Monocyte to lymphocyte blood ratio in tuberculosis and HIV patients: Comparative analysis, preliminary data

Recent data confirmed the hypothesis suggested by historical studies that the ratio of peripheral blood monocytes to lymphocytes (M/L) is associated with the risk of tuberculosis (TB) disease. We retrospectively analyzed the electronic health records of tuberculosis and HIV-positive patients who had followed day-care programs at the AIDS Center of the University of Palermo, Italy. 261 patients were recruited and divided into 6 groups as follows: healthy control group (HCG: 47 pts), latent HIV negative infected TB group (LIG, 43 pts), active HIV negative tuberculosis (TAG: 61 pts), treated tuberculosis HIV negative (TTG: 44 pts), HIV drug-naive patients tested TST and QFT-IT-negative with negative chest x-Ray (HIVnG: 44 pts), and HIV-tuberculosis coinfection (HIVTB-G: 22 pts). For each group, absolute lymphocyte (L), monocyte (M) and M/L ratio by peripheral blood was calculated. The mean value of monocytes in the TAG group was significant, the highest (0.70\uc2\ub10.37 1x103/\uce\ubcl) in comparison to HGC (0.70>0.44, p-value <0.05), HIVnG (0.70>0.40, p-value <0.05) and HIVTB-G (0.70>0.45, p-value<0.05). Monocyte to lymphocyte blood RATIO showed a significant difference between groups (p-value <0.001). In particular, the mean score of M/L ratio was higher in the TAG group compared to the HGC (0.49>0.27, p-value<0.05), LIG (0.49>0.29, p-value<0.05), TTG (0.49>0.32) and HIVTB-G groups (0.49>0.27, p-value<0.05). Our data confirm a significant difference in monocyte to lymphocyte blood ratio in tuberculosis disease. These data may be useful for monitoring and revising implementation plans for the different phases of tuberculosis disease (latent Mycobacterium tuberculosis (MTB) infection versus TB active disease). Regarding HIV samples, the small sample size is somewhat offset by the need, fully satisfied in our sample, to enlist specific patients such as co-infected HIV/TBC who voluntarily submit to clinical trials in our geographical area

MONOCYTES MACROPHAGES EXPRESSION OF Ml OR M2 PHENOTYPES IN LATENT TUBERCULOSIS, ACTIVE DISEASES AND UNINFECTED MIGRANTS AND SICILIAN PATIENTS

The high grade ofphenotype plasticity of monocytes macrophages, is resumed in two different cell subsets named M1 or M2. Several studies of microbial infections in vitro and in vivo, showed that, during the early stage of infection, macrophages are polarized toward Ml phenotype that should be protective against pathogen, while during the chronic phase of infection/disease macrophages polarize toward M2 phenotype to avoid damages from a prolonged Ml type activation.Obiettivo: In order to investigate if Mycobacterium tuberculosis infection can drive circulating monocytes toward the expression of Ml or M2 phenotypes, we have analyzed by flow cytometry monocytes obtained from patients with active tuberculosis (TB) at early phase of disease and during anti mycobacterial therapy, subjects with latent TB and healthy uninfected control. Risultatil Analysis of surface markers expression showed no clearcut Ml/M2 polarization in all tested groups, but we found a very high percentage of RANK+ monocytes in patients with active TB disease before treatment, while RANK expression was very faint in monocytes from all other experimental groups. Moreover the statistical analysis of geometric MFI of RANK showed a signif\ueccant difference between patients with active disease compared to all the others groups. Conclusioni: Given that the available in vitro diagnostic tests are limited in discriminating subjects with latent or active disease, as well as response to therapy,,we speculate that the evaluation of RANK expression on monocytes could represent an additional biomarker useful to support diagnosis of active disease and monitor the response to therapy