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2.
PLoS One ; 15(12): e0243951, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33332458

RESUMEN

In Bangladesh, there is currently no data on the burden of latent TB infection (LTBI) amongst hospital healthcare workers (HCWs). This study aimed to determine the prevalence of LTBI and compare the prevalence among HCWs in two public tertiary care hospitals. Between September 2018 and August 2019, we conducted a cross-sectional study in two public tertiary care general hospitals. Using a survey and tuberculin skin test (TST), we assessed risk factors for LTBI, adjusting for known and plausible confounders. In addition, a facility assessment was undertaken to understand the implementation of relevant IPC measures. The prevalence of LTBI among HCWs was 42%. HCWs spent a median of 6 hours (SD = 1.76, IQR 2.00) per day and attended an average of 1.87 pulmonary TB patients per week. HCWs did not receive any TB IPC training, the wards lacked a symptom checklist to screen patients for TB, and no masks were available for coughing patients. Seventy-seven percent reportedly did not use any facial protection (masks or respirators) while caring for patients. In the multivariable model adjusting for hospital level clustering effect, TST positivity was significantly higher among HCWs aged 35-45 years (aOR1.36, 95% CI: 1.06-1.73) and with >3 years of service (aOR 1.67, 95% CI: 1.62-1.72). HCWs working in the medicine ward had 3.65 (95% CI: 2.20-6.05) times, and HCWs in the gynecology and obstetrics ward had 2.46 (95% CI: 1.42-4.27) times higher odds of TST positivity compared to HCWs working in administrative areas. This study identified high prevalence of LTBI among HCWs. This may be due to the level of exposure to pulmonary TB patients, and/or limited use of personal protective equipment along with poor implementation of TB IPC in the hospitals. Considering the high prevalence of LTBI, we recommend the national TB program consider providing preventative therapy to the HCWs as the high-risk group, and implement TB IPC in the hospitals.


Asunto(s)
Personal de Salud , Tuberculosis Latente/diagnóstico , Tuberculina/aislamiento & purificación , Adolescente , Adulto , Bangladesh/epidemiología , Femenino , Humanos , Tuberculosis Latente/epidemiología , Tuberculosis Latente/microbiología , Masculino , Persona de Mediana Edad , Pruebas Cutáneas/normas , Centros de Atención Terciaria , Adulto Joven
3.
Vaccine ; 38(48): 7629-7637, 2020 11 10.
Artículo en Inglés | MEDLINE | ID: mdl-33071000

RESUMEN

This work demonstrates the presence of immune regulatory cells in the cervical lymph nodes draining Bacillus Calmette-Guérin (BCG) vaccinated site on the dorsum of the ear in guinea pigs. It is shown that whole cervical lymph node cells did not proliferate in vitro in the presence of soluble mycobacterial antigens (PPD or leprosin) despite being responsive to whole mycobacteria. Besides, T cells from these lymph nodes separated as a non-adherent fraction on a nylon wool column, proliferated to PPD in the presence of autologous antigen presenting cells. Interestingly, addition of as low as 20% nylon wool adherent cells to these, sharply decreased the proliferation by 83%. Looking into what cells in the adherent fraction suppressed the proliferation, it was found that neither the T cell nor the macrophage enriched cell fractions of this population individually showed suppressive effect, indicating that their co-presence was necessary for the suppression. Since BCG induced granulomas resolve much faster than granulomas induced by other mycobacteria such as Mycobacterium leprae the present experimental findings add to the existing evidence that intradermal BCG vaccination influences subsequent immune responses in the host and may further stress upon its beneficial role seen in Covid-19 patients.


