Probiotic-Based Therapy for Active Tuberculosis Infection: The Role of Gut-Lung Axis and Granulocyte Macrophage-Colony Stimulating Factor
Downloads
Tuberculosis is a global health problem with a total of 1.4 million cases in 2015. Over the last decade, several studies have demonstrated the potential role of gut-lung axis in the treatment of tuberculosis. The exact mechanism of the gut-lung axis on tuberculosis is still unknown, however modulation of the gut-lung axis can be performed via probiotic administration. The administered probiotics are capable of inducing an immunomodulating effect which helps in the process of tuberculosis infection. One of the molecules that can be activated with probiotics and plays a role in tuberculosis infection is granulocyte macrophage-colony stimulating factor (GM-CSF). GM-CSF can control intracellular production of M. tuberculosis, inflammation in granulomas, and lung tissue reparation. This article aimed to explore the role of the gut-lung axis, GM-CSF, and the potential of probiotic-based therapy on active tuberculosis infection. It was found that probiotics mediate the immune response via the activation of several inflammatory cytokines and interleukins related to lung infection, but not directly with the tuberculosis pathogen. Thus, probiotic-based therapy has the potential to increase immunity during active tuberculosis infection. Further studies to explore the other mechanisms of the gut-lung axis against tuberculosis through probiotic administration need to be performed.
WHO. Global Tuberculosis Report 2018. Global Tuberculosis Report 2017. 2017.
Depkes RI. Infodatin Tuberculosis. Kementerian Kesehatan RI. 2018;1.
AlSahafi AJ, Shah HBU, AlSayali MM, Mandoura N, Assiri M, Almohammadi EL, et al. High Non-Compliance Rate with Anti-Tuberculosis Treatment: A Need to Shift Facility-Based Directly Observed Therapy Short Course (DOTS) to Community Mobile Outreach Team Supervision in Saudi Arabia. BMC Public Health. 2019;19(1):1168.
Simmons JD, Stein CM, Seshadri C, Campo M, Alter G, Fortune S, et al. Immunological Mechanisms of Human Resistance to Persistent Mycobacterium tuberculosis Infection. Nature Reviews Immunology. 2018;18(9):575-89.
He Y, Wen Q, Yao F, Xu D, Huang Y, Wang J. Gut–Lung Axis: The Microbial Contributions and Clinical Implications. Critical Reviews in Microbiology. 2017;43(1):81-95.
Li W, Zhu Y, Liao Q, Wang Z, Wan C. Characterization of Gut Microbiota in Children with Pulmonary Tuberculosis. BMC Pediatrics. 2019;19(1):445.
Dumas A, Corral D, Colom A, Levillain F, Peixoto A, Hudrisier D, et al. The Host Microbiota Contributes to Early Protection against Lung Colonization by Mycobacterium tuberculosis. Frontiers in Immunology. 2018;9:2656.
Rothchild AC, Stowell B, Goyal G, Nunes-Alves C, Yang Q, Papavinasasundaram K, et al. Role of Granulocyte-Macrophage Colony-Stimulating Factor Production by T Cells during Mycobacterium tuberculosis Infection. MBio. 2017;8(5).
Zolnikova OY, Ivaschkin K, Bueverova E, Ivaschkin V. Intestinal Microbiota, Nutrients and Probiotics Viewed from the «Gut-Lung» Axis. Voprosy Pitaniia. 2019;88(3):13-22.
Horvath A, Leber B, Schmerboeck B, Tawdrous M, Zettel G, Hartl A, et al. Randomised Clinical Trial: The Effects of a Multispecies Probiotic vs. Placebo on Innate Immune Function, Bacterial Translocation and Gut Permeability in Patients with Cirrhosis. Alimentary Pharmacology & Therapeutics. 2016;44(9):926-35.
McAleer JP, Kolls JK. Contributions of the Intestinal Microbiome in Lung Immunity. European Journal of Immunology. 2018;48(1):39-49.
Ma Y, Yang X, Chatterjee V, Wu M, Yuan SY. The Gut-Lung Axis in Systemic Inflammation: Role of Mesenteric Lymph as Conduit. American Journal of Respiratory Cell and Molecular Biology. 2020(ja).
Hu Y, Yang Q, Liu B, Dong J, Sun L, Zhu Y, et al. Gut Microbiota Associated with Pulmonary Tuberculosis and Dysbiosis Caused by Anti-Tuberculosis Drugs. Journal of Infection. 2019;78(4):317-22.
Khan N, Mendonca L, Dhariwal A, Fontes G, Menzies D, Xia J, et al. Intestinal Dysbiosis Compromises Alveolar Macrophage Immunity to Mycobacterium tuberculosis. Mucosal immunology. 2019;12(3):772-83.
Negi S, Pahari S, Bashir H, Agrewala JN. Gut Microbiota Regulates Mincle Mediated Activation of Lung Dendritic Cells to Protect against Mycobacterium tuberculosis. Frontiers in Immunology. 2019;10:1142.
Geva-Zatorsky N, Sefik E, Kua L, Pasman L, Tan TG, Ortiz-Lopez A, et al. Mining the Human Gut Microbiota for Immunomodulatory Organisms. Cell. 2017;168(5):928-43. e11.
Samuelson DR, Welsh DA, Shellito JE. Regulation of Lung Immunity and Host Defense by the Intestinal Microbiota. Frontiers in Microbiology. 2015;6:1085.
Hamilton JA. GM-CSF-Dependent Inflammatory Pathways. Frontiers in Immunology. 2019;10:2055.
Robinson RT. T Cell Production of GM-CSF Protects the Host during Experimental Tuberculosis. MBio. 2017;8(6).
