Evaluation of the diagnostic utility of leucocyte in comparison to other biomarkers in the management of patients with pulmonary tuberculosis

Background: Pulmonary tuberculosis (PTB) is an infectious and debilitating disease that affects millions of people each year. Simple, reliable and cost effective biomarkers are vital to fore-stall the morbidity and mortality that is hallmark of the infection especially in resource poor economy.Methods: This comparative study enlisted 140 subjects: 80 had PTB and 60 do not. Blood of 8mls was collected; 3mls in K2-EDTA for FBC testing with XE-2100 Sysmex and ESR by Westergreen method. The remainder was used for serum CRP assay by ELISA. The radiological extent was determined from Chest X ray report and disease severity using modified Bandim TB scoring was extracted from the case note. The aim of the study is to investigate the relationship and diagnostic utility between leucocyte with CRP, ESR, radiological extent of disease and disease severity in PTB.Results: Mean Lymphocyte count was lower while TWBC, Neutrophil and Monocyte counts were higher in subjects compared to control (p<0.05). Median CRP, ESR, NLR, NMR and MLR were higher in subjects compared to control (p<0.05), NLR and MLR showed strong positive significant correlation with ESR, disease severity, and radiological extend of disease. NMR (p= 0.00) had a negative correlation with ESR (p<0.05) and inverse correlation with disease severity and radiological extent.Conclusions: This study found NLR, MLR and NMR as a readily, easily available and inexpensive indices that are as efficient and comparable to known biomarkers in PTB infection, therefore could serve as valuable predictive biomarker in areas of high disease burden with weak economy

Assessment of Alpha Fetoprotein Levels and Gamma Glutamyl Transferase Activity in Hepatitis B and Hepatitis C Seropositive Subjects in Nnewi, Nigeria

Hepatitis B and hepatitis C viral infections are the leading cause of liver cirrhosis and hepatocellular carcinoma worldwide. These conditions, which mar the hepatic functional integrity, are characterized by alterations in the liver function markers such as alpha fetoprotein (AFP) and gamma glutamyl tranferase (GGT). In the present study, a total of 90 subjects were recruited. Out of this number, 30 were hepatitis B seropositive subjects, 30 hepatitis C seropositive individuals and the remaining 30 were apparently healthy individuals. The last group served as the control. Serum alpha fetoprotein levels were estimated by the Enzyme Linked Immunosorbent Assay (ELISA) technique and the method adopted for the determination of gamma glutamyl transferase activity was the kinetic-spectrophotometric procedure. The mean serum level of alpha fetoprotein was significantly higher in hepatitis B seropositive subjects compared with the control (P&lt;0.05). The same pattern was observed when the mean serum activity of GGT of the hepatitis B seropositive subjects was compared with that of the control (P&lt;0.05). Furthermore, the mean serum level of AFP and the mean serum GGT activity were significantly higher in hepatitis C seropositive individuals compared with the control (P&lt;0.05). In contrast, no significant difference was observed in the mean serum levels of alpha fetoprotein in hepatitis B seropositive individuals compared with that of hepatitis C seropositive subjects (P&gt;0.05). A positive correlation existed between AFP levels and GGT activity in hepatitis B seropositive subjects (r=0.31) and between AFP levels and GGT activity in hepatitis C seropositive subjects (r=0.25). These findings suggest that evaluation of serum alpha fetoprotein levels and gamma glutamyl transferase activity may be a valuable adjunct in the assessment of disease progression in hepatitis B and hepatitis C seropositive individuals. Keywords: Hepatitis, alpha fetoprotein, glatamyl transferase, disease progression

Evaluation of Zinc and Copper and Immunological Implication in Menstrual Cycle of HIV Infected Females in Nnewi, Nigeria

