Altet Neus, Latorre Irene, Jiménez-Fuentes María Ángeles, Soriano-Arandes Antoni, Villar-Hernández Raquel, Milà Celia, Rodríguez-Fernández Pablo, Muriel-Moreno Beatriz, Comella-Del-Barrio Patricia, Godoy Pere, Millet Joan-Pau, de Souza-Galvão Maria Luiza, Jiménez-Ruiz Carlos A, Domínguez Jose
Unitat de Tuberculosi Vall d'Hebron-Drassanes, Hospital Universitari Vall d'Hebron, 08001 Barcelona, Spain.
Serveis Clínics, Unitat Clínica de Tractament Directament Observat de la Tuberculosi, 08022 Barcelona, Spain.
J Clin Med. 2022 Apr 2;11(7):2000. doi: 10.3390/jcm11072000.
Little is known about whether second-hand smoke (SHS) exposure affects tuberculosis (TB). Here, we investigate the association of cigarette smoke exposure with active TB and latent TB infection (LTBI) in children, analyzing Interferon-Gamma Release Assays' (IGRAs) performance and cytokine immune responses. A total of 616 children from contact-tracing studies were included and classified regarding their smoking habits [unexposed, SHS, or smokers]. Risk factors for positive IGRAs, LTBI, and active TB were defined. GM-CSF, IFN-γ, IL-2, IL-5, IL-10, IL-13, IL-22, IL-17, TNF-α, IL-1RA and IP-10 cytokines were detected in a subgroup of patients. Being SHS exposed was associated with a positive IGRA [aOR (95% CI): 8.7 (5.9-12.8)] and was a main factor related with LTBI [aOR (95% CI): 7.57 (4.79-11.94)] and active TB [aOR (95% CI): 3.40 (1.45-7.98)]. Moreover, IGRAs' sensitivity was reduced in active TB patients exposed to tobacco. IL-22, GM-CSF, IL-5, TNF-α, IP-10, and IL-13 were less secreted in LTBI children exposed to SHS. In conclusion, SHS is associated with LTBI and active TB in children. In addition, false-negative IGRAs obtained on active TB patients exposed to SHS, together with the decrease of specific cytokines released, suggest that tobacco may alter the immune response.
关于接触二手烟（SHS）是否会影响结核病（TB），目前所知甚少。在此，我们调查了儿童接触香烟烟雾与活动性结核病和潜伏性结核感染（LTBI）之间的关联，分析了干扰素-γ释放试验（IGRAs）的性能和细胞因子免疫反应。共有616名来自接触者追踪研究的儿童被纳入，并根据他们的吸烟习惯[未接触、接触二手烟或吸烟者]进行分类。确定了IGRAs阳性、LTBI和活动性结核病的危险因素。在一组患者中检测了GM-CSF、IFN-γ、IL-2、IL-5、IL-10、IL-13、IL-22、IL-17、TNF-α、IL-1RA和IP-10细胞因子。接触二手烟与IGRAs阳性相关[aOR（95%CI）：8.7（5.9-12.8）]，是与LTBI[aOR（95%CI）：7.57（4.79-11.94）]和活动性结核病[aOR（95%CI）：3.40（1.45-7.98）]相关的主要因素。此外，在接触烟草的活动性结核病患者中，IGRAs的敏感性降低。在接触二手烟的LTBI儿童中，IL-22、GM-CSF、IL-5、TNF-α、IP-10和IL-13的分泌较少。总之，二手烟与儿童的LTBI和活动性结核病相关。此外，在接触二手烟的活动性结核病患者中获得的IGRAs假阴性结果，以及特定细胞因子释放的减少，表明烟草可能会改变免疫反应。
