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Published in: BMC Infectious Diseases 1/2022

01-12-2022 | Tuberculosis | Research

Characterization of multiple soluble immune checkpoints in individuals with different Mycobacterium tuberculosis infection status and dynamic changes during anti-tuberculosis treatment

Authors: Huaxin Chen, Jingyu Zhou, Xinguo Zhao, Qianqian Liu, Lingyun Shao, Yehan Zhu, Qinfang Ou

Published in: BMC Infectious Diseases | Issue 1/2022

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Abstract

Background

Immune checkpoints are crucial for the maintenance of subtle balance between self-tolerance and effector immune responses, but the role of soluble immune checkpoints (sICs) in Mycobacterium tuberculosis (M. tb) infection remains unknown. We assessed the levels of multiple sICs in individuals with distinct M. tb infection status, and their dynamic changes during anti-tuberculosis treatment.

Methods

We enrolled 24 patients with pulmonary tuberculosis, among which 10 patients were diagnosed with tuberculous pleurisy (TBP), 10 individuals with latent tuberculosis infection (LTBI), and 10 healthy volunteers from Wuxi Fifth People’s Hospital and Huashan Hospital between February 2019 and May 2021. Plasma concentrations of thirteen sICs were measured at enrollment and during anti-tuberculosis treatment using luminex-based multiplex assay. sICs levels in tuberculous pleural effusion (TPE) and their relations to laboratory test markers of TPE were also assessed in TBP patients.

Results

The circulating levels of sPD-1, sPD-L1, sCTLA-4, sBTLA, sGITR, sIDO, sCD28, sCD27 and s4-1BB were upregulated in tuberculosis patients than in healthy controls. A lower sPD-L1 level was found in LTBI individuals than in tuberculosis patients. In TBP patients, the levels of sPD-1, sPD-L2, sCD28, sCD80, sCD27, sTIM-3, sLAG-3, sBTLA, s4-1BB and sIDO increased significantly in TPE than in plasma. In TPE, sBTLA and sLAG-3 correlated positively with the adenosine deaminase level. sIDO and sCD80 correlated positively with the lactate dehydrogenase level and the percentage of lymphocytes in TPE, respectively. Meanwhile, sCD27 correlated negatively with the specific gravity and protein level in TPE. In tuberculosis patients, the circulating levels of sBTLA and sPD-L1 gradually declined during anti-tuberculosis treatment.

