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Primary Hepatic Tuberculosis Mimicking Hepatocellular Carcinoma And Cholangiocarcinoma, Dj Jiang, Aarohi Parikh, Eric Riha, Kevin Garnepudi

Gulf Coast Division GME Research Day 2025

No abstract provided.

René Dubos: An Annotated Bibliography, Carol L. Moberg

René Dubos: An Annotated Bibliography

René Dubos (1901–1982), a prominent 20th century scientist, humanist, and philosopher, was a prolific author. Affiliated for more than 50 years with The Rockefeller Institute for Medical Research/The Rockefeller University, his studies ranged from antibiotics and the role of bacteria in human diseases to formulating broad ecological and environmental questions affecting human health and disease. His seminal writings explore a lifelong belief that a living organism—whether microbe, human being, society, or the Earth itself—could be understood only through its relationships with everything else.

This comprehensive bibliography of more than a thousand works by René Dubos includes brief annotations for each …

Efficacy And Safety Of 4-Month Rifapentine-Based Tuberculosis Treatments In Persons With Diabetes., Ekaterina V. Kurbatova, William C. Whitworth, Lakshmi Praveena Peddareddy, Patrick P. J. Phillips, Nigel A. Scott, Kia E. Bryant, Rodney Dawson, Sandra Wagner Cardoso, Wadzanai Samaneka, Melissa Engle, Ziyaad Waja, Erin Sizemore, Wendy Carr, Kelly E. Dooley, Radojka Savic, Susan Swindells, Richard E. Chaisson, Susan E. Dorman, Payam Nahid, Nhung V. Nguyen, Aids Clinical Trials Group A5349, Tuberculosis Trials Consortium Study 31

Journal Articles: Infectious Diseases

A previous study demonstrated noninferior efficacy of 4-month rifapentine/moxifloxacin regimen for tuberculosis (TB) treatment compared with the standard regimen. We explored results among study participants with diabetes. Among 2,516 randomized participants, 181 (7.2%) had diabetes. Of 166 participants with diabetes in the microbiologically eligible analysis group, 26.3% (15/57) had unfavorable outcomes in the control regimen, 13.8% (8/58) in the rifapentine/moxifloxacin regimen, and 29.4% (15/51) in the rifapentine regimen. The difference in proportion of unfavorable outcomes between the control and rifapentine/moxifloxacin arms in the microbiologically eligible analysis group was -12.5% (95% CI -27.0% to 1.9%); the difference between the control and …

Pregnancy Outcomes After Exposure To Tuberculosis Treatment In Phase 3 Clinical Trial, 2016-2020, Ekaterina V. Kurbatova, William C. Whitworth, Kia E. Bryant, Meredith G. Dixon, Kelly E. Dooley, Nigel A. Scott, Rosanna Boyd, Nicole E. Brown, Kimberley N. Chapman Hedges, Wendy Carr, Lakshmi P. Peddareddy, Grace Muzanyi, Rodney Dawson, Ziyad Waja, Neil Martinson, Jyoti S. V. Mathad, Payam Nahid, Susan Swindells, Richard E. Chaisson, Susan E. Dorman, Patrick P. J. Phillips, Aids Clinical Trials Group A5349, Tuberculosis Trials Consortium Study 31

Journal Articles: Infectious Diseases

A previous study demonstrated noninferior efficacy of 4-month rifapentine/moxifloxacin regimen for tuberculosis (TB) treatment compared with the standard regimen. We analyzed pregnancy outcomes of women who became pregnant during the study. Among 740 women, 97 (13.1%) became pregnant. Of 102 pregnancies (in 97 participants), 30 (29.4%) participants were exposed to study drugs. Fetal loss was reported for 3/13 (23.1%) in the control regimen, 1/9 (11.1%) in the rifapentine/moxifloxacin regimen, and 1/8 (12.5%) in the rifapentine regimen. Among 21 live births in exposed pregnancies (7 in each arm), 1 infant with a congenital anomaly was reported in a participant on the …

