Complications of tuberculosis

Shah, Maunank; Reed, Caitlin

doi:10.1097/qco.0000000000000090

Cited by 58 publications

(55 citation statements)

References 66 publications

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“…This is further corroborated by our data on the association of hemoptysis with elevated levels of VEGF-A, C and R2 in TB-DM, since hemoptysis typically is more likely to occur in TB-DM than TB individuals [35–37]. Our results indicate that elevated levels of angiogenic factors could potentially reflect neovascularization in lung lesions and tissue-destructive immune pathology in TB-DM, leading to increased risk of hemoptysis [38]. Also, of interest, we were not able to discern any significant differences in the systemic levels of circulating angiogenic factors between known and newly diagnosed DM amongst the TB-DM (data not shown), although this might have been influenced by the small number of newly diagnosed DM (n=10) in our study.…”

Section: Discussionsupporting

confidence: 87%

Tuberculosis-diabetes co-morbidity is characterized by heightened systemic levels of circulating angiogenic factors

Kumar

Moideen

Shanmugam

et al. 2017

Journal of Infection

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Background Tuberculosis-diabetes co-morbidity (TB-DM) is characterized by increased inflammation with elevated circulating levels of inflammatory cytokines and other factors. Circulating angiogenic factors are intricately involved in the angiogenesis-inflammation nexus. Methods To study the association of angiogenic factors with TB-DM, we examined the systemic levels of VEGF-A, VEGF-C, VEGF-D, VEGF-R1, VEGF-R2, VEGF-R3 in individuals with either TB-DM (n=44) or TB alone (n=44). Results Circulating levels of VEGF-A, C, D, R1, R2 and R3 were significantly higher in TB-DM compared to TB individuals. Moreover, the levels of VEGF-A, C, R2 and/or R3 were significantly higher in TB-DM with bilateral or cavitary disease or with hemoptysis, suggesing an association with both disease severity and adverse clinical presentation. The levels of these factors also exhibited a significant positive relationship with bacterial burdens and HbA1c levels. In addition, VEGF-A, C and R2 levels were signifantly higher (at 2 months of treatment) in culture positive compared to culture negative TB-DM individuals. Finally, the circulating levels of VEGF-A, C, D, R1, R2 and R3 were significantly reduced following successful chemotherapy at 6 months. Conclusion Our data demonstrate that TB-DM is associated with heightened levels of circulating angiogenic factors, possibly reflecting both dysregulated angiogenesis and exaggerated inflammation.

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Section: Discussionsupporting

confidence: 87%

Tuberculosis-diabetes co-morbidity is characterized by heightened systemic levels of circulating angiogenic factors

Kumar

Moideen

Shanmugam

et al. 2017

Journal of Infection

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“…Specifically, increased PROZ may inhibit thrombin generation and prevent coagulation to mitigate the risk of thrombotic complications in these patients. In addition, increased PROZ was also found significantly increased in patients with TB including cavitary lung lesions ( P = 0.03, Table 2), whom we assumed would have a higher risk for hemoptysis [25], than in those with non-cavitary lung lesions. The higher risk for hemoptysis might lead to increased clotting tendency and higher level of PROZ.…”

Section: Discussionmentioning

confidence: 99%

“…Hemoptysis occurs upon pulmonary circulation or bronchial erosion, or following pseudoaneurysm formation, leading to hemodynamic collapse in patients with TB [25]. SAA, a major acute phase protein, has been shown to enhance the expression and activity of tissue factor (TF) and inhibit the expression and secretion of TF pathway inhibitor (TFPI) [20].…”

Section: Discussionmentioning

confidence: 99%

“…SAA was also significantly increased in patients with TB exhibiting cavitary lung lesions ( P = 0.006, Table 2) compared to those with non-cavitary lung lesions, and a significantly increased level of SAA was observed in patients with TB presenting with double rather than single lung lesions ( P = 0.003, Table 2). Accordingly, we suggested that more erosion occurred in TB concomitant with cavitary and double lung lesions than in patients with non-cavitary and single lung lesions [25], leading to higher levels of SAA.…”

Section: Discussionmentioning

confidence: 99%

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Serum amyloid A, protein Z, and C4b-binding protein β chain as new potential biomarkers for pulmonary tuberculosis