Conclusions

We characterized the changing balance of sICs in M. tb infection. And our results revealed the relations of sICs to laboratory test markers and treatment responses in tuberculosis patients, indicating that certain sICs may serve as potential biomarkers for disease surveillance and prognosis of tuberculosis.
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Literature
1.
go back to reference Global tuberculosis report 2021. Geneva: World Health Organization; 2021. Global tuberculosis report 2021. Geneva: World Health Organization; 2021.
3.
go back to reference Wykes MN, Lewin SR. Immune checkpoint blockade in infectious diseases. Nat Rev Immunol. 2018;18(2):91–104.PubMedCrossRef Wykes MN, Lewin SR. Immune checkpoint blockade in infectious diseases. Nat Rev Immunol. 2018;18(2):91–104.PubMedCrossRef
4.
go back to reference Topalian SL, Taube JM, Anders RA, Pardoll DM. Mechanism-driven biomarkers to guide immune checkpoint blockade in cancer therapy. Nat Rev Cancer. 2016;16(5):275–87.PubMedPubMedCentralCrossRef Topalian SL, Taube JM, Anders RA, Pardoll DM. Mechanism-driven biomarkers to guide immune checkpoint blockade in cancer therapy. Nat Rev Cancer. 2016;16(5):275–87.PubMedPubMedCentralCrossRef
5.
go back to reference Fadriquela A, Kim CS, Lee KJ, Kang SH, Kim MY, Lee JH. Soluble type immune checkpoint regulators using multiplex luminex immunoassay in chronic hepatitis B patients. J Clin Pathol. 2021;74(12):780–6.PubMedCrossRef Fadriquela A, Kim CS, Lee KJ, Kang SH, Kim MY, Lee JH. Soluble type immune checkpoint regulators using multiplex luminex immunoassay in chronic hepatitis B patients. J Clin Pathol. 2021;74(12):780–6.PubMedCrossRef
6.
go back to reference Scriba TJ, Coussens AK, Fletcher HA. Human immunology of tuberculosis. Microbiol Spectr. 2017; 5(1). Scriba TJ, Coussens AK, Fletcher HA. Human immunology of tuberculosis. Microbiol Spectr. 2017; 5(1).
7.
go back to reference Chai Q, Lu Z, Liu CH. Host defense mechanisms against Mycobacterium tuberculosis. Cell Mol Life Sci. 2020;77(10):1859–78.PubMedCrossRef Chai Q, Lu Z, Liu CH. Host defense mechanisms against Mycobacterium tuberculosis. Cell Mol Life Sci. 2020;77(10):1859–78.PubMedCrossRef
8.
go back to reference Khan N, Vidyarthi A, Amir M, Mushtaq K, Agrewala JN. T-cell exhaustion in tuberculosis: pitfalls and prospects. Crit Rev Microbiol. 2017;43(2):133–41.PubMedCrossRef Khan N, Vidyarthi A, Amir M, Mushtaq K, Agrewala JN. T-cell exhaustion in tuberculosis: pitfalls and prospects. Crit Rev Microbiol. 2017;43(2):133–41.PubMedCrossRef
9.
go back to reference Wang PH, Wu MF, Hsu CY, Lin SY, Chang YN, Lee HS, Wei YF, Shu CC. The dynamic change of immune checkpoints and CD14+ monocytes in latent tuberculosis infection. Biomedicines. 2021;9(10):1479.PubMedPubMedCentralCrossRef Wang PH, Wu MF, Hsu CY, Lin SY, Chang YN, Lee HS, Wei YF, Shu CC. The dynamic change of immune checkpoints and CD14+ monocytes in latent tuberculosis infection. Biomedicines. 2021;9(10):1479.PubMedPubMedCentralCrossRef
10.
go back to reference Wang X, Cao Z, Jiang J, Li Y, Dong M, Ostrowski M, Cheng X. Elevated expression of Tim-3 on CD8 T cells correlates with disease severity of pulmonary tuberculosis. J Infect. 2011;62(4):292–300.PubMedCrossRef Wang X, Cao Z, Jiang J, Li Y, Dong M, Ostrowski M, Cheng X. Elevated expression of Tim-3 on CD8 T cells correlates with disease severity of pulmonary tuberculosis. J Infect. 2011;62(4):292–300.PubMedCrossRef
11.
go back to reference Djoba Siawaya JF, Bapela NB, Ronacher K, Veenstra H, Kidd M, Gie R, Beyers N, van Helden P, Walzl G. Immune parameters as markers of tuberculosis extent of disease and early prediction of anti-tuberculosis chemotherapy response. J Infect. 2008;56(5):340–7.PubMedCrossRef Djoba Siawaya JF, Bapela NB, Ronacher K, Veenstra H, Kidd M, Gie R, Beyers N, van Helden P, Walzl G. Immune parameters as markers of tuberculosis extent of disease and early prediction of anti-tuberculosis chemotherapy response. J Infect. 2008;56(5):340–7.PubMedCrossRef
13.
go back to reference Nouailles G, Day TA, Kuhlmann S, Loewe D, Dorhoi A, Gamradt P, Hurwitz R, Jörg S, Pradl L, Hutloff A, et al. Impact of inducible co-stimulatory molecule (ICOS) on T-cell responses and protection against Mycobacterium tuberculosis infection. Eur J Immunol. 2011;41(4):981–91.PubMedCrossRef Nouailles G, Day TA, Kuhlmann S, Loewe D, Dorhoi A, Gamradt P, Hurwitz R, Jörg S, Pradl L, Hutloff A, et al. Impact of inducible co-stimulatory molecule (ICOS) on T-cell responses and protection against Mycobacterium tuberculosis infection. Eur J Immunol. 2011;41(4):981–91.PubMedCrossRef