Piergallini TJ, Turner J. Tuberculosis in the Elderly: Why Inflammation Matters. Experimental Gerontology. 2018;105:32-9.
Scriba TJ, Penn-Nicholson A, Shankar S, Hraha T, Thompson EG, Sterling D, et al. Sequential Inflammatory Processes Define Human Progression from M. tuberculosis Infection to Tuberculosis Disease. PLoS pathogens. 2017;13(11):e1006687.
Benmerzoug S, Marinho FV, Rose S, Mackowiak C, Gosset D, Sedda D, et al. GM-CSF Targeted Immunomodulation Affects Host Response to M. tuberculosis Infection. Scientific Reports. 2018;8(1):1-15.
Tazawa R, Ueda T, Abe M, Tatsumi K, Eda R, Kondoh S, et al. Inhaled GM-CSF for Pulmonary Alveolar Proteinosis. New England Journal of Medicine. 2019;381(10):923-32.
Bryson BD, Rosebrock TR, Tafesse FG, Itoh CY, Nibasumba A, Babunovic GH, et al. Heterogeneous GM-CSF Signaling in Macrophages is Associated with Control of Mycobacterium tuberculosis. Nature Communications. 2019;10(1):1-11.
Kaufmann SH, Lange C, Rao M, Balaji KN, Lotze M, Schito M, et al. Progress in Tuberculosis Vaccine Development and Host-Directed Therapies”A State of the Art Review. The Lancet Respiratory Medicine. 2014;2(4):301-20.
Gupta N, Kumar R, Agrawal B. New Players in Immunity to Tuberculosis: The Host Microbiome, Lung Epithelium, and Innate Immune Cells. Frontiers in Immunology. 2018;9:709.
Mishra A, Singh VK, Actor JK, Hunter RL, Jagannath C, Subbian S, et al. GM-CSF Dependent Differential Control of Mycobacterium tuberculosis Infection in Human and Mouse Macrophages: Is Macrophage Source of GM-CSF Critical to Tuberculosis Immunity? Frontiers in Immunology. 2020;11:1599.
Cheng H, Guan X, Chen D, Ma W. The Th17/Treg Cell Balance: A Gut Microbiota-Modulated Story. Microorganisms. 2019;7(12):583.
Khan R, Petersen FC, Shekhar S. Commensal Bacteria: An Emerging Player in Defense against Respiratory Pathogens. Frontiers in Immunology. 2019;10:1203.
Brown RL, Sequeira RP, Clarke TB. The Microbiota Protects against Respiratory Infection via GM-CSF Signaling. Nature Communications. 2017;8(1):1-11.
Suprapti B, Suharjono S, Raising R, Yulistiani Y, Izzah Z, Nilamsari WP, et al. Effects of Probiotics and Vitamin B Supplementation on IFN-γ and IL-12 Levels During Intensive Phase Treatment of Tuberculosis. Indonesian Journal of Pharmacy. 2018;29(2):80.
Robak OH, Heimesaat MM, Kruglov AA, Prepens S, Ninnemann J, Gutbier B, et al. Antibiotic Treatment–Induced Secondary IgA Deficiency Enhances Susceptibility to Pseudomonas aeruginosa pneumonia. The Journal of Clinical Investigation. 2018;128(8):3535-45.
Belkacem N, Serafini N, Wheeler R, Derrien M, Boucinha L, Couesnon A, et al. Lactobacillus paracasei Feeding Improves Immune Control of Influenza Infection in Mice. PloS one. 2017;12(9):e0184976.
Youn H-N, Lee D-H, Lee Y-N, Park J-K, Yuk S-S, Yang S-Y, et al. Intranasal Administration of Live Lactobacillus Species Facilitates Protection against Influenza Virus Infection in Mice. Antiviral Research. 2012;93(1):138-43.
Khailova L, Baird CH, Rush AA, McNamee EN, Wischmeyer PE. Lactobacillus rhamnosus GG Improves Outcome in Experimental Pseudomonas aeruginosa pneumonia: Potential Role of Regulatory T cells. Shock (Augusta, Ga). 2013;40(6):496.
Martens K, Pugin B, De Boeck I, Spacova I, Steelant B, Seys S, et al. Probiotics for the Airways: Potential to Improve Epithelial and Immune Homeostasis. Allergy. 2018;73(10):1954-63.
Vieira AT, Rocha VM, Tavares L, Garcia CC, Teixeira MM, Oliveira SC, et al. Control of Klebsiella pneumoniae Pulmonary Infection and Immunomodulation by Oral Treatment with the Commensal Probiotic Bifidobacterium longum 51A. Microbes and Infection. 2016;18(3):180-9.
Lin S, Zhao S, Liu J, Zhang J, Zhang C, Hao H, et al. Efficacy of Proprietary Lactobacillus casei for Anti-Tuberculosis Associated Gastrointestinal Adverse Reactions in Adult Patients: A Randomized, Open-Label, Dose–Response Trial. Food & Function. 2020;11(1):370-7.
Copyright (c) 2021 Made Indira Dianti Sanjiwani, Nyoman Budhi Wirananda Setiawan, Agus Indra Yudhistira Diva Putra, Agus Eka Darwinata
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
1. The journal allows the author to hold the copyright of the article without restrictions.
2. The journal allows the author(s) to retain publishing rights without restrictions.
3. The legal formal aspect of journal publication accessibility refers to Creative Commons Attribution Share-Alike (CC BY-SA).
4. The Creative Commons Attribution Share-Alike (CC BY-SA) license allows re-distribution and re-use of a licensed work on the conditions that the creator is appropriately credited and that any derivative work is made available under "the same, similar or a compatible license”. Other than the conditions mentioned above, the editorial board is not responsible for copyright violation.