Shi

Wei

et al. 2017

PLoS ONE

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The aim of this study was to discover novel biomarkers for pulmonary tuberculosis (TB). Differentially expressed proteins in the serum of patients with TB were screened and identified by iTRAQ-two dimensional liquid chromatography tandem mass spectrometry analysis. A total of 79 abnormal proteins were discovered in patients with TB compared with healthy controls. Of these, significant differences were observed in 47 abnormally expressed proteins between patients with TB or pneumonia and chronic obstructive pulmonary disease (COPD). Patients with TB (n = 136) exhibited significantly higher levels of serum amyloid A (SAA), vitamin K-dependent protein Z (PROZ), and C4b-binding protein β chain (C4BPB) than those in healthy controls (n = 66) (P<0.0001 for each) albeit significantly lower levels compared with those in patients with pneumonia (n = 72) (P<0.0001 for each) or COPD (n = 72) (P<0.0001, P<0.0001, P = 0.0016, respectively). After 6 months of treatment, the levels of SAA and PROZ were significantly increased (P = 0.022, P<0.0001, respectively), whereas the level of C4BPB was significantly decreased (P = 0.0038) in treated TB cases (n = 72). Clinical analysis showed that there were significant differences in blood clotting and lipid indices in patients with TB compared with healthy controls, patients with pneumonia or COPD, and treated TB cases (P<0.05). Correlation analysis revealed significant correlations between PROZ and INR (rs = 0.414, P = 0.044), and between C4BPB and FIB (rs = 0.617, P = 0.0002) in patients with TB. Receiver operating characteristic curve analysis revealed that the area under the curve value of the diagnostic model combining SAA, PROZ, and C4BPB to discriminate the TB group from the healthy control, pneumonia, COPD, and cured TB groups was 0.972, 0.928, 0.957, and 0.969, respectively. Together, these results suggested that SAA, PROZ, and C4BPB may serve as new potential biomarkers for TB. Our study may thus provide experimental data for the differential diagnosis of TB.

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“…Shah and Reed 16 described, among the commonest complications of tuberculosis, "mycetomas developing within residual tuberculosis cavities, impaired pulmonary function, or focal neurologic deficits from tuberculomas," and, therefore, "public health tuberculosis programs and health systems require additional resources to provide comprehensive tuberculosis and post-tuberculosis care. "…”

Section: Tuberculosis Sequelae Following Diagnosis and Treatment Of Tmentioning

confidence: 99%

Is there a rationale for pulmonary rehabilitation following successful chemotherapy for tuberculosis?

et al. 2016

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The role of tuberculosis as a public health care priority and the availability of diagnostic tools to evaluate functional status (spirometry, plethysmography, and DLCO determination), arterial blood gases, capacity to perform exercise, lesions (chest X-ray and CT), and quality of life justify the effort to consider what needs to be done when patients have completed their treatment. To our knowledge, no review has ever evaluated this topic in a comprehensive manner. Our objective was to review the available evidence on this topic and draw conclusions regarding the future role of the "post-tuberculosis treatment" phase, which will potentially affect several million cases every year. We carried out a non-systematic literature review based on a PubMed search using specific keywords (various combinations of the terms "tuberculosis", "rehabilitation", "multidrug-resistant tuberculosis", "pulmonary disease", "obstructive lung disease", and "lung volume measurements"). The reference lists of the most important studies were retrieved in order to improve the sensitivity of the search. Manuscripts written in English, Spanish, and Russian were selected. The main areas of interest were tuberculosis sequelae following tuberculosis diagnosis and treatment; "destroyed lung"; functional evaluation of sequelae; pulmonary rehabilitation interventions (physiotherapy, long-term oxygen therapy, and ventilation); and multidrug-resistant tuberculosis.The evidence found suggests that tuberculosis is definitively responsible for functional sequelae, primarily causing an obstructive pattern on spirometry (but also restrictive and mixed patterns), and that there is a rationale for pulmonary rehabilitation. We also provide a list of variables that should be discussed in future studies on pulmonary rehabilitation in patients with post-tuberculosis sequelae.

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Complications of tuberculosis

Cited by 58 publications

References 66 publications

Tuberculosis-diabetes co-morbidity is characterized by heightened systemic levels of circulating angiogenic factors

Tuberculosis-diabetes co-morbidity is characterized by heightened systemic levels of circulating angiogenic factors

Serum amyloid A, protein Z, and C4b-binding protein β chain as new potential biomarkers for pulmonary tuberculosis

Is there a rationale for pulmonary rehabilitation following successful chemotherapy for tuberculosis?

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