Inclusion Of Patient-Centered, Non-Microbiological Endpoints And Biomarkers In Tuberculosis Drug Trials, Andrew R Dinardo, Wilbert Sabiiti, Stephen H Gillespie, Sophia B Georghiou, Norbert Heinrich, Norbert Hittel, Sami Taghlabi, Danna Carrero Longlax, Mikashmi Kohli, Ursula Panzner, Collins Musia, Christoph Lange, Anca Vasiliu, Rob J W Arts, Anna M Mandalakas, Morten Ruhwald, Lieven J Stuyver, Reinout Van Crevel

Faculty, Staff and Students Publications

Tuberculosis drug trials are primarily designed to identify antibiotic regimens with the strongest potency to kill Mycobacterium tuberculosis. However, microbiologic cure is not synonymous with improved health and recovery. Beyond antimicrobial efficacy, parameters such as morbidity and mortality related to lung function, cardiovascular health, and cancer should be prioritized. This narrative review emphasizes the critical need to emphasize clinical outcomes as much, if not more, than microbiological endpoints. We examine the underlying pathophysiological mechanisms and determinants of non-microbiological outcomes in tuberculosis, providing a synthesis of current knowledge. While there is growing evidence for some biomarkers to risk stratify TB …

Th9 Cells Provide Protective Tb Immunity, Mei Xia, Azra Blazevic, Huan Ning, Christopher S Eickhoff, Chad E Storer, Richard D Head, Jianguo Liu, Jessica Jarvela, David Stoeckel, Erin Rakey, Jan Tennant, Daniel L Miller, Kathleen R Holloway, Richard F Silver, Daniel F Hoft

2020-Current year OA Pubs

INTRODUCTION: CD4+ Th9 cells have been associated with inflammatory and allergic diseases. IL-9/Th9 can function as both positive and negative immune regulators, but their protective effects against

METHODS: To study TB-specific Th9 protective effects, we generated Th9 cells from ESAT6-specific TCR transgenic mice and healthy human donors.

RESULTS: Both murine and human Th9 cells significantly inhibited intracellular mycobacterial growth. In both

DISCUSSION: Th9 cells can provide important protection against Mtb infection, and should be targeted with future TB vaccine strategies. Furthermore, Th9 cells appear to utilize a novel protective mechanism independent from Th1-mediated protective responses.

Whispers In The Wind: Face Mask Sampling For Mycobacterium Tuberculosis Detection In Children With Pulmonary Tuberculosis, Lennard Meiwes, Irina Kontsevaya, Dumitru Chesov, Stela Kulciţkaia, Viola Dreyer, Doris Hillemann, Qiniso Dlamini, Caroline Williams, Michael Barer, Folke Brinkmann, Renate Krüger, Stephanie Thee, Alexander Kay, Anna Maria Mandalakas, Christoph Lange

Faculty, Staff and Students Publications

Background: Recently, face mask sampling (FMS) confirmed detection of Mycobacterium tuberculosis DNA from exhaled breath in adults with tuberculosis. To date, no study has evaluated the use of FMS to detect pulmonary tuberculosis in children. We developed a method for FMS of M. tuberculosis-specific DNA in children and performed a clinical exploration to assess feasibility in children.

Methods: Face masks were spiked, analyzed on GeneXpert-Ultra, quantitative polymerase chain reaction, and targeted next-generation sequencing. Children with pulmonary tuberculosis were asked to wear 3 modified FFP2 masks for 30 minutes as part of an exploratory clinical study.

