Progressive ocular inflammation following anti-tubercular therapy for presumed ocular tuberculosis in a high-endemic setting

Basu, Soumyava; Nayak, Sameera; Padhi, Tapas Ranjan; Das, Taraprasad

doi:10.1038/eye.2013.5

Cited by 53 publications

(30 citation statements)

References 15 publications

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“…Conversely, a significant number of patients experience recurrent intraocular inflammation despite prolonged anti-TB treatment. 8,9 Such unpredictability in treatment outcomes points to a complex intraocular immune phenomenon in TBU that extends beyond the pathogenspecific immune response. Notably, autoimmune T-cell response in the eye due to molecular mimicry between mycobacterial and retinal antigens has been proposed as a possible mechanism in pathogenesis of TBU.…”

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confidence: 99%

Autoreactive T Cells in Immunopathogenesis of TB-Associated Uveitis

Tagirasa

Parmar

Barik

et al. 2017

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. Intraocular inflammation in tuberculosis-associated uveitis (TBU) is usually widespread, and responds unpredictably to treatment. Herein, we analyze the intraocular Tcell response in TBU for its surface phenotype, antigenic specificity, and functional characteristics to explain the above observations. METHODS. We isolated T cells from vitreous humor samples of patients with TBU and non-TB uveitis (controls). These were directly stained for surface markers CD4, CD8, CD45RO, CD45RA, CCR7, as well as intracellular cytokines IFN-c, TNF-a, and IL-17 and analyzed on flow cytometry. Antigenic specificity was determined by activating with Mycobacterium tuberculosis-specific antigen Early Secreted Antigenic Target-6 (ESAT-6) or retinal crude extract (RCE). Activation-induced cell death (AICD) characteristics of each T-cell population were analyzed by staining for PI-Annexin V, Fas-FasL, phospho-Akt, and phospho-Erk1/2. RESULTS. Immunophenotyping of vitreous humor samples demonstrated polyfunctional effector and central memory CD4þ T helper cells coexpressing IFN-c, TNF-a, and IL-17. Both ESAT-6 and RCE (autoreactive) specificity was found in T cells extracted from TBU samples; however, the mycobacterial and autoreactive T-cell populations differed in their sensitivity to AICD. Autoreactive T cells appeared to resist AICD through decreased expression of apoptotic markers, FasL and caspase-3, sustained phosphorylation of Akt, and lowered Erk1/2 activity.CONCLUSIONS. Autoreactive T cells are present in TBU eyes and are relatively resistant to AICD. An understanding of this epiphenomenon could be crucial in planning treatment of TBU patients, and interpreting response to anti-TB therapy.

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confidence: 99%

Autoreactive T Cells in Immunopathogenesis of TB-Associated Uveitis

Tagirasa

Parmar

Barik

et al. 2017

Invest. Ophthalmol. Vis. Sci.

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“…Le délai médian d'apparition allait de 15 jours à 3,5 mois. Il s'agirait d'une réaction immunitaire paradoxale secondaire à la libération d'antigènes mycobactériens [9].…”

Section: Discussionunclassified

Un tuberculome associé à une sclérite postérieure bilatérale révélateur d’une tuberculose ganglionnaire : à propos d’un cas

Chan

Ailem

Seong

et al. 2016

Journal Français d'Ophtalmologie

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“…Currently, intraocular tuberculosis is mostly diagnosed based on characteristic clinical signs (mentioned above), associated ancillary tests (immunologic and radiological), and exclusion of other disease entities -infectious and noninfectious -that may have similar clinical presentation, in a given geographic region [ 29 ].…”

Section: Diagnosismentioning

confidence: 99%