“…1 a, b). Similar morphologic descriptions of CT or MRI findings could be found in some other studies that provided sufficient information on morphologic characteristics [ 20 , 21 , 26 , 29 , 31 ]. Fig.…”
Section: Main Textsupporting
confidence: 81%
“…One study was conducted on contacts infected with HIV [ 35 ], while the other 24 studies were conducted in immunocompetent contacts. Four studies partly [ 25 , 29 ] or entirely [ 23 , 26 ] included close contacts with drug-resistant TB. Bacterial and molecular testing with sputum or other specimens (e.g., gastric aspirates) generally yielded a low positivity rate in contacts with minimal CT or PET abnormalities, reflecting a low bacillary burden (Table 1 ).…”
Section: Main Textmentioning
confidence: 99%
“…There are two fundamental points to consider: (1) the risk of TB infection and developing active TB and (2) the probability of active TB manifesting as normal radiographs. If the risk is not sufficiently intense (e.g., in a mass screening context), most examinations will not additionally depict changes from incipient TB to active TB beyond what is portrayed by X-ray examinations, as TB disease infrequently occurs and progresses [ 29 , 50 , 68 , 69 ]. TB more frequently manifests with normal radiographs in immunocompromised contacts or children.…”
Close contacts of individuals with pulmonary tuberculosis are at risk for tuberculosis infection and the development of active tuberculosis. In current contact investigations, immunologic tests (the tuberculin skin test and interferon-gamma release assay) and chest X-ray examinations are used to dichotomize contacts with Mycobacterium tuberculosis infections into those with active (X-ray abnormalities) versus latent tuberculosis (normal radiographs). This article is a critical review of computed tomographic (CT) and 18-fluorodeoxyglucose positron emission tomographic (PET) findings of incipient tuberculosis without X-ray abnormalities based on a systematic literature review of twenty-five publications. The CT and 18-fluorodeoxyglucose PET studies revealed minimal pauci-nodular infiltrations in the lung parenchyma and mediastinal lymph nodes abnormalities with metabolic uptake in approximately one-third of asymptomatic close contacts with negative chest radiographic and bacteriological/molecular results for active tuberculosis. Tuberculosis with minimal changes challenge the validity of simply dichotomizing cases of recent M. tuberculosis infections in contacts depending on the presence of X-ray abnormalities as the recent infections may spontaneously regress, remain stagnant, or progress to active tuberculosis in human and nonhuman primate studies. Whether contacts with tuberculosis with minimal changes are interpreted as having active tuberculosis or latent tuberculosis has clinical implications in terms of specific benefits and harms under the current contact management. Advanced imaging tools may help further stratify contacts intensely exposed to M. tuberculosis on a continuous spectrum from latent tuberculosis to incipient, subclinical and active tuberculosis. Identifying incipient tuberculosis would provide an opportunity for earlier and tailored treatment before active tuberculosis is established.