Asunto(s)
Antígenos Bacterianos/farmacología , Vacuna BCG/farmacología , Granuloma/inmunología , Ganglios Linfáticos/inmunología , Linfocitos T/inmunología , Tuberculina/farmacología , Animales , Células Presentadoras de Antígenos/efectos de los fármacos , Células Presentadoras de Antígenos/inmunología , Células Presentadoras de Antígenos/microbiología , Adhesión Celular , Proliferación Celular , Infecciones por Coronavirus/prevención & control , Oído , Femenino , Granuloma/microbiología , Cobayas , Humanos , Inyecciones Intradérmicas , Ganglios Linfáticos/microbiología , Macrófagos/efectos de los fármacos , Macrófagos/inmunología , Macrófagos/microbiología , Masculino , Mycobacterium bovis/inmunología , Mycobacterium leprae/inmunología , Pandemias/prevención & control , Neumonía Viral/prevención & control , Remisión Espontánea , Linfocitos T/clasificación , Linfocitos T/efectos de los fármacos , Linfocitos T/microbiología
4.
Medicine (Baltimore) ; 99(40): e22583, 2020 Oct 02.
Artículo en Inglés | MEDLINE | ID: mdl-33019474

RESUMEN

INTRODUCTION: Henoch-Schönlein purpura (HSP) is an extremely rare condition in patients with pulmonary tuberculosis, with only a few reported cases. Compared to patients with typical clinical symptoms, it is difficult to make a definitive diagnosis when HSP presents as an initial manifestation in pulmonary tuberculosis patients. Herein, a case of pulmonary tuberculosis that showed HSP at first was reported, and the related literatures were reviewed. PATIENT CONCERNS: A 24-year-old man presented with palpable purpura on the extremities, accompanied by abdominal pain, bloody stools, and knee pain. DIAGNOSES: The patient was diagnosed with pulmonary tuberculosis based on the results of interferon gamma release assays, purified protein derivative test, and computed tomography. INTERVENTIONS: The patient was treated with vitamin C and chlorpheniramine for 2 weeks, and the above-mentioned symptoms were relieved. However, 3 weeks later, the purpura recurred with high-grade fever and chest pain during the inspiratory phase. The patient was then treated with anti-tuberculosis drugs, and the purpura as well as the high fever disappeared. OUTCOMES: The patient recovered well and remained free of symptoms during the follow-up examination. CONCLUSION: Pulmonary tuberculosis presenting with HSP as an initial manifestation is not common. Therefore, it is difficult to clinically diagnose and treat this disease. When an adult patient shows HSP, it is important to consider the possibility of tuberculosis to avoid misdiagnosis and delayed treatment.


Asunto(s)
Antituberculosos/uso terapéutico , Púrpura de Schoenlein-Henoch/etiología , Tuberculosis Pulmonar/complicaciones , Tuberculosis Pulmonar/tratamiento farmacológico , Dolor Abdominal/diagnóstico , Dolor Abdominal/etiología , Cuidados Posteriores , Ácido Ascórbico/uso terapéutico , Clorfeniramina/uso terapéutico , Diagnóstico Diferencial , Fiebre/diagnóstico , Fiebre/etiología , Hemorragia Gastrointestinal/diagnóstico , Hemorragia Gastrointestinal/etiología , Antagonistas de los Receptores Histamínicos H1/uso terapéutico , Humanos , Ensayos de Liberación de Interferón gamma/métodos , Masculino , Púrpura de Schoenlein-Henoch/tratamiento farmacológico , Resultado del Tratamiento , Tuberculina , Tuberculosis Pulmonar/sangre , Tuberculosis Pulmonar/diagnóstico por imagen , Vitaminas/uso terapéutico , Adulto Joven
5.
Dermatol Online J ; 26(3)2020 Mar 15.
Artículo en Inglés | MEDLINE | ID: mdl-32609439

RESUMEN

BACKGROUND: New treatment options for warts include intralesional wart injection with agents such as vitamin D, measles, mumps, and rubella (MMR) vaccine antigen, Bacillus Calmette-Guerin (BCG) antigen, and candida antigen but there have been limited studies to compare their efficacies. OBJECTIVE: The purpose of this systematic review is to compare the efficacy and safety of injectable agents used for the treatment of warts. METHODS: A PubMed search included terms "intralesional wart therapy," "wart injection" and "verruca injection." Articles reviewed were published over 10 years. RESULTS: A total of 43 articles were reviewed; 30 covered studies with more than 10 participants and 13 were case reports, case series, and reviews. In comparison studies intralesional agents have equal or superior efficacy (66%-94.9%) compared to first-line salicylic acid or cryotherapy (65.5-76.5%). One advantage of intralesional injections is the rate of complete resolution of distant warts. LIMITATIONS: Each study varied in their agents, treatment interval, and treatment dose, making comparisons difficult. CONCLUSIONS: Intralesional wart injections are safe, affordable, and efficacious treatments for warts. Physicians should consider intralesional injections for patients with refractory warts, multiple warts, or warts in sensitive areas.