Zinc and Copper are essential for the immune system and the interaction between reproductive system and immune cells plays important immunoregulatory roles in menstrual cycle of women. It is estimated that nearly 16 million women are living with HIV/AIDS worldwide, making up approximately half of all infections. Importantly, the understanding of the burden of HIV/AIDS lies within resource limited areas particularly Sub-Saharan Africa. This was a prospective study designed to evaluate the immunological implication of Zinc and Copper in menstrual cycle of HIV infected females in NAUTH, Nnewi, Nigeria. The study composed of 120 premenopausal females with regular menstrual cycle (between 27-31 days) and aged 15-45 years. 30 were apparently healthy females recruited as Control group while 90 were HIV infected females grouped as HIV stage 1, HIV stage 2 and HIV stage 2 on ART (n=30 respectively). Blood samples were collected at follicular (7th - 13th day) and luteal (21st -23rd day) phases of menstrual cycle after obtaining their informed consent for determination of Zinc, Copper, Interleukin-6, interleukin-4 and TNF? using AAS and ELISA methods. The result showed significantly lower levels of Zn and Cu  with significantly higher levels of IL-6, IL-4 and TNF? in HIV infected females with or without therapy compared to Control at both phases of menstrual cycle (P&lt;0.05). The Zn levels was significantly higher in stage 2 HIV infected females on ART compared to their counterparts not on ART (P&lt;0.05). The significantly lower levels of Zn and Cu with increased levels of cytokines indicate immunosuppression and active inflammatory response in HIV infected females at both phases of menstrual cycle which was improved in the participants who were placed on ART. Keywords: Copper; Zinc; Immunological Implication; HIV; Menstrual cycle; Reproductive age

Active case finding and evaluation of IL-6 production among household contacts of pulmonary tuberculosis patients in a high disease setting

Background: Tuberculosis (TB) is a top infectious disease killer worldwide and remains a huge public health concern. However, most TB case findings are limited to self-referral (passive case finding), when individuals develop symptoms of TB. Only 15% of disease burden in Nigeria are reported. In view of this, it is important to assess the latent and active disease burden amongst HHC of TB patients suffering from pulmonary TB. In addition, it has been suggested that IL-6 levels could be used as a prognostic marker in exposed individuals. IL-6 levels were assessed in this cohort. Methods: A total of 205 subjects participated in this study, comprising 62 pulmonary TB index cases and 143 of their household contacts. Also, 54 apparently healthy subjects were recruited to serve as controls. Active case finding was performed amongst the HHC, using sputum and blood samples; they were tested for active TB. Blood samples were also collected for measuring IL-6 levels. Results: Findings reveal 6.3% previously undiagnosed active TB among the HHC of the TB patients and a significantly higher number of latently infected TB cases compared to the control population (p=0.0078). There were significant differences when comparing HIV co-infected index group to their HIV negative counterparts (P=0.032). Significantly different IL-6 levels were found among the study groups and sub-groups (p&lt;0.0001), with significantly higher levels in TB mono-infection compared to in TB/HIV co-infection (p=0.031).Conclusions: These results demonstrate the importance of active TB case finding for TB control and the possible role of IL-6 as a diagnostic marker in TB control.Unfunde

Active case finding and evaluation of IL-6 production among household contacts of pulmonary tuberculosis patients in a high disease setting

Background: Tuberculosis (TB) is a top infectious disease killer worldwide and remains a huge public health concern. However, most TB case findings are limited to self-referral (passive case finding), when individuals develop symptoms of TB. Only 15% of disease burden in Nigeria are reported. In view of this, it is important to assess the latent and active disease burden amongst HHC of TB patients suffering from pulmonary TB. In addition, it has been suggested that IL-6 levels could be used as a prognostic marker in exposed individuals. IL-6 levels were assessed in this cohort.Methods: A total of 205 subjects participated in this study, comprising 62 pulmonary TB index cases and 143 of their household contacts. Also, 54 apparently healthy subjects were recruited to serve as controls. Active case finding was performed amongst the HHC, using sputum and blood samples; they were tested for active TB. Blood samples were also collected for measuring IL-6 levels.Results: Findings reveal 6.3% previously undiagnosed active TB among the HHC of the TB patients and a significantly higher number of latently infected TB cases compared to the control population (p=0.0078). There were significant differences when comparing HIV co-infected index group to their HIV negative counterparts (P=0.032). Significantly different IL-6 levels were found among the study groups and sub-groups (p<0.0001), with significantly higher levels in TB mono-infection compared to in TB/HIV co-infection (p=0.031).Conclusions: These results demonstrate the importance of active TB case finding for TB control and the possible role of IL-6 as a diagnostic marker in TB control

