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1.
Front Immunol ; 14: 1093640, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36814914

RESUMEN

Introduction: Chitinase, Indoleamine 2,3-dioxygenesae-1 (IDO-1) and heme oxygenase-1 (HO-1) are candidate diagnostic biomarkers for tuberculosis (TB). Whether these immune markers could also serve as predictive biomarkers of unfavorable treatment outcomes in pulmonary TB (PTB) is not known. Methods: A cohort of newly diagnosed, sputum culture-positive adults with drug-sensitive PTB were recruited. Plasma chitinase protein, IDO protein and HO-1 levels measured before treatment initiation were compared between 68 cases with unfavorable outcomes (treatment failure, death, or recurrence) and 108 control individuals who had recurrence-free cure. Results: Plasma chitinase and IDO protein levels but not HO-1 levels were lower in cases compared to controls. The low chitinase and IDO protein levels were associated with increased risk of unfavourable outcomes in unadjusted and adjusted analyses. Receiver operating characteristic analysis revealed that chitinase and IDO proteins exhibited high sensitivity and specificity in differentiating cases vs controls as well as in differentiating treatment failure vs controls and recurrence vs controls, respectively. Classification and regression trees (CART) were used to determine threshold values for these two immune markers. Discussion: Our study revealed a plasma chitinase and IDO protein signature that may be used as a tool for predicting adverse treatment outcomes in PTB.


Asunto(s)
Quitinasas , Tuberculosis Pulmonar , Adulto , Humanos , Pronóstico , Tuberculosis Pulmonar/diagnóstico , Resultado del Tratamiento , Biomarcadores , Indolamina-Pirrol 2,3,-Dioxigenasa , Triptófano Oxigenasa
2.
Clin Infect Dis ; 75(10): 1820-1826, 2022 11 14.
Artículo en Inglés | MEDLINE | ID: mdl-35352112

RESUMEN

BACKGROUND: Microbial translocation is a known characteristic of pulmonary tuberculosis (PTB). Whether microbial translocation is also a biomarker of recurrence in PTB is not known. METHODS: We examined the presence of microbial translocation in a cohort of newly diagnosed, sputum smear, and culture positive individuals with drug-sensitive PTB. Participants were followed up for a year following the end of anti-tuberculosis treatment. They were classified as cases (in the event of recurrence, n = 30) and compared to age and gender matched controls (in the event of successful, recurrence free cure; n = 51). Plasma samples were used to measure the circulating microbial translocation markers. All the enrolled study participants were treatment naïve, HIV negative and with or without diabetes mellitus. RESULTS: Baseline levels of lipopolysaccharide (LPS) (P = .0002), sCD14 (P = .0191), and LPS-binding protein (LBP) (P < .0001) were significantly higher in recurrence than controls and were associated with increased risk for recurrence, whereas intestinal fatty acid binding protein (I-FABP) and Endocab showed no association. Receiver operating characteristic (ROC) curve analysis demonstrated the utility of these individual microbial markers in discriminating recurrence from cure with high sensitivity, specificity, and area under the curve (AUC). CONCLUSIONS: Recurrence following microbiological cure in PTB is characterized by heightened baseline microbial translocation. These markers can be used as a rapid prognostic tool for predicting recurrence in PTB.


Asunto(s)
Tuberculosis Pulmonar , Tuberculosis , Humanos , Pronóstico , Tuberculosis Pulmonar/diagnóstico , Tuberculosis Pulmonar/microbiología , Esputo/microbiología , Biomarcadores
3.
Front Immunol ; 12: 731878, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34867953

RESUMEN

Systemic inflammation is a characteristic feature of pulmonary tuberculosis (PTB). Whether systemic inflammation is associated with treatment failure in PTB is not known. Participants, who were newly diagnosed, sputum smear and culture positive individuals with drug-sensitive PTB, were treated with standard anti-tuberculosis treatment and classified as having treatment failure or microbiological cure. The plasma levels of acute phase proteins were assessed at baseline (pre-treatment). Baseline levels of C-reactive protein (CRP), alpha-2 macroglobulin (a2M), Haptoglobin and serum amyloid P (SAP) were significantly higher in treatment failure compared to cured individuals. ROC curve analysis demonstrated the utility of these individual markers in discriminating treatment failure from cure. Finally, combined ROC analysis revealed high sensitivity and specificity of 3 marker signatures comprising of CRP, a2M and SAP in distinguishing treatment failure from cured individuals with a sensitivity of 100%, specificity of 100% and area under the curve of 1. Therefore, acute phase proteins are very accurate baseline predictors of PTB treatment failure. If validated in larger cohorts, these markers hold promise for a rapid prognostic testing for adverse treatment outcomes in PTB.