Asunto(s)
Inyecciones Intralesiones , Verrugas/tratamiento farmacológico , Ácido Aminolevulínico/administración & dosificación , Antibacterianos/administración & dosificación , Antivirales/administración & dosificación , Vacuna BCG/administración & dosificación , Vacunas Bacterianas/administración & dosificación , Humanos , Interferón-alfa/administración & dosificación , Mycobacterium , Tuberculina/administración & dosificación , Vitamina D/administración & dosificación
6.
Vet Immunol Immunopathol ; 221: 110016, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32050091

RESUMEN

Immunological memory is a central feature of adaptive immunity. Memory B cells are generated upon stimulation with antigen presented by follicular dendritic cells in the peripheral lymphoid tissues. This process typically involves class-switch recombination and somatic hypermutation and it can be dependent or independent on germinal centers or T cell help. The mature B cell memory pool is generally characterized by remarkable heterogeneity of functionally and phenotypically distinct sub-populations supporting multi-layer immune plasticity. Memory B cells found in human patients infected with Mycobacterium tuberculosis include IgD+ CD27+ and IgM+ CD27+ subsets. In addition, expansion of atypical memory B cells characterized by the lack of CD27 expression and by inability to respond to antigen-induced re-activation is documented in human tuberculosis. These functionally impaired memory B cells are believed to have adverse effects on host immunity. Human and animal studies demonstrate recruitment of antigen-activated B cells to the infection sites and their presence in lung granulomas where proliferating B cells are organized into discrete clusters resembling germinal centers of secondary lymphoid organs. Cattle studies show development of IgM+, IgG+, and IgA+ memory B cells in M. bovis infection with the ability to rapidly differentiate into antibody-producing plasma cells upon antigen re-exposure. This review discusses recent advances in research on generation, re-activation, heterogeneity, and immunobiological functions of memory B cells in tuberculosis. The role of memory B cells in post-skin test recall antibody responses in bovine tuberculosis and implications for development of improved immunodiagnostics are also reviewed.


Asunto(s)
Subgrupos de Linfocitos B/inmunología , Memoria Inmunológica , Tuberculosis/inmunología , Inmunidad Adaptativa , Animales , Bovinos , Humanos , Activación de Linfocitos , Mycobacterium bovis , Mycobacterium tuberculosis , Tuberculina/administración & dosificación
7.
Prev Vet Med ; 176: 104932, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32088530

RESUMEN

Mycobacterial diseases are important health issues in farmed deer. The single intradermal tuberculin test is the standard test for tuberculosis testing in deer. We studied two factors which might influence the response of deer to skin testing: the inoculation site and the injection device. Deer included in this study were 2.5 years old farmed red deer (Cervus elaphus) hinds (n = 80). Two areas of 3 cm × 3 cm were shaved at the left side of the neck. Site A (SA) was situated about 10 cm caudal to the head, while site B (SB) was 10 cm caudal to SA. All hinds received at the same time two 0.1 ml inoculations of Mycobacterium avium derived purified protein derivative (aPPD). One inoculation was made by syringe and the other one with the needle-free syringe Dermojet. To test the inoculation site effect, half of the animals were inoculated by Dermojet in SA and by syringe in SB to compare with the inoculation in SA by syringe and Dermojet in SB in the other half. No differences were recorded for the injection device nor for the inoculation site. Ten hinds had a skinfold increase larger than 30 tenths of mm by any injection device and inoculation site. Seven (9%) and 6 (8%) hinds were classified as positive by syringe and Dermojet, and at the anterior or posterior inoculation site, respectively. The distribution of skinfold thickness increases did not differ by injection device. Our findings support the needle-free Dermojet syringe as a suitable tool for skin-testing in red deer and suggest no relevant effect of the position of the inoculation site along the neck in red deer.


