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https://www.readbyqxmd.com/read/28303782/paradoxical-reactions-and-the-immune-reconstitution-inflammatory-syndrome
#1
L W Preston Church, Amit Chopra, Marc A Judson
In HIV-infected individuals, paradoxical reactions after the initiation of antiretroviral therapy (ART) are associated with a variety of underlying infections and have been called the immune reconstitution inflammatory syndrome (IRIS). In cases of IRIS associated with tuberculosis (TB), two distinct patterns of disease are recognized: (i) the progression of subclinical TB to clinical disease after the initiation of ART, referred to as unmasking, and (ii) the progression or appearance of new clinical and/or radiographic disease in patients with previously recognized TB after the initiation of ART, the classic or "paradoxical" TB-IRIS...
March 2017: Microbiology Spectrum
https://www.readbyqxmd.com/read/28283189/metal-ions-and-phosphatidylinositol-4-5-bisphosphate-as-interacting-effectors-of-%C3%AE-type-plant-phospholipase-d
#2
Lars Dreßler, Florian Michel, Iris Thondorf, Johanna Mansfeld, Ralph Golbik, Renate Ulbrich-Hofmann
Plant phospholipases D (PLD) are typically characterized by a C2 domain with at least two Ca(2+) binding sites. In vitro, the predominantly expressed α-type PLDs need 20-100 mM CaCl2 for optimum activity, whereas the essential activator of β- or γ-type PLDs, phosphatidylinositol 4,5-bisphosphate (PIP2), plays a secondary role. In the present paper, we have studied the interplay between PIP2 and metal ion activation of the well-known α-type PLD from cabbage (PLDα). With mixed micelles containing phosphatidyl-p-nitrophenol as substrate, PIP2-concentrations in the nanomolar range are able to activate the enzyme in addition to the essential Ca(2+) activation...
March 7, 2017: Phytochemistry
https://www.readbyqxmd.com/read/28256380/the-cursed-duet-today-tuberculosis-and-hiv-coinfection
#3
Simon Tiberi, Anna Cristina C Carvalho, Giorgia Sulis, Devan Vaghela, Adrian Rendon, Fernanda C de Q Mello, Ananna Rahman, Nashaba Matin, Ali Zumla, Emanuele Pontali
The tuberculosis (TB) and HIV syndemic continues to rage and are a major public health concern worldwide. This deadly association raises complexity and represent a significant barrier towards TB elimination. TB continues to be the leading cause of death amongst HIV-infected people. This paper reports the challenges that lay ahead and outlines some of the current and future strategies that may be able to address this co-epidemic efficiently. Improved diagnostics, cheaper and more effective drugs, shorter treatment regimens for both drug-sensitive and drug-resistant TB are discussed...
February 27, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28209523/tb-iris-proteomic-analysis-of-in-vitro-pbmc-responses-to-mycobacterium-tuberculosis-and-response-modulation-by-dexamethasone
#4
Liam Bell, Janique M Peyper, Shaun Garnett, Rabecca Tadokera, Robert Wilkinson, Graeme Meintjes, Jonathan M Blackburn
Paradoxical tuberculosis-associated immune reconstitution inflammatory syndrome (TB-IRIS) occurs in 8-54% of South African patients undergoing treatment for tuberculosis/human immunodeficiency virus co-infection. Improved TB-IRIS molecular pathogenesis understanding would enhance risk stratification, diagnosis, prognostication, and treatment. We assessed how TB-IRIS status and dexamethasone influence leukocyte proteomic responses to Mycobacterium tuberculosis (Mtb). Patient blood was obtained three weeks post-anti-retroviral therapy initiation...
