Gut microbiome dysbiosis and correlation with blood biomarkers in active-tuberculosis in endemic setting.

Aasia Khaliq,Samia Afzal,Muhammad Waheed Akhtar,Kauser Abdulla Malik,Prasant Kumar Jena,Muhammad Irfan,Yu-Jui Yvonne Wan,Imran H Khan,Atiqa Ambreen,Resmi Ravindran,Selvakumar Subbian

doi:10.1371/journal.pone.0245534

Abstract

Tuberculosis (TB) is the largest infectious disease with 10 million new active-TB patients and1.7 million deaths per year. Active-TB is an inflammatory disease and is increasingly viewed as an imbalance of immune responses to M. tb. infection. The mechanisms of a switch from latent infection to active disease is not well worked out but a shift in the immune responses is thought to be responsible. Increasingly, the role of gut microbiota has been described as a major influencer of the immune system. And because the gut is the largest immune organ, we aimed to analyze the gut microbiome in active-TB patients in a TB-endemic country, Pakistan. The study revealed that Ruminococcacea, Enetrobactericeae, Erysipelotrichaceae, Bifidobacterium, etc. were the major genera associated with active-TB, also associated with chronic inflammatory disease. Plasma antibody profiles against several M. tb. antigens, as specific biomarkers for active-TB, correlated closely with the patient gut microbial profiles. Besides, bcoA gene copy number, indicative of the level of butyrate production by the gut microbiome was five-fold lower in TB patients compared to healthy individuals. These findings suggest that gut health in TB patients is compromised, with implications for disease morbidity (e.g., severe weight loss) as well as immune impairment.

Highlights

The etiologic agent of tuberculosis (TB), Mycobacterium tuberculosis (M. tb.), latently infects a third of the world’s population and leads to an estimated 10.4 million new cases of active disease every year [1]
The difference between median ages is because the volunteers who consented to participate in the study were younger among TB patients than healthy individuals
Majority of the TB patients were showing typical symptoms of TB e.g. cough (98%), fever (86%), night sweats (76%), loss of appetite (71%) and weight loss (76%). 24% of the cases were having contact with active TB patients either as household contact or at work place and 24% of the patients have the co-morbidity of diabetes

Summary

Introduction

The etiologic agent of tuberculosis (TB), Mycobacterium tuberculosis (M. tb.), latently infects a third of the world’s population (approximately two billion) and leads to an estimated 10.4 million new cases of active disease (active TB) every year [1]. The funders has no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

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Conclusion