2.1 TB burden and epidemiology
Tuberculosis (TB) is the disease of the lung caused by a slow-growing intracellular pathogen called Mycobacterium tuberculosis (M.tb) (1). In 2014, there were 9.6 million cases of active TB disease worldwide, and 1.2 million TB-related deaths according to World Health Organization (WHO) (2). The burden of the disease can be appreciated with the knowledge that one third of the world population is latently infected with M.tb, and 5-10% of exposed individuals develop active disease and are able to spread the infection to more people every year (3,1). To reduce this burden, effective strategies are required in both preventative and therapeutic areas of research.
2.2 Primary infection and host defense in TB
2.2.1
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We have shown that the recruitment of antigen-presenting cells (APCs) is delayed for up to day 7 post-infection which can be attributed to the lack of pro-inflammatory cytokines, in particular, TNF-α which is critical for the control of mycobacterial infection (5). Delayed influx of APCs to the airway lumen impairs the ability of the host immune system to control the bacterial infection in a timely manner. Once there is a high influx of APCs at the site of pathogen entry, antigens or mycobacteria are transported from the lung to the draining lymph node (DLN). The migration of APCs to DLN is mediated by the upregulation of expression of chemokine receptor CCR7 that allows APCs to respond to CCL19 and CCL21 chemokine gradients which are constitutively expressed in the LN (3,5,8). Normally migration of DCs occurs within few hours after infection; for example in case of influenza, the required time is 20 hours, whereas in the case of TB infection it takes between 8-10 days, implying that this delayed migration is the limiting step towards the initiation of adaptive immune responses.
2.2.2 Initiation of adaptive immunity
Cellular immunity plays a critical role in the control of M.tb infection. It has been shown that CD4+T-helper 1 (Th1) cells play a central role in protection against TB disease, primarily through the production of macrophage-activating cytokines such as IFN-γ and TNF-α (9–11). In the process of primary infection,
Tuberculosis has been part of human history for a long time but how long is a long time? Recent research using genetic data has allowed us to know that the tuberculosis progenitor has been on this planet for about 3 million years affecting even our earlier ancestors (Gutierrez et al, 2005). Additionally this research showed that the bacilli from tuberculosis are capable of mixing sections of their genome with other strains and giving the pathogen a composite assembly, which resulted from ancient horizontal exchanges before its clonal expansion. This quality provided tuberculosis a big advantage that even now a days allows the organism to evade, adapt and create resistance to treatments that were once successful. In order to fix current and
Tuberculosis, the white plague as used to be called once upon a time is still one of the deadliest bacterial killers affecting almost all parts, all corners of the globe. Though successful anti-tubercular antibiotic regimens and effective vaccine are available for decades and being used in the battle against Koch’s bacillus, Mycobacterium tuberculosis, the causative agent of this chronic multi organ granulomatous disease, our strand in the battle continuously seems to be in the losing side. Moreover the increasing prevalence of HIV-AIDS and diabetes mellitus is being proved to be providing predisposition to tuberculosis. As witnessed by the WHO, which has estimated that, in the year 2012, 8.6 million people have developed tuberculosis and 1.3 million have died of the disease including 320000 deaths of HIV-TB co-infected people (Global tuberculosis report 2013. World Health Organization; 2013). Long term antibiotic therapy and that too associated with several side effects and discomforts have diminished patient compliance with the anti-tubercular chemotherapy. This fact in turn has raised the new deadlier MDR-TB and XDR-TB strains. The whole scenario is a matter of panic and questioning the effectiveness of anti-tubercular antibiotics, immunologic efficacy of century old BCG vaccine and all other medical advents.