Asunto(s)
Proteínas de Fase Aguda/metabolismo , Tuberculosis Pulmonar/sangre , Tuberculosis Pulmonar/tratamiento farmacológico , Adulto , Antituberculosos/uso terapéutico , Biomarcadores/sangre , Proteína C-Reactiva/metabolismo , Estudios de Cohortes , Femenino , Haptoglobinas/metabolismo , Humanos , Masculino , Persona de Mediana Edad , alfa 2-Macroglobulinas Asociadas al Embarazo/metabolismo , Estudios Prospectivos , Curva ROC , Componente Amiloide P Sérico/metabolismo , Insuficiencia del Tratamiento , Tuberculosis Pulmonar/microbiología
4.
J Clin Tuberc Other Mycobact Dis ; 23: 100237, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-33997311

RESUMEN

OBJECTIVES: To study the association of Tissue inhibitors of matrix metalloproteinases (TIMP) levels with tuberculosis-diabetes comorbidity (TB-DM) comorbidity at baseline and in response to anti-TB treatment (ATT). METHODS: We examined the levels of TIMP-1, -2, -3 and -4 in pulmonary tuberculosis alone (TB) or TB-DM at baseline and after ATT. RESULTS: TIMP-1, -3 and -4 were significantly increased in TB-DM compared to TB at baseline and after ATT. ATT resulted in a significant reduction in TIMP-2 and -3 levels and a significant increase in TIMP-1 in both TB and TB-DM. TIMP-1, -3 and -4 were also significantly increased in TB-DM individuals with bilateral, cavitary disease and also exhibited a positive relationship with bacterial burden in TB-DM and HbA1c in all TB individuals. Within the TB-DM group, those known to be diabetic before incident TB (KDM) exhibited higher levels of TIMP-1, -2, -3 and -4 at baseline and TIMP-2 at post-treatment compared to those newly diagnosed with DM (NDM). KDM individuals on metformin treatment exhibited lower levels of TIMP-1, -2 and -4 at baseline and of TIMP-4 at post-treatment. CONCLUSIONS: TIMP levels were elevated in TB-DM, associated with disease severity and bacterial burden, correlated with HbA1c levels and modulated by duration of DM and metformin treatment.

5.
Clin Infect Dis ; 73(9): e3419-e3427, 2021 11 02.
Artículo en Inglés | MEDLINE | ID: mdl-32766812

RESUMEN

BACKGROUND: Plasma chemokines are biomarkers of greater disease severity, higher bacterial burden, and delayed sputum culture conversion in pulmonary tuberculosis (PTB). Whether plasma chemokines could also serve as biomarkers of unfavorable treatment outcomes in PTB is not known. METHODS: A cohort of newly diagnosed, sputum smear- and culture-positive adults with drug-sensitive PTB were recruited under the Effect of Diabetes on Tuberculosis Severity study in Chennai, India. Plasma chemokine levels measured before treatment initiation were compared between 68 cases with unfavorable outcomes (treatment failure, death, or recurrence) and 136 control individuals who had recurrence-free cure. A second validation cohort comprising newly diagnosed, culture-positive adults with drug-sensitive TB was used to measure plasma chemokine levels in 20 cases and 40 controls. RESULTS: Six chemokines (CCL2, CCL3, CCL4, CXCL8, CXCL10, and CX3CL1) were associated with increased risk, while CXCL1 was associated with decreased risk of unfavorable outcomes in unadjusted and adjusted analyses in the test cohort. Similarly, CCL3, CXCL8, and CXCL10 were associated with increased risk of unfavorable treatment outcomes in the validation cohort. Receiver operating characteristic analysis revealed that combinations of CCL3, CXCL8, and CXCL10 exhibited very high sensitivity and specificity in differentiating cases vs controls. CONCLUSIONS: Our study reveals a plasma chemokine signature that can be used as a novel biomarker for predicting adverse treatment outcomes in PTB.


Asunto(s)
Preparaciones Farmacéuticas , Tuberculosis Pulmonar , Adulto , Quimiocinas , Humanos , India/epidemiología , Esputo , Resultado del Tratamiento , Tuberculosis Pulmonar/diagnóstico , Tuberculosis Pulmonar/tratamiento farmacológico
6.
JAMA Netw Open ; 3(12): e2027754, 2020 12 01.
Artículo en Inglés | MEDLINE | ID: mdl-33258908

