Tuberculosis and Bacillus Calmette-Guérin Disease in Patients with Chronic Granulomatous Disease: an Experience from a Tertiary Care Center in North India

Vignesh, Pandiarajan; Sil, Archan; Aggarwal, Ridhima; Laha, Wrik; Mondal, Sanjib; Dhaliwal, Manpreet; Sharma, Saniya; Pilania, Rakesh Kumar; Jindal, Ankur Kumar; Suri, Deepti; Sethi, Sunil; Rawat, Amit; Singh, Surjit

doi:10.1007/s10875-023-01581-w

Cited by 4 publications

(4 citation statements)

References 31 publications

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“…Therefore, the treatment of mycobacterial infections in CGD must be individualized and involve collaboration between pediatricians, immunologists, and pediatric infectious disease specialists, with close follow-up owing to the risk of relapse. In the patients reported here, disseminated BCG infection was not the cause of death, which correlated with the results of an Indian cohort (9).…”

Section: Discussionsupporting

confidence: 90%

“…(4). Bacillus Calmette-Guérin disease is reported in 11-58% of patients with CGD in Latin American and Asian countries, where the vaccine is routinely administered (5)(6)(7)(8)(9). Adverse reactions to the BCG vaccine may be the rst signs of CGD (10).…”

Section: Introductionmentioning

confidence: 99%

“…Additionally, TB is reported in 11-42% of the patients with CGD from endemic countries, such as Iran, India, Turkey, and China, with more severe and complicated features (6, 7,9,11,12). Information on the clinical evolution and treatment of mycobacterial diseases in patients with CGD is limited.…”

Section: Introductionmentioning

confidence: 99%

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Description of BCG and Tuberculosis Disease in a Cohort of 79 Patients with Chronic Granulomatous Disease

León-Lara,

Pérez-Blanco,

Yamazaki-Nakashimada

et al. 2024

Preprint

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Purpose. Chronic granulomatous disease (CGD) is an inherited immunodeficiency caused by pathogenic variants of genes encoding the enzyme complex NADPH oxidase. In countries where tuberculosis (TB) is endemic and the Bacillus Calmette–Guérin (BCG) vaccine is routinely administered, mycobacteria are major disease-causing pathogens in CGD. However, information on the clinical evolution and treatment of mycobacterial diseases in patients with CGD is limited. The present study describes the adverse reactions to BCG and TB in Mexican patients with CGD. Methods. Patients with CGD who were evaluated at the Immunodeficiency Laboratory of the National Institute of Pediatrics between 2013 and 2024 were included. Medical records were reviewed to determine the clinical course and treatment of adverse reactions to BCG and TB disease. Results. A total of 79 patients with CGD were included in this study. Adverse reactions to BCG were reported in 55 (72%) of 76 patients who received the vaccine. Tuberculosis was diagnosed in 19 (24%) patients. Relapse was documented in three (10%) of 31 patients with BGC-osis and six (32%) of 19 patients with TB, despite antituberculosis treatment. There was no difference in the frequency of BCG and TB disease between patients with pathogenic variants of the X-linked CYBB gene versus recessive variants. Conclusions. This report highlights the importance of considering TB in endemic areas and BCG in children with CGD to enable appropriate diagnostic and therapeutic approaches to improve prognosis and reduce the risk of relapse.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

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Description of BCG and Tuberculosis Disease in a Cohort of 79 Patients with Chronic Granulomatous Disease

León-Lara,

Pérez-Blanco,

Yamazaki-Nakashimada

et al. 2024

Preprint

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“…This was confirmed in studies of alveolar macrophages from mice knockout for the p47phox -/-subunit of NADPH oxidase, which were unable to destroy phagocytosed Pseudomonas aeruginosa bacteria, despite a decrease in pH and recruitment of hydrolyzing enzymes into the phagosome [28]. Also, indirectly, this is confirmed by clinical data on the contribution of NADPH oxidase to innate immunity: patients with chronic granulomatous disease (CGD) have a higher susceptibility to mycobacterial infection, especially in countries with endemic areas for tuberculosis [29][30][31][32][33]. In this case, only NADPH oxidase function is affected in CGD patients, due to abnormalities in genes encoding oxidase subunits, while other phagocyte functions are not impaired.…”

Section: Discussionmentioning

confidence: 85%

Effect of Isolated <em>Mycobacterium bovis</em> Proteins on the Respiratory Response of Mouse Granulocytes

Gabdoulkhakova,

Korovina,

Filina

et al. 2023

Preprint

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Proteins are considered to be the main carriers of antigenic properties of Mycobacterium tuberculosis and Mycobacterium bovis, the causative agents of tuberculosis, the most serious infectious disease. Neutrophils, following resident macrophages, are among the first to attack the mycobacteria in defense of the organism. Neutrophils themselves are also the target of mycobacterial products; and their effect on neutrophil functions has been less studied. We have obtained about 70 protein fractions from M. bovis lysate; among them four protein fractions (10, 22, 24, and 40 kDa) had high serological activity against the serum of a rabbit immunized with M. bovis cells. We studied the effect of the serologically active proteins isolated from M. bovis on the generation of reactive oxygen species by bone marrow granulocytes of the Balb/c mouse, evaluated by luminol-dependent chemiluminescence. For comparison, two synthetic peptides (both 3 kDa) carrying immunogenic epitopes of MPB 70 protein (M. bovis) were taken. Proteins of 10, 22, and 24 kDa at concentrations of 83, 80, and 59 ng/mL, respectively, were found to activate ROS generation by mouse granulocytes. The 10- and 40-kDa antigens inhibited the receptor-mediated respiratory responses to opsonized zymosan (OZ) and N-formyl-MLF peptide (fMLF) but significantly enhanced the response to the phorbol ester PMA, which directly activates protein kinase C. Antigens with molecular weights of 22 and 24 kDa enhanced the fMLF-induced response and had no effect on the response activated by PMA. The response to OZ was suppressed in the presence of the 22 kDa protein. Synthetic peptides over a wide range of concentrations showed no activity in any case. All M. bovis proteins examined did not affect both proliferation and cell viability of the A549 and THP-1 cells; therefore, they have no cytotoxic or proliferative effects. Thus, serologically active proteins with molecular weights of 10, 22, 24, and 40 kDa isolated from M. bovis modulated the respiratory responses of mouse granulocytes induced by the formyl peptide, while proteins of 10, 22, and 40 kDa inhibited the responses induced by OZ.

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Description of BCG and Tuberculosis Disease in a Cohort of 79 Patients with Chronic Granulomatous Disease

León-Lara,

Pérez-Blanco,

Yamazaki-Nakashimada

et al. 2024

J Clin Immunol

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Tuberculosis and Bacillus Calmette-Guérin Disease in Patients with Chronic Granulomatous Disease: an Experience from a Tertiary Care Center in North India

Cited by 4 publications

References 31 publications

Description of BCG and Tuberculosis Disease in a Cohort of 79 Patients with Chronic Granulomatous Disease

Description of BCG and Tuberculosis Disease in a Cohort of 79 Patients with Chronic Granulomatous Disease

Effect of Isolated <em>Mycobacterium bovis</em> Proteins on the Respiratory Response of Mouse Granulocytes

Description of BCG and Tuberculosis Disease in a Cohort of 79 Patients with Chronic Granulomatous Disease

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