Skip to main content

Advertisement

SpringerLink
Log in

Diagnosis of gastrointestinal tuberculosis: Using cytomorphological, microbiological, immunological and molecular techniques — A study from Central India

  • Original Article
  • Published:
Indian Journal of Clinical Biochemistry Aims and scope Submit manuscript

Abstract

The present study included three groups: (A) age and gender matched control (n=24) with no previous signs of M. tuberculosis complex (MTBC) infection, (B) patients (n=28) diagnosed with gastro-intestinal TB (GITB), (C) patients (n=50) with clinical and histo-pathological signs of GITB, but were culture and AFB negative. Real time assay performed using fluorescence resonance energy transfer hybridization probes showed a positivity index of 36 % in group C, i.e. 18 were found reactive from the total 50 cases studied. In addition, immune characterization of these 18 cases showed depleted CD +4 count and increased levels of IFN-γ and TNF-α cytokines. No positive case was found in group A, while in group B, out of total 28 cases studied 27 were found positive. A combinatorial diagnostic approach for rapid detection and characterization of GITB might provide specific therapeutic strategies for prevention and treatment of the infection in future.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Global Tuberculosis Control — Surveillance, Planning, Financing. World Health Organization Report, 2008 [cited 2008 Dec 10]. http://www.who.int/tb/publications/globalreport/2008/en/index.html.

  2. Sterling TR. New approaches to the treatment of latent tuberculosis. Semin Respir Crit Care Med 2008; 29: 532–541.

    Article  PubMed  Google Scholar 

  3. Rasheed S, Zinicola R, Watson D, Bajwa A, McDonald PJ. Intraabdominal and gastrointestinal tuberculosis. Colorectal Dis 2007; 9: 773–783.

    Article  CAS  PubMed  Google Scholar 

  4. Caputo D, Alloni R, Garberini A, Dicuonzo G, Angeletti S, Gherardi G, et al. Experience with two cases of intestinal tuberculosis: utility of the QuantiFERON-TB Gold test for diagnosis. Surg Infect (Larchmt) 2008; 9: 407–410.

    Article  Google Scholar 

  5. Collins T. Acute and chronic inflammation. In: Cotran RS, Kumar VK, Collins T, editor. Robbins Pathologic Basis of Disease. Philadelphia: Pa: Saunders Co, 1999; 50–58.

    Google Scholar 

  6. Mounadif B, Badre W, Elamraoui F, Hamdani A, Mourid A, Biadillah MC, et al. Ileocecal tuberculosis-apropos of 27 cases. Ann Gastroenterol Hepatol 1995; 31: 145–149.

    CAS  Google Scholar 

  7. Chien HP, Yu MC, Wu MH, Lin TP, Luh KT. Comparison of the BACTEC MGIT 960 with Lowenstein-Jensen medium for recovery of mycobacteria from clinical specimens. Int J Tuberc Lung Dis 2000; 4: 866–870.

    CAS  PubMed  Google Scholar 

  8. Sheer TA, Coyle WJ. Gastrointestinal tuberculosis. Curr Gastroenterol Rep 2003; 5: 273–278.

    Article  PubMed  Google Scholar 

  9. Small PM, Moss A. Molecular epidemiology and the new tuberculosis. Infect Agents Dis 1993; 2: 132–138.

    CAS  PubMed  Google Scholar 

  10. American Thoracic Society. Diagnostic standards and classification of tuberculosis in adults and children. Am J Respir Crit Care Med 2000; 161: 1376–1395.

    Google Scholar 

  11. Bai X, Wilson SE, Chmura K, Feldman NE, Chan ED. Morphometric analysis of Th(1) and Th(2) cytokine expression in human pulmonary tuberculosis. Tuberculosis (Edinb) 2004; 84: 375–385.

    Article  Google Scholar 

  12. Bekker LG, Moreira AL, Bergtold A, Freeman S, Ryffel B, Kaplan G. Immunopathologic effects of tumor necrosis factor alpha in murine mycobacterial infection are dose dependent. Infect Immun 2000; 68: 6954–6961.

    Article  CAS  PubMed  Google Scholar 

  13. Mohan VP, Scanga CA, Yu K, Scott HM, Tanaka KE, Tsang E, et al. Effects of tumor necrosis factor alpha on host immune response in chronic persistent tuberculosis: possible role for limiting pathology. Infect Immun 2001; 69: 1847–1855.

    Article  CAS  PubMed  Google Scholar 

  14. Guyot-Revol V, Innes JA, Hackforth S, Hinks T, Lalvani A. Regulatory T cells are expanded in blood and disease sites in patients with tuberculosis. Am J Respir Crit Care Med 2006; 173: 803–810.

    Article  CAS  PubMed  Google Scholar 

  15. Finan C, Ota MO, Marchant A, Newport MJ. Natural variation in immune responses to neonatal Mycobacterium bovis Bacillus Calmette-Guerin (BCG) Vaccination in a Cohort of Gambian infants. PLoS One 2008; 3: e3485.

    Article  PubMed  Google Scholar 

  16. Gillespie SH, McHugh TD, Newport LE. Specificity of IS6110-based amplification assays for Mycobacterium tuberculosis complex. J Clin Microbiol 1997; 35: 799–801.

