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Asymptomatic Helminth Infection in Active Tuberculosis Is Associated with Increased Regulatory and Th-2 Responses and a Lower Sputum Smear Positivity

Abate, Ebba (author)
Linköpings universitet,Avdelningen för mikrobiologi och molekylär medicin,Medicinska fakulteten,University of Gondar, Ethiopia
Belayneh, Meseret (author)
University of Addis Ababa, Ethiopia
Idh, Jonna (author)
Vastervik Hospital, Sweden
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Diro, Ermias (author)
University of Gondar, Ethiopia
Elias, Daniel (author)
University of Southern Denmark, Denmark
Britton, Sven (author)
Karolinska Hospital, Sweden
Aseffa, Abraham (author)
Armauer Hansen Research Institute, Ethiopia
Stendahl, Olle (author)
Linköpings universitet,Avdelningen för mikrobiologi och molekylär medicin,Medicinska fakulteten
Schön, Thomas (author)
Linköpings universitet,Avdelningen för mikrobiologi och molekylär medicin,Medicinska fakulteten,Kalmar County Hospital, Sweden
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 (creator_code:org_t)
2015-08-06
2015
English.
In: PLoS Neglected Tropical Diseases. - : PUBLIC LIBRARY SCIENCE. - 1935-2727 .- 1935-2735. ; 9:8
  • Journal article (peer-reviewed)
Abstract Subject headings
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  • Background The impact of intestinal helminth infection on the clinical presentation and immune response during active tuberculosis (TB) infection is not well characterized. Our aim was to investigate whether asymptomatic intestinal helminth infection alters the clinical signs and symptoms as well as the cell mediated immune responses in patients with active TB.Methodology Consecutive, newly diagnosed TB patients and healthy community controls (CCs) were recruited in North-west Ethiopia. TB-score, body mass index and stool samples were analyzed. Cells from HIV-negative TB patients (HIV-/TB) and from CCs were analyzed for regulatory T-cells (Tregs) and cytokine responses using flow cytometry and ELISPOT, respectively.Results A significantly higher ratio of helminth co-infection was observed in TB patients without HIV (Helm+/HIV-/TB) compared to HIV negative CCs, (40% (121/306) versus 28% (85/306), p = 0.003). Helm+/HIV-/TB patients showed significantly increased IL-5 secreting cells compared to Helm-/HIV-/TB (37 SFU (IQR:13-103) versus 2 SFU (1-50); p = 0.02, n = 30). Likewise, levels of absolute Tregs (9.4 (3.2-16.7) cells/mu l versus 2.4 (1.1-4.0) cells/mu l; p = 0.041) and IL-10 secreting cells (65 SFU (7-196) versus 1 SFU (0-31); p = 0.014) were significantly higher in Helm+/HIV-/TB patients compared to Helm-/HIV-/TB patients. In a multivariate analysis, a lower rate of sputum smear positivity for acid fast bacilli, lower body temperature, and eosinophilia were independently associated with helminth infection in TB patients.Conclusions Asymptomatic helminth infection is associated with increased regulatory T-cell and Th2-type responses and a lower rate of sputum smear positivity. Further studies are warranted to investigate the clinical and immunological impact of helminth infection in TB patients.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Medicinska och farmaceutiska grundvetenskaper -- Mikrobiologi inom det medicinska området (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Basic Medicine -- Microbiology in the medical area (hsv//eng)

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