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Latent Tuberculosis (latent + tuberculosis)

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Medical Sciences100%

Terms modified by Latent Tuberculosis

  • latent tuberculosis infection
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    Selected Abstracts

    Review article: infliximab therapy for inflammatory bowel disease , seven years on

    ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 4 2006
    P. RUTGEERTS
    Summary Infliximab, the chimeric monoclonal IgG1 antibody to tumour necrosis factor, is indicated for refractory luminal and fistulizing Crohn's disease and extra-intestinal manifestations of inflammatory bowel disease. Recently, the active ulcerative colitis trials (ACT) studies have shown that infliximab is also efficacious to treat ulcerative colitis resistant to standard therapy. Induction with 5 mg/kg infliximab at weeks 0, 2 and 6 is advocated. The response to infliximab is improved when concomitant immunosuppressive therapy is given. As the majority of patients will relapse if not retreated, a long-term strategy is necessary. Although episodic therapy can be used, the optimal strategy is systematic maintenance treatment with 5 mg/kg intravenous (i.v.) every 8 weeks. Long-term maintenance therapy with infliximab results in a reduction of the rate of complications, hospitalizations and surgeries associated with Crohn's disease. Safety problems with the monoclonal antibody infliximab treatment mainly concern the formation of antibodies to infliximab, which may lead to infusion reactions, loss of response and serum sickness-like delayed infusion reactions. Latent tuberculosis needs to be screened for. The rate of other opportunistic infections is slightly increased mainly in patients treated concomitantly with immunosuppression. There is no evidence that malignancy rates in patients treated with antitumour necrosis factor strategies are increased. [source]

    Tumor necrosis factor neutralization results in disseminated disease in acute and latent Mycobacterium tuberculosis infection with normal granuloma structure in a cynomolgus macaque model

    ARTHRITIS & RHEUMATISM, Issue 2 2010
    Philana Ling Lin
    Objective An increased risk of tuberculosis has been documented in humans treated with tumor necrosis factor , (TNF,),neutralizing agents. In murine models, impaired signaling by TNF causes exacerbation of both acute and chronic infection associated with aberrant granuloma formation and maintenance. This study was undertaken to investigate immune modulation in the setting of TNF neutralization in primary and latent tuberculosis in a non-human primate model. Methods Cynomolgus macaques 4 years of age or older were infected with Mycobacterium tuberculosis and subjected to clinical, microbiologic, immunologic, and radiographic examinations. Monkeys were classified as having active or latent disease 6,8 months after infection, based on clinical criteria. Monkeys used in acute infection studies were randomized to receive either adalimumab (prior to and during infection) or no treatment. Monkeys with latent infection that were randomized to receive TNF-neutralizing agent were given either an inhibitor of soluble TNF, recombinant methionyl human soluble TNF receptor I (p55-TNFRI), or adalimumab. Control monkeys with latent infection were given no treatment or saline. Data from previously studied monkeys with active or latent disease were also used for comparison. Results Administration of TNF-neutralizing agents prior to M tuberculosis infection resulted in fulminant and disseminated disease by 8 weeks after infection. Neutralization of TNF in latently infected cynomolgus macaques caused reactivation in a majority of animals as determined by gross pathologic examination and bacterial burden. A spectrum of dissemination was noted, including extrapulmonary disease. Surprisingly, monkeys that developed primary and reactivation tuberculosis after TNF neutralization had similar granuloma structure and composition to that of control monkeys with active disease. TNF neutralization was associated with increased levels of interleukin-12, decreased levels of CCL4, increased chemokine receptor expression, and reduced mycobacteria-induced interferon-, production in blood but not in the affected mediastinal lymph nodes. Finally, the first signs of reactivation often occurred in thoracic lymph nodes. Conclusion These findings have important clinical implications for determining the mechanism of TNF neutralization,related tuberculosis. [source]

    Study of the immune response in patients with uveitis and latent tuberculosis

    ACTA OPHTHALMOLOGICA, Issue 2009
    D MAKHOUL
    Purpose Mycobacterium tuberculosis infects up to 30 % of the population worldwide. In the majority of the cases a lifelong immune response, based on the production of IFN, by CD4+ lymphocytes, restricts the infection into lung granulomas. A dysregulation of T regulatory cell function has also been implicated. It has been postulated that this constant immune response might contribute to certain forms of tuberculosis associated uveitis (hypersensitivity uveitis). The aim of this work is to analyse the lymphocyte production of IFN, and the percentage of regulatory T cells in sight threatening uveitis patients with or without latent tuberculosis. Methods Patients with sight threatening uveitis suspected to be related to tuberculosis or to autoimmune disease will be recruited at the CHU St-Pierre. Patients will be included if the work-up is compatible with the diagnosis of tuberculosis related uveitis or autoimmune uveitis used as a control. Signed informed consent will be obtained and blood samples will be taken. Results IFN, production in response to different mycobacterial peptides will be measured by QuantiFERONÔ-TB Gold in-tube and by ELISA. IL-17 will be quantified by ELISA and the percentage of T regulatory cells analysed by flow cytometry (CD3+CD4+ CD25high, CD127low, FOXP3+). Conclusion The diagnosis of tuberculosis uveitis is a clinical challenge. The disease is probably mediated through infectious and immune mechanisms. By studying the CD4 + and regulatory T lymphocytes function in patients with uveitis and latent tuberculosis, we hope that we will better understand this pathology. In addition, this study will evaluate the usefulness of QuantiFERONÔ-TB Gold in-tube in the evaluation of patient with uveitis. [source]