Results: Experiments with H37Ra M. …

Interaction Between Type 2 Diabetes And Past Covid-19 On Active Tuberculosis, Liz E. Calles-Cabanillas, Genesis P. Aguillón-Durán, Doris Ayala, Jose A. Caso, Miguel Garza, Mateo Joya-Ayala, Raúl Loera-Salazar, America Cruz-González, John M. Thomas Iii, Blanca I. Restrepo

School of Medicine Publications

Background

The global setback in tuberculosis (TB) prevalence and mortality in the post-COVID-19 era has been partially attributed to pandemic-related disruptions in healthcare systems. The additional biological contribution of COVID-19 to TB is less clear. The goal of this study was to determine if there is an association between COVID-19 in the past 18 months and a new TB episode, and the role played by type 2 diabetes mellitus (DM) comorbidity in this relationship.

Methods

A cross-sectional study was conducted among 112 new active TB patients and 373 non-TB controls, identified between June 2020 and November 2021 in communities along …

Strategies To Enhance Diagnostic Capabilities For The New Drug-Resistant Tuberculosis (Dr-Tb) Drugs, Antonia Morita Iswari Saktiawati, Anca Vasiliu, Francesca Saluzzo, Onno W Akkerman

Faculty, Staff and Students Publications

The global burden of drug-resistant tuberculosis (DR-TB) continues to challenge healthcare systems worldwide. There is a critical need to tackle DR-TB by enhancing diagnostics and drug susceptibility testing (DST) capabilities, particularly for emerging DR-TB drugs. This endeavor is crucial to optimize the efficacy of new therapeutic regimens and prevent the resistance and overuse of these invaluable weapons. Despite this urgency, there remains a lack of comprehensive review of public health measures aimed at improving the diagnostics and DST capabilities. In this review, we outline strategies to enhance the capabilities, especially tailored to address the challenges posed by resistance to new …

Risk-Stratified Treatment For Drug-Susceptible Pulmonary Tuberculosis, Vincent K Chang, Marjorie Z Imperial, Patrick P J Phillips, Gustavo E Velásquez, Payam Nahid, Andrew Vernon, Ekaterina V Kurbatova, Susan Swindells, Richard E Chaisson, Susan E Dorman, John L Johnson, Marc Weiner, Amina Jindani, Thomas Harrison, Erin E Sizemore, William Whitworth, Wendy Carr, Kia E Bryant, Deron Burton, Kelly E Dooley, Melissa Engle, Pheona Nsubuga, Andreas H Diacon, Nguyen Viet Nhung, Rodney Dawson, Radojka M Savic, Aids Clinical Trial Group, Tuberculosis Trials Consortium

Faculty, Staff and Student Publications

The Phase 3 randomized controlled trial, TBTC Study 31/ACTG A5349 (NCT02410772) demonstrated that a 4-month rifapentine-moxifloxacin regimen for drug-susceptible pulmonary tuberculosis was safe and effective. The primary efficacy outcome was 12-month tuberculosis disease free survival, while the primary safety outcome was the proportion of grade 3 or higher adverse events during the treatment period. We conducted an analysis of demographic, clinical, microbiologic, radiographic, and pharmacokinetic data and identified risk factors for unfavorable outcomes and adverse events. Among participants receiving the rifapentine-moxifloxacin regimen, low rifapentine exposure is the strongest driver of tuberculosis-related unfavorable outcomes (HR 0.65 for every 100 µg∙h/mL increase, …

Mutations And Antibiotic Resistance In Mycobacterium Tuberculosis, Ryan M. Johnson, Bodhi Brady, Nicklaus Busse, Connor Beckman, Hunter Gloden, Joseph Glasrud, Zachary Smith, Hari P. Nepal, Madhav P. Nepal

Life Science Reports

Mycobacterium tuberculosis (MTB) is a bacterium known to target, infect, and destroy lung cells as well as connective tissues within the body. This bacterium is prevalent worldwide and has infected over a quarter of the current world population, becoming one of the most successful pathogens in history. Due to its extreme transmission rates as an airborne pathogen, MTB strains have been treated with antibiotics such as rifampicin and isoniazid, which inhibit bacterial infection in the human body. These first-round drugs remained as successful mechanisms for slowing and killing the pathogen, notably through rifampicin's inhibition of RNA-polymerase and isoniazid’s ability to …