February 14, 2017: Experimental and Molecular Pathology
https://www.readbyqxmd.com/read/28104935/neurotuberculosis-immune-reconstitution-inflammatory-syndrome-in-the-setting-of-hiv-infection-a-case-report-and-review-of-literature
#5
Deepasree Jaganmohan, Sunitha V Chakkalakkoombil, Anjana A Beena, Nagarajan Krishnan
Immune reconstitution inflammatory syndrome (IRIS) is an exaggerated immune response which can occur with various coinfections in human immunodeficiency virus (HIV) infected patients, of which the most commonly implicated in central nervous system (CNS)-IRIS are progressive multifocal leukoencephalopathy (PML), cryptococcosis, and tuberculosis (TB). TB-IRIS is a known complication of pulmonary TB or TB lymphadenitis coinfection in HIV infected patients who are on antituberculosis treatment (ATT) after the initiation of antiretroviral therapy (ART)...
October 2016: Indian Journal of Radiology & Imaging
https://www.readbyqxmd.com/read/28098445/circular-and-chainlike-copper-ii-lanthanide-iii-complexes-generated-by-assembly-reactions-of-racemic-and-chiral-copper-ii-cross-linking-ligand-complexes-with-ln-iii-no3-3%C3%A2-6h2o-ln-iii-gd-iii-tb-iii-dy-iii
#6
Takahiro Ueno, Takeshi Fujinami, Naohide Matsumoto, Masaki Furusawa, Ryo Irie, Nazzareno Re, Takuya Kanetomo, Takayuki Ishida, Yukinari Sunatsuki
The 1:1 assembly reaction of the racemic form of the cross-linking ligand complex Na[Cu(II)L(dpen(1R2R/1S2S))] with Ln(III)(NO3)3·6H2O gave the centrosymmetric circular (Cu(II)Ln(III))2 complex [Cu(II)L(dpen(1R2R/1S2S))Ln(III)(NO3)2]2 (1Ln: Ln = Gd, Tb, Dy), while the reaction of the enantiopure form Na[Cu(II)L(dpen(1R2R))] with Ln(III)(NO3)3·6H2O gave the chiral chainlike (Cu(II)Ln(III))1∞ complex [Cu(II)L(dpen(1R2R))Ln(III)(NO3)2(CH3CN)]1∞·CH3CN (2Ln: Ln = Gd, Tb, Dy), where {Cu(II)L(dpen(1R2R))}(-) is (N-((1R,2R)-2-(((E)-3-ethoxy-2-oxybenzylidene)amino)-1,2-diphenylethyl)-2-oxybenzamide)copper(II) and {Cu(II)L(dpen(1R2R/1S2S))}(-) is the racemic mixture of {Cu(II)L(dpen(1R2R))}(-) and {Cu(II)L(dpen(1S2S))}(-)...
January 18, 2017: Inorganic Chemistry
https://www.readbyqxmd.com/read/28043540/nationwide-hiv-mdr-tb-survey-in-japan-and-collaborative-study-in-the-philippines
#7
Toshio Hattori, Nobuyuki Kobayashi, Hideaki Nagai, Haorile Chagan-Yasutan, Elizabeth Telan, Marietta B Solante
BACKGROUND: Although the prevalence of pulmonary tuberculosis (TB) and HIV infection in Japan is low, careful monitoring of these two diseases is necessary. We conducted a nationwide survey on multidrug resistant (MDR)-TB (2011-2013) and HIV-TB (2007-2014) to understand the mode of prevention and the effect of therapy. A study on MDR-TB and HIV in San Lazaro Hospital (SLH) in the Philippines was also conducted. These studies introduced an international collaborative study against the global epidemics of HIV-TB/MDR-TB...
December 2016: International Journal of Mycobacteriology
https://www.readbyqxmd.com/read/28013100/the-impact-of-highly-active-antiretroviral-therapy-on-obstetric-conditions-a-review
#8
REVIEW
Hannah M Sebitloane, Dhayendre Moodley
HIV is the leading cause of maternal and neonatal morbidity and mortality in resource constrained countries. Highly active antiretroviral treatment (HAART) initiated in pregnancy has now almost eliminated mother to child transmission of the virus, and is beginning to show the desired effect of reducing HIV related maternal mortality. By modulating host immunological responses HAART has the potential to alter infections during pregnancy, in addition to modifying clinical conditions such as preeclampsia. There is increasing evidence of the benefits of HAART given to pregnant women, however there is paucity of data that distinguishes HIV or HAART as the cause or exacerbation of pre-existing medical conditions or conditions specific to pregnancy...