TB is a complex, chronic disease which induces immune dysregulation of several arms of the immune system. In this study, we analyzed the specific concentration of IFN-γ, TNF-α , IL-1β, and IL-10 cytokines from smear negative PTB(SNPTB) and smear positive PTB (SPPTB) to determine the effect of mycobacterial load on the cytokine concentration utilizing a simple whole blood assay stimulation with a whole sonicate MTB. Different concentration of cytokines(IFN-γ, TNF-α, and IL-10 ) detected in present study were associated with bacillary load of MTB in sputum from PTB patients. Our results demonstrate that , individuals with smear-negative PTB was associated with increased concentration in Th1 cytokine IFN-γ and decreased TNF-α ,IL-1β , as well as decreased concentration of specific Th2 cytokine IL-10 as compared with individuals with smear positive. These results strongly suggest that the sputum positive group had the lowest immune response (lowest IFN-γ levels, and highest IL-10 level) and indicate that the cytokine concentration is progressively impaired with increased mycobacterial load. In addition, PTB patients presented with a higher expression of IL-10 and TNF-α in contrast to the lower expression of IFN-γ and IL-1β as compared with healthy control. IFN-γ secreted in low concentration in two clinical PTB patient groups(SNPTB,SPPTB) as compared with health control(HC), but these levels insignificant between two
Tuberculosis is one of the major causes of death from many infectious diseases (3). Out of 9 million people who are infected with mycobacteria, about 2 million deaths occur from tuberculosis every year (3). Unfortunately, the prevalence of tuberculosis is in a continuous increase due to increased number of Human immunodeificnecy virus (HIV) patients, bacterial resistance to anti-tuberculous drugs, and growing number of recreational drug users (3). The pathogen responsible for bacterial infection, potentially causing tuberculosis, is mycobacterium tuberculosis (MTB) (2). Persons with adequate immune system can control the bacterial infection so mycobacteria remain dormant for a long time (11). In a typical tuberculous granuloma, mature
Tuberculosis, TB (tubercle bacillus) or MTB (mycobacterium tuberculosis) is a widespread, and in numerous cases fatal, communicable disease produced by a variety of forms of mycobacteria. The disease is distributed within the air when individuals who are infected with active TB infection sneeze, cough, or pass on breathing fluids throughout the air. Generally infections are asymptomatic, meaning they feel or show no symptoms, and dormant, but then again approximately one in ten dormant infections in the long run move on to the active disease. If left untouched, active TB is fatal to more than half of those infected.
Tuberculosis (TB) is a chronic bacterial infection that affects millions of people globally. It is a contagious disease that is spread through the air, and it usually affects the lungs. It is transmitted from person to person through droplets from the respiratory tract of those who are already infected with the disease. Some who are infected with the bacteria that causes TB often exhibit no symptoms, because their immune systems stop the bacteria from growing and multiplying. Those with compromised immune systems are more susceptible to developing the full blown disease which can cause symptoms that include coughing, spitting blood, chest pains, weakness, weight loss, and fever. Tuberculosis can be treated with a six to nine month course of a combination of antibiotics. If left untreated, TB will spread and can be fatal.
Infectious diseases are one of the most challenging adversities that the human race faces. Diseases that once wiped out large populations are now well understood, preventative measures can be taken, and effective treatment methods provided. However, as science has evolved so have the infectious diseases that are seen. An example of an infectious disease that has been studied and continues to be seen today is Tuberculosis. Tuberculosis has been a health hazard for many centuries and was once an epidemic. Medical advances and studies have been able to enlighten not only the etiology, but also the mode of transmission, ways to diagnose, and ways to treat and/or manage infection.
Tuberculosis (TB) is a very prevalent, very contagious, and very deadly disease worldwide. According to the Centers for Disease Control, one third of the population is infected with TB. (Centers for Disease Control Data and statistics) While less common than it has ever been, tuberculosis has seen an upsurge in the last three decades directly related to the AIDS epidemic, but also as a result of the development of many multi-drug-resistant strains. This is of particular concern in developing nations hit hard by AIDS infections, but it is also evidenced in an upswing in the United States. (Nester, Anderson and Roberts)
Tuberculosis(TB) is a highly contagious disease that primarily affects the lungs, although it can also be found in other body parts. The disorder is caused by a bacteria called myocardial tuberculosis, and is mostly spread through the air when an infected person coughs. Many years ago, tuberculosis accounted for nearly 30% of deaths in the US. In the 1940’s and 50’s, however, its fatality rate dropped significantly due to antibiotics and vaccinations. Since the outbreak of AIDS, tuberculosis has increasingly been an issue again since people with the disease cannot fight off TB (Bontrager & Lampignano 2005, Basic TB Facts 2012).