Tca Metabolism Regulates Dna Hypermethylation In Lps And Mycobacterium Tuberculosis–Induced Immune Tolerance, Abhimanyu, Santiago Carrero Longlax, Tomoki Nishiguchi, Malik Ladki, Daanish Sheikh, Amera L Martinez, Emily M Mace, Sandra L Grimm, Thaleia Caldwell, Alexandra Portillo Varela, Rajagopal V Sekhar, Anna M Mandalakas, Mandla Mlotshwa, Sibuse Ginidza, Jeffrey D Cirillo, Robert S Wallis, Mihai G Netea, Reinout Van Crevel, Cristian Coarfa, Andrew R Dinardo

Faculty, Staff and Students Publications

Severe and chronic infections, including pneumonia, sepsis, and tuberculosis (TB), induce long-lasting epigenetic changes that are associated with an increase in all-cause postinfectious morbidity and mortality. Oncology studies identified metabolic drivers of the epigenetic landscape, with the tricarboxylic acid (TCA) cycle acting as a central hub. It is unknown if the TCA cycle also regulates epigenetics, specifically DNA methylation, after infection-induced immune tolerance. The following studies demonstrate that lipopolysaccharide and Mycobacterium tuberculosis induce changes in DNA methylation that are mediated by the TCA cycle. Infection-induced DNA hypermethylation is mitigated by inhibitors of cellular metabolism (rapamycin, everolimus, metformin) and the TCA …

Houston, We Have A Problem: Diagnostic Difficulties In The Aids Patient With Tuberculosis Infection, Hector D. Preciado, Maria E. Torres, Muhammad A. Siddiqui, Liza Salloum, Lee Gelpi, Jose E. Campo Maldonado

Research Colloquium

Background: Tuberculosis (TB) is the leading cause of infectious death worldwide with 1.5 million deaths annually and nearly 1/4th of the world’s population (1.7 billion) infected with latent tuberculosis infection (LTBI) in 2014. Its diagnosis conventionally relies on tuberculin skin testing (TST), and Interferon-Gamma Release Assay (IGRA) which relies on the production of Interferon Gamma (IFN-y) in response to Mycobacterium tuberculosis (MTB) specific antigens. IGRA is a useful tool for detecting latent TB disease, and can be used as an adjunct for the diagnosis of active TB cases. Increases in IFN-y levels might support the diagnosis of a new TB …

Gender Bias Issues Among Women Dropping Out Of Tuberculosis Treatment In Batanghari Regency, Jambi, Indonesia, Guspianto Guspianto, Dessy Pramudiani, Ade Adriadi

Journal of Health Research

Background: One primary objective of a tuberculosis (TB) eradication program is the recovery of patients. Consistent medication intake is vital for TB sufferers to achieve recovery, as discontinuation or dropout can impede progress. Gender bias stemming from differences in social roles between men and women may influence the utilization of TB treatment programs. This study seeks to provide an overview of gender bias in the utilization of TB treatment programs.

Methods: This qualitative research study employed an exploratory descriptive approach to examine the experiences of gender bias among six women who withdrew from TB treatment in Batanghari regency, Jambi Province, …

A Pilot Program To Improve Tb Care With Primary And Specialty Care Coordination In Tb Public Health Clinic, Priyanka Jadhav, Gabrielle Boudoin, R Miles, Shandrica Seymour, J Parham, Amy Wolfe, Juzar Ali

School of Medicine Faculty Publications

BACKGROUND: The Wetmore Tuberculosis (TB) Clinic in New Orleans serves patients who often lack primary care (PC) or specialty care (SC), which is complicated by comorbidities. An initiative to provide on-site PC and coordinate care aims to enhance TB patient management. METHODS: Data collection involved categorizing patients based on their PC status: Group I (regular PC), Group II (intermittent PC), and Group III (no PC), with on-site Nurse Practitioner-based Bridge Care (NPBC) provided as needed. RESULTS: Over 12 months, 209 out of 354 patients required NPBC and PC/SC coordination, with a 20% shift from Group III to Group I, reducing …

