Hongyan Xu; Yueqing Yang; Qianhong Wu; Yan Zhang
Abstract
Background: Patient immune status might be indicative of the variance in bacterial genetics in drug-resistant tuberculous pleuritis and could be used for predicting the risk of multi-drug resistant tuberculous pleuritis (MDR-TB). Objective: To determine the significance of Th2/Th1 ratio and concentration ...
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Background: Patient immune status might be indicative of the variance in bacterial genetics in drug-resistant tuberculous pleuritis and could be used for predicting the risk of multi-drug resistant tuberculous pleuritis (MDR-TB). Objective: To determine the significance of Th2/Th1 ratio and concentration of PD-L1 in the pleural effusions for prediction of MDR-TB. Methods: We measured the ratio of Th2 to Th1 T cells from pleural effusions in 373 tuberculous pleuritis patients. We also measured the concentration of programmed death ligand-1 (PD-L1) in the pleural effusions of these patients. Afterwards, we determined the optimal cut-off value for predicting the occurrence of multi-drug resistant tuberculous based on the Youden index, diagnostic evaluation test, and receiver operation curve. Multiple logistic analysis was employed to identify the independent risk factors for MDR-TB occurrence. Results: The area under the curve (AUC) of the Th2 to Th1 ratio was 0.66 and the concentration of PD-L1 was 0.71. Based on the combined detection of PD-L1 concentration in pleural effusion and the Th2 to Th1 ratio, our AUC was 0.81 and had a specificity of 0.92. Only a combined detection was able to identify patients developing multidrug-resistant tuberculosis. Multiple logistic analysis showed that a high concentration of PD-L1 and a high Th2 to Th1 T ratio in pleural effusions were indicative of an immunocompromised status. Therefore, these measurements might be independent risk factors for the occurrence of multidrug-resistant tuberculous. Conclusion: Evaluation of immune status based on PD-L1 pleural concentration and Th2 to Th1 ratio might predict the risk of MDR-TB occurrence.
Luoya Ling; Youqing Wang; Ye Ding; Lin Zheng; Xiaohua Qi; Mingjuan Jin; Kun Chen; Shuyun Xie
Volume 12, Issue 1 , March 2015, , Pages 70-73
Abstract
Background: Bacillus Calmette-Guérin (BCG) vaccination is recommended for newborn infants worldwide to prevent tuberculosis. However, complications do occur inevitably in a very low rate, among which the most serious is disseminated disease. The disseminated bacillus Calmette–Guérin ...
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Background: Bacillus Calmette-Guérin (BCG) vaccination is recommended for newborn infants worldwide to prevent tuberculosis. However, complications do occur inevitably in a very low rate, among which the most serious is disseminated disease. The disseminated bacillus Calmette–Guérin disease is a rare disease with high fatality, and can be seen among persons with an underlying immunodeficiency. Case presentation: We report a 4-month-old male infant presenting with recurrent fever, an isolated left axillary massand swelling at the site of BCG inoculation. The cellular immune function analysis showed that the value of CD4/CD8 was 0.994, indicating the existence of immunodeficiency.The results of blood culture and throat swab culture showed conditional pathogen infection. He died of cardiopulmonary failure. Conclusion: In this case, necropsy played a significant role in the final diagnosis of disseminated pulmonary tuberculosis.
Farhad Shahsavar; Tahereh Mousavi; Alireza Azargoon; Kobra Entezami
Volume 9, Issue 1 , March 2012, , Pages 39-47
Abstract
Background: Natural killer (NK) cells are the effector cells of innate immunity that respond to infection and tumor. Interactions between killer cell immunoglobulin like receptors (KIR) and human leukocyte antigen (HLA) class I molecules regulate NK cells responses to eliminate infected and transformed ...
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Background: Natural killer (NK) cells are the effector cells of innate immunity that respond to infection and tumor. Interactions between killer cell immunoglobulin like receptors (KIR) and human leukocyte antigen (HLA) class I molecules regulate NK cells responses to eliminate infected and transformed cells. Objective: To investigate the impact of KIR genes, HLA ligand genes, and KIR-HLA combinations on susceptibility to tuberculosis (TB) in Lur population of Iran. Methods: The genomic DNA of 50 patients with TB from Lorestan province of Iran was genotyped for sixteen KIR genes and their five major HLA class I ligands were determined by a polymerase chain reaction-sequence-specific primers (PCR-SSP) assay. The results were compared with those of 200 healthy unrelated Iranian individuals. Results: In Lur population of Iran, a significant decrease in frequency of KIR3DS1 was found in TB patients compared to control group (24% vs. 44.5%, OR=0.394, CI=0.194-0.798, p=0.013). Also, among the three activating genes that may use HLA class I molecules as their ligands, a significant decrease was shown in frequency of KIR3DS1 with HLA-B Bw4Ile80 ligand in TB patients compared to control group (4% vs. 23%, OR=0.14, CI=0.033-0.596, p=0.004). Conclusion: These findings imply a genetic imbalance between activating and inhibitory KIR genes and KIR-HLA combinations in Lur TB patients. Low level of activating KIR3DS1 and its combination with HLA-B Bw4Ile80 ligand might have an influence on the susceptibility to TB in Lur population of Iran.
