Nontuberculous Mycobacteria: Clinical Importance and Relevance to Bacille Calmette-Guerin Vaccination

Valadas, Emília

doi:10.1086/422326

Cited by 10 publications

(8 citation statements)

References 9 publications

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“…In this paper, we asked a different question: can BCG revaccination boost anti-TB immunity in the absence of INH treatment altogether? The fact that we demonstrate this to be the case is important, as current thinking proposes that underlying infection with Mtb or cross-reactive NTM responses (10)(11)(12)(13)17) can potentially blunt responses to BCG revaccination. Hence, most BCG revaccination studies have focused on subjects without Mtb infection (IGRA -) or latent TB subjects (IGRA + ) after INH.…”

Section: L I N I C a L M E D I C I N Ementioning

confidence: 53%

BCG revaccination boosts adaptive polyfunctional Th1/Th17 and innate effectors in IGRA+ and IGRA– Indian adults

Rakshit¹,

Ahmed²,

Adiga³

et al. 2019

JCI Insight

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BACKGROUND. Bacille Calmette-Guérin (BCG) vaccine is protective against Tuberculosis (TB) in children, but its efficacy wanes with age. Consequently, determining if BCG revaccination augments anti-TB immunity in young adults in TB endemic regions is vital. METHODS. Two hundred healthy adults, BCG vaccinated at birth, were tested for their IFN-γ release assay (IGRA) status. Of these, 28 IGRA + and 30 IGRAwere BCG revaccinated, and 24 IGRA + and 23 IGRAsubjects served as unvaccinated controls. T and innate cell responses to mycobacterial antigens were analyzed by 14-color flow cytometry over 34 weeks. RESULTS. IFN-γ and/or IL-2 Ag85A-and BCG-specific CD4 + and CD8 + T cell responses were boosted by revacciantion at 4 and 34 weeks, respectively, and were > 2-fold higher in IGRA + compared with IGRAvaccinees. Polyfunctional Ag85A, BCG, and mycobacterium tuberculosis (Mtb) latency Agspecific (LTAg-specific) CD4 + T cells expressing up to 8 cytokines were also significantly enhanced in both IGRA + and IGRAvaccinees relative to unvaccinated controls, most markedly in IGRA + vaccinees. A focused analysis of Th17 responses revealed expansion of Ag85A-, BCG-, and LTAgspecific total IL-17A + ,IL-17F + ,IL-22 + , and IL-10 + CD4 + T cell effectors in both IGRA + and IGRAsubjects. Also, innate IFN-γ + NK/γδ/NKT cell responses were higher in both IGRA + and IGRAvaccinees compared with controls. This is the first evidence to our knowledge that BCG revaccination significantly boosts antimycobacterial Th1/Th17 responses in IGRA + and IGRAsubjects. CONCLUSION. These data show that BCG revaccination is immunogenic in IGRAand IGRA + subjects, implying that Mtb preinfection in IGRA + subjects does not impact immunogenicity. This has implications for public health and vaccine development strategies.

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Section: L I N I C a L M E D I C I N Ementioning

confidence: 53%

BCG revaccination boosts adaptive polyfunctional Th1/Th17 and innate effectors in IGRA+ and IGRA– Indian adults

Rakshit¹,

Ahmed²,

Adiga³

et al. 2019

JCI Insight

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“…Another possibility could be less “herd immunity” because of decreasing rates of tuberculosis and less use of the Bacille Calmette-Guérin (BCG) vaccine. [9], [10] Also, the increase in number of immunocompromised hosts is suggested to be another contributing factor. [11] It is also assumed that the rise in NTM infections is congruent with the worldwide Human immunodeficiency virus (HIV) epidemic as well as scientific advancements leading to the more widespread use of chemotherapy and organ and tissue transplantation.…”

