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
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)...
Main Authors: | , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Public Library of Science (PLoS)
2021-01-01
|
Series: | PLoS ONE |
Online Access: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8328311/?tool=EBI |
_version_ | 1818639950218788864 |
---|---|
author | Shashi Kant Kumar Suvrat Arya Ankita Singh Ramnath Misra Amita Aggarwal Sudhir Sinha |
author_facet | Shashi Kant Kumar Suvrat Arya Ankita Singh Ramnath Misra Amita Aggarwal Sudhir Sinha |
author_sort | Shashi Kant Kumar |
collection | DOAJ |
description | 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. |
first_indexed | 2024-12-16T23:03:31Z |
format | Article |
id | doaj.art-cf1de4dbe8d74dfe8ec27c903a0c63bf |
institution | Directory Open Access Journal |
issn | 1932-6203 |
language | English |
last_indexed | 2024-12-16T23:03:31Z |
publishDate | 2021-01-01 |
publisher | Public Library of Science (PLoS) |
record_format | Article |
series | PLoS ONE |
spelling | doaj.art-cf1de4dbe8d74dfe8ec27c903a0c63bf2022-12-21T22:12:39ZengPublic Library of Science (PLoS)PLoS ONE1932-62032021-01-01168Patterns 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 infectionShashi Kant KumarSuvrat AryaAnkita SinghRamnath MisraAmita AggarwalSudhir SinhaThis 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.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8328311/?tool=EBI |
spellingShingle | Shashi Kant Kumar Suvrat Arya Ankita Singh Ramnath Misra Amita Aggarwal Sudhir Sinha 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 PLoS ONE |
title | 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 |
title_full | 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 |
title_fullStr | 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 |
title_full_unstemmed | 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 |
title_short | 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 |
title_sort | 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 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8328311/?tool=EBI |
work_keys_str_mv | AT shashikantkumar patternsoftandbcellresponsestomycobacteriumtuberculosismembraneassociatedantigensandtheirrelationshipwithdiseaseactivityinrheumatoidarthritispatientswithlatenttuberculosisinfection AT suvratarya patternsoftandbcellresponsestomycobacteriumtuberculosismembraneassociatedantigensandtheirrelationshipwithdiseaseactivityinrheumatoidarthritispatientswithlatenttuberculosisinfection AT ankitasingh patternsoftandbcellresponsestomycobacteriumtuberculosismembraneassociatedantigensandtheirrelationshipwithdiseaseactivityinrheumatoidarthritispatientswithlatenttuberculosisinfection AT ramnathmisra patternsoftandbcellresponsestomycobacteriumtuberculosismembraneassociatedantigensandtheirrelationshipwithdiseaseactivityinrheumatoidarthritispatientswithlatenttuberculosisinfection AT amitaaggarwal patternsoftandbcellresponsestomycobacteriumtuberculosismembraneassociatedantigensandtheirrelationshipwithdiseaseactivityinrheumatoidarthritispatientswithlatenttuberculosisinfection AT sudhirsinha patternsoftandbcellresponsestomycobacteriumtuberculosismembraneassociatedantigensandtheirrelationshipwithdiseaseactivityinrheumatoidarthritispatientswithlatenttuberculosisinfection |