Prevalence Of Non-Communicable Diseases Among Household Contacts Of People With Tuberculosis: A Systematic Review And Individual Participant Data Meta-Analysis, Yohhei Hamada, Matteo Quartagno, Farihah Malik, Keolebogile Ntshamane, Anna Tisler, Sanjay Gaikwad, Carlos Acuna-Villaorduna, Perumal Kannabiran Bhavani, Bachti Alisjahbana, Blanca I. Restrepo

School of Medicine Publications

Objective

To investigate the prevalence of non-communicable diseases among household contacts of people with tuberculosis.

Methods

We conducted a systematic review and individual participant data meta-analysis. We searched Medline, Embase and the Global Index Medicus from inception to 16 May 2023. We included studies that assessed for at least one non-communicable disease among household contacts of people with clinical tuberculosis. We estimated the non-communicable disease prevalence through mixed effects logistic regression for studies providing individual participant data, and compared it with estimates from aggregated data meta-analyses. Furthermore, we compared age and sex-standardised non-communicable disease prevalence with national-level estimates standardised for …

Tuberculosis Prevention: Current Strategies And Future Directions, Anca Vasiliu, Leonardo Martinez, Rishi K Gupta, Yohhei Hamada, Tara Ness, Alexander Kay, Maryline Bonnet, Martina Sester, Stefan H E Kaufmann, Christoph Lange, Anna M Mandalakas

Faculty, Staff and Students Publications

BACKGROUND: An estimated one fourth of the world's population is infected with Mycobacterium tuberculosis, and 5-10% of those infected develop tuberculosis in their lifetime. Preventing tuberculosis is one of the most underutilized but essential components of curtailing the tuberculosis epidemic. Moreover, current evidence illustrates that tuberculosis manifestations occur along a dynamic spectrum from infection to disease rather than a binary state as historically conceptualized. Elucidating determinants of transition between these states is crucial to decreasing the tuberculosis burden and reaching the END-TB Strategy goals as defined by the WHO. Vaccination, detection of infection, and provision of preventive treatment are key …

Update On The Diagnosis Of Tuberculosis, Irina Kontsevaya, Andrea Maurizio Cabibbe, Daniela Maria Cirillo, Andrew R Dinardo, Nicole Frahm, Stephen H Gillespie, David Holtzman, Lennard Meiwes, Elisa Petruccioli, Maja Reimann, Morten Ruhwald, Wilber Sabiiti, Francesca Saluzzo, Elisa Tagliani, Delia Goletti

Faculty, Staff and Students Publications

Background: Tuberculosis (TB) remains a global public health threat, and the development of rapid and precise diagnostic tools is the key to enabling the early start of treatment, monitoring response to treatment, and preventing the spread of the disease.

Objectives: An overview of recent progress in host- and pathogen-based TB diagnostics.

Sources: We conducted a PubMed search of recent relevant articles and guidelines on TB screening and diagnosis.

Content: An overview of currently used methods and perspectives in the following areas of TB diagnostics is provided: immune-based diagnostics, X-ray, clinical symptoms and scores, cough detection, culture of Mycobacterium tuberculosis and …

Data Mining Analysis With Orange In The Development Of Tuberculosis Among Diabetes Mellitus Patients, Malahayati Rusli Bintang, Adang Bachtiar, Cicilya Candi

Kesmas

Prevention and treatment of diabetes will have a positive influence on tuberculosis (TB) since people may get TB because they have diabetes mellitus (DM). Recording and reporting through the TB Information System are not run optimally because of many factors. The information system must be strengthened to be used by private health facilities. This study used secondary data from the 2013 and 2018 Indonesian Basic Health Research (IBHR). The data was analyzed univariately and analyzed further using Orange Data Mining Tools to test the screening tool model used to predict TB in diabetic individuals. The total sample in this study …

