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SYSTEMIC INFLAMMATION I 1 N PREGNANT WOMEN WITH 2 LATENT TUBERCULOSIS INFECTION
Terceiro Trimestre da Gravidez
Inflamação
Gestantes
Citocinas
Author
Affilliation
Johns Hopkins University Clinical Research. Byramjee-Jeejeebhoy Government Medical college. Pune, India / Byramjee Jeejeebhoy Government Medical College, Pune, India.
Johns Hopkins University Clinical Research. Byramjee-Jeejeebhoy Government Medical college. Pune, India.
International Centers for Excellence in Research. Pune, India.
Johns Hopkins University Clinical Research. Byramjee-Jeejeebhoy Government Medical college. Pune, India.
Johns Hopkins University Clinical Research. Byramjee-Jeejeebhoy Government Medical college. Pune, India.
Columbia University Mailman School of Public Health. Department of Epidemiology. New York, USA.
Columbia University Mailman School of Public Health. Department of Epidemiology. New York, USA.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Bahia, Brasil / Fundação José Silveira. Multinational Organization Network Sponsoring Translational and Epidemiological Research. Salvador, BA, Brasil / Universidade Federal da Bahia. Faculdade de Medicina. Salvador, BA, Brasil.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Bahia, Brasil / Fundação José Silveira. Multinational Organization Network Sponsoring Translational and Epidemiological Research. Salvador, BA, Brasil / Universidade Federal da Bahia. Faculdade de Medicina. Salvador, BA, Brasil. / Faculdade de Tecnologia e Ciências. Curso de Medicina. Salvador, BA, Brasil / Universidade Salvador. Laureate Universities. Salvador, BA, Brasil /Escola Bahiana de Medicina e Saúde Pública. Salvador, BA, Brasil.
ohns Hopkins University Clinical Research. Byramjee-Jeejeebhoy Government Medical college. Pune, India / Byramjee Jeejeebhoy Government Medical College, Pune, India.
International Centers for Excellence in Research. Pune, India.
Johns Hopkins University Clinical Research. Byramjee-Jeejeebhoy Government Medical college. Pune, India / Johns Hopkins University School.of Medicine, Department of Medicine. Baltimore, USA.
Weill Cornell Medical College. Department of Medicine. New York, USA.
Columbia University Mailman School of Public Health. Department of Epidemiology. New York, USA.
Johns Hopkins University Clinical Research. Byramjee-Jeejeebhoy Government Medical college. Pune, India.
International Centers for Excellence in Research. Pune, India.
Johns Hopkins University Clinical Research. Byramjee-Jeejeebhoy Government Medical college. Pune, India.
Johns Hopkins University Clinical Research. Byramjee-Jeejeebhoy Government Medical college. Pune, India.
Columbia University Mailman School of Public Health. Department of Epidemiology. New York, USA.
Columbia University Mailman School of Public Health. Department of Epidemiology. New York, USA.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Bahia, Brasil / Fundação José Silveira. Multinational Organization Network Sponsoring Translational and Epidemiological Research. Salvador, BA, Brasil / Universidade Federal da Bahia. Faculdade de Medicina. Salvador, BA, Brasil.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Bahia, Brasil / Fundação José Silveira. Multinational Organization Network Sponsoring Translational and Epidemiological Research. Salvador, BA, Brasil / Universidade Federal da Bahia. Faculdade de Medicina. Salvador, BA, Brasil. / Faculdade de Tecnologia e Ciências. Curso de Medicina. Salvador, BA, Brasil / Universidade Salvador. Laureate Universities. Salvador, BA, Brasil /Escola Bahiana de Medicina e Saúde Pública. Salvador, BA, Brasil.
ohns Hopkins University Clinical Research. Byramjee-Jeejeebhoy Government Medical college. Pune, India / Byramjee Jeejeebhoy Government Medical College, Pune, India.
International Centers for Excellence in Research. Pune, India.
Johns Hopkins University Clinical Research. Byramjee-Jeejeebhoy Government Medical college. Pune, India / Johns Hopkins University School.of Medicine, Department of Medicine. Baltimore, USA.
Weill Cornell Medical College. Department of Medicine. New York, USA.
Columbia University Mailman School of Public Health. Department of Epidemiology. New York, USA.
Abstract
Recent studies in adults have characterized differences in systemic inflammation
49 between adults with and without latent tuberculosis infection (LTBI+ vs. LTBI-). Potential
50 differences in systemic inflammation by LTBI status has not been assess in pregnant women.
51
52 Methods: We conducted a cohort study of 155 LTBI+ and 65 LTBI- pregnant women, stratified by
53 HIV status, attending an antenatal clinic in Pune, India. LTBI status was assessed by interferon
54 gamma release assay. Plasma was used to measure systemic inflammation markers using
55 immunoassays: IFNβ, CRP, AGP, I-FABP, IFNγ, IL-1β, soluble CD14 (sCD14), sCD163, TNF, IL-
56 6, IL-17a and IL-13. Linear regression models were fit to test the association of LTBI status with
57 each inflammation marker. We also conducted an exploratory analysis using logistic regression to
58 test the association of inflammatory markers with TB progression.
59
60 Results: Study population was a median age of 23 (Interquartile range: 21-27), 28% undernourished
61 (mid-upper arm circumference (MUAC) <23 cm), 12% were vegetarian, 10% with gestational
62 diabetes and 32% with HIV. In multivariable models, LTBI+ women had significantly lower levels
63 of third trimester AGP, IL1β, sCD163, IL-6 and IL-17a. Interestingly, in exploratory analysis,
64 LTBI+ TB progressors had significantly higher levels of IL1β, IL-6 and IL-13 in multivariable
65 models compared to LTBI+ non-progressors. Conclusions: Our data shows a distinct systemic immune profile in LTBI+ pregnant women
68 compared to LTBI- women. Data from our exploratory analysis suggest that LTBI+ TB progressors
69 do not have this immune profile, suggesting negative association of this profile with TB progression.
Keywords in Portuguese
Tuberculose latenteTerceiro Trimestre da Gravidez
Inflamação
Gestantes
Citocinas
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