Allopatric tuberculosis host–pathogen relationships are associated with greater pulmonary impairment

Pasipanodya, Jotam G.; Moonan, Patrick K.; Vecino, Elena; Miller, Thaddeus L.; Fernandez, Michel; Slocum, Philip; Drewyer, Gerry; Weis, Stephen E.

doi:10.1016/j.meegid.2013.02.015

Cited by 23 publications

(17 citation statements)

References 47 publications

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“…Six studies analysed the association between CS exposure and ‘severity’ of TB—defined by the presence of cavitary disease, need for hospitalization, delayed sputum culture conversion, lung impairment and/or drug resistance (Table ) . Four of these studies quantified the link and found a significant association between CS exposure and markers of TB severity (Fig.…”

Section: Severity Of and Mortality From Tb And Cs Exposurementioning

confidence: 99%

“…A study of 297 smokers and 141 non‐smokers with pulmonary TB observed that smokers had more severe and disseminated disease . Lung function has also been evaluated in patients with treated TB . While it was not surprising to find lower lung function with greater cumulative smoking history, it is not possible to dissect whether smoking synergizes with TB in causing the impairment in lung function or whether the two processes are independent and additive in reducing lung function …”

Section: Severity Of and Mortality From Tb And Cs Exposurementioning

confidence: 99%

“…69 While it was not surprising to find lower lung function with greater cumulative smoking history, it is not possible to dissect whether smoking synergizes with TB in causing the impairment in lung function or whether the two processes are independent and additive in reducing lung function. 69 Eight studies have investigated the effects of CS exposure and mortality (Table 4). 3,[62][63][64][65]67,70,71 Of the seven studies that quantified the link, six found a significant association between CS exposure and death from TB (Fig.…”

Section: Severity Of and Mortality From Tb And Cs Exposurementioning

confidence: 99%

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Epidemiologic link between tuberculosis and cigarette/biomass smoke exposure: Limitations despite the vast literature

et al. 2015

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The geographic overlap between the prevalence of cigarette smoke (CS) exposure and tuberculosis (TB) in the world is striking. In recent years, relatively large number of studies has linked cigarette or biomass fuel smoke exposure and various aspects of TB. Our goals are to summarize the significance of the known published studies, graphically represent reports that quantified the association and discuss their potential limitations. PubMed searches were performed using the key words 'tuberculosis' with 'cigarette', 'tobacco', 'smoke' or 'biomass fuel smoke.' The references of relevant articles were examined for additional pertinent papers. A large number of mostly case-control and cross-sectional studies significantly associate both direct and second-hand smoke exposure with tuberculous infection, active TB, and/or more severe and lethal TB. Fewer link biomass fuel smoke exposure and TB. While a number of studies interpreted the association with multivariate analysis, other confounders are often not accounted for in these analyses. It is also important to emphasize that these retrospective studies can only show an association and not any causal link.We further explored the possibility that even if CS exposure is a risk factor for TB, several mechanisms may be responsible. Numerous studies associate cigarette and biomass smoke exposure with TB but the mechanism(s) remains largely unknown. While the associative link of these two health maladies is well established, more definitive, mechanistic studies are needed to cement the effect of smoke exposure on TB pathogenesis and to utilize this knowledge in empowering public health policies.

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Section: Severity Of and Mortality From Tb And Cs Exposurementioning

confidence: 99%

Section: Severity Of and Mortality From Tb And Cs Exposurementioning

confidence: 99%

Section: Severity Of and Mortality From Tb And Cs Exposurementioning

confidence: 99%

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Epidemiologic link between tuberculosis and cigarette/biomass smoke exposure: Limitations despite the vast literature

et al. 2015

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“…When combined with spatio-temporal data, MIRU/VNTR and spoligotyping are considered the gold standard for identifying and tracking chains of Mtb transmission. More importantly, both have become indispensable for tuberculosis (TB) epidemiology studies of drug resistance within communities and across the world [5,7,14,16,19,20]. The optimal TB treatment duration for the different anatomic sites, including skin, meninges and pericardial spaces, is unknown [5].…”

Section: Introductionmentioning

confidence: 99%

Machine-learning (ML) reveals that Mycobacterium tuberculosis genotypes and anatomic disease site impacts drug resistance and disease transmission among patients with proven extra-pulmonary tuberculosis