Asunto(s)
Ciervos , Inyecciones Intradérmicas/métodos , Mycobacterium avium/fisiología , Prueba de Tuberculina/veterinaria , Tuberculina/farmacología , Tuberculosis/veterinaria , Animales , Femenino , Inyecciones Intradérmicas/instrumentación , Tuberculosis/diagnóstico
10.
J Dermatolog Treat ; 31(8): 850-854, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31418621

RESUMEN

Background: The immune system plays an important part in the clearance of molluscum contagiosum (MC) and, therefore, there has lately been a trend in using immunotherapy in MC therapy. Tuberculin-purified protein derivatives (PPDs) and topical cantharidin have not earlier been compared with their effectiveness in therapyAim: The aim of this research was to determine the effectiveness and security of intralesional immunotherapy in the therapy of MC with tuberculin PPD versus topical cantharidinPatients and methods: Twenty patients with various MC lesions received topical cantharidin as control (group A) and 20 MC patients received intralesional tuberculin PPD following prior intradermal immunity tests (group B ).Results: Complete clearance of lesions was detected in 90.0% of patients in the cantharidin group; the partial response was detected in10.0% of the patients. However, in the PPD group, 85% of the patients showed a complete response and 15% showed a partial response, with no significant difference in the clinical response between the two groups. Mild side effects were detected .Conclusion: The results suggest that intralesional PPD and topical cantharidin 0.7% are effective and safe treatment modalities, but benefits of intralesional PPD is being a simple, effective and safe treatment with tolerable pain and can be an alternative treatment for multiple resistant types .


Asunto(s)
Cantaridina/administración & dosificación , Inmunoterapia , Molusco Contagioso/tratamiento farmacológico , Tuberculina/administración & dosificación , Administración Tópica , Adolescente , Adulto , Proteínas Bacterianas/administración & dosificación , Cantaridina/efectos adversos , Niño , Preescolar , Femenino , Humanos , Inmunocompetencia , Inmunoterapia/métodos , Inyecciones Intralesiones/efectos adversos , Masculino , Molusco Contagioso/terapia , Inducción de Remisión , Tuberculina/efectos adversos
11.
Am J Respir Crit Care Med ; 201(10): 1277-1291, 2020 05 15.
Artículo en Inglés | MEDLINE | ID: mdl-31860339

RESUMEN

Rationale: A human model to better understand tuberculosis immunopathogenesis and facilitate vaccine development is urgently needed.Objectives: We evaluated the feasibility, safety, and immunogenicity of live bacillus Calmette-Guérin (BCG) in a lung-oriented controlled human infection model.Methods: We recruited 106 healthy South African participants with varying degrees of tuberculosis susceptibility. Live BCG, sterile PPD, and saline were bronchoscopically instilled into separate lung segments (n = 65). A control group (n = 34) underwent a single bronchoscopy without challenge. The primary outcome was safety. Cellular and antibody immune signatures were identified in BAL before and 3 days after challenge using flow cytometry, ELISA, RNA sequencing, and mass spectrometry.Measurements and Main Results: The frequency of adverse events was low (9.4%; n = 10), similar in the challenge versus control groups (P = 0.8), and all adverse events were mild and managed conservatively in an outpatient setting. The optimal PPD and BCG dose was 0.5 TU and 104 cfu, respectively, based on changes in BAL cellular profiles (P = 0.02) and antibody responses (P = 0.01) at incremental doses before versus after challenge. At 104 versus 103 cfu BCG, there was a significant increase in number of differentially expressed genes (367 vs. 3; P < 0.001) and dysregulated proteins (64 vs. 0; P < 0.001). Immune responses were highly setting specific (in vitro vs. in vivo) and compartment specific (BAL vs. blood) and localized to the challenged lung segments.Conclusions: A lung-oriented mycobacterial controlled human infection model using live BCG and PPD is feasible and safe. These data inform the study of tuberculosis immunopathogenesis and strategies for evaluation and development of tuberculosis vaccine candidates.


