IMMUNE STATUS OF PATIENTS WITH LUNG TUBERCULOSIS AND ALCOHOL CONSUMPTION
Tuberculosis is a great medical and social problem. An important risk factor for tuberculosis progress is the systematic use of alcohol. The relationship between alcohol intake and TB has been clear after numerous studies and meta-analyzes. However, there are still open questions about whether alcohol is the direct cause of TB development, which doses of alcohol have the greatest trigger value in progress of TB process, what kind of immunological reactions are significantly associated with alcohol intake and what immune background can determining role of alcohol in progression of TB infection. The features of the immune response in TB patients with different value of alcohol use remain poorly understood.
The aim of the research - to investigate the immune status in patients with firstly diagnosed pulmonary tuberculosis with various levels of alcohol consumption.
Materials and methods. We selected for participating in the study 102 males with tuberculosis and alcohol consumption. Examination of the patients included: clinical methods, chest X-ray, sputum tests, Alcohol Use Disorders Identification Test and immunological blood analysis.
Results. Patients with tuberculosis and alcohol consumption, have increase inflammatory response: higher level of stab neutrophils, CRP, ESR, as well as phagocyte activity, circulating immune complexes levels and medium molecular weight peptides levels. On the other hand we found decreasing of phagocytic number, index of phagocytosis completeness and differentiation clusters CD2+, CD3+, CD4+, CD8+ of T-lymphocytes` sub-populations. The highest changes were observed in the group of alcohol abusers.
Conclusions. Patients with tuberculosis and alcohol intake, even at low levels of its consumption, have a dysregulation of their immune response. On the one hand, there is an increase of non-specific inflammatory reactions, and on the other - a situation, when antigen-presenting cells cannot adequately to process and present the antigen to phagocytes. This prevents the immune system from responding quickly, correctly evaluating and suppressing foreign agents.
Global tuberculosis report 2019 (2019). Geneva: World Health Organization. Available at: https://www.who.int/tb/publications/global_report/en/
Rehm, J., Samokhvalov, A. V., Neuman, M. G., Room, R., Parry, C., Lönnroth, K. et. al. (2009). The association between alcohol use, alcohol use disorders and tuberculosis (TB). A systematic review. BMC Public Health, 9(1). doi: http://doi.org/10.1186/1471-2458-9-450
Simou, E., Britton, J., Leonardi-Bee, J. (2018). Alcohol consumption and risk of tuberculosis: a systematic review and meta-analysis. The International Journal of Tuberculosis and Lung Disease, 22 (11), 1277–1285. doi: http://doi.org/10.5588/ijtld.18.0092
Silva, D. R., Muñoz-Torrico, M., Duarte, R., Galvão, T., Bonini, E. H., Arbex, F. F. et. al. (2018). Risk factors for tuberculosis: diabetes, smoking, alcohol use, and the use of other drugs. Jornal Brasileiro de Pneumologia, 44 (2), 145–152. doi: http://doi.org/10.1590/s1806-37562017000000443
Duarte, R., Lönnroth, K., Carvalho, C., Lima, F., Carvalho, A. C. C., Muñoz-Torrico, M., Centis, R. (2018). Tuberculosis, social determinants and co-morbidities (including HIV). Pulmonology, 24 (2), 115–119. doi: http://doi.org/10.1016/j.rppnen.2017.11.003
Myers, B., Bouton, T. C., Ragan, E. J., White, L. F., McIlleron, H., Theron, D. et. al. (2018). Impact of alcohol consumption on tuberculosis treatment outcomes: a prospective longitudinal cohort study protocol. BMC Infectious Diseases, 18 (1). doi: http://doi.org/10.1186/s12879-018-3396-y
Unifikovanyi klinichnyi protocol pervynnoi, vtorynnoi (spetsializovanoi) ta tretynnoi (vysokospetsializovanoi) medychnoi dopomohy «Tuberkuloz» (2014). Zatverdzhenyi nakazom MOZ Ukrainy No. 620 04.09.2014 «Pro zatverdzhennia ta vprovadzhennia medyko-tekhnolohichnykh dokumentiv zi standartyzatsii medychnoi dopomohy pry tuberkulozi». Kyiv: MOZ Ukrainy. Available at: https://phc.org.ua/sites/default/files/uploads/files/dn_20141231_1039dod.pdf
Babor, T., Higgins-Biddle, J. C., Saunders, J. B., Monteiro, M. G. (2001). Audit, the alcohol use disorders identification test: guidelines for use in primary care. Geneva: World Health Organization. Available at: https://apps.who.int/iris/bitstream/handle/10665/67205/WHO_MSD_MSB_01.6a.pdf;jsessionid=41CE9E9FB04F71DF95D9874F0C180B4D?sequence=1
Szabo, G., Saha, B. (2015). Alcohol's Effect on Host Defense. Alcohol research: current reviews, 37 (2), 159–170.