Modulation of the immune response to Mycobacterium tuberculosis during malaria/M. tuberculosis co-infection

Tuberculosis (TB) causes significant morbidity and mortality on a global scale. The African region has 24% of the world's TB cases. TB overlaps with other infectious diseases such as malaria and HIV, which are also highly prevalent in the African region. TB is a leading cause of death among HIV-positive patients and co-infection with HIV and TB has been described as a syndemic. In view of the overlapping epidemiology of these diseases, it is important to understand the dynamics of the immune response to TB in the context of co-infection. We investigated the cytokine response to purified protein derivative (PPD) in peripheral blood mononuclear cells from TB patients co-infected with HIV or malaria and compared it to that of malaria- and HIV-free TB patients. A total of 231 subjects were recruited for this study and classified into six groups; untreated TB-positive, TB positive subjects on TB drugs, TB- and HIV-positive, TB- and malaria-positive, latent TB and apparently healthy control subjects. Our results demonstrate maintenance of interferon (IFN)-γ production in HIV and malaria co-infected TB patients in spite of lower CD4 counts in the HIV-infected cohort. Malaria co-infection caused an increase in the production of the T helper type 2 (Th2)-associated cytokine interleukin (IL)-4 and the anti-inflammatory cytokine IL-10 in PPD-stimulated cultures. These results suggest that malaria co-infection diverts immune response against M. tuberculosis towards a Th-2/anti-inflammatory response which might have important consequences for disease progression

Variation in The Antimicrobial Potency of Honey Samples from Different Sources

Background: Honey has been used for different purposes including management of wounds for centuries. Reports of considerable variations in the antimicrobial potency of honey samples from different sources exists but we found none from our sub-region. This comparative study tested the antibacterial activities of honey from five different sources in South-East Nigeria.Methodology: The study involved 23 isolates from surgical wounds. Honey samples from five different sources were procured from the farmers. In-vitro antibacterial activity using dilution technique was done with the five honey samples and standard antibiotic susceptibility tests as control. The results were analysed by simple statistical methods and compared.Results: All the honey samples inhibited the growth of isolates at neat concentration (without dilution) but their antimicrobial activities diminished as the samples were diluted. Honey samples from Chorophora excels (Iroko tree) and Pentachlethra macrophyla (oil bean tree) inhibited Proteus species at neat concentration only. Honey from rock inhibited methicillin resistant staphylococcus aureus (MRSA) at neat concentration only but honey&nbsp; from Anarechadium occidentale (Cashew tree) did same from a dilution of 1:2 and below. Escherichia coli, Pseudomonas species, Klebsiella species and Proteus were susceptible to Ciprofloxacin (used as quality control).Conclusion: This work shows that antibacterial activity of honey differs according to sources. Honeys from Anarchadium occidentale (cashew) and Vitex doniana (“uchakiri or eli-eli”) have higher efficacy in wound&nbsp; management than honeys from other sources in South-East Nigeri

Modulation of the immune response to Mycobacterium tuberculosis during malaria/M. tuberculosis co-infection