RESUMEN

Importance: Identifying biomarkers of treatment response is an urgent need in the treatment of tuberculosis (TB). Matrix metalloproteinases (MMPs) and tissue inhibitors of matrix metalloproteinases (TIMPs) are potential diagnostic biomarkers in pulmonary TB (PTB). Objective: To assess whether baseline plasma levels of MMPs and TIMPs are also prognostic biomarkers for adverse treatment outcomes in patients with PTB. Design, Setting, and Participants: Two different cohorts (test and validation) of individuals with PTB were recruited from 2 different sets of primary care centers in Chennai, India, and were followed up for treatment outcomes. Participants were individuals with newly diagnosed TB that was sputum smear and culture positive and drug sensitive. A total of 68 cases and 133 controls were in the test cohort and 20 cases and 40 controls were in the validation cohort. A nested case-control study was performed by matching case patients to control participants in a 1:2 ratio for age, sex, and body mass index. Data for the test cohort was taken from a study performed from 2014 to 2019, and data for the validation cohort, from a study performed from 2008 to 2012. The data analysis was performed from November 2019 to May 2020. Interventions: Individuals with PTB were treated with antituberculosis chemotherapy for 6 months and followed up for 1 year after completion of treatment. Main Outcomes and Measures: Individuals with PTB with adverse outcomes (treatment failure, all-cause mortality, or recurrent TB) were defined as cases and those with favorable outcomes (recurrence-free cure) were defined as controls. Plasma levels of MMPs and TIMPs were measured before treatment as potential biomarkers. Results: In all, 68 cases and 133 matched controls were enrolled in the study (170 [85%] males and 31 [15%] females; median age, 45 years [range, 23-73 years]) in the test cohort and 20 cases with 40 matched controls (51 [85%] males and 9 [15%] females; median age, 45 years [range, 19-61 years]) in the validation cohort. Baseline plasma levels of 5 MMPs and 2 TIMPs in the test cohort and 5 MMPs and all 4 TIMPS in the validation cohort were significantly higher in cases vs controls. In the test cohort, the geometric means (GMs), cases vs controls, were as follows: for MMP-1, 3680 vs 2484 pg/mL (P = .008); for MMP-2, 6523 vs 4762 pg/mL (P < .001); for MMP-7, 3346 vs 2100 pg/mL (P < .001); for MMP-8, 1915 vs 1066 pg/mL (P < .001); for MMP-9, 2774 vs 2336 pg/mL (P = .009); for TIMP-1, 4491 vs 2910 pg/mL (P < .001); and for TIMP-2, 3082 vs 2115 pg/mL (P < .001). In the validation cohort, the GMs, cases vs controls were as follows: for MMP-1, 3680 vs 2484 pg/mL (P < .001); for MMP-2, 6523 vs 4762 pg/mL (P < .001); for MMP-7, 3346 vs 2100 pg/mL (P < .001); for MMP-9, 1915 vs 1066 pg/mL (P < .001); for MMP-13, 2774 vs 2336 pg/mL (P < .001); for TIMP-1, 4491 vs 2910 pg/mL (P = .003); for TIMP-2, 3082 vs 2115 pg/mL (P = .003); for TIMP-3, 2066 vs 1020 pg/mL (P < .001); and for TIMP-4, 2130 vs 694 pg/mL (P < .001). Plasma levels of MMPs and TIMPs were associated with increased risk of adverse outcomes according to both univariate and multivariable analysis in the test cohort (eg, univariate analysis: odds ratio [OR] for MMP-8, 2.04; 95% CI, 1.33-3.14; P = .001; multivariable analysis: OR for MMP-8, 2.16; 95% CI, 1.34-3.47; P = .001). Combined receiver operating characteristic analysis revealed significant area under the curve (AUC), with high sensitivity and specificity in both cohorts (eg, for a combination of MMP-2, MMP-7, and TIMP-1 in the test cohort: sensitivity, 84%; specificity, 83%; and AUC, 0.886; for a combination of MMP-2, MMP-7, TIMP-1, and TIMP-2 in the validation cohort: sensitivity, 85%; specificity, 95%; and AUC, 0.944). Conclusions and Relevance: Baseline plasma MMP and TIMP levels may be correlates of risk and prognostic biomarkers for treatment failure, relapse, and death in individuals with PTB and merit further evaluation as predictive biomarkers for stratification of patients to shortened or intensified treatment regimens.


Asunto(s)
Antituberculosos/uso terapéutico , Metaloproteinasas de la Matriz/sangre , Inhibidores Tisulares de Metaloproteinasas/sangre , Tuberculosis Pulmonar/sangre , Tuberculosis Pulmonar/tratamiento farmacológico , Adulto , Anciano , Biomarcadores/sangre , Estudios de Casos y Controles , Femenino , Humanos , India , Masculino , Persona de Mediana Edad , Análisis Multivariante , Oportunidad Relativa , Valor Predictivo de las Pruebas , Pronóstico , Curva ROC , Recurrencia , Medición de Riesgo , Factores de Riesgo , Sensibilidad y Especificidad , Insuficiencia del Tratamiento , Tuberculosis Pulmonar/mortalidad , Adulto Joven
7.
BMC Infect Dis ; 20(1): 894, 2020 Nov 26.
Artículo en Inglés | MEDLINE | ID: mdl-33243148

RESUMEN

BACKGROUND: Tuberculosis (TB) though primarily affects the lungs it may also affect the other parts of the body and referred as extra pulmonary (EPTB). This study is focused on understanding the genetic diversity and molecular epidemiology of Mycobacterium tuberculosis (M.tb) among tuberculous lymphadenitis (TBL), a form of EPTB patients identified in Chennai, Tamil Nadu. METHODS: The genetic diversity was identified by performing spoligotyping on the M.tb clinical isolates that were recovered from lymph node samples. A total of 71 M.tb isolates were recovered from extra pulmonary lymph node samples and subjected to Drug susceptibility testing and spoligotyping was carried out. In addition, immunological characterization from blood of same individuals from whom M.tb was isolated was carried out between the two major lineages groups East African Indian 3 (EAI3) and non-EAI3 strains by ELISA. The results of spoligotyping patterns were compared with the world Spoligotyping Database of Institute Pasteur de Guadeloupe (SpolDB4). RESULTS: We found 41 spoligotype patterns and their associated lineages. Out of 41 spoligotype pattern, only 22 patterns are available in the spoldB4 database with Spoligotype international Type (SIT) number and remaining patterns were orphan strains without SIT number. The most predominant spoligotype lineage that was found in lymph node sample in this region of India was EAI (36), followed by central Asian strain (CAS) (6), T1 (5), Beijing (3), Latin American & Mediterranean (LAM) (2), U (1), X2 (1) and orphan (22). In addition to EAI, CAS and Beijing, our study identified the presence of orphan and unique spoligotyping patterns in Chennai region. We observed six drug resistant isolates. Out of six drug resistant isolates, four were resistant to isoniazid drug and associated with EAI family. Moreover, we observed increased levels of type 2 and type 17 cytokine profiles between EAI3 and non-EAI family, infected individuals. CONCLUSIONS: The study confirms that EAI lineage to be the most predominant lineages in EPTB patients with lymphadenitis and were found to have increased type 1 and type 17 proinflammatory cytokine profiles.