González-Reimers, E. (2014). Alcoholism: A systemic proinflammatory condition. World Journal of Gastroenterology, 20 (40), 14660. doi: http://doi.org/10.3748/wjg.v20.i40.14660
Kalejaiye, O., Getachew, B., Ferguson, C. L., Taylor, R. E., Tizabi, Y. (2017). Alcohol-Induced Increases in Inflammatory Cytokines Are Attenuated by Nicotine in Region-Selective Manner in Male Rats. Journal of Drug and Alcohol Research, 6, 1–6. doi: http://doi.org/10.4303/jdar/236036
Pai, M., Behr, M. A., Dowdy, D., Dheda, K., Divangahi, M., Boehme, C. C. et. al. (2016). Tuberculosis. Nature Reviews Disease Primers, 2 (1). doi: http://doi.org/10.1038/nrdp.2016.76
Simmons, J. D., Stein, C. M., Seshadri, C., Campo, M., Alter, G., Fortune, S. et. al. (2018). Immunological mechanisms of human resistance to persistent Mycobacterium tuberculosis infection. Nature Reviews Immunology, 18 (9), 575–589. doi: http://doi.org/10.1038/s41577-018-0025-3
Alcover, A., Alarcón, B., Di Bartolo, V. (2018). Cell Biology of T Cell Receptor Expression and Regulation. Annual Review of Immunology, 36 (1), 103–125. doi: http://doi.org/10.1146/annurev-immunol-042617-053429
Liu, L. L., Landskron, J., Ask, E. H., Enqvist, M., Sohlberg, E., Traherne, J. A. et. al. (2016). Critical Role of CD2 Co-stimulation in Adaptive Natural Killer Cell Responses Revealed in NKG2C-Deficient Humans. Cell Reports, 15 (5), 1088–1099. doi: http://doi.org/10.1016/j.celrep.2016.04.005
Jasenosky, L. D., Scriba, T. J., Hanekom, W. A., Goldfeld, A. E. (2015). T cells and adaptive immunity toMycobacterium tuberculosisin humans. Immunological Reviews, 264 (1), 74–87. doi: http://doi.org/10.1111/imr.12274
Martin, M. D., Badovinac, V. P. (2018). Defining Memory CD8 T Cell. Frontiers in Immunology, 9. doi: http://doi.org/10.3389/fimmu.2018.02692
Singhania, A., Wilkinson, R. J., Rodrigue, M., Haldar, P., O’Garra, A. (2018). The value of transcriptomics in advancing knowledge of the immune response and diagnosis in tuberculosis. Nature Immunology, 19 (11), 1159–1168. doi: http://doi.org/10.1038/s41590-018-0225-9
Wen, Y., Mu, L., Shi, Y. (2016). Immunoregulatory functions of immune complexes in vaccine and therapy. EMBO Molecular Medicine, 8 (10), 1120–1133. doi: http://doi.org/10.15252/emmm.201606593
Burel, J. G., Pomaznoy, M., Lindestam Arlehamn, C. S., Weiskopf, D., da Silva Antunes, R., Jung, Y. et. al. (2019). Circulating T cell-monocyte complexes are markers of immune perturbations. eLife, 8. doi: http://doi.org/10.7554/elife.46045
Jacobs, A. J., Mongkolsapaya, J., Screaton, G. R., McShane, H., Wilkinson, R. J. (2016). Antibodies and tuberculosis. Tuberculosis, 101, 102–113. doi: http://doi.org/10.1016/j.tube.2016.08.001
Stek, C., Allwood, B., Walker, N. F., Wilkinson, R. J., Lynen, L., Meintjes, G. (2018). The Immune Mechanisms of Lung Parenchymal Damage in Tuberculosis and the Role of Host-Directed Therapy. Frontiers in Microbiology, 9. doi: http://doi.org/10.3389/fmicb.2018.02603
Copyright (c) 2020 Ivan Hrek
This work is licensed under a Creative Commons Attribution 4.0 International License.
Our journal abides by the Creative Commons CC BY copyright rights and permissions for open access journals.
Authors, who are published in this journal, agree to the following conditions:
1. The authors reserve the right to authorship of the work and pass the first publication right of this work to the journal under the terms of a Creative Commons CC BY, which allows others to freely distribute the published research with the obligatory reference to the authors of the original work and the first publication of the work in this journal.
2. The authors have the right to conclude separate supplement agreements that relate to non-exclusive work distribution in the form in which it has been published by the journal (for example, to upload the work to the online storage of the journal or publish it as part of a monograph), provided that the reference to the first publication of the work in this journal is included.