Section: Introductionmentioning

confidence: 99%

Nontuberculous Mycobacterial Disease Mortality in the United States, 1999–2010: A Population-Based Comparative Study

et al. 2014

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BackgroundEnvironmental nontuberculous mycobacteria (NTM) are ubiquitous organisms with which humans commonly interact. The epidemiologic characteristics of NTM diseases including mortality rate and its associated factors remain largely unknown. In this study, we explored the geographical area of exposure and mortality and comorbid conditions of affected persons to determine environment, host, and host-pathogen interactive factors.MethodsWe analyzed mortality related to nontuberculous mycobacterial infections from 1999 through 2010 by examining multiple-cause-of-death data from the National Center for Health Statistics. Among those who died with these diseases, we analyzed age-adjusted mortality rates, trends, associations with demographic variables, and comorbid conditions and correlated this information with similar data for tuberculosis-related mortality during the same time.Measurements and Mean ResultsFrom 1999 through 2010, nontuberculous mycobacterial disease was reported as an immediate cause of death in 2,990 people in the United States with a combined overall mean age-adjusted mortality rate of 0.1 per 100,000 person-years. A significant increase in the number of NTM related deaths was seen from 1999 through 2010 (R2 = 0.72, p<0.0001), but it was not significant after adjustment for age. Persons aged 55 years and older, women, those living in Hawaii and Louisiana, and those of non-Hispanic, white ethnicity had higher mortality rates. Compared to tuberculosis-related mortality, chronic obstructive pulmonary disease, bronchiectasis, HIV, interstitial lung diseases, and tobacco use were significantly more common in persons with nontuberculous mycobacteria-related deaths.ConclusionsNontuberculous mycobacteria-related death numbers are rising and are unevenly distributed. The strong association of nontuberculous mycobacterial disease with age suggests that its prevalence will increase as the United States population ages.

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“…However, it has recently been shown that NTM infections are increasing in patients with chronic respiratory diseases [6]. Moreover, increased rates of NTM infections have been reported in areas in which the bacille CalmetteGuerin vaccination has been stopped due to the prevalence of tuberculosis [6,7]. In contrast to tuberculosis, which is a disease of obligatory declaration in France and for which the annual incidence is therefore well known, the incidence of NTM infections in France is unknown due to a lack of systematic reporting.…”

mentioning

confidence: 99%

Respiratory infections associated with nontuberculous mycobacteria in non-HIV patients

Dailloux

Abalain²,

Laurain³

et al. 2006

Eur Respir J

108

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The incidence of nontuberculous mycobacteria (NTM) pulmonary diseases in HIVnegative patients was studied prospectively from January 1, 2001 to December 31, 2003 by 32 sentinel sites distributed throughout France.In total, 262 patients who yielded NTM isolates from respiratory clinical specimens, met the bacteriological, radiological and clinical criteria established by the American Thoracic Society for NTM respiratory disease. Among the 262 NTM isolates, 234 were slow-growing mycobacteria (125 Mycobacterium avium-intracellulare complex (MAC), 66 M. xenopi, 34 M. kansasii) and 28 were rapidly growing mycobacteria (25 M. abscessus complex). In the Paris area, M. xenopi was the most frequently isolated species, followed by MAC.Most patients (.50%), except those with M. kansasii, had underlying predisposing factors such as pre-existing pulmonary disease or immune deficiency. Asthenia, weight loss, chronic cough and dyspnoea were the most common clinical symptoms. The classical radiological appearance of NTM infections was indistinguishable from that observed in patients with pulmonary tuberculosis.In summary, the incidence of nontuberculous mycobacteria pulmonary infections in HIVnegative patients was estimated at 0.74, 0.73 and 0.72 cases per 100,000 inhabitants in

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Nontuberculous Mycobacteria: Clinical Importance and Relevance to Bacille Calmette-Guerin Vaccination

Cited by 10 publications

References 9 publications

BCG revaccination boosts adaptive polyfunctional Th1/Th17 and innate effectors in IGRA+ and IGRA– Indian adults

BCG revaccination boosts adaptive polyfunctional Th1/Th17 and innate effectors in IGRA+ and IGRA– Indian adults

Nontuberculous Mycobacterial Disease Mortality in the United States, 1999–2010: A Population-Based Comparative Study

Respiratory infections associated with nontuberculous mycobacteria in non-HIV patients

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