Abstract

Introduction:Suspicion on the association between Takayasu Arteritis (TA) and Tubcerculosis (TB) has been in vogue for years. Prevalence of TB in TA is reported to be higher. We aimed to study innate immune responses in patients with TA on exposure to Trehalose-6,6-dibehenate (TDB), a synthetic analogue of Trehalose-6,6-Dimycolate (TDM, also known as mycobacterial cord factor) in comparison with healthy controls.Materials and Methods:Patients with type V TA, satisfying 1990 ACR criteria, and age and sex matched healthy controls were recruited. PBMCs were cultured with 5µg/ml, 50µg/ml or without any TDB for 48 hours in RPMI medium inside a 5% Co2 incubator. IL-6, TNF-α and IL-17 were measured in cell culture supernatant, which was separated from the cells at the end of the incubation period. Gene expressions of IL-6, IL-8, TNFα, IFN-γ, MINCLE and BCL-10 were quantified in real time PCR using specific primers and SYBR green chemistry.Results:Twenty two TA patients and 21 healthy controls were recruited. Both patients and controls showed response by secreting IL-6 and TNF-α upon stimulation by TDB. Relative induction (TDB stimulated TA sample / unstimulated control) of IL-6 was significantly higher in TA [31.88(0.74-168)] patients as compared to healthy controls [1.931(0.644-8.21); p<0.002], when co-cultured with 50µg/ml TDB. The expression of MINCLE, the TDB receptor was higher in TA samples than healthy controls upon TDB stimulation.Conclusion:Stimulation with mycobacterial synthetic analogue led to higher secretion of IL-6 and higher expression of MINCLE in PBMCs of patients with TA as compared to healthy controls.

Highlights

  • Suspicion on the association between Takayasu Arteritis (TA) and Tubcerculosis (TB) has been in vogue for years

  • Relative induction (TDB stimulated TA sample / unstimulated control) of IL-6 was significantly higher in TA [31.88(0.74-168)] patients as compared to healthy controls [1.931(0.644-8.21); p

  • The expression of macrophage inducible Ca2+-dependent lectin (MINCLE), the TDB receptor was higher in TA samples than healthy controls upon TDB stimulation

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Summary

Introduction

Suspicion on the association between Takayasu Arteritis (TA) and Tubcerculosis (TB) has been in vogue for years. In a cohort of 272 cases with TA, Mwipatayi et al reported active pulmonary tuberculosis in 20% of their patients [3]. Patients with TA have been observed to have heightened T cell response and antibody titer to mycrobaterial 65 kDa HSP [8, 9]. This may be due to molecular mimicry or sharing of antigenic region of HSP between humans and mycobacterium tuberculosis (9). Patients of TA and TB share common inflammatory signals which can trigger Th1 and Th17 responses and granuloma formation noted in both the scenarios [10, 11]

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