Asunto(s)
Adyuvantes Inmunológicos/administración & dosificación , Vacuna BCG/administración & dosificación , Broncoscopía , Inmunogenicidad Vacunal , Tuberculina/administración & dosificación , Tuberculosis/prevención & control , Administración Tópica , Adulto , Estudios de Factibilidad , Femenino , Humanos , Inmunidad Mucosa , Masculino , Adulto Joven
12.
Sci Rep ; 9(1): 17791, 2019 11 28.
Artículo en Inglés | MEDLINE | ID: mdl-31780694

RESUMEN

Bovine tuberculosis (BTB) caused by Mycobacterium bovis remains a major problem in both the developed and developing countries. Control of BTB in the UK is carried out by test and slaughter of infected animals, based primarily on the tuberculin skin test (PPD). Vaccination with the attenuated strain of the M. bovis pathogen, BCG, is not used to control bovine tuberculosis in cattle at present, due to its variable efficacy and because it interferes with the PPD test. Diagnostic tests capable of Differentiating Infected from Vaccinated Animals (DIVA) have been developed that detect immune responses to M. bovis antigens absent in BCG; but these are too expensive and insufficiently sensitive to be used for BTB control worldwide. To address these problems we aimed to generate a synergistic vaccine and diagnostic approach that would permit the vaccination of cattle without interfering with the conventional PPD-based surveillance. The approach was to widen the pool of M. bovis antigens that could be used as DIVA targets, by identifying antigenic proteins that could be deleted from BCG without affecting the persistence and protective efficacy of the vaccine in cattle. Using transposon mutagenesis we identified genes that were essential and those that were non-essential for persistence in bovine lymph nodes. We then inactivated selected immunogenic, but non-essential genes in BCG Danish to create a diagnostic-compatible triple knock-out ΔBCG TK strain. The protective efficacy of the ΔBCG TK was tested in guinea pigs experimentally infected with M. bovis by aerosol and found to be equivalent to wild-type BCG. A complementary diagnostic skin test was developed with the antigenic proteins encoded by the deleted genes which did not cross-react in vaccinated or in uninfected guinea pigs. This study demonstrates the functionality of a new and improved BCG strain which retains its protective efficacy but is diagnostically compatible with a novel DIVA skin test that could be implemented in control programmes.


Asunto(s)
Vacuna BCG/inmunología , Mycobacterium bovis/inmunología , Tuberculosis Bovina/diagnóstico , Tuberculosis/diagnóstico , Tuberculosis/veterinaria , Animales , Vacuna BCG/genética , Bovinos , Reacciones Cruzadas , Técnicas de Inactivación de Genes , Cobayas , Macrófagos/metabolismo , Macrófagos/microbiología , Mycobacterium bovis/genética , Transducción Genética , Tuberculina/genética , Tuberculina/inmunología , Prueba de Tuberculina , Tuberculosis/microbiología , Tuberculosis Bovina/microbiología , Vacunación , Vacunas Atenuadas/inmunología
14.
Int J Dermatol ; 58(12): 1477-1482, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31591706

RESUMEN

BACKGROUND: Despite the numerous studies on the use of purified protein derivative (PPD), a protein extracted from Mycobacterium tuberculosis, in verruca vulgaris, there is no standardized regimen, and efficacy of single versus multiple injections has not been compared. METHODS: This is a randomized, open-label, superiority trial. Sixty-six patients with at least three warts in two different anatomic sites were randomized into two groups: a single injection (n = 29) and multiple injection (n = 29) groups. Patients were treated every 2 weeks until a maximum of six sessions. RESULTS: Multiple injections (79.3%) showed superior clearance rates compared to a single injection of PPD (58.6%) (P-value = 0.0236). Multiple injections also exhibited faster clearance at each time point (P = 0.048). Pain was statistically more significant in the multiple injection group (P = 0.0005). There was no statistically significant difference in incidence of adverse events (P = 0.1795). Amongst all cleared patients in both groups, there were no recurrences after 6 months. CONCLUSION: Multiple injections of warts with PPD cleared more patients with multiple common warts than the use of single injections at the end of 12 weeks and were faster in clearing patients at every time point. Single injection was better tolerated than multiple injections. Both treatments exhibited similar safety profiles and recurrence rates.


