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Modulation of dendritic cell and monocyte subsets in tuberculosis-diabetes co-morbidity upon standard tuberculosis treatment
indian journal of tuberculosis 63 (2016) 276–278
Available online at www.sciencedirect.com
ScienceDirect journal homepage: http://www.journals.elsevier.com/ indian-journal-of-tuberculosis/
Abstracts
Modulation of dendritic cell and monocyte subsets in tuberculosis-diabetes co-morbidity upon standard tuberculosis treatment Pavan Kumar N, Moideen K, Sivakumar S, Menon PA, Viswanathan V, Kornfeld H, Babu S. Tuberculosis September 2016;100. http://dx.doi.org/10.1016/j.tube.2016.10.004 Type 2 diabetes mellitus (DM) is a major risk factor for the development of active pulmonary tuberculosis (PTB), with development of DM pandemic in countries where tuberculosis (TB) is also endemic. However, the effect of anti-TB treatment on the changes in dentritic cell (DC) and monocyte subset phenotype in TB-DM co-morbidity is not well understood. In this study, we characterized the frequency of DC and monocyte subsets in individuals with PTB with (PTB-DM) or without coincident diabetes mellitus (PTB-NDM) before, during and after completion of anti-TB treatment. PTB-DM is characterized by diminished frequencies of plasmacytoid and myeloid DCs and classical and intermediate monocytes at baseline and 2 months of anti-TB treatment but not following 6 months of treatment completion in comparison to PTB-NDM. DC and monocyte subsets exhibit significant but borderline correlation with fasting blood glucose and glycated hemoglobin levels. Finally, while minor changes in the DC and monocyte compartment were observed at 2 months of treatment, significantly increased frequencies of plasmacytoid and myeloid DCs and classical and intermediate monocytes were observed at the successful completion of anti-TB treatment. Our data show that coincident diabetes alters the frequencies of innate subset distribution of DC and monocytes in TB-DM co-morbidity and suggests that most of these changes are reversible following anti-TB therapy. http://dx.doi.org/10.1016/j.ijtb.2016.11.019
Occupational exposure and tuberculosis among medical residents in a high-burden setting: An open-cohort study Rao SA, Kadhiravan T, Swaminathan RP, Mahadevan S. Int J Tuberc Lung Dis 2016;20(9):1162–1167. http://dx.doi.org/10.5588/ ijtld.15.0638 Setting: Postgraduate (PG) residency programme of a tertiary care teaching hospital in southern India. Objective: To estimate the incidence of tuberculosis (TB) among PG residents, determine the frequency of exposure to infectious TB patients and assess whether particular specialties were associated with higher risk of exposure and incident TB.
Design: We assembled an open cohort of PG residents who were on the academic rolls for more than 3 months at any time between December 2011 and January 2013. We collected data both retrospectively and prospectively using two surveys—an entry survey at study initiation or entry into the cohort, and an exit survey at residency completion or study closure. Results: Among 398 PG residents enrolled in the study, we identified five cases of incident TB during a cumulative followup period of 10 962 person-months. The incidence rate was 547 per 100 000 person-years, which was 3.1 times the incidence in the general population. Nearly two thirds (n = 257, 65%) of the residents were exposed to at least one infectious patient. Across the three specialty-based risk strata, there was an ordered increase in the median number of exposures (P < 0.001) and evaluation for presumptive TB (P = 0.024), as well as a trend towards higher incident TB. Conclusion: TB incidence is significantly higher among PG residents than in the general population. http://dx.doi.org/10.1016/j.ijtb.2016.11.020
Dotting the Three I's for collaborative TB-HIV activities: Evaluation of a pilot programme in Kathmandu, Nepal Sah SK, Sahu SK, Lamichhane B, Bhatta GK, Bhandari KB, Owiti P, Majumdar SS. Public Health Action 2016;6(3):169–175. http://dx.doi.org/10.5588/pha.16.0012 Setting: The three government tertiary care hospitals providing care for people living with the human immunodeficiency virus (PLHIV) in Kathmandu, Nepal. Objectives: To assess (1) the screening cascades for intensified case finding for tuberculosis (TB), (2) isoniazid preventive therapy (IPT), including demographic and clinical factors associated with treatment interruption, and (3) TB infection control (IC) in the health facilities. Design: A cross-sectional study of new PLHIV enrolled from January 2012 to December 2014. Results: Among 572 registered PLHIV, 91% were on antiretroviral therapy. Of those registered, 561 (98%) were screened for TB and 73 (13%) were diagnosed with TB (17 [25%] sputum smear-positive, 17 [25%] smear-negative and 35 [51%] extrapulmonary). Among the 488 (87%) PLHIV without active TB, 157 (32%) were initiated on IPT, of whom 136 (87%) completed treatment and 17 (11%) interrupted treatment. Those who experienced adverse events were 12 times more likely to interrupt IPT. TB IC showed gaps in personal control measures and supporting structures and policies.