Iraj Nikokar; Manouchehr Makvandi; Mohammad Javad Kajbaf; Ahmad Farajzadeh; Mehdi Mirsaeidi; Eskandar Kamali-Sarvestani; Ali Mostafaie; Kris Huygen
Volume 3, Issue 2 , June 2006, , Pages 70-77
Abstract
Background: Tuberculosis (TB) remains an important health problem throughout the world. Despite its significance in public health, mechanisms of protective immunity against Mycobacyerium Tuberculosis in humans have not yet been understood. Objective: To evaluate cell mediated immune response against ...
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Background: Tuberculosis (TB) remains an important health problem throughout the world. Despite its significance in public health, mechanisms of protective immunity against Mycobacyerium Tuberculosis in humans have not yet been understood. Objective: To evaluate cell mediated immune response against purified Ag 85, PPD and Phytohemagglutinin (PHA) in patients with tuberculosis and healthy tuberculin positive and negative individuals. Methods: Thirty patients with tuberculosis and 60 healthy tuberculin skin test positive and negative volunteers were participated in this study. Cell mediated immunity was assessed by measuring [³H]-thymidine uptake and detection of IFN-γ in the culture supernatant using commercial ELISA test. Results: In the present study, we showed that IFN- γ production and cell proliferation response to Ag 85 were significantly higher in tuberculin positive than tuberculin negative individuals (P<0.01). Among tuberculous patients, IFN-γ production and cell proliferative responses to Ag 85 was significantly lower in contrast to healthy tuberculin positive individuals (P<0.01). In addition, IFN- γ response in patients with cavitary tuberculosis was lower than patients without cavitation (P<0.05). Conclusion: Based on the higher cell mediated immune responses to Ag 85 in healthy tuberculin positive volunteers compared to patients (especially with advanced disease), purified Ag 85 can be used as a sensitive marker for analysis of immune responses in tuberculosis.
Ali Akbar Amirzargar; Abdol Ali Danesh; Farideh Khosravi; Mohammad Hossein Niknam; Behrouz Nikbin
Volume 1, Issue 2 , September 2004, , Pages 125-129
Abstract
Background: Pulmonary tuberculosis (PTB) has recently become a major problem in developed countries especially in immune compromised HIV infected individuals. Cytokines, their genes and receptors have been implicated in the protective immunity, pathophysiology and development of tuberculosis. ...
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Background: Pulmonary tuberculosis (PTB) has recently become a major problem in developed countries especially in immune compromised HIV infected individuals. Cytokines, their genes and receptors have been implicated in the protective immunity, pathophysiology and development of tuberculosis. Material & Methods: In the present study the genotype frequencies of a number of polymorphic genes coding for cytokines or for cytokine receptors have been investigated in a case control study including a group of 40 Iranian PTB patients and 40 healthy individuals. The allelic polymorphism of cytokines SNPs were analyzed according to the protocols of the cytokine component designed for the 13th IHW by the Heidelberg University group. Using PCR-SSP method the following cytokine genes have been determined: IL-1 ¿ (T/C –889), IL-1¾ (C/T +3962), IL-1R (C/T pstI 1970), IL-1RA ( T/C mspaI 1100), IL-4RA (G/A +1902), IL- 12 (C/A –1188), TGF- ¾ (C/T codon 10, G/C codon 25), TNF-¿ (G/A –308, G/A –238), IL-2 (T/G –330 G/T +166), IL-4 (T/G –1098, T/C –590, T/C –33), IL-6 (G/C –174, G/A nt 560), IL-10 (G/A –1082, C/T –819, C/A –592). Results: From IL-1R cluster (pro- inflammatory cytokines) a positive significant association was found at position pstI 1970 C/T polymorphism where the C allele was over presented in the PTB patients (60% vs. 37.5%, P = 0.04). A significant negative association at codon 10 TGF- ¾ C/T polymorphism has also been shown in our patients, where the T allele was not detected in the patients but 10% of the control subjects expressed this allele (Fisher exact test, P = 0.05). At this codon allele T (Leucine substitution) is associated with high TGF- ¾ production. For TNF ¿ an insignificant tendency was found at position -308 A/G polymorphism where the G allele carried by 80% of cases and 65% of controls (P = 0.07). At position -238 a negative association was found at the GA polymorphism (10% vs. 25%, P = 0.07). For IL-6 an insignificant positive association at position -174 C/G polymorphism, G allele (57.5% vs. 37.5, P = 0.07) was found. At the other cytokine genes no specific association were found. Conclusion: In conclusion it is suggested that C allele at position pstI 1970 of IL-1 cluster increases and T allele at codon 10 of TGF- ¾ decreases in PTB patients.
