, respectively. There was no isolated strain that showed mutation in the inhA promoter region gene. All INH resistant strains had mutations in the katG gene at codon 315 with amino acid change of S315T1. Among rifampicin resistant strains, two isolates displayed mutations at codon 531 in the rpoB gene with amino acid change of S531L and one isolate was by omission of wild type probes at Q513L. According to mutations associated with ethambutol resistance, all of the isolates had mutations in the embB gene with aminoacid change of M306I. All isolates resistant to INH, RMP and MDR using BacT/AlerT 3D system were correctly identified by GenoType® MTBDRplus assay. CONCLUSION We observed mutations conferring resistance to INH at S315T1 of the katG gene, RMP at S531L and Q513L in the rpoB genes and EMB at M306I of the embB gene. In the absence of conventional drug susceptibility testing, the effort to develop easy, rapid and cost effective molecular assays for drug resistance TB monitoring is definitely desirable and the GenoType® MTBDRplus assay was found to be a useful method for diagnosis of resistance to INH, RMP and MDR from lymph node aspirates. Further molecular cluster analysis to determine transmission dynamics of mutated strain is required.
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Affiliation(s)
- Fantahun Biadglegne
- 1. College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia; ; 2. Institute of Medical Microbiology and Epidemiology of Infectious Diseases, University Hospital, University of Leipzig, Leipzig, Germany; ; 3. Institute of Clinical Immunology, University Hospital, University of Leipzig, Leipzig, Germany; ; 5. Translational Centre for Regenerative Medicine (TRM)-Leipzig, University Hospital, University of Leipzig, Leipzig, Germany
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Tiwari A, Gupta S, Srivastava S, Srivastava R, Rawat AK. A ClpP protein model as tuberculosis target for screening marine compounds. Bioinformation 2010; 4:405-8. [PMID: 20975890 PMCID: PMC2951636 DOI: 10.6026/97320630004405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2009] [Accepted: 11/13/2009] [Indexed: 12/04/2022] Open
Abstract
ATP-dependent Clp protease (ClpP) is a core unit of a major bacterial protease complex employing as a new attractive drug target for that isolates, which are resistant to antibiotics. Mycobacterium tuberculosis, a gram-positive bacterium, is one of the major causes of hospital acquired infections. ClpP in Mycobacterium tuberculosis is usually tightly regulated and strictly requires a member of the family of Clp-ATPase and often further accessory proteins for proteolytic activation. Inhibition of ClpP eliminates these safeguards and start proteolytic degradation. Such uncontrolled proteolysis leads to inhibition of bacterial cell division and eventually cell death. In order to inhibit Clp protease, at first three dimensional structure model of ClpP in Mycobacterium tuberculosis was determined by comparative homology modeling program MODELLER based on crystal structure of the proteolytic component of the caseinolytic Clp protease (ClpP) from E. coli as a template protein and has 55%sequence identity with ClpP protein. The computed model's energy was minimized and validated using PROCHECK to obtain a stable model structure and is submitted in Protein Model Database (PMDB-ID: PM0075741). Stable model was further used for virtual screening against marine derived bioactive compound database through molecular docking studies using AutoDock 3.05. The docked complexes were validated and enumerated based on the AutoDock Scoring function to pick out the best marine inhibitors based on docked Energy. Thus from the entire 186 Marine compounds which were Docked, we got best 5 of them with optimal docked Energy (Ara-A: -14.31 kcal/mol, Dysinosin C: - 14.90kcal/mol, Nagelamide A: -20.49 kcal/mol, Strobilin: -8.02 kcal/mol, Manoalide: -8.81 kcal/mol). Further the five best-docked complexes were analyzed through Python Molecular Viewer software for their interaction studies. Thus from the Complex scoring and binding ability its deciphered that these Marine compounds could be promising inhibitors for ClpP as Drug target yet pharmacological studies have to confirm it.
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Affiliation(s)
- Abhilasha Tiwari
- Biotechnology and Bioinformatics Division, BIOBRAINZ, 566/29 J, Jai Prakash Nagar, Alambagh, Lucknow 226005, U.P., India
| | - Smita Gupta
- Biotechnology and Bioinformatics Division, BIOBRAINZ, 566/29 J, Jai Prakash Nagar, Alambagh, Lucknow 226005, U.P., India
| | - Shipra Srivastava
- Biotechnology and Bioinformatics Division, BIOBRAINZ, 566/29 J, Jai Prakash Nagar, Alambagh, Lucknow 226005, U.P., India
| | - Rajeev Srivastava
- Biotechnology and Bioinformatics Division, BIOBRAINZ, 566/29 J, Jai Prakash Nagar, Alambagh, Lucknow 226005, U.P., India
| | - Anil Kumar Rawat
- Biotechnology and Bioinformatics Division, BIOBRAINZ, 566/29 J, Jai Prakash Nagar, Alambagh, Lucknow 226005, U.P., India
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