Available online at www.sciencedirect.com
ScienceDirect journal homepage: http://www.journals.elsevier.com/ indian-journal-of-tuberculosis/
Abstracts
Modulation of dendritic cell and monocyte subsets in tuberculosis-diabetes co-morbidity upon standard tuberculosis treatment Pavan Kumar N, Moideen K, Sivakumar S, Menon PA, Viswanathan V, Kornfeld H, Babu S. Tuberculosis September 2016;100. http://dx.doi.org/10.1016/j.tube.2016.10.004 Type 2 diabetes mellitus (DM) is a major risk factor for the development of active pulmonary tuberculosis (PTB), with development of DM pandemic in countries where tuberculosis (TB) is also endemic. However, the effect of anti-TB treatment on the changes in dentritic cell (DC) and monocyte subset phenotype in TB-DM co-morbidity is not well understood. In this study, we characterized the frequency of DC and monocyte subsets in individuals with PTB with (PTB-DM) or without coincident diabetes mellitus (PTB-NDM) before, during and after completion of anti-TB treatment. PTB-DM is characterized by diminished frequencies of plasmacytoid and myeloid DCs and classical and intermediate monocytes at baseline and 2 months of anti-TB treatment but not following 6 months of treatment completion in comparison to PTB-NDM. DC and monocyte subsets exhibit significant but borderline correlation with fasting blood glucose and glycated hemoglobin levels. Finally, while minor changes in the DC and monocyte compartment were observed at 2 months of treatment, significantly increased frequencies of plasmacytoid and myeloid DCs and classical and intermediate monocytes were observed at the successful completion of anti-TB treatment. Our data show that coincident diabetes alters the frequencies of innate subset distribution of DC and monocytes in TB-DM co-morbidity and suggests that most of these changes are reversible following anti-TB therapy. http://dx.doi.org/10.1016/j.ijtb.2016.11.019
Occupational exposure and tuberculosis among medical residents in a high-burden setting: An open-cohort study Rao SA, Kadhiravan T, Swaminathan RP, Mahadevan S. Int J Tuberc Lung Dis 2016;20(9):1162–1167. http://dx.doi.org/10.5588/ ijtld.15.0638 Setting: Postgraduate (PG) residency programme of a tertiary care teaching hospital in southern India. Objective: To estimate the incidence of tuberculosis (TB) among PG residents, determine the frequency of exposure to infectious TB patients and assess whether particular specialties were associated with higher risk of exposure and incident TB.
Design: We assembled an open cohort of PG residents who were on the academic rolls for more than 3 months at any time between December 2011 and January 2013. We collected data both retrospectively and prospectively using two surveys—an entry survey at study initiation or entry into the cohort, and an exit survey at residency completion or study closure. Results: Among 398 PG residents enrolled in the study, we identified five cases of incident TB during a cumulative followup period of 10 962 person-months. The incidence rate was 547 per 100 000 person-years, which was 3.1 times the incidence in the general population. Nearly two thirds (n = 257, 65%) of the residents were exposed to at least one infectious patient. Across the three specialty-based risk strata, there was an ordered increase in the median number of exposures (P < 0.001) and evaluation for presumptive TB (P = 0.024), as well as a trend towards higher incident TB. Conclusion: TB incidence is significantly higher among PG residents than in the general population. http://dx.doi.org/10.1016/j.ijtb.2016.11.020
Dotting the Three I's for collaborative TB-HIV activities: Evaluation of a pilot programme in Kathmandu, Nepal Sah SK, Sahu SK, Lamichhane B, Bhatta GK, Bhandari KB, Owiti P, Majumdar SS. Public Health Action 2016;6(3):169–175. http://dx.doi.org/10.5588/pha.16.0012 Setting: The three government tertiary care hospitals providing care for people living with the human immunodeficiency virus (PLHIV) in Kathmandu, Nepal. Objectives: To assess (1) the screening cascades for intensified case finding for tuberculosis (TB), (2) isoniazid preventive therapy (IPT), including demographic and clinical factors associated with treatment interruption, and (3) TB infection control (IC) in the health facilities. Design: A cross-sectional study of new PLHIV enrolled from January 2012 to December 2014. Results: Among 572 registered PLHIV, 91% were on antiretroviral therapy. Of those registered, 561 (98%) were screened for TB and 73 (13%) were diagnosed with TB (17 [25%] sputum smear-positive, 17 [25%] smear-negative and 35 [51%] extrapulmonary). Among the 488 (87%) PLHIV without active TB, 157 (32%) were initiated on IPT, of whom 136 (87%) completed treatment and 17 (11%) interrupted treatment. Those who experienced adverse events were 12 times more likely to interrupt IPT. TB IC showed gaps in personal control measures and supporting structures and policies.