Asunto(s)
Resistencia a Medicamentos , Variación Genética , Mycobacterium tuberculosis/efectos de los fármacos , Mycobacterium tuberculosis/genética , Tuberculosis Ganglionar/inmunología , Tuberculosis Ganglionar/microbiología , Antibacterianos/farmacología , Genotipo , Humanos , India/epidemiología , Isoniazida/farmacología , Ganglios Linfáticos/microbiología , Pruebas de Sensibilidad Microbiana , Epidemiología Molecular , Mycobacterium tuberculosis/clasificación
8.
Cytokine ; 125: 154824, 2020 01.
Artículo en Inglés | MEDLINE | ID: mdl-31472402

RESUMEN

Tuberculosis - diabetes (TB-DM) co-morbidity is characterized by heterogeneity in clinical and biochemical parameters between newly diagnosed diabetic individuals with TB (TB-NDM) and known diabetic individuals at incident TB (TB-KDM). However, the immunological profile underlying this heterogeneity is not explored. To identify the cytokine profiles in TB-NDM and TB-KDM individuals, we examined the plasma cytokine levels as well as TB-antigen stimulated levels of pro-inflammatory cytokines. TB-KDM individuals exhibit significantly higher levels of IFNγ, IL-2, TNFα, IL-17A, IL-1α, IL-1ß and IL-6 in comparison to TB-NDM, TB alone and DM alone individuals. TB-NDM individuals are characterized by significantly lower levels of blood glucose and glycated hemoglobin in comparison to TB-KDM with both groups exhibiting a significant lowering of glycated hemoglobin levels at 6  months of anti-tuberculosis therapy (ATT). TB-NDM individuals are characterized by significantly diminished - unstimulated levels of IFNγ, IL-2, TNFα, IL-17A, IL-1α, IL-1ß and IL-12 at pre-treatment, of IFNγ, IL-2 and IL-1α at 2  months of ATT and IL-2 at post-treatment in comparison to TB-KDM. TB-NDM individuals are also characterized by significantly diminished TB-antigen stimulated levels of IFNγ, IL-2, TNFα, IL-17A, IL-17F, IL-1α, IL-1ß and/or IL-6 at pre-treatment and at 2  months of ATT and IFNγ, IL-2, IL-1α and IL-1ß at post-treatment. In addition, TB-NDM individuals are characterized by significantly diminished mitogen - stimulated levels of IL-17F and IL-6 at pre-treatment and IL-6 alone at 6 months of ATT. Therefore, our data reveal considerable heterogeneity in the immunological underpinnings of TB-DM co-morbidity. Our data also suggest that TB-NDM exhibits a characteristic profile, which is both biochemically and immunologically distinct from TB-KDM.


Asunto(s)
Citocinas/sangre , Diabetes Mellitus Tipo 2/sangre , Diabetes Mellitus Tipo 2/complicaciones , Tuberculosis/sangre , Tuberculosis/inmunología , Adulto , Anciano , Glucemia/metabolismo , Comorbilidad , Regulación hacia Abajo , Femenino , Hemoglobina Glucada/metabolismo , Humanos , Interferón gamma/sangre , Interleucina-17/sangre , Interleucina-1alfa/sangre , Interleucina-1beta/sangre , Interleucina-6/sangre , Masculino , Persona de Mediana Edad , Tuberculosis/complicaciones , Tuberculosis/terapia , Factor de Necrosis Tumoral alfa/sangre , Regulación hacia Arriba
9.
BMC Infect Dis ; 19(1): 1039, 2019 Dec 09.
Artículo en Inglés | MEDLINE | ID: mdl-31818258

RESUMEN

BACKGROUND: Ligands of the receptor for advanced glycation end products (RAGE) are key signalling molecules in the innate immune system but their role in tuberculosis-diabetes comorbidity (TB-DM) has not been investigated. METHODS: We examined the systemic levels of soluble RAGE (sRAGE), advanced glycation end products (AGE), S100A12 and high mobility group box 1 (HMGB1) in participants with either TB-DM, TB, DM or healthy controls (HC). RESULTS: Systemic levels of AGE, sRAGE and S100A12 were significantly elevated in TB-DM and DM in comparison to TB and HC. During follow up, AGE, sRAGE and S100A12 remained significantly elevated in TB-DM compared to TB at 2nd month and 6th month of anti-TB treatment (ATT). RAGE ligands were increased in TB-DM individuals with bilateral and cavitary disease. sRAGE and S100A12 correlated with glycated hemoglobin levels. Within the TB-DM group, those with known diabetes (KDM) revealed significantly increased levels of AGE and sRAGE compared to newly diagnosed DM (NDM). KDM participants on metformin treatment exhibited significantly diminished levels of AGE and sRAGE in comparison to those on non-metformin regimens. CONCLUSIONS: Our data demonstrate that RAGE ligand levels reflect disease severity and extent in TB-DM, distinguish KDM from NDM and are modulated by metformin therapy.