TB is the most common cause of infectious disease–related mortality worldwide. in 2014, TB killed 1.5 million people (1.1 million HIV-negative and 0.4 million HIV-positive). The disease included 890 000 men, 480 000 women and 140 000 children. TB now ranks alongside HIV as a leading cause of death worldwide. HIV’s death in 2014 was estimated at 1.2 Million, which included the 0.4 million TB deaths among HIV positive people. Worldwide, 9.6 million people are estimated to have fallen ill with TB in 2014: 5.4 million men, 3.2 million women and 1.0 million children. Globally, 12% of the 9.6 million new TB cases in 2014 were
For thousands of years’ tuberculosis, has been a continuous epidemic. The disease itself continually finds way to become resistant to the drugs found to fight against it. Mainly affecting developing countries, and those with less access to health care the infection continues to be a clear and present danger. Educating the people on tuberculosis and the way to prevent it, along with the risks factors associated with the disease may help save many lives. The vaccine needs to be more readily available to make sure the people are protected. This paper explains the basics of tuberculosis along with its risk factors, prevalence, assessment, and prevention techniques centered around the global aspect of this disease. Within the paper there are two journal articles along with other internet sources that will more thoroughly explain what tuberculosis is, how to prevent it, and how to treat it. The first article Tuberculosis: a clear and present danger by Lowth (2016) essentially summarizes everything there is to know about tuberculosis including the risks and symptoms of the infection. While the other article Tuberculosis: Which drug regimen and when by Hall, J., &Elliot, C (2015) focuses on the treatment of the two different types of Tuberculosis along with the interventions and complication involved.
Tuberculosis (TB) is considered to be a leading cause of infectious lung disease, and considered the foremost cause of death due to a single microorganism, Mycobacterium tuberculosis (MTB). According to the latest WHO report, there were around 9.6 million new TB cases emerging and 1.5 million deaths caused by TB in 2014. Furthermore, the number of cases with latent TB, who are asymptomatically infected by MTB, was estimated to include one third of the world population, which corresponds to more than two billion individuals. (1) The disease is further complicated with the development of drug resistance and co-infection, which sets a huge obstacle for TB treatment.
Tuberculosis is a prime leading health problem throughout the universe. It is the second utmost cause of death from a contagious agent killing nearly 20 million people each year. There are two major elements that are contributing to the current TB endemic and its combined morbidity and mortality include; growing human immunodeficiency virus outbreaks and rising prevalence of resistance of Mycobacterium tuberculosis strains of the most effective anti-TB drugs. Another causative to the development of resistance is the destitute quality of drugs, improper treatment management, patient non-cooperation and malabsorption due to other integral conditions. This paper is comprised of the pathophysiology of TB, etiology, diagnosis, signs and
Tuberculosis, also identified as TB, has been around for countless years. In the past, however, the disease was not known, which made it untreatable in most healthcare settings. The evolution of time made it possible to easily detect and manage tuberculosis before people were adversely affected by it. It is a disease that often affects an individual’s lungs, but it can also affect other body parts. The spine, kidneys, bones, and even the lymph nodes may sometimes be affected by the disease. The spread is usually from one person with the disease to an uninfected person through the air. Whenever individuals with the TB disease cough, laugh, or even talk, the disease is spread through tiny droplets that are found in the person’s respiratory
Tuberculosis is among the fatal diseases that are spread through the air. It’s contagious, meaning that it spreads from one infected individual to another, and at times it spreads very fast. In addition to being contagious, the disease is an opportunist infection as it takes advantage of those with weak defense mechanism, and especially the ones with terminal diseases like HIV and AIDS. Tuberculosis is therefore among the major concerns for the World Health Organization due to its contagious nature (World Health Organization 1).