Tuberculosis (TB) causes significant morbidity and mortality on a global scale. The African region has 24% of the world's TB cases. TB overlaps with other infectious diseases such as malaria and HIV, which are also highly prevalent in the African region. TB is a leading cause of death among HIV-positive patients and co-infection with HIV and TB has been described as a syndemic. In view of the overlapping epidemiology of these diseases, it is important to understand the dynamics of the immune response to TB in the context of co-infection. We investigated the cytokine response to purified protein derivative (PPD) in peripheral blood mononuclear cells from TB patients co-infected with HIV or malaria and compared it to that of malaria- and HIV-free TB patients. A total of 231 subjects were recruited for this study and classified into six groups; untreated TB-positive, TB positive subjects on TB drugs, TB- and HIV-positive, TB- and malaria-positive, latent TB and apparently healthy control subjects. Our results demonstrate maintenance of interferon (IFN)-γ production in HIV and malaria co-infected TB patients in spite of lower CD4 counts in the HIV-infected cohort. Malaria co-infection caused an increase in the production of the T helper type 2 (Th2)-associated cytokine interleukin (IL)-4 and the anti-inflammatory cytokine IL-10 in PPD-stimulated cultures. These results suggest that malaria co-infection diverts immune response against M. tuberculosis towards a Th-2/anti-inflammatory response which might have important consequences for disease progression

Immuno-informatics design of a multimeric epitope peptide based vaccine targeting SARS-CoV-2 spike glycoprotein.

Developing an efficacious vaccine for SARS-CoV-2 infection is critical to stemming COVID-19 fatalities and providing the global community with immune protection. We have used a bioinformatic approach to aid in designing an epitope peptide-based vaccine against the spike protein of the virus. Five antigenic B cell epitopes with viable antigenicity and a total of 27 discontinuous B cell epitopes were mapped out structurally in the spike protein for antibody recognition. We identified eight CD8+ T cell 9-mers and 12 CD4+ T cell 14-15-mer as promising candidate epitopes putatively restricted by a large number of MHC I and II alleles, respectively. We used this information to construct an in silico chimeric peptide vaccine whose translational rate was highly expressed when cloned in pET28a (+) vector. With our In silico test, the vaccine construct was predicted to elicit high antigenicity and cell-mediated immunity when given as a homologous prime-boost, triggering of toll-like receptor 5 by the adjuvant linker. The vaccine was also characterized by an increase in IgM and IgG and an array of Th1 and Th2 cytokines. Upon in silico challenge with SARS-CoV-2, there was a decrease in antigen levels using our immune simulations. We, therefore, propose that potential vaccine designs consider this approach

Attenuated Subcomponent Vaccine Design Targeting the SARS-CoV-2 Nucleocapsid Phosphoprotein RNA Binding Domain: In Silico Analysis

The novel coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has previously never been identified with humans, thereby creating devastation in public health. The need for an effective vaccine to curb this pandemic cannot be overemphasized. In view of this, we designed a subcomponent antigenic peptide vaccine targeting the N-terminal (NT) and C-terminal (CT) RNA binding domains of the nucleocapsid protein that aid in viral replication. Promising antigenic B cell and T cell epitopes were predicted using computational pipelines. The peptides “RIRGGDGKMKDL” and “AFGRRGPEQTQGNFG” were the B cell linear epitopes with good antigenic index and nonallergenic property. Two CD8+ and Three CD4+ T cell epitopes were also selected considering their safe immunogenic profiling such as allergenicity, antigen level conservancy, antigenicity, peptide toxicity, and putative restrictions to a number of MHC-I and MHC-II alleles. With these selected epitopes, a nonallergenic chimeric peptide vaccine incapable of inducing a type II hypersensitivity reaction was constructed. The molecular interaction between the Toll-like receptor-5 (TLR5) which was triggered by the vaccine was analyzed by molecular docking and scrutinized using dynamics simulation. Finally, in silico cloning was performed to ensure the expression and translation efficiency of the vaccine, utilizing the pET-28a vector. This research, therefore, provides a guide for experimental investigation and validation