Asunto(s)
Antígenos de Neoplasias/sangre , Diabetes Mellitus/tratamiento farmacológico , Metformina/uso terapéutico , Proteínas Quinasas Activadas por Mitógenos/sangre , Proteína S100A12/sangre , Tuberculosis Pulmonar/sangre , Adulto , Anciano , Antituberculosos/uso terapéutico , Estudios de Casos y Controles , Comorbilidad , Diabetes Mellitus/sangre , Diabetes Mellitus/epidemiología , Femenino , Productos Finales de Glicación Avanzada/sangre , Proteína HMGB1/sangre , Humanos , Hipoglucemiantes/uso terapéutico , Masculino , Persona de Mediana Edad , Tuberculosis Pulmonar/tratamiento farmacológico , Tuberculosis Pulmonar/epidemiología , Regulación hacia Arriba
10.
Sci Rep ; 9(1): 18217, 2019 12 03.
Artículo en Inglés | MEDLINE | ID: mdl-31796883

RESUMEN

Plasma cytokines are biomarkers of disease extent and mycobacterial burden in pulmonary tuberculosis (PTB). Whether chemokines can perform the same role in PTB is not known. We examined the plasma levels of chemokines in individuals with PTB, latent TB (LTB) or healthy controls (HC) and their association with disease severity and mycobacterial burdens in PTB. We also examined the chemokines in PTB individuals at the end of anti-tuberculous chemotherapy (ATT). PTB individuals exhibited significantly higher levels of CCL1, CCL3, CXCL1, CXCL2, CXCL9 and CXCL10 in comparison to LTB and/or HC individuals. PTB individuals with bilateral or cavitary disease displayed significantly elevated levels of CCL1, CCL3, CXCL1, CXCL10 and CXCL11 compared to those with unilateral or non-cavitary disease and also exhibited a significant positive relationship with bacterial burdens. In addition, PTB individuals with slower culture conversion displayed significantly elevated levels of CCL1, CCL3, CXCL1 and CXCL9 at the time of PTB diagnosis and prior to ATT. Finally, the chemokines were significantly reduced following successful ATT. Our data demonstrate that PTB is associated with elevated levels of chemokines, which are partially reversed followed chemotherapy. Our data demonstrate that chemokines are markers of disease severity, predicting increased bacterial burden and delayed culture conversion in PTB.


Asunto(s)
Antituberculosos/uso terapéutico , Quimiocinas/sangre , Tuberculosis Latente/diagnóstico , Mycobacterium tuberculosis/aislamiento & purificación , Tuberculosis Pulmonar/diagnóstico , Adulto , Anciano , Antituberculosos/farmacología , Carga Bacteriana/efectos de los fármacos , Biomarcadores/sangre , Estudios de Casos y Controles , Quimiocinas/inmunología , Femenino , Humanos , Tuberculosis Latente/sangre , Tuberculosis Latente/tratamiento farmacológico , Tuberculosis Latente/microbiología , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Mycobacterium tuberculosis/inmunología , Índice de Severidad de la Enfermedad , Esputo/microbiología , Tuberculosis Pulmonar/sangre , Tuberculosis Pulmonar/tratamiento farmacológico , Tuberculosis Pulmonar/microbiología , Adulto Joven
11.
Immunology ; 156(3): 249-258, 2019 03.
Artículo en Inglés | MEDLINE | ID: mdl-30427060

RESUMEN

Alteration in the frequency of monocyte subsets is a hallmark of tuberculosis-diabetes co-morbidity (TB-DM). To study this association, we examined the plasma levels of sCD14, sCD163, C-reactive protein (CRP) and soluble tissue factor (sTF) in individuals with TB-DM, TB or diabetes mellitus (DM), and in healthy controls (HC). Circulating levels of sCD14, sCD163 and sTF were significantly increased in TB-DM and DM compared with TB and HC; however, CRP was significantly increased in TB-DM and TB compared with DM and HC. During longitudinal follow up, sCD14, CRP and sTF levels remained significantly increased in TB-DM compared with TB from baseline (pre-treatment), during treatment (2nd month) and at the completion (6th month) of anti-TB treatment (ATT), whereas sCD163 was significantly higher in TB-DM compared with TB only at baseline. Moreover, the levels of sCD14 and sCD163 were significantly higher in TB-DM individuals with bilateral and cavitary disease and exhibited a significant positive relationship with bacterial burden. Levels of sCD14, sCD163 and CRP exhibited a positive relationship with HbA1c levels. Within the TB-DM group, those with known diabetes before incident TB (KDM) exhibited significantly higher levels of sCD14 and sCD163 compared with individuals with newly diagnosed DM with TB (NDM). Finally, KDM individuals on metformin treatment exhibited significantly lower levels of sCD14, sCD163 and CRP compared with those on non-metformin-containing regimens. Our data demonstrate that systemic monocyte activation marker levels reflect baseline disease severity and extent in TB-DM, differentiate KDM from NDM and are modulated by ATT and metformin therapy.