Sibandze¹,

Magazi

Malinga

et al. 2020

Preprint

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Background There is a general dearth of information on extrapulmonary tuberculosis (EPTB). We investigated Mycobacterium tuberculosis (Mtb) drug resistance and transmission patterns in EPTB patients treated in the Tshwane metropolitan, South Africa. Methods Consecutive Mtb culture-positive non-pulmonary samples from unique EPTB patients underwent further mycobacterial genotyping and were assigned to phylogenetic lineages and transmission clusters based on spoligotypes. MTBDR plus assay was used to test for isoniazid and rifampin susceptibility. ML algorithms were used to identify clinically meaningful patterns in data. We computed odds ratio (OR), attributable risk (AR) and corresponding 95% confidence intervals (CI). Results Of the 70 isolates examined, the largest cluster comprised of 25 (36%) Mtb strains that belonged to the East Asian lineage. East Asian lineage was significantly more likely to occur within chains of transmission when compared to the Euro-American and East-African Indian lineages: OR= 10.11 (95% CI: 1.56-116). Lymphadenitis, meningitis and skin TB, were significantly more likely to be associated with drug resistance: OR=12.69 (95% CI: 1.82-141.60) and AR = 0.25 (95% CI: 0.06-0.43) when compared with other EPTB sites, which suggests that poor rifampin penetration might be a contributing factor. Conclusions Majority of Mtb strains circulating in the Tshwane metropolis belongs to East Asian, Euro-American and East-African Indian lineages. Each of these are likely to be clustered, suggesting on-going EPTB transmission. Since 25% of the drug resistance was attributable to sanctuary EPTB sites notorious for poor rifampin penetration, we hypothesize that poor anti-tuberculosis drug dosing might have a role in the resistance.

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“…tuberculosis lineages [ 29 – 33 ]. Thus, these have been classified as sympatric host-pathogen relationships, when host and pathogen share a common ancestral geographic origin, or allopatric, when they originate from non-overlapping geographic areas [ 34 ]. Accordingly, the more stable associations between these lineages and their human populations would characterize the sympatric host-pathogen relationship [ 6 – 7 , 35 ].…”

Section: Introductionmentioning

confidence: 99%

Determinants of the Sympatric Host-Pathogen Relationship in Tuberculosis

et al. 2015

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Major contributions from pathogen genome analysis and host genetics have equated the possibility of Mycobacterium tuberculosis co-evolution with its human host leading to more stable sympatric host–pathogen relationships. However, the attribution to either sympatric or allopatric categories depends on the resolution or grain of genotypic characterization. We explored the influence on the sympatric host-pathogen relationship of clinical (HIV infection and multidrug-resistant tuberculosis [MDRTB]) and demographic (gender and age) factors in regards to the genotypic grain by using spacer oligonucleotide typing (spoligotyping) for classification of M. tuberculosis strains within the Euro-American lineage. We analyzed a total of 547 tuberculosis (TB) cases, from six year consecutive sampling in a setting with high TB-HIV coinfection (32.0%). Of these, 62.0% were caused by major circulating pathogen genotypes. The sympatric relationship was defined according to spoligotype in comparison to the international spoligotype database SpolDB4. While no significant association with Euro-American lineage was observed with any of the factors analyzed, increasing the resolution with spoligotyping evidenced a significant association of MDRTB with sympatric strains, regardless of the HIV status. Furthermore, distribution curves of the prevalence of sympatric and allopatric TB in relation to patients’ age showed an accentuation of the relevance of the age of onset in the allopatric relationship, as reflected in the trimodal distribution. On the contrary, sympatric TB was characterized by the tendency towards a typical (standard) distribution curve. Our results suggest that within the Euro-American lineage a greater degree of genotyping fine-tuning is necessary in modeling the biological processes behind the host-pathogen interplay. Furthermore, prevalence distribution of sympatric TB to age was suggestive of host genetic determinisms driven by more common variants.

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Allopatric tuberculosis host–pathogen relationships are associated with greater pulmonary impairment

Cited by 23 publications

References 47 publications

Epidemiologic link between tuberculosis and cigarette/biomass smoke exposure: Limitations despite the vast literature

Epidemiologic link between tuberculosis and cigarette/biomass smoke exposure: Limitations despite the vast literature

Machine-learning (ML) reveals that Mycobacterium tuberculosis genotypes and anatomic disease site impacts drug resistance and disease transmission among patients with proven extra-pulmonary tuberculosis

Determinants of the Sympatric Host-Pathogen Relationship in Tuberculosis

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