Immunological Interactions between Intestinal Helminth Infections and Tuberculosis

Khethiwe Nomcebo Bhengu; Pragalathan Naidoo; Ravesh Singh; Miranda N Mpaka-Mbatha; Nomzamo Nembe; Zamathombeni Duma; Roxanne Pillay; Zilungile L Mkhize-Kwitshana

doi:10.3390/diagnostics12112676

Immunological Interactions between Intestinal Helminth Infections and Tuberculosis

Diagnostics (Basel). 2022 Nov 4;12(11):2676. doi: 10.3390/diagnostics12112676.

Authors

Khethiwe Nomcebo Bhengu^{1

2

3}, Pragalathan Naidoo^{1

2}, Ravesh Singh⁴, Miranda N Mpaka-Mbatha^{1

2

3}, Nomzamo Nembe^{1

2}, Zamathombeni Duma^{1

2}, Roxanne Pillay^{1

2

3}, Zilungile L Mkhize-Kwitshana^{1

2}

Affiliations

¹ Department of Medical Microbiology, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban 4001, South Africa.
² Division of Research Capacity Development, South African Medical Research Council (SAMRC), Cape Town 7505, South Africa.
³ Department of Biomedical Sciences, Faculty of Natural Sciences, Mangosuthu University of Technology, Umlazi, Durban 4031, South Africa.
⁴ Department of Medical Microbiology, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, Howard College, University of KwaZulu-Natal, Durban 4041, South Africa.

Abstract

Helminth infections are among the neglected tropical diseases affecting billions of people globally, predominantly in developing countries. Helminths' effects are augmented by coincident tuberculosis disease, which infects a third of the world's population. The role of helminth infections on the pathogenesis and pathology of active tuberculosis (T.B.) remains controversial. Parasite-induced suppression of the efficacy of Bacille Calmette-Guerin (BCG) has been widely reported in helminth-endemic areas worldwide. T.B. immune response is predominantly proinflammatory T-helper type 1 (Th1)-dependent. On the other hand, helminth infections induce an opposing anti-inflammatory Th2 and Th3 immune-regulatory response. This review summarizes the literature focusing on host immune response profiles during single-helminth, T.B. and dual infections. It also aims to necessitate investigations into the complexity of immunity in helminth/T.B. coinfected patients since the research data are limited and contradictory. Helminths overlap geographically with T.B., particularly in Sub-Saharan Africa. Each disease elicits a response which may skew the immune responses. However, these effects are helminth species-dependent, where some parasites have no impact on the immune responses to concurrent T.B. The implications for the complex immunological interactions that occur during coinfection are highlighted to inform government treatment policies and encourage the development of high-efficacy T.B. vaccines in areas where helminths are prevalent.

Keywords: Bacille Calmette-Guerin; Mycobacterium tuberculosis; coinfection; helminths; immune response; vaccination.

Publication types

Review

Grants and funding

Research reported in this publication was supported by the South African Medical Research Council (SAMRC) through its Division of Research Capacity Development under the Research Capacity Development Initiative from funding received from the South African National Treasury. The content and findings reported/illustrated are the sole deduction, view and responsibility of the researchers and do not reflect the official position and sentiments of the SAMRC.