Asunto(s)
Biomarcadores/sangre , Diabetes Mellitus Tipo 2/inmunología , Monocitos/inmunología , Tuberculosis/inmunología , Adulto , Anciano , Comorbilidad , Diabetes Mellitus Tipo 2/sangre , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Femenino , Humanos , Masculino , Metformina/uso terapéutico , Persona de Mediana Edad , Monocitos/efectos de los fármacos , Tuberculosis/sangre , Adulto Joven
12.
Langmuir ; 34(46): 13897-13904, 2018 11 20.
Artículo en Inglés | MEDLINE | ID: mdl-30365894

RESUMEN

A new class of core-shell metallic nanostructures with tunable near-surface composition and surface morphology with excellent catalytic activity is reported. Very thin shells of metal nanoassemblies such as monolayer (Ag and Au), bilayer of Ag or Au, and AgAu alloy layer with controlled size and morphology were deposited onto a gold nanocube (AuNC) core. UV-vis absorption spectroscopy and high-resolution transmission electron microscopy analyses along with selected-area electron diffraction, energy dispersive X-ray spectroscopy, inductively coupled plasma mass spectrometer, and X-ray diffraction techniques were used to characterize the prepared core-shell nanocubes. High-angle annular dark field scanning transmission electron microscopy-energy dispersive X-ray spectroscopy mapping images were recorded for the bilayer shell and alloy layer shell in the core-shell nanostructures. Reduction of 4-nitroaniline in the presence of sodium borohydride was chosen to validate the catalytic activity of the prepared core-shell metal nanocubes. Interestingly, the AgAu alloy shell layer over the AuNC (AuNC1@Ag0.25Au0.25) showed excellent catalytic activity compared with the pristine AuNC and monolayer and bilayer core-shell nanostructures.

13.
BMC Infect Dis ; 18(1): 345, 2018 07 25.
Artículo en Inglés | MEDLINE | ID: mdl-30045688

RESUMEN

BACKGROUND: Matrix metalloproteinases (MMPs) are considered to be key mediators of tuberculosis (TB) pathology but their role in tuberculosis - diabetes comorbidity (TB-DM) is not well understood. METHODS: To study the association of MMP levels with severity and extent of disease as well as bacterial burden in TB-DM, we examined the systemic levels of MMP-1, - 2, - 3, - 7, - 8, - 9, - 10, - 12 and - 13 in individuals with TB-DM and compared them to those with TB alone (TB) or healthy controls (HC). RESULTS: Circulating levels of MMP-1, - 2, - 3, - 7, - 10 and - 12 were significantly higher in TB-DM compared to both TB and HC and MMP -13 levels were higher in comparison to HC alone. To understand the effect of standard anti-tuberculosis therapy (ATT) on these MMP levels in TB-DM, we measured the levels of MMPs at the end of treatment (post-treatment). Our findings indicate that ATT is associated with a significant reduction in the levels of MMP-1, - 2, - 3, - 8 and - 13 post-treatment. Moreover, the levels of MMP-1, - 2, - 3, - 9 and - 12 were significantly higher in TB-DM individuals with cavitary disease and/or bilateral disease at baseline but not post-treatment. Similarly, the levels of MMP -1, - 2, - 3 and - 8 exhibited a significant positive relationship with bacterial burden and HbA1c levels at baseline but not post-treatment. Within the TB-DM group, those known to be diabetic before incident TB (KDM) exhibited significantly higher levels of MMP-1, - 2, - 10 and - 12 at baseline and of MMP-1 and -3 post-treatment compared to those newly diagnosed with DM (NDM). Finally, KDM individuals on metformin treatment exhibited significantly lower levels of MMP-1, - 2, - 3, - 7, - 9 and - 12 at baseline and of MMP-7 post-treatment. CONCLUSIONS: Our data demonstrate that systemic MMP levels reflect baseline disease severity and extent in TB-DM, differentiate KDM from NDM and are modulated by ATT and metformin therapy.


Asunto(s)
Antituberculosos/uso terapéutico , Complicaciones de la Diabetes , Diabetes Mellitus , Metaloproteinasas de la Matriz/sangre , Metformina/uso terapéutico , Tuberculosis , Comorbilidad , Complicaciones de la Diabetes/sangre , Complicaciones de la Diabetes/tratamiento farmacológico , Complicaciones de la Diabetes/epidemiología , Diabetes Mellitus/tratamiento farmacológico , Diabetes Mellitus/epidemiología , Humanos , Tuberculosis/sangre , Tuberculosis/complicaciones , Tuberculosis/tratamiento farmacológico , Tuberculosis/epidemiología
14.
PLoS One ; 12(9): e0184753, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28910369

