Immunological Aspects of Diagnosis and Management of Childhood Tuberculosis

Gutiérrez‐González, Luis H.; Juárez, Esmeralda; Carranza, Claudia; Carreto-Binaghi, Laura E.; Alejandre, Alejandro; Cabello-Gutiérrrez, Carlos; González, Yolanda

doi:10.2147/idr.s295798

Cited by 14 publications

(16 citation statements)

References 139 publications

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“…Following a meta-analysis of current data, L. H. Gutiérrez-González et al [8] concluded that the correct diagnosis of immunological changes, prognosis and the use of potential immunomodulators as adjunct therapy in TB would meet personalized treatment.…”

Section: ключові словаmentioning

confidence: 99%

The effect of immunomodulator azoximer bromide on the cytokine profile in a complex therapy for children with newly diagnosed tuberculosis

Mironchuk

Raznatovska

2022

ZMJ

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Aim. To analyze the effect of immunomodulator azoximer bromide on the serum cytokine profile (IL-2, IL-6, IL-4, IL-10) in the complex therapy for children with newly diagnosed tuberculosis (TB). Materials and methods. The study included 51 newly diagnosed TB children, who were divided into 2 groups: 26 children received immunomodulator azoximer bromide (main group) in combined therapy with concurrent antimycobacterial therapy (AMBT) and 25 children were assigned to only AMBT (control group). The main group children received azoximer bromide (immunomodulator) adjunctive therapy for immunological changes correction concurrently with the standard AMBT: children under the age of 10 years – orally 6 mg twice a day, children aged over 10 years – 12 mg twice a day; the treatment course – 14 days. The serum cytokine profile (IL-2, IL-6, IL-4, IL-10) was examined on the basis of the Immunological Department in the Training Medical and Laboratory Center of ZSMU by solid-phase enzyme-linked immunosorbent assay (ELISA) using a device ELISA – reader Sirio S with respective kits (Bender MedSystems GmbH, Austria, pcg/ml) before AMBT initiation and at the end of AMBT maintenance phase (MF). The study results were processed on a personal computer using the statistical package of the licensed program Statistica, version 13 (Copyright 1984–2018 TIBCO Software Inc. All rights reserved, License No. JPZ8041382130ARCN10-J). Results. At the AMBT initiation, newly diagnosed TB children of both groups showed a clear imbalance between pro- and anti-inflammatory cytokines towards pro-inflammatory ones with a predominance and high activity of Th1 type cellular immune response. The ratios of IL-2/IL-10 and IL-6/IL-10 pointed to the normalized balance in the regulatory system of pro- and anti-inflammatory cytokines in the main group children upon the MF of AMBT completion. The ratio of IL-2/IL-10 dropped 7.3-fold at the treatment completion relative to that at the initiation of treatment, however, compared to the control group at the end of treatment, it was 7.2 times less. The controls did not show significant on-treatment dynamics of the IL-2/IL-10 and IL-6/IL-10 ratios, the IL-2/IL-10 ratio was 12.8 times higher than in the healthy children group at the treatment completion. Conclusions. The use of immunomodulator azoximer bromide in combination therapy for newly diagnosed TB children helps to normalize all cytokine profiles and the balance in the regulatory system of pro- and anti-inflammatory cytokines after the AMBT completion. Therefore, the effect of immunomodulator azoximer bromide on the cytokine profile in the treatment for newly diagnosed TB children is substantial, which would increase the AMBT effectiveness among this patient group as a whole.

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Section: ключові словаmentioning

confidence: 99%

The effect of immunomodulator azoximer bromide on the cytokine profile in a complex therapy for children with newly diagnosed tuberculosis

Mironchuk

Raznatovska

2022

ZMJ

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“…Alterations of specific Ig classes may potentially correlate with the extent of the disease ( 19 , 22 ). However, limited information about the humoral response in children is available ( 26 , 27 ).…”