December 9, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/27932622/inflammasome-activation-underlies-central-nervous-system-deterioration-in-hiv-associated-tuberculosis
#9
Suzaan Marais, Rachel P J Lai, Katalin A Wilkinson, Graeme Meintjes, Anne O'Garra, Robert J Wilkinson
Tuberculosis meningitis (TBM) is a frequent cause of meningitis in HIV-infected individuals, resulting in death in ~ 40% of affected patients. A severe complication of antiretroviral therapy (ART) in these patients is neurological TB-immune reconstitution inflammatory syndrome (IRIS), but its underlying cause remains poorly understood. To investigate the pathogenesis of TBM-IRIS, we performed longitudinal whole blood microarray analysis of HIV-infected TBM patients and reflected the findings at the protein level...
December 8, 2016: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/27828731/the-pharmacological-challenges-of-treating-tuberculosis-and-hiv-coinfections
#10
Eric F Egelund, Lori Dupree, Emily Huesgen, Charles A Peloquin
Tuberculosis (TB) is the most prevalent opportunistic infection among HIV patients, and the leading cause of death among HIV patients worldwide. Simultaneous treatment of both diseases is recommended by current guidelines, but can be challenging due to the potential for drug-drug interactions, overlapping toxicities, difficulty adhering to medications, and an increased risk for immune reconstitution inflammatory syndrome (IRIS). Clinical manifestations of TB can also vary between HIV-infected patients and uninfected patients, which can increase the risk for delayed diagnosis...
February 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/27677424/prolonged-tuberculosis-associated-immune-reconstitution-inflammatory-syndrome-characteristics-and-risk-factors
#11
Tasnim M Bana, Maia Lesosky, Dominique J Pepper, Helen van der Plas, Charlotte Schutz, Rene Goliath, Chelsea Morroni, Marc Mendelson, Gary Maartens, Robert J Wilkinson, Graeme Meintjes
BACKGROUND: In a proportion of patients with HIV-associated tuberculosis who develop paradoxical immune reconstitution inflammatory syndrome (IRIS), the clinical course of IRIS is prolonged necessitating substantial health care utilization for diagnostic and therapeutic interventions. Prolonged TB-IRIS has not been prospectively studied to date. We aimed to determine the proportion of patients with prolonged TB-IRIS, as well as the clinical characteristics and risk factors for prolonged TB-IRIS...
September 27, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27643598/role-of-lta4h-polymorphism-in-tuberculosis-associated-immune-reconstitution-inflammatory-syndrome-occurrence-and-clinical-severity-in-patients-infected-with-hiv
#12
Gopalan Narendran, Dhanasekaran Kavitha, Ramesh Karunaianantham, Leonardo Gil-Santana, Jilson L Almeida-Junior, Sirasanambatti Devarajulu Reddy, Marimuthu Makesh Kumar, Haribabu Hemalatha, Nagesh Nalini Jayanthi, Narayanan Ravichandran, Raja Krishnaraja, Angamuthu Prabhakar, Tamizhselvan Manoharan, Lokeswaran Nithyananthan, Gunasundari Arjunan, Mohan Natrajan, Soumya Swaminathan, Bruno B Andrade
BACKGROUND: Paradoxical tuberculosis-associated immune reconstitution inflammatory syndrome (TB-IRIS) is an inflammatory phenomenon complicating HIV management in coincidental tuberculosis (TB) infection, upon immune reconstitution driven by antiretroviral therapy (ART). Leukotriene A4 hydroxylase (LTA4H), an enzyme which converts LTA4 to LTB4, regulates the balance between the anti-inflammatory lipoxins and pro-inflammatory LTB4, with direct implications in TB-driven inflammation. In humans, a single nucleotide polymorphism (SNP) in the LTA4H promoter which regulates its transcriptional activity (rs17525495) has been identified and described to impact clinical severity of TB presentation and response to corticosteroid therapy...