RESUMEN

BACKGROUND: The association of antimicrobial peptides (AMPs) with tuberculosis-diabetes comorbidity (PTB-DM) is not well understood. METHODS: To study the association of AMPs with PTB-DM, we examined the systemic levels of cathelicidin (LL37), human beta defensin- 2 (HBD2), human neutrophil peptides 1-3, (HNP1-3) and granulysin in individuals with either PTB-DM, PTB, latent TB (LTB) or no TB infection (NTB). RESULTS: Circulating levels of cathelicidin and HBD2 were significantly higher and granulysin levels were significantly lower in PTB-DM compared to PTB, LTB or NTB, while the levels of HNP1-3 were significantly higher in PTB-DM compared to LTB or NTB individuals. Moreover, the levels of cathelicidin and/or HBD2 were significantly higher in PTB-DM or PTB individuals with bilateral and cavitary disease and also exhibited a significant positive relationship with bacterial burden. Cathelidin, HBD2 and HNP1-3 levels exhibited a positive relationship with HbA1c and/or fasting blood glucose levels. Finally, anti-tuberculosis therapy resulted in significantly diminished levels of cathelicidin, HBD2, granulysin and significantly enhanced levels of HNP1-3 and granulysin in PTB-DM and/or PTB individuals. CONCLUSION: Therefore, our data demonstrate that PTB-DM is associated with markedly enhanced levels of AMPs and diminished levels of granulysin.


Asunto(s)
Péptidos Catiónicos Antimicrobianos/sangre , Antituberculosos/uso terapéutico , Diabetes Mellitus Tipo 2/metabolismo , Tuberculosis Pulmonar/tratamiento farmacológico , alfa-Defensinas/sangre , Adulto , Anciano , Antígenos de Diferenciación de Linfocitos T/sangre , Catelicidinas/sangre , Comorbilidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Tuberculosis Pulmonar/metabolismo , Adulto Joven , beta-Defensinas/sangre
15.
Sci Rep ; 7(1): 1999, 2017 05 17.
Artículo en Inglés | MEDLINE | ID: mdl-28515464

RESUMEN

Comorbid diabetes mellitus (DM) increases tuberculosis (TB) risk and adverse outcomes but the pathological interactions between DM and TB remain incompletely understood. We performed an integrative analysis of whole blood gene expression and plasma analytes, comparing South Indian TB patients with and without DM to diabetic and non-diabetic controls without TB. Luminex assay of plasma cytokines and growth factors delineated a distinct biosignature in comorbid TBDM in this cohort. Transcriptional profiling revealed elements in common with published TB signatures from cohorts that excluded DM. Neutrophil count correlated with the molecular degree of perturbation, especially in TBDM patients. Body mass index and HDL cholesterol were negatively correlated with molecular degree of perturbation. Diabetic complication pathways including several pathways linked to epigenetic reprogramming were activated in TBDM above levels observed with DM alone. Our data provide a rationale for trials of host-directed therapies in TBDM, targeting neutrophilic inflammation and diabetic complication pathways to address the greater morbidity and mortality associated with this increasingly prevalent dual burden of communicable and non-communicable diseases.


Asunto(s)
Complicaciones de la Diabetes , Diabetes Mellitus/epidemiología , Diabetes Mellitus/inmunología , Inmunidad , Tuberculosis/epidemiología , Tuberculosis/inmunología , Biomarcadores , Comorbilidad , Biología Computacional/métodos , Citocinas/sangre , Citocinas/metabolismo , Diabetes Mellitus/genética , Diabetes Mellitus/metabolismo , Susceptibilidad a Enfermedades , Femenino , Perfilación de la Expresión Génica , Humanos , Inmunidad/genética , India/epidemiología , Masculino , Proteoma , Proteómica/métodos , Vigilancia en Salud Pública , Factores de Riesgo , Transcriptoma , Tuberculosis/genética , Tuberculosis/metabolismo
16.
J Infect ; 74(1): 10-21, 2017 01.
Artículo en Inglés | MEDLINE | ID: mdl-27717783

RESUMEN

BACKGROUND: Tuberculosis-diabetes co-morbidity (TB-DM) is characterized by increased inflammation with elevated circulating levels of inflammatory cytokines and other factors. Circulating angiogenic factors are intricately involved in the angiogenesis-inflammation nexus. METHODS: To study the association of angiogenic factors with TB-DM, we examined the systemic levels of VEGF-A, VEGF-C, VEGF-D, VEGF-R1, VEGF-R2, VEGF-R3 in individuals with either TB-DM (n = 44) or TB alone (n = 44). RESULTS: Circulating levels of VEGF-A, C, D, R1, R2 and R3 were significantly higher in TB-DM compared to TB individuals. Moreover, the levels of VEGF-A, C, R2 and/or R3 were significantly higher in TB-DM with bilateral or cavitary disease or with hemoptysis, suggesting an association with both disease severity and adverse clinical presentation. The levels of these factors also exhibited a significant positive relationship with bacterial burdens and HbA1c levels. In addition, VEGF-A, C and R2 levels were significantly higher (at 2 months of treatment) in culture positive compared to culture negative TB-DM individuals. Finally, the circulating levels of VEGF-A, C, D, R1, R2 and R3 were significantly reduced following successful chemotherapy at 6 months. CONCLUSION: Our data demonstrate that TB-DM is associated with heightened levels of circulating angiogenic factors, possibly reflecting both dysregulated angiogenesis and exaggerated inflammation.