14.
go back to reference Barber DL, Mayer-Barber KD, Feng CG, Sharpe AH, Sher A. CD4 T cells promote rather than control tuberculosis in the absence of PD-1-mediated inhibition. J Immunol. 2011;186(3):1598–607.PubMedCrossRef Barber DL, Mayer-Barber KD, Feng CG, Sharpe AH, Sher A. CD4 T cells promote rather than control tuberculosis in the absence of PD-1-mediated inhibition. J Immunol. 2011;186(3):1598–607.PubMedCrossRef
15.
go back to reference Kauffman KD, Sakai S, Lora NE, Namasivayam S, Baker PJ, Kamenyeva O, Foreman TW, Nelson CE, Oliveira-de-Souza D, Vinhaes CL et al. PD-1 blockade exacerbates Mycobacterium tuberculosis infection in rhesus macaques. Sci Immunol. 2021; 6(55). Kauffman KD, Sakai S, Lora NE, Namasivayam S, Baker PJ, Kamenyeva O, Foreman TW, Nelson CE, Oliveira-de-Souza D, Vinhaes CL et al. PD-1 blockade exacerbates Mycobacterium tuberculosis infection in rhesus macaques. Sci Immunol. 2021; 6(55).
16.
go back to reference Shen L, Shi H, Gao Y, Ou Q, Liu Q, Liu Y, Wu J, Zhang W, Fan L, Shao L. The characteristic profiles of PD-1 and PD-L1 expressions and dynamic changes during treatment in active tuberculosis. Tuberculosis (Edinb). 2016;101:146–50.CrossRef Shen L, Shi H, Gao Y, Ou Q, Liu Q, Liu Y, Wu J, Zhang W, Fan L, Shao L. The characteristic profiles of PD-1 and PD-L1 expressions and dynamic changes during treatment in active tuberculosis. Tuberculosis (Edinb). 2016;101:146–50.CrossRef
17.
go back to reference Yin W, Tong ZH, Cui A, Zhang JC, Ye ZJ, Yuan ML, Zhou Q, Shi HZ. PD-1/PD-Ls pathways between CD4(+) T cells and pleural mesothelial cells in human tuberculous pleurisy. Tuberculosis (Edinb). 2014;94(2):131–9.CrossRef Yin W, Tong ZH, Cui A, Zhang JC, Ye ZJ, Yuan ML, Zhou Q, Shi HZ. PD-1/PD-Ls pathways between CD4(+) T cells and pleural mesothelial cells in human tuberculous pleurisy. Tuberculosis (Edinb). 2014;94(2):131–9.CrossRef
18.
go back to reference Qiao D, Li L, Guo J, Lao S, Zhang X, Zhang J, Wu C. Mycobacterium tuberculosis culture filtrate protein 10-specific effector/memory CD4+ and CD8+ T cells in tubercular pleural fluid, with biased usage of T cell receptor Vβ chains. Infect Immun. 2011;79(8):3358–65.PubMedPubMedCentralCrossRef Qiao D, Li L, Guo J, Lao S, Zhang X, Zhang J, Wu C. Mycobacterium tuberculosis culture filtrate protein 10-specific effector/memory CD4+ and CD8+ T cells in tubercular pleural fluid, with biased usage of T cell receptor Vβ chains. Infect Immun. 2011;79(8):3358–65.PubMedPubMedCentralCrossRef
19.
go back to reference Li L, Qiao D, Fu X, Lao S, Zhang X, Wu C. Identification of M. tuberculosis-specific Th1 cells expressing CD69 generated in vivo in pleural fluid cells from patients with tuberculous pleurisy. PLoS ONE. 2011;6(8):e23700.PubMedPubMedCentralCrossRef Li L, Qiao D, Fu X, Lao S, Zhang X, Wu C. Identification of M. tuberculosis-specific Th1 cells expressing CD69 generated in vivo in pleural fluid cells from patients with tuberculous pleurisy. PLoS ONE. 2011;6(8):e23700.PubMedPubMedCentralCrossRef
20.
go back to reference Petruccioli E, Petrone L, Vanini V, Cuzzi G, Navarra A, Gualano G, Palmieri F, Girardi E, Goletti D. Assessment of CD27 expression as a tool for active and latent tuberculosis diagnosis. J Infect. 2015;71(5):526–33.PubMedCrossRef Petruccioli E, Petrone L, Vanini V, Cuzzi G, Navarra A, Gualano G, Palmieri F, Girardi E, Goletti D. Assessment of CD27 expression as a tool for active and latent tuberculosis diagnosis. J Infect. 2015;71(5):526–33.PubMedCrossRef
21.
go back to reference Jiang J, Wang X, Wang X, Cao Z, Liu Y, Dong M, Tong A, Cheng X. Reduced CD27 expression on antigen-specific CD4+ T cells correlates with persistent active tuberculosis. J Clin Immunol. 2010;30(4):566–73.PubMedCrossRef Jiang J, Wang X, Wang X, Cao Z, Liu Y, Dong M, Tong A, Cheng X. Reduced CD27 expression on antigen-specific CD4+ T cells correlates with persistent active tuberculosis. J Clin Immunol. 2010;30(4):566–73.PubMedCrossRef
22.