Adverse Events Of Bedaquiline Drug Use In The Treatment Of Multidrug-Resistant Tuberculosis (Mdr-Tb) Patients: A Review Artcile, Nabilah Nihlah, Bilqis Nailah, Imam Wicaksono

Pharmacology and Clinical Pharmacy Research

Adverse Drug Reaction (ADR) is any unfavorable and unexpected drug response in patients dosed for prevention, diagnosis, or therapy. Tuberculosis is a contagious infectious disease caused by the bacterium Mycobacterium tuberculosis. Multi-drug resistance Tuberculosis (MDR TB) is caused by bacteria that are resistant to the two most powerful first-line anti-TB drugs - isoniazid and rifampicin; cases of resistance to both drugs result in worse treatment outcomes, longer treatment duration, high costs, and various other complications. All medications used to treat MDR TB patients have the potential to cause mild, moderate, and severe side effects, especially Bedaquiline. This article will explain …

Detection Of Tuberculosis Using 2-D Photonic Crystal-Based Biosensor, Markov Vladimir, Skobelev Maksim, Neeraja Patil, Prathap P B, Saara K

Manipal Journal of Science and Technology

While there has been a significant increase in healthcare demands and the need for precise clinical judgment, it is important to note that the performance enhancement of photonic crystal sensors is not solely attributed to this surge in demand. Instead, photonic crystal-based biosensors have demonstrated improved performance over conventional biosensors. In this study, a 2-D photonic crystal-based biosensor with a square lattice structure, measuring 6 x 6 µm in length and width respectively, was proposed. The biosensor utilizes Titanium Dioxide (TiO2) as a sensing material, where TiO2 is employed to attract target molecules present in the sample. The proposed biosensor …

Assessing The Impact Of Tuberculosis On Economic Growth In Asean Countries: A Conceptual Framework And Panel Data Analysis, Agus Fitriangga, Alex Alex

Jurnal Ekonomi Kesehatan Indonesia

Tuberculosis (TB) remains a major global health issue, particularly in Southeast Asia, where its impact extends beyond public health to affect economic performance. This study evaluates the economic implications of TB incidence on gross domestic product (GDP) growth across eight ASEAN countries from 2000 to 2020. We employed a panel data regression approach, utilizing Common Effect Model (CEM), Fixed Effects Model (FEM), and Random Effects Model (REM) to analyze the relationship between TB incidence and economic growth. The dataset included annual GDP figures, TB incidence rates, foreign direct investment (FDI), labor force size, and trade openness, sourced from international databases. …

Immune Responses To Mycobacterium Tuberculosis Infection In The Liver Of Diabetic Mice, Ali Badaoui, Kayvan Sasaninia, Aishvaryaa Shree Mohan, Abrianna Beever, Nala Kachour, Anmol Raien, Afsal Kolloli, Ranjeet Kumar, Santhamani Ramasamy, Selvakumar Subbian, Vishwanath Venketaraman

Student Publications

Individuals with uncontrolled diabetes are highly susceptible to tuberculosis (TB) caused by Mycobacterium tuberculosis (M. tb) infection. Novel treatments for TB are needed to address the increased antibiotic resistance and hepatoxicity. Previous studies showed that the administration of liposomal glutathione (L-GSH) can mitigate oxidative stress, bolster a granulomatous response, and diminish the M. tb burden in the lungs of M. tb-infected mice. Nonetheless, the impact of combining L-GSH with conventional TB treatment (RIF) on the cytokine levels and granuloma formation in the livers of diabetic mice remains unexplored. In this study, we evaluated hepatic cytokine profiles, GSH, and tissue pathologies …