    CAS  PubMed  Google Scholar 

  17. Hellyer TJ, DesJardin LE, Assaf MK, Bates JH, Cave MD, Eisenach KD. Specificity of IS6110-based amplification assays for Mycobacterium tuberculosis complex. J Clin Microbiol 1996; 34: 2843–2846.

    CAS  PubMed  Google Scholar 

  18. Parsons LM, Brosch R, Cole ST, Somoskovi A, Loder A, Bretzel G, et al. Rapid and simple approach for identification of Mycobacterium tuberculosis complex isolates by PCR-based genomic deletion analysis. J Clin Microbiol 2002; 40: 2339–2345.

    Article  CAS  PubMed  Google Scholar 

  19. Uygur-Bayramicli O, Dabak G, Dabak R. A clinical dilemma: abdominal tuberculosis. World J Gastroenterol 2003; 9: 1098–1101.

    PubMed  Google Scholar 

  20. Dalovisio JR, Montenegro-James S, Kemmerly SA, Genre CF, Chambers R, Greer D, et al. Comparison of the amplified Mycobacterium tuberculosis direct test, Amplicor MTB PCR and IS6110-PCR for detection of MTB in respiratory specimens. Clin Infec Dis 1996; 23: 1099–1106.

    CAS  Google Scholar 

  21. Antas PR, Ding L, Hackman J, Reeves-Hammock L, Shintani AK, Schiffer J, et al. Decreased CD4 + lymphocytes and innate immune responses in adults with previous extrapulmonary tuberculosis. J Allergy Clin Immunol 2006; 117: 916–923.

    Article  CAS  PubMed  Google Scholar 

  22. Serbina NV, Lazarevic V, Flynn JL. CD4 (+) T cells are required for the development of cytotoxic CD8 (+) T cells during Mycobacterium tuberculosis infection. J Immunol 2001; 167: 6991–7000.

    CAS  PubMed  Google Scholar 

  23. Tan JS, Canaday DH, Boom WH, Balaji KN, Schwander SK, Rich EA. Human alveolar T lymphocyte responses to Mycobacterium tuberculosis antigens: role for CD4+ and CD8+ cytotoxic T cells and relative resistance of alveolar macrophages to lysis. J Immunol 1997; 159: 290–297.

    CAS  PubMed  Google Scholar 

  24. De La Barrera SS, Finiasz M, Frias A, Aleman M, Barrionuevo P, Fink S, et al. Specific lytic activity against mycobacterial antigens is inversely correlated with the severity of tuberculosis. Clin Exp Immunol 2003; 132: 450–461.

    Article  Google Scholar 

  25. Hussain R, Kaleem A, Shahid F, Dojki M, Jamil B, Mehmood H, et al. Cytokine profiles using whole-blood assays can discriminate between tuberculosis patients and healthy endemic controls in a BCG-vaccinated population. J Immunol Methods 2002; 264: 95–108.

    Article  CAS  PubMed  Google Scholar 

  26. Ribeiro-Rodrigues R, Resende Co T, Rojas R, Toossi Z, Dietze R, Boom WH, et al. A role for CD4+CD25+T cells in regulation of the immune response during human tuberculosis. Clin Exp Immunol 2006; 144: 25–34.

    Article  CAS  PubMed  Google Scholar 

  27. Winkler S, Necek M, Winkler H, Adegnika AA, Perkmann T, Ramharter M, et al. Increased specific T cell cytokine responses in patients with active pulmonary tuberculosis from Central Africa. Microbes Infect 2005; 7:1161–1169.

    Article  CAS  PubMed  Google Scholar 

  28. Fathy MM, Asaad A, Mansour M, El-Said H, El-Haddad OK. Cellular interferon-gamma based assay for diagnosis of pulmonary tuberculosis. Egypt J Immunol 2007; 14: 33–41.

    PubMed  Google Scholar 

  29. Shkarin AV, Belousov SS, Anikina OA. Plasma levels of cytokines in patients with active infiltrative pulmonary tuberculosis. Probl Tuberk Bolezn Legk 2008; 8: 34–38.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Research, Bhopal Memorial Hospital & Research Centre, Bhopal, India

    Pradyumna Kumar Mishra, A. Bhargava, R. P. Punde & N. Pathak

  2. Department of Microbiology, Bhopal Memorial Hospital & Research Centre, Bhopal, India

    P. Desikan

  3. Department of Pathology, Bhopal Memorial Hospital & Research Centre, Bhopal, India

    A. Jain

  4. Department of Surgical Gastroenterology, Bhopal Memorial Hospital & Research Centre, Bhopal, India

    S. Varshney & K. K. Maudar

  5. Department of Research & Training, Bhopal Memorial Hospital & Research Centre, Bhopal, India

    Pradyumna Kumar Mishra

Authors
  1. Pradyumna Kumar Mishra
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Bhargava
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. R. P. Punde
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. N. Pathak
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. P. Desikan
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. A. Jain
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. S. Varshney
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. K. K. Maudar
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Pradyumna Kumar Mishra.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mishra, P.K., Bhargava, A., Punde, R.P. et al. Diagnosis of gastrointestinal tuberculosis: Using cytomorphological, microbiological, immunological and molecular techniques — A study from Central India. Indian J Clin Biochem 25, 158–163 (2010). https://doi.org/10.1007/s12291-010-0029-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12291-010-0029-7

Key Words

Search

Navigation