Coexistent Malnutrition Is Associated with Perturbations in Systemic and Antigen-Specific Cytokine Responses in Latent Tuberculosis Infection

Ray, Anuradha; Munisankar, Saravanan; Bhootra, Yukthi; Kumar, Nathalla Pavan; Dolla, Chandrakumar; Kumaran, Paul; Babu, Subash

doi:10.1128/cvi.00009-16

Cited by 39 publications

(30 citation statements)

References 33 publications

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“…A recent study has shown a link between BMI and inflammatory cytokines of TB. Individuals with low BMI have diminished circulating levels of proinflammatory (IFN-γ, TNF-α, IL-22, IL-1α, IL-1β, and IL-6) cytokines but elevated levels of regulatory cytokines (IL-10, TGF-β, IL-5, IL-13) ( 52 ). This group demonstrated a positive correlation between the circulating levels of pro-inflammatory cytokines and high BMI (between 25 and 29.9) and a negative correlation between the circulating levels of anti-inflammatory cytokines and low BMI ( 53 , 54 ).…”

Section: Introductionmentioning

confidence: 99%

Malnutrition: Modulator of Immune Responses in Tuberculosis

et al. 2017

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Nutrition plays a major role in the management of both acute and chronic diseases, in terms of body’s response to the pathogenic organism. An array of nutrients like macro- and micro-nutrients, vitamins, etc., are associated with boosting the host’s immune responses against intracellular pathogens including mycobacterium tuberculosis (M.tb). These nutrients have an immunomodulatory effects in controlling the infection and inflammation process and nutritional deficiency of any form, i.e., malnutrition may lead to nutritionally acquired immunodeficiency syndrome, which greatly increases an individual’s susceptibility to progression of infection to disease. This narrative review looks at the various mechanisms by which nutrition or its deficiency leads to impaired cell mediated and humoral immune responses, which in turn affects the ability of an individual to fight M.tb infection or disease. There is very little evidence in the literature that any specific food on its own or a specific quantity can alter the course of TB disease or be effective in the treatment of malnutrition. Further clinical trials or studies will be needed to recommend and to better understand the link between malnutrition, tuberculosis, and impaired immunity.

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Section: Introductionmentioning

confidence: 99%

Malnutrition: Modulator of Immune Responses in Tuberculosis

et al. 2017

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“…Malnutrition and dietary factors are important risk factors for the global burden of diseases such as diabetes [3], cardiovascular disease [4], and tuberculosis [5,6]. According to the 2016 Global Nutrition report, the economic consequences of malnutrition represent losses of 11% of Gross Domestic Product (GDP) every year in Africa and Asia, whereas preventing malnutrition delivers US$16 in returns on investment for every US$1 spent [1].…”

Section: Introductionmentioning

confidence: 99%

Malnutrition status and associated factors among HIV-positive patients enrolled in ART clinics in Zimbabwe

et al. 2017

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Background: Sub-Saharan Africa suffers from a high burden of undernutrition, affecting 23.2% of its population, and in 2015 constituted 69% of the estimated people living with Human Immunodeficiency Virus (HIV) globally. Zimbabwe, in Southern African has a HIV prevalence of 14.7%, but malnutrition (under-and over-nutrition) in this population has not been characterized. A nationally representative survey was therefore conducted to determine malnutrition prevalence and associated factors among HIV-positive adults (≥15 years) enrolled at antiretroviral therapy (ART) clinics in Zimbabwe. Methods: Height and weight measurements were taken for all enrolled participants who had attended their scheduled clinic review visits. Malnutrition was determined using body mass index (BMI) calculations and classified as undernutrition (<18.5 kg/m

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“…Concomitant and weakening physical conditions in older people blunt inflammatory responses which then constrain cavitation [ 33]. The increased risk of cavitation and smear positivity in undernourished patients could be either way: under-nutrition led to immune-deficiency and enhanced disease progression [ 34,35] or the disease itself might lead to under-nutrition [ 36]. Moreover, other evidences revealed diabetes, smoking, low income and absence of HIV [37][38][39] as independent predictors of cavitation and smear positivity.…”

Section: Discussionmentioning

confidence: 99%

Delay in Diagnosis of Pulmonary Tuberculosis is Associated with Increased Risk of Transmission in Pastoralist Setting, Ethiopia

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Demissie

Yalew

et al. 2019

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Background To comprehend the effect of delayed care on risk of tuberculosis (TB) transmission in a TB prevalent but low case detection area, this study examined the association of diagnosis delay with patient infectiousness (cavitation and smear positivity) and determined the threshold delay that optimizes infectiousness. It also assessed transmission drivers in Somali region of Ethiopia, an area with ample pastoralist population. Methods A cross-sectional study was conducted using 434 new pulmonary TB patients, aged ≥15 years, who were recruited prospectively in five major facilities between December 2017 and October 2018. Data were collected on delays in diagnosis, socio-demographics, clinical and epidemiological information using interview, record-review, anthropometry, sputum microscopy and chest radiography techniques. Log-binomial regression models were used to reveal predictors of cavitation and smear positivity at p<0.05 using Stata/SE®14. C-statistics was applied to determine predictive ability and threshold delay that classifies infectiousness. Results Median age of participants was 30 years. Majorities were male (62.9%), nearly half (46.5%) were pastoralist and 2.3% TB/HIV co-infected. Median delay from debut of illness to diagnosis was 49 days (IQR=37). Among all cases, 45.6% [95%CI: 40.9-50.4] had pulmonary cavity and 42.0% [95%CI: 37.3˗46.9] were smear positive. On multivariable analysis, cavitation was higher in patients delayed over a month [P<0.001], ≤35 years [APR (95%CI) =1.3(1.01-1.6)], with chronic diseases [APR (95%CI) =1.8(1.2-2.6)] and low MUAC*female [APR (95%CI) =1.8(1.2-2.8)]. Smear positivity was higher in patients delayed >49 days [p=0.02], ≤35 years [APR (95%CI) =1.4(1.1-1.8)], low BMI [APR (95%CI) =1.3(1.01-1.7)] and low MUAC [APR (95%CI) =1.5(1.2-1.9)]. Delay discriminates cavitation [AUC (95%CI) =0.67(0.62-0.72)] at 43 days optimal cutoff and 74.6% sensitivity. Conclusion This study highlights that delay in diagnosis of pulmonary TB remains high and is associated with increased risk of cavitation and smear positivity in pastoral setting in Ethiopia. In pastoral settings, this may call upon a socio-cultural tailored TB prevention and control strategies.

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Coexistent Malnutrition Is Associated with Perturbations in Systemic and Antigen-Specific Cytokine Responses in Latent Tuberculosis Infection

Cited by 39 publications

References 33 publications

Malnutrition: Modulator of Immune Responses in Tuberculosis

Malnutrition: Modulator of Immune Responses in Tuberculosis

Malnutrition status and associated factors among HIV-positive patients enrolled in ART clinics in Zimbabwe

Delay in Diagnosis of Pulmonary Tuberculosis is Associated with Increased Risk of Transmission in Pastoralist Setting, Ethiopia

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