Screening Of Tuberculosis Infection Through Acid-Fast Bacilli Tests Among Waste Workers In Gresik, Indonesia, Budi Utomo, Widati Fatmaningrum, Sulistiawati, Shifa Fauziyah, Chan Chow Khuen, Nur Fadhilah, Teguh Hari Sucipto

Folia Medica Indonesiana

Highlights: 1. This study was the first in Gresik, Indonesia, to conduct mass screening of tuberculosis among waste workers, comprising various demographic profiles. 2. Although the tuberculosis screening of the waste workers showed negative results, mass examination using an acid-fast bacilli smear remains crucial to detect latent infections and prevent transmissions. Abstract Tuberculosis is a major source of illness and mortality worldwide. Therefore, tuberculosis screening is important to increase the number of active case-finding in a community. Bacteriological examinations can be used to initiate community-based active case-finding. Waste workers face a high risk of contracting Mycobacterium tuberculosis due to their …

Systems Genetics Uncover New Loci Containing Functional Gene Candidates In Mycobacterium Tuberculosis-Infected Diversity Outbred Mice., Daniel Mario Gatti, Anna L. Tyler, J Matthew Mahoney, Gary Churchill, Bulent Yener, Deniz Koyuncu, Metin N Gurcan, Mk Khalid Niazi, Thomas Tavolara, Adam Gower, Denise Dayao, Emily Mcglone, Melanie L Ginese, Aubrey Specht, Anas Alsharaydeh, Philipe A Tessier, Sherry L Kurtz, Karen L Elkins, Igor Kramnik, Gillian Beamer

Faculty Research 2024

Mycobacterium tuberculosis infects two billion people across the globe, and results in 8-9 million new tuberculosis (TB) cases and 1-1.5 million deaths each year. Most patients have no known genetic basis that predisposes them to disease. Here, we investigate the complex genetic basis of pulmonary TB by modelling human genetic diversity with the Diversity Outbred mouse population. When infected with M. tuberculosis, one-third develop early onset, rapidly progressive, necrotizing granulomas and succumb within 60 days. The remaining develop non-necrotizing granulomas and survive longer than 60 days. Genetic mapping using immune and inflammatory mediators; and clinical, microbiological, and granuloma correlates of …

Immune Responses Of Neonatal (14-Day Old) And Adult (6 Weeks Old) Mice Lung And Spleen Cells To Gamma-Irradiated Mycobacterium Tuberculosis Stimulation, Oyinkansola F. Adeyemi

Biotechnology Theses

Tuberculosis (TB) caused by Mycobacterium tuberculosis (Mtb) is a global health challenge, especially in vulnerable populations like neonates, whose immune systems are still developing. Understanding the immune responses to Mtb in neonates is critical for the development of better vaccine and treatment strategies. Building upon previous research from our laboratory, which demonstrated that γMtb stimulated neonatal mice (0, 3, and 7 days old) lung cells displayed distinct cytokine profiles and increased expansion of myeloid-derived suppressor cell subpopulations than adult mice lung cells. In the current study, we investigated age-dependent immune responses in 14-day-old (neonates) and 6-week-old (adults) mice. We found …

Impact Of Toll-Like Receptor 10 Mutations On Tuberculosis Infections, Adriana Nicole Rafael, Sangman Kim

Master's Theses

Tuberculosis (TB), caused by the intracellular pathogen Mycobacterium tuberculosis (M. tb), is a leading global health crisis causing millions of cases and deaths each year. Though it affects individuals of any race, ethnicity, or cultural group, research shows the disease disproportionately affects individuals with Asian ancestry. Immunity to M. tb starts with its recognition by pattern recognition receptors such as Toll-like receptors (TLRs), which are key players in immune responses. TLR-10, an understudied toll-like receptor due to its inability to be studied through mouse models, is thought to play a key role in the clearance of inflammatory diseases. SNP I775V, …