Section: Introductionmentioning

confidence: 99%

Unbalanced serum immunoglobulins in clinical subtypes of pediatric tuberculosis disease

et al. 2022

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Immune response to tuberculosis (TB) has been extensively studied in the past decades and classically involves cellular immunity. However, evidence suggests that humoral immunity may play a relevant role. Past studies regarding serum immunoglobulin (Ig) levels in TB are dated and only involve adult subjects. In this study, we retrospectively studied a cohort of 256 children with TB disease and analyzed 111 patients screened for total serum Ig at diagnosis. According to the severity and extent of organ involvement, subjects were divided into four groups, namely, uncomplicated pulmonary TB (UCPTB, 56.3% of patients), complicated pulmonary TB (CPTB, 22.5%), lymph node extrapulmonary TB (LN-EPTB, 7.2%), and extra-nodal extrapulmonary TB (EN-EPTB, 13.5%). Serum IgG and IgA levels were significantly higher in more severe and extended TB disease. Median IgG levels progressively increased from uncomplicated to complicated pulmonary and nodal forms, reaching their highest values in diffuse extra-pulmonary TB. In parallel, UCPTB showed significantly lower frequencies of patients presenting a substantial increase in IgG levels when compared with the other three groups. No relevant differences in IgM levels were detected. Ig screening at follow-up showed a significant reduction in IgG and IgA levels. Finally, we unveiled three cases of selective IgA and one case of selective IgM deficiencies (SIgMD), the latter with a severe clinical course. Serum IgG and IgA may be a useful clinical tool to assess the severity and monitor the treatment response in pediatric TB disease. Moreover, immunological workup in children with TB disease may unmask primary defects of humoral immunity.

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“…The test has been acquainted in clinical practice with the measure of interferon gamma (IFN-γ) delivered by Mtb-contaminated platelets; lamentably, this strategy is more costly and requires a blood test to a typical leukocyte level [ 16 ], which is not generally imaginable in immunocompromised people. Accordingly, elective quantitative polymerase chain response techniques were created to recognize the safe reaction to TB contamination [ 17 ]. Be that as it may, as most quality articulation concentrates to show, the hereditary foundations can impact the particularity and affectability of the conclusion [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

Analysis of real-time PCR Melanocortin 3 (MC3R) gene expression to identify new biomarkers inflammation in tuberculosis

Tenriola

Hidayah

Subair

et al. 2022

Egypt J Med Hum Genet

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Background Diagnosis of tuberculosis (TB) in the era of technological sophistication requires accuracy and speed to provide as much information as possible so that TB treatment can be carried out quickly and precisely. New studies have also begun to be carried out to diagnose TB, one of which is by examining genes, either by looking at polymorphisms, mutations, or expressions. Several previous studies have confirmed the association of MC3R and TB genes with polymorphisms; MC3R is a gene that participates in the regulation of the inflammatory process and is also found in macrophages; therefore, we tried to analyze gene expression in the active TB group, household contacts, and healthy controls for looked at the differences between the three groups and confirmed the correlation of MC3R with TB by seeing which group's gene expression increased the most expression of the three groups so that the results can be considered as a TB diagnostic biomarker in the future. Methods This study included 122 people, 49 patients with confirmed TB, 46 close relatives of patients, and 27 healthy controls. This study used a real-time PCR technique to analyze MC3R gene expression in the three groups, and all data were analyzed using Bio-Rad CFXTM software version 3.1 and one-way ANOVA using SPSS 21.0. Results The value of MC3R gene expression in the active TB group increased 3.6-fold in the healthy group (p = 0.143), and that of gene expression in the healthy control group increased 1.09-fold in the healthy group (p = 0.007). Conclusion There is a relationship between MC3R and TB based on the results of gene expression analysis that increased in the active TB group compared to the household contact group and healthy controls.

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Immunological Aspects of Diagnosis and Management of Childhood Tuberculosis

Cited by 14 publications

References 139 publications

The effect of immunomodulator azoximer bromide on the cytokine profile in a complex therapy for children with newly diagnosed tuberculosis

The effect of immunomodulator azoximer bromide on the cytokine profile in a complex therapy for children with newly diagnosed tuberculosis

Unbalanced serum immunoglobulins in clinical subtypes of pediatric tuberculosis disease

Analysis of real-time PCR Melanocortin 3 (MC3R) gene expression to identify new biomarkers inflammation in tuberculosis

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