Different macrophage polarization between drug-susceptible and multidrug-resistant pulmonary tuberculosis

Abstract

Background: Macrophages play a key role in the infection process, and alternatively activated macrophages (M2 polarization) play important roles in persistent infection via the immune escape of pathogens. This suggests that immune escape of pathogens from host immunity is an important factor to consider in treatment failure and multidrug-resistant tuberculosis (MDR-TB)/extensively drug-resistant tuberculosis (XDR-TB). In this study, we investigated the association between macrophage polarization and MDR-TB/XDR-TB and the association between macrophage polarization and the anti-TB drugs used. Methods: iNOS and arginase-1, a surface marker of polarized macrophages, were quantified by immunohistochemical staining and imaging analysis of lung tissues of patients who underwent surgical treatment for pulmonary TB. Drug susceptibility/resistance and the type and timing of anti-tuberculosis drugs used were investigated.Results: The M2-like polarization rate and the ratio of the M2-like polarization rate to the M1-like polarization rate were significantly higher in the MDR-TB/XDR-TB group than in the DS-TB group. The association between a high M2-like polarization rate and MDR-TB/XDR-TB was more pronounced in patients with a low M1-like polarization rate. Younger age and a higher M2-like polarization rate were independent associated factors for MDR-TB/XDR-TB. The M2-like polarization rate was significantly higher in patients who received anti-TB drugs containing pyrazinamide continuously for 4 or 6 weeks than in those who received anti-TB drugs not containing pyrazinamide. Conclusions:The M2-like polarization of macrophages is associated with MDR-TB/XDR-TB and anti-TB drug regimens including pyrazinamide or a combination of pyrazinamide, prothionamide and cycloserine.

The Dynamics of Macrophage Function in Reparation of Natural Immune System in Tuberculosis Disease

“…Pyrazinamide treatment influences the host immune response by decreasing proinflammatory cytokine production in Mtb infection. First-line intervention of anti-TB therapy to pleural TB patients is induces polarization of pleural macrophages to M2, so from this study showed that anti-TB treatment was able modulated the host immune response (6) .…”

“…Pyrazinamide treatment influences the host immune response by decreasing pro-inflammatory cytokine production in Mtb infection. The administration of firstline anti-TB therapy to pleural TB patients will induces polarization of pleural macrophages towards M2, so this study showed that anti-TB treatment was modulated the host immune response (6) . The interaction between host, Mtb and treatment are influence each other and it are able to mediate immunomodulation and bring the successful of treatment, so it will be main discussion in this study review.…”

Blood M2a monocyte polarization and increased formyl peptide receptor 1 expression are associated with progression from latent tuberculosis infection to active pulmonary tuberculosis disease

“…M1 macrophages promote TB granuloma formation and cause eradication of Mtb, while M2 macrophages inhibit this process, are permissive of Mtb growth, and lead to an anti-inflammatory status (Huang et al, 2015b). A higher M2-like polarization rate has been shown to be independently associated with active or multidrug-resistant-TB (Cho et al, 2020;Huang et al, 2015a). MicroRNA 26a/KLF4, CREB-C/ EBP-β, IRAK-M, and vitamin D [1,25(OH)2D3] can regulate the polarization of macrophages during Mtb infection (Rao Muvva et al, 2019;Sahu et al, 2017;Shen et al, 2017).…”

Sensitivity and specificity of the mean corpuscular volume and CD4/CD8 ratio in discriminating between rifampicin resistant and rifampicin sensitive tuberculosis

“…The mean corpuscular volume (MCV) correlates with levels of exhaled nitric oxide [15] , a marker of pulmonary inflammation that promotes increased T-helper 2 (Th2) immune responses [16] . Studies have demonstrated a local and systemic anti-inflammatory Th2 response in DR – TB that significantly differs from that observed in drug sensitive tuberculosis (DS – TB) [17] , [18] , [19] , [20] . However, the relationship between the MCV and drug resistant TB is unknown.…”