Advertisement

 

 

Matrix Metalloproteinases in Tuberculosis-Immune Reconstitution Inflammatory Syndrome and Impaired Lung Function Among Advanced HIV/TB Co-infected Patients Initiating Antiretroviral Therapy.

Author Information (click to view)

Ravimohan S, Tamuhla N, Kung SJ, Nfanyana K, Steenhoff AP, Gross R, Weissman D, Bisson GP,


Ravimohan S, Tamuhla N, Kung SJ, Nfanyana K, Steenhoff AP, Gross R, Weissman D, Bisson GP, (click to view)

Ravimohan S, Tamuhla N, Kung SJ, Nfanyana K, Steenhoff AP, Gross R, Weissman D, Bisson GP,

Advertisement
Share on FacebookTweet about this on TwitterShare on LinkedIn

EBioMedicine 2015 11 253() 100-7 doi 10.1016/j.ebiom.2015.11.040

Abstract
BACKGROUND
HIV-infected patients with pulmonary TB (pTB) can have worsening of respiratory symptoms as part of TB-immune reconstitution inflammatory syndrome (TB-IRIS) following antiretroviral therapy (ART) initiation. Thus, reconstitution of immune function on ART could drive incident lung damage in HIV/TB.

METHODS
We hypothesized that increases in matrix metalloproteinases (MMPs), which can degrade lung matrix, on ART are associated with TB-IRIS among a cohort of advanced, ART naïve, HIV-infected adults with pTB. Furthermore, we related early changes in immune measures and MMPs on ART to lung function in an exploratory subset of patients post-TB cure. This study was nested within a prospective cohort study. Rank sum and chi-square tests, Spearman’s correlation coefficient, and logistic regression were used for analyses.

RESULTS
Increases in MMP-8 following ART initiation were independently associated with TB-IRIS (p = 0.04; adjusted odds ratio 1.5 [95% confidence interval: 1.0-2.1]; n = 32). Increases in CD4 counts and MMP-8 on ART were also associated with reduced forced expiratory volume in one-second post-TB treatment completion (r = – 0.7, p = 0.006 and r = – 0.6, p = 0.02, respectively; n = 14).

CONCLUSIONS
ART-induced MMP increases are associated with TB-IRIS and may affect lung function post-TB cure. End-organ damage due to TB-IRIS and mechanisms whereby immune restoration impairs lung function in pTB deserve further investigation.

Submit a Comment

Your email address will not be published. Required fields are marked *

18 − ten =

[ HIDE/SHOW ]