The role of T regulatory cell-associated markers in monitoring tuberculosis treatment completion and failure

• Published in: Immunologic research Vol. 66; no. 5; pp. 620 - 631
• Main Authors: Agrawal, Sonali, Parkash, Om, Palaniappan, Alangudi Natarajan, Bhatia, Ashok K., Kumar, Santosh, Chauhan, Devendra S., Madhan Kumar, M.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-10-2018; Springer Nature B.V
• Subjects: Adolescent; Adult; Allergology; Antibodies; Antigens, CD - metabolism; Antitubercular Agents - therapeutic use; Apyrase - metabolism; Biomarkers - metabolism; Biomedical and Life Sciences; Biomedicine; CD25 antigen; CD4 antigen; Cell Separation; Cohort Studies; Decision making; Female; Flow Cytometry; Forkhead Transcription Factors - metabolism; Foxp3 protein; Humans; Immunology; Interleukin-2 Receptor alpha Subunit - metabolism; Internal Medicine; Leukocytes (mononuclear); Lymphocytes T; Male; Markers; Medicine/Public Health; Microscopy; Middle Aged; Monitoring; Mycobacterium tuberculosis - physiology; Original Article; Patients; Peripheral blood mononuclear cells; Smear; Sputum; Success; T-Lymphocytes, Regulatory - immunology; Treatment Failure; Treatment Outcome; Tuberculosis; Tuberculosis, Pulmonary - diagnosis; Young Adult; TB treatment; Tuberculosis; Marker; Treg; Treatment success
• ISSN: 0257-277X; 1559-0755
• DOI: 10.1007/s12026-018-9022-7

Monitoring tuberculosis (TB) treatment success is crucial for clinical decision-making. The only available tool in this regard is sputum microscopy, but it has demerits. Moreover, in case of smear negatives and extrapulmonary TB, an efficient tool is still sought for. Therefore, we evaluated T regulatory cell (Treg)-associated markers (CD25, CD39, and FoxP3) and cellular subsets in monitoring treatment success in treatment-completed groups. Expression profile of various markers and subsets were compared real time among treatment-naive pulmonary TB patients (TN-PTB), followed-up treatment-completed (TC-fu) cohort, and a not followed-up (TC-nfu) cohort. Peripheral blood mononuclear cells from various groups were incubated overnight and were stained with antibodies for specific markers and studied by flow cytometry. In both the treatment-completed groups, a decline in frequencies of CD25
+
marker and CD4
+
CD25
+
, CD4
+
CD25
+
FoxP3, CD4
+
CD25
+
CD39
+
Treg was observed with clearance of infection, indicating their potential in monitoring treatment success. However, in the case of treatment failure patient (Tfp), a drastic increase in frequency of CD4
+
CD25
+
FoxP3
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Treg subset was found, indicating its usefulness in predicting treatment failure. Although the investigation unveils markers useful in predicting treatment success or failure, the findings from this study needs to be validated in a larger cohort.