1. Patterns of T and B cell responses to Mycobacterium tuberculosis membrane-associated antigens and their relationship with disease activity in rheumatoid arthritis patients with latent tuberculosis infection
- Author
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Ankita Singh, Amita Aggarwal, Suvrat Arya, Ramnath Misra, Shashi Kumar, and Sudhir Sinha
- Subjects
0301 basic medicine ,Bacterial Diseases ,Male ,B Cells ,T-Lymphocytes ,Antibody Response ,Adaptive Immunity ,Arthritis, Rheumatoid ,White Blood Cells ,0302 clinical medicine ,Medical Conditions ,Animal Cells ,Medicine and Health Sciences ,alpha-Crystallins ,Enzyme-Linked Immunoassays ,Immune Response ,B-Lymphocytes ,Multidisciplinary ,biology ,Latent tuberculosis ,T Cells ,Antibody Isotype Determination ,Middle Aged ,Actinobacteria ,medicine.anatomical_structure ,Infectious Diseases ,Rheumatoid arthritis ,Medicine ,Female ,Antibody ,Cellular Types ,Research Article ,Adult ,Science ,T cell ,Immune Cells ,Immunology ,Tuberculin ,Enzyme-Linked Immunosorbent Assay ,Research and Analysis Methods ,Antibodies ,Mycobacterium tuberculosis ,03 medical and health sciences ,Antigen ,Latent Tuberculosis ,medicine ,Tuberculosis ,Humans ,Antibody-Producing Cells ,Immunoassays ,B cell ,030203 arthritis & rheumatology ,Antigens, Bacterial ,Blood Cells ,Bacteria ,business.industry ,Tuberculin Test ,Organisms ,Biology and Life Sciences ,Cell Biology ,medicine.disease ,biology.organism_classification ,Tropical Diseases ,Immunoglobulin A ,030104 developmental biology ,Immunoglobulin M ,biology.protein ,Immunologic Techniques ,business ,Follow-Up Studies - Abstract
This study was aimed at exploring whether latent tuberculosis infection (LTBI) contributes to the pathogenesis of immune-mediated inflammatory diseases in a TB endemic setting. We screened 198 rheumatoid arthritis (RA) patients with tuberculin skin test (TST) and studied 61 (median DAS28-ESR = 6.3) who were positive. Whole blood T cell proliferative responses to Mycobacterium tuberculosis (Mtb) membrane (MtM) antigens, including the latency-induced protein alpha crystallin (Acr), were determined by flow cytometry using Ki67 expression as the marker for nuclear proliferation. Serum antibody levels were determined by ELISA. Follow-up investigations (at 3–6, 9–12 and 15–18 months after baseline) were performed in 41 patients who were classified empirically as ‘high’ (HR-T/HR-B) or ‘low’ (LR-T/LR-B) responders based on their dynamic T cell or antibody responses. Significant correlations were seen between baseline T cell responses to MtM and Acr, and between IgG, IgA and IgM antibody responses to MtM. However, no correlation was seen between T and B cell responses. At all time points during the follow-up, T cell responses to both antigens (except for MtM at one point) were significantly higher in HR-T (n = 25) than LR-T (n = 16) patients. Levels of IgA and IgM (but not IgG) antibodies to MtM were also significantly higher in HR-B (n = 13) than LR-B (n = 28) at all time points. Importantly, HR-T patients exhibited significantly higher baseline and follow-up DAS28 scores than LR-T. Ten (of 61) patients had a history of TB and developed RA 6 years (median) after contracting TB. Three new TB cases (1 from TST-positive and 2 from TST-negative groups) emerged during the follow-up. Our results suggest that persistently elevated T cell responses to Mtb antigens may contribute to disease activity in RA.
- Published
- 2021