Asunto(s)
Proteínas Angiogénicas/sangre , Complicaciones de la Diabetes/sangre , Diabetes Mellitus/sangre , Tuberculosis/sangre , Tuberculosis/complicaciones , Adulto , Anciano , Proteínas Angiogénicas/aislamiento & purificación , Carga Bacteriana , Biomarcadores/sangre , Comorbilidad , Citocinas/sangre , Diabetes Mellitus/microbiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Tuberculosis/microbiología , Factor A de Crecimiento Endotelial Vascular/sangre , Factor A de Crecimiento Endotelial Vascular/aislamiento & purificación , Factor C de Crecimiento Endotelial Vascular/sangre , Factor C de Crecimiento Endotelial Vascular/aislamiento & purificación , Factor D de Crecimiento Endotelial Vascular/sangre , Factor D de Crecimiento Endotelial Vascular/aislamiento & purificación
17.
Tuberculosis (Edinb) ; 101: 191-200, 2016 12.
Artículo en Inglés | MEDLINE | ID: mdl-27865391

RESUMEN

Type 2 diabetes mellitus (DM) is a major risk factor for the development of active pulmonary tuberculosis (PTB), with development of DM pandemic in countries where tuberculosis (TB) is also endemic. However, the effect of anti-TB treatment on the changes in dentritic cell (DC) and monocyte subset phenotype in TB-DM co-morbidity is not well understood. In this study, we characterized the frequency of DC and monocyte subsets in individuals with PTB with (PTB-DM) or without coincident diabetes mellitus (PTB-NDM) before, during and after completion of anti-TB treatment. PTB-DM is characterized by diminished frequencies of plasmacytoid and myeloid DCs and classical and intermediate monocytes at baseline and 2 months of anti-TB treatment but not following 6 months of treatment completion in comparison to PTB-NDM. DC and monocyte subsets exhibit significant but borderline correlation with fasting blood glucose and glycated hemoglobin levels. Finally, while minor changes in the DC and monocyte compartment were observed at 2 months of treatment, significantly increased frequencies of plasmacytoid and myeloid DCs and classical and intermediate monocytes were observed at the successful completion of anti-TB treatment. Our data show that coincident diabetes alters the frequencies of innate subset distribution of DC and monocytes in TB-DM co-morbidity and suggests that most of these changes are reversible following anti-TB therapy.


Asunto(s)
Antituberculosos/farmacología , Células Dendríticas/efectos de los fármacos , Diabetes Mellitus Tipo 2/inmunología , Monocitos/efectos de los fármacos , Tuberculosis Pulmonar/inmunología , Adulto , Antituberculosos/uso terapéutico , Células Cultivadas , Comorbilidad , Células Dendríticas/inmunología , Diabetes Mellitus Tipo 2/epidemiología , Femenino , Humanos , Hiperglucemia/epidemiología , Hiperglucemia/inmunología , Inmunofenotipificación , India/epidemiología , Masculino , Monocitos/inmunología , Mycobacterium tuberculosis/aislamiento & purificación , Esputo/microbiología , Tuberculosis Pulmonar/tratamiento farmacológico , Tuberculosis Pulmonar/epidemiología , Tuberculosis Pulmonar/microbiología
18.
J Med Microbiol ; 61(Pt 10): 1352-1359, 2012 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-22723257

RESUMEN

RD1, the region of difference between the virulent strains of Mycobacterium tuberculosis and Mycobacterium bovis BCG, is the most explored region in terms of mycobacterial virulence and vaccine design. This study found a polymorphic intergenic region between two genes, Rv3870 and Rv3871, in the RD1 region. Sequence analysis revealed a 53 bp repeat element that created a polymorphism among the clinical isolates, reported previously as the mycobacterial interspersed repetitive unit (MIRU) 39 locus. The discriminatory power of this locus was found to be high for EAI strains, as indicated by a Hunter-Gaston diversity index value of 0.58, and low for Beijing (0.26) and CAS (0.29) strains. The presence and variability of MIRU 39 in the intergenic region led us to investigate the functional role of the repeat element by measuring the transcription levels of the downstream genes Rv3871 and Rv3874 by quantitative RT-PCR among the different clades of clinical strains. Higher transcription levels of Rv3871 were observed in strains with four copies of the repeat element in the upstream region, whereas the transcription level of Rv3874 was higher in strains with six copies of the repeat element. These data suggest that changes in transcription levels resulting from insertion of different copy numbers of the repeat element may affect regulation of gene expression in M. tuberculosis.


Asunto(s)
Proteínas Bacterianas/metabolismo , Regulación Bacteriana de la Expresión Génica/fisiología , Mycobacterium tuberculosis/genética , Mycobacterium tuberculosis/metabolismo , Polimorfismo Genético , Tuberculosis/microbiología , Proteínas Bacterianas/genética , Secuencia de Bases , Genotipo , Técnicas de Genotipaje , Humanos , India/epidemiología , Datos de Secuencia Molecular , Mycobacterium tuberculosis/patogenicidad , Reacción en Cadena de la Polimerasa , Tuberculosis/epidemiología , Virulencia
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