Sputum and serum from patients with active pulmonary tuberculosis (TB), healthy purified protein derivative-positive adults, and patients with bacterial pneumonia were collected to simultaneously assess local immunity in the lungs and peripheral blood. To determine whether cytokine profiles in sputum from TB patients and control subjects were a reflection of its cellular composition, cytospin slides were prepared in parallel and assessed for the presence of relative proportions of epithelial cells, neutrophils, macrophages, and T cells. Gamma interferon (IFN-␥) in sputum from TB patients was markedly elevated over levels for both control groups. With anti-TB therapy, IFN-␥ levels in sputum from TB patients decreased rapidly and by week 4 of treatment were comparable to those in sputum from controls. Further, IFN-␥ levels in sputum closely followed mycobacterial clearance. Although detected at fourfold-lower levels, IFN-␥ immunoreactivities in serum followed kinetics in sputum. TNF-␣, interleukin 8 (IL-8) and IL-6 also were readily detected in sputum from TB patients at baseline and responded to anti-TB therapy. In contrast to IFN-␥, however, TNF-␣ and IL-8 levels also were elevated in sputum from pneumonia controls. These data indicate that sputum cytokines correlate with disease activity during active TB of the lung and may serve as potential early markers for sputum conversion and response to anti-TB therapy.Despite efforts to improve diagnosis and treatment, tuberculosis (TB) remains a major health problem worldwide, especially in developing countries. Obstacles to TB control include the long duration of therapy and the lack of concrete markers indicating success or failure of treatment early during the course of active disease.Sputum culture conversion following 8 weeks of treatment has been used as a surrogate of response to antituberculous chemotherapy (16). However, cultures require up to 6 weeks to perform and, therefore, are not ideally suited for real-time assessment of response to treatment. By contrast, assessment of immunological parameters in biological fluids can be accomplished within days of sample collection and, if validated as a surrogate marker, may be particularly useful in settings where the activity of short-term administration of new drugs (early bactericidal activity studies) or of immunoadjuvants to standard anti-TB therapy is tested. Further, identifying immunological parameters that correlate with culture sterilization may provide important information about host factors most relevant to anti-Mycobacterium tuberculosis (MTB) immunity.Since TB predominantly affects the lung, assessment of specimens recovered from this site may best reflect the interaction between the host and MTB during active disease. Fiber optic bronchoscopy and bronchoalveolar lavage (BAL) has been used to assess anti-MTB immunity in situ (18,19). However, this invasive technique cannot be applied serially during treatment. As a result we investigated alternative approaches for evaluating anti-MTB immune responses ...
The timely evaluation of new drugs that can be used to shorten tuberculosis (TB) treatment will require surrogate markers for relapse. This study examined bactericidal activity against intracellular Mycobacterium tuberculosis in whole blood culture (whole blood bactericidal activity; WBA) during TB treatment. In the absence of chemotherapy, immune mechanisms in patient blood resulted in bacteriostasis, whereas administration of oral chemotherapy resulted in bacillary killing. Total WBA per dose was greater during the intensive phase of treatment than during the continuation phase (mean, -2.32 vs. -1.67 log(10) cfu-days, respectively; P<.001). Cumulative WBA throughout treatment was greater in subjects whose sputum cultures converted to negative by the eighth week of treatment than in those for whom conversion was delayed (mean, -365 vs. -250 log(10) cfu-days; P=.04) and correlated with the rate of decrease of sputum colony-forming unit counts during the first 4 weeks of treatment (P=.018), both of which are indicative of prognosis. These findings indicate that measurement of WBA may have a role in assessing the sterilizing activity of new anti-TB drugs.
We report a significantly higher prevalence of intestinal nematodes in patients with pulmonary tuberculosis (TB) compared to a matched control group: 33/57 (57.8%) in patients with TB and 18/86 (20.9%) in the control group; OR=5.19; 95% CI= 2.33-11.69; p=0.000). When TB patients eosinophilia was also significantly higher among those with intestinal parasites (69.8%) compared to those without this condition (45.6%). We hypothesized that the immune modulation induced by nematodes is a factor that enhances TB infection/ progression and that eosinophilia seen in TB patients is a consequence of helminth infection. Key-words: Tuberculosis. Helminthiasis. Strongyloidiasis. Mycobacterium tuberculosis.Resumo Nesta comunicação relatamos uma prevalência significativamente maior de nematóides intestinais em pacientes com tuberculose pulmonar (TB), comparada a um grupo controle pareado: 33/57 (57,8%) nos pacientes com TB e 18/86 (20,9%) no grupo controle; OR=5.19; IC a 95%= 2.33-11.69;p=0.000). Dentre os pacientes com TB, a eosinofilia foi significativamente maior nos pacientes com nematóides intestinais (69,8%) comparados àqueles sem parasitas (45,6%). Nossa hipótese é que a imunomodulação induzida por nematóides é fator facilitador da infecção/progressão da doença na TB e que a eosinofilia frequentemente vista em pacientes com TB é secundária à infecção helmíntica.
Resumo Objetivo Analisar os fatores associados ao óbito em indivíduos internados por COVID-19 em hospitais do Espírito Santo, Brasil. Métodos Estudo transversal, com dados secundários. Modelos de regressão logística foram empregados para estimar razões de chance (odds ratio: OR) brutas e ajustadas. Resultados Até 14 de maio de 2020, 200 indivíduos receberam alta e 220 foram a óbito. Do total de pessoas estudadas, 57,1% eram do sexo masculino, 46,4% maiores de 60 anos de idade, 57,9% foram notificados por instituição privada e 61,7% apresentaram mais de 1 comorbidade. Na análise ajustada, a mortalidade hospitalar foi maior entre aqueles nas faixas etárias de 51 a 60 (OR=4,33 – IC95% 1,50;12,46) e mais de 60 anos (OR=11,84 – IC95% 4,31;32,54), notificados por instituição pública (OR=8,23 – IC95% 4,84;13,99) e com maior número de comorbidades (duas [OR=2,74 – IC95% 1,40;5,34] e três [OR=2,90 – IC95% 1,07;7,81]). Conclusão Observa-se maior mortalidade em idosos, com comorbidades e usuários de hospitais públicos.
It was possible to identify the relationship of dengue with factors outside the health sector and to identify areas with higher risk of disease.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.