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The Role of a Mycobacterium Growth Inhibition Assay to Quantify Host Immune Control of M. Tuberculosis

Recruiting
Conditions
Tuberculosis
Immunologic Activity Alteration
Interventions
Other: No intervention.
Registration Number
NCT06580639
Lead Sponsor
Linkoeping University
Brief Summary

The goal of this observational study is to learn about how the blood leucocytes from patients with and without exposure or disease from tuberculosis (TB) are able to kill live mycobacteria (M. tuberculosis). The main question it aims to answer is:

Is intracellular growth suppression of M. tuberculosis in peripheral blood mononuclear cells variable among healthy blood donors and higher than in patients with latent TB compared to active TB?

Detailed Description

Background: The host immune response is crucial in determining the outcome after exposure to Mtb. A substantial proportion of exposed individuals (40-70%) never develop infection indicating an efficient cell mediated immune response against Mtb and early clearance by the host immune defense (Verall et al, Immunology 2014). Thus, the outcome of exposure is highly dependent on host immunity. In this study, our aim was to investigate whether the previously developed mycobacterium groth inhibition assay (MGIA) method (Andersson et al, Tuberculosis 2020) could be used to quantify the host immune response to Mtb.

Study design: In this study we will include healthy donors (n=80), patient with active TB (n=40), subjects recently exposed to active TB (n=80) and patients with latent TB (LTBI) (n=80). Exclusion criteria for all groups are known HIV infection or other immunosuppression from treatment or disease. Patients and healthy blood donors will be recruited at the departments of infectious diseases in Region Kalmar and Region Östergötland. From patients giving oral and written consent, 40 ml of blood will be collected for MGIA analysis.

Primary aim: To determine the difference in MGIA between healthy blood donors and patients with latent and active TB as well as the variation in host control of Mtb within each group.

Method: The Mycobacterial growth inhibition assay (MGIA) using human PBMCs isolated by density gradient by Lymhoprep (Axis-Shield) and SepMate tubes (StemCell Technologies) will be performed as described in study I with minor modifications. The PBMCs are infected with GFP expressing M. tuberculosis H37Rv and intracellular growth of Mtb and viability of PBMCs are assessed by live-cell imaging (Incucyte©) and measured as relative fluorescence units (RFU) during 5 days with and without stimulation with the purified protein derivate (PPD) is included. The cytokine response following exposure to gamma-irradiated H37Rv will be quantified by Olink proteomics.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
280
Inclusion Criteria

Healthy blood donors or subjects who will get vaccinated.

Exclusion Criteria

Known HIV infection, not Swedish citizen, chronic liver och kidney disease,immunosuppression from treatment or disease.

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Healthy IndividualsNo intervention.Patients with a negative IGRA (Quantiferon) who are apparently healthy.
Close contacts to patients with active TBNo intervention.Close contacts to patients with active, smear positive pulmonary TB.
Patients with (latent) tuberculosis infectionNo intervention.Patients without active TB who have a positive IGRA (Quantiferon Plus) result.
Patients with active TBNo intervention.Culture or PCR-verified active TB who are initiated on treatment.
Primary Outcome Measures
NameTimeMethod
Mycobacterial inhibition of host macrophagesUp to 10 days incubation

Mycobacterial inhibition of host macrophages

Mycobacterial inhibition of host peripheral blood mononuclear cells (PBMCs)Up to 10 days incubation

Mycobacterial inhibition of host peripheral blood mononuclear cells (PBMCs)

Secondary Outcome Measures
NameTimeMethod
Cytokine expression of host peripheral blood mononuclear cells (PBMCs)24 hours

Proteome analysis following exposure of PBMCs to gamma-irradiated M. tuberculosis

Trial Locations

Locations (2)

Kalmar County Hospital

🇸🇪

Kalmar, Sweden

Dept of Infectious Diseases

🇸🇪

Linköping, Sweden

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