“…1 a, b). Similar morphologic descriptions of CT or MRI findings could be found in some other studies that provided sufficient information on morphologic characteristics [ 20 , 21 , 26 , 29 , 31 ]. Fig.…”
Section: Main Textsupporting
confidence: 81%
“…One study was conducted on contacts infected with HIV [ 35 ], while the other 24 studies were conducted in immunocompetent contacts. Four studies partly [ 25 , 29 ] or entirely [ 23 , 26 ] included close contacts with drug-resistant TB. Bacterial and molecular testing with sputum or other specimens (e.g., gastric aspirates) generally yielded a low positivity rate in contacts with minimal CT or PET abnormalities, reflecting a low bacillary burden (Table 1 ).…”
Section: Main Textmentioning
confidence: 99%
“…There are two fundamental points to consider: (1) the risk of TB infection and developing active TB and (2) the probability of active TB manifesting as normal radiographs. If the risk is not sufficiently intense (e.g., in a mass screening context), most examinations will not additionally depict changes from incipient TB to active TB beyond what is portrayed by X-ray examinations, as TB disease infrequently occurs and progresses [ 29 , 50 , 68 , 69 ]. TB more frequently manifests with normal radiographs in immunocompromised contacts or children.…”
Close contacts of individuals with pulmonary tuberculosis are at risk for tuberculosis infection and the development of active tuberculosis. In current contact investigations, immunologic tests (the tuberculin skin test and interferon-gamma release assay) and chest X-ray examinations are used to dichotomize contacts with Mycobacterium tuberculosis infections into those with active (X-ray abnormalities) versus latent tuberculosis (normal radiographs). This article is a critical review of computed tomographic (CT) and 18-fluorodeoxyglucose positron emission tomographic (PET) findings of incipient tuberculosis without X-ray abnormalities based on a systematic literature review of twenty-five publications. The CT and 18-fluorodeoxyglucose PET studies revealed minimal pauci-nodular infiltrations in the lung parenchyma and mediastinal lymph nodes abnormalities with metabolic uptake in approximately one-third of asymptomatic close contacts with negative chest radiographic and bacteriological/molecular results for active tuberculosis. Tuberculosis with minimal changes challenge the validity of simply dichotomizing cases of recent M. tuberculosis infections in contacts depending on the presence of X-ray abnormalities as the recent infections may spontaneously regress, remain stagnant, or progress to active tuberculosis in human and nonhuman primate studies. Whether contacts with tuberculosis with minimal changes are interpreted as having active tuberculosis or latent tuberculosis has clinical implications in terms of specific benefits and harms under the current contact management. Advanced imaging tools may help further stratify contacts intensely exposed to M. tuberculosis on a continuous spectrum from latent tuberculosis to incipient, subclinical and active tuberculosis. Identifying incipient tuberculosis would provide an opportunity for earlier and tailored treatment before active tuberculosis is established.
“…Original Article in use for infants; however, it is not ideal for adults (2), and so far, there is no effective vaccine to protect against all strains of Mtb. Moreover, the current drug treatment faces the obstacle of drug resistance (5), and the current methods for diagnosing tuberculosis, such as bacteriological detection, sputum smear, and CT lack efficiency (6)(7)(8). With all of this considered, there is an urgent need to clarify the pathological mechanisms of Mtb so that effective therapeutic targets and diagnosis biomarkers can be identified.…”
Section: Bacillus Calmette Guérin (Bcg) Is the Current Vaccinementioning
Background: Recent studies have revealed the involvement of circular RNAs (circRNAs) in the control and elimination of invading Mycobacterium tuberculosis (Mtb) by macrophages. However, the regulatory mechanism of circAGFG1 in macrophages infected by Mtb has not been fully explored. In this study, we sought to investigate the role of circAGFG1 on autophagy and apoptosis of Mtb-infected macrophages and reveal its the molecular mechanism.
Methods: The expression of circAGFG1 in macrophages from patients with active tuberculosis and inMtb-treated macrophages in vitro was explored. Then, the effect of circAGFG1 on autophagy and apoptosis of Mtb-infected macrophages was evaluated by flow cytometry, electron microscope, immunofluorescence, and Western blotting. Bioinformatics analysis was used to identify and validate the downstream regulatory pathway of circAGFG1, miRNA-1257/Notch. For further analysis, the role of miRNA-1257 on autophagy and apoptosis was assessed.Results: In vitro, ectopic expression of circAGFG1 upregulated autophagy and reduced apoptosis significantly in Mtb-infected cells. Notch levels were discovered to be increased by the silencing effect of circAGFG1 on miRNA-1257 expression. miRNA-1257 was found to noticeably reduce autophagy and promote macrophage apoptosis. Increased circAGFG1 expression, decreased monocyte apoptosis, and enhanced autophagy were found in macrophages from patients with active tuberculosis.
Conclusions:In active tuberculosis, circAGFG1 enhances autophagy and reduces apoptosis via the miRNA-1257/Notch axis; this provides new therapeutic targets for tuberculosis patients.
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