2016: PloS One
https://www.readbyqxmd.com/read/27571786/preventing-paradoxical-tuberculosis-associated-immune-reconstitution-inflammatory-syndrome-in-high-risk-patients-protocol-of-a-randomized-placebo-controlled-trial-of-prednisone-predart-trial
#13
Cari Stek, Charlotte Schutz, Lisette Blumenthal, Friedrich Thienemann, Jozefien Buyze, Christiana Nöstlinger, Raffaella Ravinetto, Edwin Wouters, Robert Colebunders, Gary Maartens, Robert J Wilkinson, Lutgarde Lynen, Graeme Meintjes
BACKGROUND: Early antiretroviral therapy (ART) initiation in patients diagnosed with HIV-associated tuberculosis (TB) reduces mortality among those with the lowest CD4 counts. At the same time, both early ART and a low CD4 count heighten the risk of paradoxical TB-associated immune reconstitution inflammatory syndrome (TB-IRIS). TB is common in patients starting ART in sub-Saharan Africa. Safe interventions that reduce the incidence or severity of TB-IRIS are needed. Prednisone has been shown to reduce symptoms and markers of inflammation when used to treat TB-IRIS...
August 29, 2016: JMIR Research Protocols
https://www.readbyqxmd.com/read/27469157/hiv-associated-renal-disease-an-overview
#14
Nicola Wearne, Ikechi G Okpechi
The cause of the human immunodeficiency virus (HIV) epidemic in South Africa (SA) was worsened by the denial by key political players that HIV causes acquired immunodeficiency syndrome (AIDS). South Africa continues to have the highest rate of HIV world-wide, which has had a huge impact on the development of both chronic kidney disease and acute kidney injury. Fortunately, there is now an effective antiretroviral therapy (ART) roll-out program. SA is also dealing with a collision of epidemics of HIV, tuberculosis, and non-communicable disease, particularly hypertension and diabetes...
2016: Clinical Nephrology
https://www.readbyqxmd.com/read/27451593/immune-reconstitution-inflammatory-syndrome-in-central-nervous-system-tuberculosis
#15
Eliza Manea, Daniela Munteanu, Raluca Jipa, Ruxandra Moroti, Victoria Arama, Ioan-Alexandru Diaconu, Adriana Hristea
BACKGROUND: Immune reconstitution inflammatory syndrome (IRIS) related to tuberculosis (TB) is an exacerbation of an inflammatory response that most often occurs in HIV-infected patients but it has also been observed in non-HIV immunocompromised hosts. We describe two cases of TB associated IRIS with CNS involvement, one in a patient diagnosed with HIV infection and the other in a patient with immunosuppression due to anti tumor necrosis factor treatment. CASE REPORT; The first case was a 40-year-old man, newly diagnosed with HIV infection, who developed right hemiplegia and expressive aphasia...
October 2015: Pneumologia: Revista Societății Române de Pneumologie
https://www.readbyqxmd.com/read/27306506/added-value-of-long-term-cytokine-release-assays-to-detect-mycobacterium-tuberculosis-infection-in-hiv-infected-subjects-in-uganda
#16
Violette Dirix, Kinda Schepers, Marguerite Massinga-Loembe, William Worodria, Robert Colebunders, Mahavir Singh, Camille Locht, Luc Kestens, Françoise Mascart
OBJECTIVES: To investigate whether mycobacterial antigen-induced cytokine secretions are helpful in detecting Mycobacterium tuberculosis (Mtb) infection in a cohort of HIV-infected patients living in a country with a high burden of Mtb and HIV infections, and to determine their predictive value for the development of tuberculosis (TB)-associated immune reconstitution inflammatory syndrome. DESIGN: A total of 352 HIV-infected patients (186 with active TB) were prospectively enrolled when initiating antiretroviral therapy (ART)...
