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Tuberculosis and COVID-19 Dually Affect Human Th17 Cell Immune Response
Anna Starshinova1, Igor Kudryavtsev2, Artem Rubinstein2
1Almazov National Medical Research Centre, 197341 St-Petersburg, Russia.
Biomedicines
|August 26, 2023
Summary
COVID-19 significantly alters immune responses in tuberculosis patients, affecting disease course and severity. Understanding these changes is crucial for managing both latent tuberculosis infection and active tuberculosis, especially post-SARS-CoV-2 infection.
Area of Science:
- Immunology
- Infectious Diseases
- Pulmonology
Background:
- COVID-19 impacts tuberculosis (TB) detection and immune responses.
- Alterations in immune responses are critical for understanding TB development and progression, particularly in co-infected patients.
- Investigating immune changes in latent TB infection (LTBI) and SARS-CoV-2-infected TB patients is essential.
Purpose of the Study:
- To review immune response characteristics in TB patients and in convalescent COVID-19 patients with LTBI.
- To analyze how SARS-CoV-2 infection influences the immune landscape relevant to tuberculosis.
Main Methods:
- Systematic literature review of publications from December 2019 to March 2023.
- Searched major databases (Medline, PubMed, Scopus) using keywords: COVID-19, SARS-CoV-2, tuberculosis, pulmonary tuberculosis, LTBI, Treg, follicular Treg, Treg subsets.
- Analyzed immune response features in tuberculosis and COVID-19 patients.
Main Results:
- Tuberculosis patients with prior COVID-19 showed elevated Th1 and Th2 cell levels, indicating activated immune responses.
- COVID-19 or post-COVID-19 subjects exhibited decreased Th17 levels, potentially limiting TB development.
- While TB typically increases Treg levels, COVID-19 can induce a hyperinflammatory response, contrasting with typical Treg-associated immune regulation.
Conclusions:
- SARS-CoV-2 infection distinctly alters tuberculosis progression through modified immune responses.
- A decline in regulatory T cell (Treg) levels is linked to the development of severe active tuberculosis.
- Both pathogens disrupt immune homeostasis, increasing the risk of severe TB and necessitating improved management strategies for individuals with latent and active tuberculosis.
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