title: Modulation of the immune response to Mycobacterium tuberculosis during malaria/M. tuberculosis co-infection.
abstract: Tuberculosis (TB) causes significant morbidity and mortality on a global scale. The African region has 24% of the world's TB cases. TB overlaps with other infectious diseases such as malaria and HIV, which are also highly prevalent in the African region. TB is a leading cause of death among HIV-positive patients and co-infection with HIV and TB has been described as a syndemic. In view of the overlapping epidemiology of these diseases, it is important to understand the dynamics of the immune response to TB in the context of co-infection. We investigated the cytokine response to purified protein derivative (PPD) in peripheral blood mononuclear cells from TB patients co-infected with HIV or malaria and compared it to that of malaria- and HIV-free TB patients. A total of 231 subjects were recruited for this study and classified into six groups; untreated TB-positive, TB positive subjects on TB drugs, TB- and HIV-positive, TB- and malaria-positive, latent TB and apparently healthy control subjects. Our results demonstrate maintenance of interferon (IFN)-γ production in HIV and malaria co-infected TB patients in spite of lower CD4 counts in the HIV-infected cohort. Malaria co-infection caused an increase in the production of the T helper type 2 (Th2)-associated cytokine interleukin (IL)-4 and the anti-inflammatory cytokine IL-10 in PPD-stimulated cultures. These results suggest that malaria co-infection diverts immune response against M. tuberculosis towards a Th-2/anti-inflammatory response which might have important consequences for disease progression.
authors: Medical Laboratory Science Department, Nnamdi Azikiwe University, Nnewi Campus, Nigeria.
authors: R C
authors: RC
authors: Chukwuanukwu
authors: Medical Laboratory Science Department, Nnamdi Azikiwe University, Nnewi Campus, Nigeria.
authors: C C
authors: CC
authors: Onyenekwe
authors: School of Life, University of Nottingham, Nottingham, UK.
authors: L
authors: L
authors: Martinez-Pomares
authors: School of Veterinary Medicine and Science, University of Nottingham, Nottingham, UK.
authors: R
authors: R
authors: Flynn
authors: School of Life, University of Nottingham, Nottingham, UK.
authors: S
authors: S
authors: Singh
authors: Haematology Department, Nnamdi Azikiwe University, Nnewi Campus, Nigeria.
authors: G I
authors: GI
authors: Amilo
authors: Medical Laboratory Science Department, Nnamdi Azikiwe University, Nnewi Campus, Nigeria.
authors: N R
authors: NR
authors: Agbakoba
authors: Medical Laboratory Science Department, Nnamdi Azikiwe University, Nnewi Campus, Nigeria.
authors: J O
authors: JO
authors: Okoye
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology* / Q000382:microbiology / Q000469:parasitology; D002478:Cells, Cultured; D002648:Child; D060085:Coinfection; D016207:Cytokines / Q000378:metabolism; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000276:immunology*; D006801:Humans; D008288:Malaria / Q000150:complications / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000276:immunology*; D009549:Nigeria; D058408:Th1-Th2 Balance; D014373:Tuberculin / Q000276:immunology; D014376:Tuberculosis / Q000150:complications / Q000276:immunology*; D055815:Young Adult
chemical_list: D016207:Cytokines; D014373:Tuberculin
keywords: HIV; co-infection; cytokines; malaria; tuberculosis