Abstract
One-third of the world's population has been infected with Mycobacterium tuberculosis (M. tuberculosis), a primary pathogen of the mammalian respiratory system, while about 10% of latent infections progress to active tuberculosis (TB), indicating that host and environmental factors may determine the outcomes such as infection clearance/persistence and treatment prognosis. The gut microbiota is essential for development of host immunity, defense, nutrition and metabolic homeostasis. Thus, the pattern of gut microbiota may contribute to M. tuberculosis infection and prognosis. In current study we characterized the differences in gut bacterial communities in new tuberculosis patients (NTB), recurrent tuberculosis patients (RTB), and healthy control. The abundance-based coverage estimator (ACE) showed the diversity index of the gut microbiota in the patients with recurrent tuberculosis was increased significantly compared with healthy controls (p < 0.05). At the phyla level, Actinobacteria and Proteobacteria, which contain many pathogenic species, were significantly enriched in the feces RTB patients. Conversely, phylum Bacteroidetes, containing a variety of beneficial commensal organisms, was reduced in the patients with the recurrent tuberculosis compared to healthy controls. The Gram-negative genus Prevotella of oral origin from phylum of Bacteroidetes and genus Lachnospira from phylum of Firmicutes were significantly decreased in both the new and recurrent TB patient groups, compared with the healthy control group (p < 0.05). We also found that there was a positive correlation between the gut microbiota and peripheral CD4+ T cell counts in the patients. This study, for the first time, showed associations between gut microbiota with tuberculosis and its clinical outcomes. Maintaining eubiosis, namely homeostasis of gut microbiota, may be beneficial for host recovery and prevention of recurrence of M. tuberculosis infection.
Highlights
Tuberculosis (TB) is a chronic potentially fatal infectious disease caused by Mycobacterium tuberculosis (M. tuberculosis)
Age was similar between the tuberculosis patients (45.1y for new tuberculosis patients (NTB), 46.6 for recurrent tuberculosis patients (RTB)), but differed from the healthy controls (35.3y)
We identified an average of 632 operational taxonomic unit (OTU) for the NTB, and an average of 675 OTUs were identified for the recurrent group
Summary
Tuberculosis (TB) is a chronic potentially fatal infectious disease caused by Mycobacterium tuberculosis (M. tuberculosis). One-third of the world population has been infected with M. tuberculosis. While most of the initially infected individuals recover from infection through immune clearance, about only 5–10% develop active/chronic tuberculosis, implying. Changing Gut Microbiota in Pulmonary Tuberculosis that host and environmental factors are critical in determining the outcomes of M. tuberculosis infection, including drug resistance and recurrence (Tuberculosis Programme and World Health Organization, 2015). Other environmental factors make people more susceptible to tuberculosis infection. Malnutrition, poverty, under privileged communities contribute to the high incidence of active M. tuberculosis infections, again showing critical roles of environmental factors in the patho-physiological development for infection/transmission and prognosis of M. tuberculosis. Identification of other environmental factors is valuable for treatment and prevention of tuberculosis infection, persistence, and recurrence
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