go back to reference Phillips BL, Mehra S, Ahsan MH, Selman M, Khader SA, Kaushal D. LAG3 expression in active Mycobacterium tuberculosis infections. Am J Pathol. 2015;185(3):820–33.PubMedPubMedCentralCrossRef Phillips BL, Mehra S, Ahsan MH, Selman M, Khader SA, Kaushal D. LAG3 expression in active Mycobacterium tuberculosis infections. Am J Pathol. 2015;185(3):820–33.PubMedPubMedCentralCrossRef
23.
go back to reference Phillips BL, Gautam US, Bucsan AN, Foreman TW, Golden NA, Niu T, Kaushal D, Mehra S. LAG-3 potentiates the survival of Mycobacterium tuberculosis in host phagocytes by modulating mitochondrial signaling in an in-vitro granuloma model. PLoS ONE. 2017;12(9): e0180413.PubMedPubMedCentralCrossRef Phillips BL, Gautam US, Bucsan AN, Foreman TW, Golden NA, Niu T, Kaushal D, Mehra S. LAG-3 potentiates the survival of Mycobacterium tuberculosis in host phagocytes by modulating mitochondrial signaling in an in-vitro granuloma model. PLoS ONE. 2017;12(9): e0180413.PubMedPubMedCentralCrossRef
24.
25.
go back to reference Cao H, Zhang R, Zhang W. CTLA-4 interferes with the HBV-specific T cell immune response (Review). Int J Mol Med. 2018;42(2):703–12.PubMedPubMedCentral Cao H, Zhang R, Zhang W. CTLA-4 interferes with the HBV-specific T cell immune response (Review). Int J Mol Med. 2018;42(2):703–12.PubMedPubMedCentral
26.
go back to reference Yu X, Zheng Y, Mao R, Su Z, Zhang J. BTLA/HVEM signaling: milestones in research and role in chronic hepatitis B virus infection. Front Immunol. 2019;10:617.PubMedPubMedCentralCrossRef Yu X, Zheng Y, Mao R, Su Z, Zhang J. BTLA/HVEM signaling: milestones in research and role in chronic hepatitis B virus infection. Front Immunol. 2019;10:617.PubMedPubMedCentralCrossRef
27.
go back to reference Wang WD, Gao YC, Lu YB, Zhang JA, Liu GB, Kong B, Xiang WY, Dai YC, Yu SY, Jia Y, et al. BTLA-expressing CD11c antigen presenting cells in patients with active tuberculosis exhibit low capacity to stimulate T cell proliferation. Cell Immunol. 2017;311:28–35.PubMedCrossRef Wang WD, Gao YC, Lu YB, Zhang JA, Liu GB, Kong B, Xiang WY, Dai YC, Yu SY, Jia Y, et al. BTLA-expressing CD11c antigen presenting cells in patients with active tuberculosis exhibit low capacity to stimulate T cell proliferation. Cell Immunol. 2017;311:28–35.PubMedCrossRef
28.
go back to reference Cai X, Ge N, Rong R, Lu Y, Zhang J, Xu J. High expression of BTLA and B7–H4 on the surface of myeloid dendritic cells has a negative regulatory effect on their anti-tuberculosis immunity activity in pleural tuberculosis patients. Tuberculosis (Edinb). 2019;119: 101877.CrossRef Cai X, Ge N, Rong R, Lu Y, Zhang J, Xu J. High expression of BTLA and B7–H4 on the surface of myeloid dendritic cells has a negative regulatory effect on their anti-tuberculosis immunity activity in pleural tuberculosis patients. Tuberculosis (Edinb). 2019;119: 101877.CrossRef
29.
go back to reference Zhang JA, Lu YB, Wang WD, Liu GB, Chen C, Shen L, Luo HL, Xu H, Peng Y, Luo H, et al. BTLA-expressing dendritic cells in patients with tuberculosis exhibit reduced production of IL-12/IFN-α and increased production of IL-4 and TGF-β, favoring Th2 and Foxp3(+) Treg polarization. Front Immunol. 2020;11:518.PubMedPubMedCentralCrossRef Zhang JA, Lu YB, Wang WD, Liu GB, Chen C, Shen L, Luo HL, Xu H, Peng Y, Luo H, et al. BTLA-expressing dendritic cells in patients with tuberculosis exhibit reduced production of IL-12/IFN-α and increased production of IL-4 and TGF-β, favoring Th2 and Foxp3(+) Treg polarization. Front Immunol. 2020;11:518.PubMedPubMedCentralCrossRef
30.
go back to reference Henderson JG, Opejin A, Jones A, Gross C, Hawiger D. CD5 instructs extrathymic regulatory T cell development in response to self and tolerizing antigens. Immunity. 2015;42(3):471–83.PubMedCrossRef Henderson JG, Opejin A, Jones A, Gross C, Hawiger D. CD5 instructs extrathymic regulatory T cell development in response to self and tolerizing antigens. Immunity. 2015;42(3):471–83.PubMedCrossRef
Metadata
Title
Characterization of multiple soluble immune checkpoints in individuals with different Mycobacterium tuberculosis infection status and dynamic changes during anti-tuberculosis treatment
Authors
Huaxin Chen
Jingyu Zhou
Xinguo Zhao
Qianqian Liu
Lingyun Shao
Yehan Zhu
Qinfang Ou
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2022
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/s12879-022-07506-z

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