July 1, 2016: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/27109272/tb-hiv-co-infection-a-catastrophic-comradeship
#17
G Narendran, S Swaminathan
The symbiotic association of tuberculosis (TB) and HIV poses a challenge to human survival. HIV complicates every aspect of TB including presentation, diagnosis and treatment. HIV-TB patients encounter unique problems like drug-drug interactions, cumulative toxicity, immune reconstitution inflammatory syndrome (IRIS), lower plasma drug levels and emergence of drug resistance during treatment despite adherence. TB may also be overdiagnosed in HIV due to a number of diseases that closely resemble TB. Notable among them are non-tuberculous mycobacteria, Pneumocystis Jirovecii and Nocardia...
April 2016: Oral Diseases
https://www.readbyqxmd.com/read/27076678/aberrant-inflammasome-activation-characterizes-tuberculosis-associated-immune-reconstitution-inflammatory-syndrome
#18
Hong Yien Tan, Yean Kong Yong, Esaki M Shankar, Geza Paukovics, Rada Ellegård, Marie Larsson, Adeeba Kamarulzaman, Martyn A French, Suzanne M Crowe
Tuberculosis-associated immune reconstitution inflammatory syndrome (TB-IRIS) complicates combination antiretroviral therapy (cART) in up to 25% of patients with HIV/TB coinfection. Monocytes and IL-18, a signature cytokine of inflammasome activation, are implicated in TB-IRIS pathogenesis. In this study, we investigated inflammasome activation both pre- and post-cART in TB-IRIS patients. HIV/TB patients exhibited higher proportions of monocytes expressing activated caspase-1 (casp1) pre-cART, compared with HIV patients without TB, and patients who developed TB-IRIS exhibited the greatest increase in casp1 expression...
May 15, 2016: Journal of Immunology: Official Journal of the American Association of Immunologists
https://www.readbyqxmd.com/read/27014741/matrix-metalloproteinases-in-tuberculosis-immune-reconstitution-inflammatory-syndrome-and-impaired-lung-function-among-advanced-hiv-tb-co-infected-patients-initiating-antiretroviral-therapy
#19
Shruthi Ravimohan, Neo Tamuhla, Shiang-Ju Kung, Kebatshabile Nfanyana, Andrew P Steenhoff, Robert Gross, Drew Weissman, Gregory P Bisson
BACKGROUND: HIV-infected patients with pulmonary TB (pTB) can have worsening of respiratory symptoms as part of TB-immune reconstitution inflammatory syndrome (TB-IRIS) following antiretroviral therapy (ART) initiation. Thus, reconstitution of immune function on ART could drive incident lung damage in HIV/TB. METHODS: We hypothesized that increases in matrix metalloproteinases (MMPs), which can degrade lung matrix, on ART are associated with TB-IRIS among a cohort of advanced, ART naïve, HIV-infected adults with pTB...
January 2016: EBioMedicine
https://www.readbyqxmd.com/read/26986567/in-vivo-molecular-dissection-of-the-effects-of-hiv-1-in-active-tuberculosis
#20
Lucy C K Bell, Gabriele Pollara, Mellissa Pascoe, Gillian S Tomlinson, Rannakoe J Lehloenya, Jennifer Roe, Richard Meldau, Robert F Miller, Alan Ramsay, Benjamin M Chain, Keertan Dheda, Mahdad Noursadeghi
Increased risk of tuberculosis (TB) associated with HIV-1 infection is primarily attributed to deficient T helper (Th)1 immune responses, but most people with active TB have robust Th1 responses, indicating that these are not sufficient to protect against disease. Recent findings suggest that favourable outcomes following Mycobacterium tuberculosis infection arise from finely balanced inflammatory and regulatory pathways, achieving pathogen control without immunopathology. We hypothesised that HIV-1 and antiretroviral therapy (ART) exert widespread changes to cell mediated immunity, which may compromise the optimal host protective response to TB and provide novel insights into the correlates of immune protection and pathogenesis...
March 2016: PLoS Pathogens
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