Asunto(s)
Inmunoterapia/métodos , Tuberculina/administración & dosificación , Verrugas/terapia , Adulto , Esquema de Medicación , Femenino , Humanos , Inyecciones Intralesiones , Masculino , Recurrencia , Resultado del Tratamiento , Tuberculina/efectos adversos
15.
J Med Primatol ; 48(6): 329-337, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31478213

RESUMEN

BACKGROUND: As the widely used biomarker of whole-blood stimulation assays for tuberculosis diagnosis, the release of IFN-γ might be affected by multiple factors, such as immunosuppression and some infectious agents. Here, we evaluated additional cytokines as diagnostic biomarkers. METHODS: Forty-three cytokines were measured by Luminex xMAP technologies in 30 healthy and 10 naturally Mycobacterium tuberculosis (MTB)-infected rhesus monkeys pre- and post-stimulation by purified protein derivative (PPD). RESULTS: After stimulation, production of 23 and 38 cytokines was markedly increased in healthy and MTB-infected macaques, respectively. A comparison of the stimulation index (SI) between MTB infections and healthy macaques showed that the SIs of 32 cytokines in MTB-infected macaques were significantly higher than those in healthy macaques. Pooling the results, eight cytokines were suggested as ideal biomarkers for a whole-blood stimulation assay for MTB diagnosis. CONCLUSION: PPD could induce multiple cytokine responses in either healthy or MTB-infected monkeys, and eight cytokines had reliable predictive capacity as diagnostic biomarkers of MTB infection.


Asunto(s)
Citocinas/metabolismo , Macaca mulatta , Enfermedades de los Monos/metabolismo , Mycobacterium tuberculosis/fisiología , Tuberculina/administración & dosificación , Tuberculosis/veterinaria , Animales , Tuberculosis/metabolismo
16.
Tuberculosis (Edinb) ; 117: 36-44, 2019 07.
Artículo en Inglés | MEDLINE | ID: mdl-31378266

RESUMEN

Plasminogen and plasmin are fundamental components of the fibrinolytic system that interact with microorganisms generating different immunopathological effects. The molecules of Mycobacterium tuberculosis interplaying with plasminogen have already been identified and characterized. In this work, we studied the effects of plasmin(ogen) bound toMycobacterium bovisCalmette-Guérin (BCG) on phagocytosis in THP1 macrophages as well as in granuloma formation and development on in vitrohuman granuloma model. For this purpose, BCG was coated with plasminogen and plasmin, obtained after activation of zymogen by tissue plasminogen activator. The results showed a significant reduction in the number of bacteria phagocytosed by macrophages in presence of plasminogen or plasmin on BCG surface. On the other hand, at 3 days BCG/plasminogen/plasmin induced an increase granuloma numbers with respect to those induced by uncoated bacteria. BCG/plasminogen/environments also showed a significant increase of IL-6 secretion. At 7 days, a reduced number of granulomas and an increased number of bacteria was observed with respect to uncoated BCG environment. Altogether, these results showed that plasmin(ogen) on the mycobacterial surface affects phagocytosis, granuloma development and the cytokine context, thus resulting in an increased number of bacteria in granulomas.


Asunto(s)
Fibrinolisina/metabolismo , Granuloma/microbiología , Mycobacterium bovis/metabolismo , Fagocitosis/fisiología , Plasminógeno/metabolismo , Tuberculosis/microbiología , Células Cultivadas , Citocinas/biosíntesis , Granuloma/inmunología , Humanos , Macrófagos/microbiología , Mycobacterium bovis/aislamiento & purificación , Tuberculina , Tuberculosis/inmunología , Tuberculosis/metabolismo
17.
Tuberculosis (Edinb) ; 117: 56-61, 2019 07.
Artículo en Inglés | MEDLINE | ID: mdl-31378269

RESUMEN

Diagnostic tests based on cell-mediated immunity are used in programs for the control and eradication of bovine tuberculosis (bTB), which is mainly caused by Mycobacterium bovis. Additional serological assays could be performed as an ancillary method to detect an infected animal that fails to produce an immune response against the intradermal reaction (IDR), the official bTB test. In this study, we evaluated the effectiveness of an enzyme-linked immunosorbent assay (ELISA) that uses bovine PPD as a capture antigen as a complement to the IDR in herds with confirmed cases of bTB. The study was conducted in two stages. First, a panel of 200 serum samples was analyzed by ELISA. The sensitivity and specificity obtained were 60% and 99%, respectively. The subsequent stage consisted of evaluating 7,494 bovines from 14 selected dairy farms. The number of animals yielding a IDR negative/ELISA positive result were 200. A necropsy analysis of 33 of these IDR negative/ELISA positive animals revealed that 30 (91%) presented granulomatous lesions and positive M. bovis isolation. This finding confirmed bTB in most cases. Altogether, the results obtained in the present study suggest that the combined use of IDR and ELISA is an effective strategy to improve the control of bTB in endemic herds.


