Strongyloides Stercoralis Coinfection Is Associated With Greater Disease Severity, Higher Bacterial Burden, and Elevated Plasma Matrix Metalloproteinases in Pulmonary Tuberculosis

Overview

Journal J Infect Dis

Publisher Oxford University Press

Specialty Infectious Diseases

Date 2020 Apr 21

PMID 32307511

Citations 13

Authors

Nathella P Kumar

Gokul R Kathamuthu

Kadar Moideen

Vaithilingam V Banurekha

Dina Nair

Michael P Fay

Thomas B Nutman

Subash Babu

Affiliations

Soon will be listed here.

Abstract

Background: Helminths and tuberculosis (TB) largely overlap at the population level. Whether helminth infections influence disease severity and bacterial burdens in TB is not well understood.

Methods: This study was conducted to examine the disease severity in a cohort of pulmonary TB (PTB) individuals with (Ss+) or without (Ss-) seropositivity for Strongyloides stercoralis infection.

Results: Ss+ was associated with increased risk of cavitation (odds ratio [OR], 4.54; 95% confidence interval [CI], 2.33-9.04; P < .0001) and bilateral lung involvement (OR, 5.97; 95% CI, 3.03-12.09; P < .0001) in PTB individuals. Ss+ was also associated with higher bacterial burdens (OR, 7.57; 95% CI, 4.18-14.05; P < .0001) in PTB individuals. After multivariate analysis adjusting for covariates, Ss+ was still associated with greater risk of cavitation (adjusted OR [aOR], 3.99; 95% CI, 1.73-9.19; P = .0014), bilateral lung involvement (aOR, 4.09; 95% CI, 1.78-9.41; P = .0011), and higher bacterial burden (aOR, 9.32; 95% CI, 6.30-13.96; P < .0001). Finally, Ss+ was also associated with higher plasma levels of matrix metalloproteinases ([MMP]-1, -2, -7, -8, and -9) in PTB individuals.

Conclusions: Therefore, our data demonstrate that coexistent Ss infection is associated with greater disease severity and higher bacterial burden in PTB. Our data also demonstrate enhanced plasma levels of MMPs in coinfected individuals, suggesting a plausible biological mechanism for these effects.

Citing Articles

Impact of Coinfection on Disease Severity and Treatment Outcomes in Pulmonary Tuberculosis.

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Up-regulated matrix metalloproteinase activity in soil-transmitted helminth-tuberculosis co-infection is associated with increased lung pathology.

Loader M, Vasquez Alves S, Gilman R, Coronel J, Taquiri C, Vasquez Alves N Eur Respir J. 2025; 65(1).

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Humans seropositive for Trypanosoma cruzi co-infected with intestinal helminths have higher infectiousness, parasitaemia and Th2-type response in the Argentine Chaco.

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Bacilli load in PTB- intestinal helminths co-infected and PTB non -infected patients at selected public health facilities in Jimma zone, Oromia, Ethiopia: comparative cross-sectional study.

Mekuria M, Abebe G, Hasen H, Zeynudin A BMC Infect Dis. 2024; 24(1):783.

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