High All-Cause Mortality And Increasing Proportion Of Older Adults With Tuberculosis In Texas, 2008–2020, Belinda A Medrano, Miryoung Lee, Gretchen Gemeinhardt, Lana Yamba, Blanca I Restrepo

Faculty, Staff and Student Publications

Pulmonary tuberculosis (PTB) elimination efforts must consider the global growth of the ageing population. Here we used TB surveillance data from Texas, United States (2008-2020; total n = 10656) to identify unique characteristics and outcomes in older adults (OA, ≥65 years) with PTB, compared to young adults (YA, 18-39 years) or middle-aged adults (40-64 years). We found that the proportion of OA with PTB increased from 15% in 2008 to 24% in 2020 (trend p < 0.05). Diabetes was highly prevalent in OA (32%) but not associated with adverse outcomes. Death was 13-fold higher in OA compared to YA and was 7% at the time of diagnosis which suggests diagnostic delays. However, once TB was suspected, we found no differences in culture, smear, or nucleic acid detection of mycobacteria (although less lung cavitations) in OA. During treatment, OA had less drug-resistant TB, few adverse reactions and adhered with TB treatment. We recommend training healthcare workers to 'think TB' in OA, for prompt treatment initiation to diminish deaths. Furthermore, OA should be added as a priority group to the latent TB treatment guidelines by the World Health Organization, to prevent TB disease in this highly vulnerable group.

High All-Cause Mortality And Increasing Proportion Of Older Adults With Tuberculosis In Texas, 2008–2020, Belinda A. Medrano, Miryoung Lee, Gretchen L. Gemeinhardt, Lana Yamba, Blanca I. Restrepo

School of Medicine Publications

Pulmonary tuberculosis (PTB) elimination efforts must consider the global growth of the ageing population. Here we used TB surveillance data from Texas, United States (2008–2020; total n = 10656) to identify unique characteristics and outcomes in older adults (OA, ≥65 years) with PTB, compared to young adults (YA, 18–39 years) or middle-aged adults (40–64 years). We found that the proportion of OA with PTB increased from 15% in 2008 to 24% in 2020 (trend p < 0.05). Diabetes was highly prevalent in OA (32%) but not associated with adverse outcomes. Death was 13-fold higher in OA compared to YA and was 7% at the time of diagnosis which suggests diagnostic delays. However, once TB was suspected, we found no differences in culture, smear, or nucleic acid detection of mycobacteria (although less lung cavitations) in OA. During treatment, OA had less drug-resistant TB, few adverse reactions and adhered with TB treatment. We recommend training healthcare workers to ‘think TB’ in OA, for prompt treatment initiation to diminish deaths. Furthermore, OA should be added as a priority group to the latent TB treatment guidelines by the World Health Organization, to prevent TB disease in this highly vulnerable group.

Parallel Use Of Low-Complexity Automated Nucleic Acid Amplification Tests On Respiratory Samples And Stool With Or Without Lateral Flow Lipoarabinomannan Assays To Detect Pulmonary Tuberculosis Disease In Children, Laura Olbrich, Alexander W Kay, Stephanie Bjerrum, Bada Yang, Johanna Åhsberg, Ruvandhi R Nathavitharana, Andreas Lundh, Maunank Shah, Devan Jaganath

Faculty, Staff and Students Publications

This is a protocol for a Cochrane Review (diagnostic). The objectives are as follows: To compare the diagnostic accuracy of the parallel use of low-complexity automated nucleic acid amplification tests on respiratory and stool specimens in children and lateral flow urine lipoarabinomannan amongst children with HIV versus each assay alone for detecting pulmonary tuberculosis. Secondary objectives To compare the diagnostic accuracy of low-complexity automated nucleic acid amplification tests on respiratory and stool specimens in combination versus each sample type alone. To investigate the following sources of heterogeneity: clinical setting, signs and symptoms of pulmonary tuberculosis disease, screening positivity by chest …