Asunto(s)
Ensayo de Inmunoadsorción Enzimática/veterinaria , Prueba de Tuberculina/veterinaria , Tuberculosis Bovina/diagnóstico , Animales , Bovinos , Ensayo de Inmunoadsorción Enzimática/métodos , Reacciones Falso Negativas , Mycobacterium bovis/inmunología , Sensibilidad y Especificidad , Tuberculina/inmunología , Prueba de Tuberculina/métodos , Tuberculosis Bovina/patología
18.
Braz J Infect Dis ; 23(4): 246-253, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31421107

RESUMEN

Accurate and rapid diagnostic tools are important aspects of managing tuberculosis (TB) cases appropriately. However, the sensitivity and specificity of diagnostic kits based on immune response such as the tuberculin skin test (TST) and interferon gamma release assay (IGRA) are still debated. Thus, the exploration and assessment of specific biomarker-targeted antibodies are needed for the development of an accurate and rapid diagnostic tool. The present study was conducted in patients with a respiratory problem suspected to be TB at Dr. Soetomo Hospital, Surabaya, Indonesia. Among 102 patients tested by GeneXpert and AFB, 59 serum samples were from cases retrospectively determined to have active TB. A total of 102 serum of healthy controls (HC) was also collected. The PPD antigen and the recombinant CFP-10 and ESAT-6 proteins were prepared. Antibody responses against these proteins were evaluated by ELISA. All samples were also screened for the possibility of Mycobacterium avium-intracellulare complex (MAC) infection using Capilla MaC kit. The results showed that TB patients had a significantly higher concentration of IgG antibody in response to PPD than the HC. In addition, the receiver operating characteristic (ROC) curve analysis showed that PPD was acceptable for diagnostic purposes with an AUC value of 0.835 (95% CI 0.770-0.900, p < 0.0001). However, ESAT-6 and CFP-10 had low AUCs, and 32 samples from both groups showed a low concentration of IgA antibody against all antigens. The MAC detection results also showed that the concentration of IgA in the HC group was the highest. The current results indicate that PPD is a better antigen for antibody-based detection of TB than ESAT-6 and CFP-10. Based on the MAC detection assay, 53 people in the HC group were probably infected with rapidly growing nontuberculous mycobacteria (NTM), although antibody response to PPD was low.


Asunto(s)
Formación de Anticuerpos/inmunología , Antígenos Bacterianos/inmunología , Proteínas Bacterianas/inmunología , Mycobacterium tuberculosis/inmunología , Tuberculina/inmunología , Tuberculosis Pulmonar/diagnóstico , Tuberculosis Pulmonar/microbiología , Adolescente , Adulto , Anciano , Estudios de Casos y Controles , Niño , Ensayo de Inmunoadsorción Enzimática , Femenino , Humanos , Indonesia , Masculino , Persona de Mediana Edad , Valores de Referencia , Estudios Retrospectivos , Sensibilidad y Especificidad , Estadísticas no Paramétricas , Prueba de Tuberculina , Tuberculosis Pulmonar/sangre , Adulto Joven
19.
Braz. j. infect. dis ; 23(4): 246-253, July-Aug. 2019. tab, graf
Artículo en Inglés | LILACS | ID: biblio-1039236

