Skip to main content

Table 5 Immunological research of co-infection between TB and parasitic diseases

From: Co-infection of tuberculosis and parasitic diseases in humans: a systematic review

Country Year of report Tuberculosis Parasitic disease/species Subject Conclusions No. of reference
France 2003 PTB American cutaneous leishmaniasis A 44-year-old man with triple infection of cutaneous leishmaniasis, lepromatous leprosy, and PTB Unresponsiveness to IL-12 of patient’s T cells after stimulation with Leishmania guyanensis, M. bovis bacille Calmette-Guerin, and M. leprae antigens suggested the inability to mount an appropriate Th cell response to upregulate the IL-12 receptor expression. [14]
Gambia 1999 M. TB Malaria Review Malarial parasites can decrease their vertebrate host’s effective humoral and cellular immune responses to M. TB. [35]
USA 2004 M. TB Plasmodium yoelii NL Mice Co-infected mice were less able to contain growth of M. TB in lung, spleen, and liver and had increased mortality. [36]
Thailand 2006 M. TB Plasmodium falciparum HSP70 (M. TB) and ATPBP (Plasmodium falciparum) HSP70 and ATPBP share a common molecular function as ATP binding resulting from purine nucleotide binding. Therefore, a competitive antagonist effect between both molecules can be expected. [37]
Germany 2012 M. TB Plasmodium berghei NK65 An experimental mouse model of co-infection Co-infection exacerbated chronic TB while rendering mice less refractory to Plasmodium. Co-infected animals presented with enhanced inflammatory immune responses as reflected by exacerbated leukocyte infiltrates, tissue pathology and hypercytokinemia accompanied by altered T-cell responses. [38]
Unknown 1989 PTB Opisthorchiasis 173 patients with PTB complicated by opisthorchiasis Among them, activity of the α1-proteinase inhibitor was more frequently higher and carriers of two markers i.e. Hp 2–2 and Gc 1–1 were more frequent. [39]
Unknown 1992 PTB Opisthorchiasis 12 PTB patients concurrent with opisthorchiasis When the course of TB is aggravated by opisthorchiasis invasion, the number of cases of antibacterial therapy intolerance increases and prognosis of the diseases deteriorates. It was shown that the antibacterial and anthelminthic therapy had a favourable clinical and immunologic effect. [40]
Unknown 1992 M. TB Opisthorchiasis Animal In comparison with the groups of animals with monoinvasion and monoinfection, at the acute invasive phase of mixed pathology (2 weeks) the activity of the host’s immune system increases, while the biological activities of both pathogens decrease; however, at the subacute phase (2.5 months), all were contrary respectively. [41]
Russia 2003 TB Opisthorchiasis Golden hamsters with SRBC parasitocenosis In cases of mixed pathology, at the acute stage of invasion, the immune system showed increased responses with respect to specific and heterologous antigens; in the chronization of invasion the formation of antibodies to heterologous antigens (SRBC) and the level of specific antiopisthorchiasis and anti-TB immune responses decreased together. [42]
China 2009 PTB Echinococcosis A 18 years old male and a 36 years female As the echinococcosis chronicity increased, the immune profile in both subjects changed from a Th1 to Th2 response. Such an elevated Th2 immune profile, with subsequent suppression of the Th1 immune response, is a common feature of chronic helminth infections. [27]
USA 2012 M. TB Litomosoides sigmodontis Cotton rats with chronic L. sigmodontis infection and uninfected controls were challenged with M. TB by intranasal inoculation. Chronic filarial infections do not exacerbate M. TB infection in the cotton rat model. It may be possible to develop worm-derived therapies for autoimmune diseases that do not substantially increase the risk for infections. [43]
USA 2012 M. TB Filarial infections Review Filarial infections very clearly alter the magnitude and quality of the mycobacteria-specific cytokine responses, responses that have been typically associated with control of these intracellular pathogens. [44]
Denmark 2007 TB Intestinal helminth Review Co-infections cause a range of immunomodulation characterized by enhanced Th2-type cytokine profiles, high IgE levels and upregulated regulatory T-cell activity, as well as chronic immune activation. [45]
Brazil 2007 PTB Intestinal helminth 40 PTB patients and 25 healthy controls Compared to either TB patients or healthy controls, co-infected patients’ absolute frequencies of CD3+, CD4+, CD8+, NK T cell and CD4+CD25high T cell increased. Differences in CD4 T cell frequencies were accompanied by lower IFN-γ and elevated and sustained IL-10 levels in WB cultures from co-infected patients compared to TB patients. [46]
Mexico 2012 TB Helminthic infections Review Helminths very clearly alter the magnitude of the mycobacteria-specific cytokine responses, altering the control of the mycobacteria growth. Mycobacteria-induced immune responses are suppressed by helminth infections. [47]
USA 2012 TB Helminths Review Helminth-induced Th2 and T reg responses impinge on host resistance against M. TB infection. Th1 response is reduced in helminth co-infected hosts. Helminth-induced alternatively activated macrophages contribute to enhanced susceptibility to TB. [48]
Brazil 2002 BCG vaccination Ascaris lumbricoides, Entamoeba histolytica, and Strongyloides stercoralis 14 male students aged 12–15 years: 7 having protozoan or helminthic infections and 7 free of intestinal parasites Th2-like IL-10 responses induced by intestinal parasites may interfere in BCG-induced Th1-like IFN-γ response. Intestinal parasitic infections may significantly alter the protective immune response to BCG vaccination. [49]
Sweden 2005 BCG vaccination to protect against M. TB S. mansoni BCG vaccinated mice with prior S. mansoni infection S. mansoni infection reduces the protective efficacy of BCG vaccination against M. TB possibly by attenuation of protective immune responses to mycobacterial antigens and/or by polarizing the general immune responses to the Th2 profile. [50]
USA 2011 TB vaccines in protecting against M. TB Plasmodium yoelii NL TB vaccines in a co-infection mouse model of two pathogens The effectiveness of novel TB vaccines in protecting against TB was unaffected by a primary malaria co-infection in a mouse model of PTB. [51]
  1. Abbreviations: PTB = pulmonary tuberculosis; M. leprae = mycobacterium leprae; M. TB = mycobacterium tuberculosis; SRBC = sheep red blood cells; IL = interleukin; Th = T helper; Treg = T regulatory; NL = non-lethal; HSP = heat shock protein; ATP = adenosine triphosphate; ATPBP = ATP-binding protein; Ig = immunoglobulin; CD = cluster of differentiation; NK = natural killer; IFN = interferon; WB = whole blood; BCG = Bacillus Calmette-Guerin; L. sigmodontis = litomosoides sigmodontis; S. mansoni = schistosoma mansoni.