RESUMEN

Abstract Accurate and rapid diagnostic tools are important aspects of managing tuberculosis (TB) cases appropriately. However, the sensitivity and specificity of diagnostic kits based on immune response such as the tuberculin skin test (TST) and interferon gamma release assay (IGRA) are still debated. Thus, the exploration and assessment of specific biomarker-targeted antibodies are needed for the development of an accurate and rapid diagnostic tool. The present study was conducted in patients with a respiratory problem suspected to be TB at Dr. Soetomo Hospital, Surabaya, Indonesia. Among 102 patients tested by GeneXpert and AFB, 59 serum samples were from cases retrospectively determined to have active TB. A total of 102 serum of healthy controls (HC) was also collected. The PPD antigen and the recombinant CFP-10 and ESAT-6 proteins were prepared. Antibody responses against these proteins were evaluated by ELISA. All samples were also screened for the possibility of Mycobacterium avium-intracellulare complex (MAC) infection using Capilla MaC kit. The results showed that TB patients had a significantly higher concentration of IgG antibody in response to PPD than the HC. In addition, the receiver operating characteristic (ROC) curve analysis showed that PPD was acceptable for diagnostic purposes with an AUC value of 0.835 (95% CI 0.770-0.900, p < 0.0001). However, ESAT-6 and CFP-10 had low AUCs, and 32 samples from both groups showed a low concentration of IgA antibody against all antigens. The MAC detection results also showed that the concentration of IgA in the HC group was the highest. The current results indicate that PPD is a better antigen for antibody-based detection of TB than ESAT-6 and CFP-10. Based on the MAC detection assay, 53 people in the HC group were probably infected with rapidly growing nontuberculous mycobacteria (NTM), although antibody response to PPD was low.


Asunto(s)
Humanos , Masculino , Femenino , Niño , Adolescente , Adulto , Persona de Mediana Edad , Anciano , Adulto Joven , Proteínas Bacterianas/inmunología , Tuberculina/inmunología , Tuberculosis Pulmonar/diagnóstico , Tuberculosis Pulmonar/microbiología , Formación de Anticuerpos/inmunología , Mycobacterium tuberculosis/inmunología , Antígenos Bacterianos/inmunología , Valores de Referencia , Tuberculosis Pulmonar/sangre , Ensayo de Inmunoadsorción Enzimática , Prueba de Tuberculina , Estudios de Casos y Controles , Estudios Retrospectivos , Sensibilidad y Especificidad , Estadísticas no Paramétricas , Indonesia
20.
Dermatol Ther ; 32(5): e13034, 2019 09.
Artículo en Inglés | MEDLINE | ID: mdl-31355514

RESUMEN

Intralesional (IL) vitamin D3 is an emerging treatment for cutaneous warts. However, its effectiveness and exact mechanism is not fully evaluated. We aimed to compare the efficacy and safety of IL purified protein derivative (PPD) and IL vitamin D3 in multiple warts and to investigate their systemic effect clinically and immunologically. Forty-five patients with multiple extragenital warts were treated with IL-PPD (22 patients) or IL vitamin D3 injection (23 patients) for a maximum of three sessions at 3 week intervals. Decrease in size and number of warts and adverse effects were evaluated. Serum interleukin-12 (IL-12) and interferon-gamma (IFN-γ) levels were measured before and 3 weeks after the last session. Higher clearance rates for all warts were observed with IL-PPD compared to IL vitamin D (59.1% vs. 21.7% complete clearance, p < .001). Significant increase was found in both serum IL-12 and IFN-γ after PPD treatment (p = .034 and p = .04, respectively), but only IFN-γ after vitamin D3 treatment (p = 0.02). Both IL vitamin D3 and PPD showed positive results in treatment of multiple warts. However, PPD showed higher clinical efficacy and more increase in both IL-12 and IFN-γ levels.


Asunto(s)
Colecalciferol/administración & dosificación , Dermatosis del Pie/tratamiento farmacológico , Inmunidad Celular , Células TH1/inmunología , Tuberculina/administración & dosificación , Verrugas/tratamiento farmacológico , Adulto , Biomarcadores/sangre , Relación Dosis-Respuesta a Droga , Ensayo de Inmunoadsorción Enzimática , Femenino , Estudios de Seguimiento , Dermatosis del Pie/sangre , Dermatosis del Pie/inmunología , Humanos , Inyecciones Intralesiones , Interferón gamma/sangre , Interleucina-12/sangre , Masculino , Estudios Prospectivos , Resultado del Tratamiento , Vitaminas/administración & dosificación , Verrugas/sangre , Verrugas/inmunología
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