muramidase and Tuberculosis--Pulmonary

The airway provides numerous defense mechanisms to prevent microbial colonization by the large numbers of bacteria and viruses present in ambient air. An important component of this defense is the antimicrobial peptides and proteins present in the airway surface fluid (ASF), the mucin-rich fluid covering the respiratory epithelium. These include larger proteins such as lysozyme and lactoferrin, as well as the cationic defensin and cathelicidin peptides. While some of these peptides, such as human beta-defensin (hBD)-1, are present constitutively, others, including hBD2 and -3 are inducible in response to bacterial recognition by Toll-like receptor-mediated pathways. These peptides can act as microbicides in the ASF, but also exhibit other activities, including potent chemotactic activity for cells of the innate and adaptive immune systems, suggesting they play a complex role in the host defense of the airway. Inhibition of antimicrobial peptide activity or gene expression can result in increased susceptibility to infections. This has been observed with cystic fibrosis (CF), where the CF phenotype leads to reduced antimicrobial capacity of peptides in the airway. Pathogenic virulence factors can inhibit defensin gene expression, as can environmental factors such as air pollution. Such an interference can result in infections by airway-specific pathogens including Bordetella bronchiseptica, Mycobacterium tuberculosis, and influenza virus. Research into the modulation of peptide gene expression in animal models, as well as the optimization of peptide-based therapeutics shows promise for the treatment and prevention of airway infectious diseases.

Topics: Animals; Antimicrobial Cationic Peptides; Cathelicidins; Cystic Fibrosis; Defensins; Disease Models, Animal; Humans; Lactoferrin; Muramidase; Proteinase Inhibitory Proteins, Secretory; Proteins; Respiratory System; Toll-Like Receptors; Tuberculosis, Pulmonary; Virus Diseases

The current state of knowledge of lung defenses has been reviewed. First, mechanical factors such as aerodynamic filtration and mucociliary transport were considered. Then, in general terms, the contributions of alveolar macrophages, neutrophils, lymphocytes, and immunoglobulins, and the roles of complement, antiproteases, lysozyme, and fibronectin were examined. Interactions between these components may regulate their effect. Finally, the responses to five specific microorganisms were reviewed to illustrate different aspects of the lung's defenses. Streptococcus pneumoniae was selected as a representative extracellular bacterial pathogen, Mycobacterium tuberculosis as an intracellular bacterial pathogen, Mycoplasma pneumoniae because it elicits significant humoral and cell-mediated immunity, respiratory syncytial virus as an example of a local viral pathogen, and measles as a viral pathogen that causes generalized disease. It was shown that these responses may not always be beneficial for the host. For each of the five infections, recommendations for improving the outcome were made.

Topics: Cilia; Complement System Proteins; Fibronectins; Filtration; Humans; Immunoglobulins; Lung; Lymphocytes; Macrophages; Measles; Mucus; Muramidase; Neutrophils; Phagocytosis; Pneumonia, Mycoplasma; Pneumonia, Pneumococcal; Pneumonia, Viral; Protease Inhibitors; Respiratory Tract Infections; Respirovirus Infections; Tuberculosis, Pulmonary

Topics: Anaphylaxis; Anti-Glomerular Basement Membrane Disease; Antigen-Antibody Complex; Asthma; Complement System Proteins; Cytotoxicity, Immunologic; Humans; Immunoglobulins; Interferons; Lactoferrin; Leukocytes; Lung; Macrophages; Muramidase; Phagocytosis; Reagins; Respiratory Hypersensitivity; Rhinitis, Allergic, Seasonal; Sarcoidosis; Tuberculosis, Pulmonary

A procedure has been developed to detect antilysozymatic activity n L forms of Mycobacterium tuberculosis (MBT). A mode of predicting the course of a tuberculosis process in the lungs by the degree of antilysozymatic activity of MBT is outlined. Thus, when the level is 4 micrograms/ml or higher, progression or exacerbation of tuberculosis is predicted, when that of 0-3 micrograms/ml, a good prognosis is expected.

Topics: Adult; Aged; Anti-Bacterial Agents; Female; Humans; L Forms; Male; Middle Aged; Muramidase; Mycobacterium tuberculosis; Prognosis; Tuberculosis, Pulmonary

The estimations of adenosine deaminase (ADA) activity and lysozyme (LYS) levels in pleural fluid have been proved useful tools in the diagnosis of tuberculous pleural effusions. Little is known about their usefulness when estimated in bronchoalveolar lavage fluid (BALF).. To evaluate whether both ADA activity and LYS levels in BALF could be employed in the diagnosis of pulmonary tuberculosis, and especially in active but acid fast bacilli (AFB) smear negative cases.. ADA activity and LYS levels were determined in BALF and serum obtained on the same day in 28 patients with tuberculosis, 21 with interstitial lung diseases, 14 with lung cancer and 13 with infectious diseases.. Patients with pulmonary tuberculosis had significantly higher ADA activity in BALF than patients with non-tuberculous lung diseases (P < 0.001). High BALF ADA activity in pulmonary tuberculosis patients suggests increased local production. In contrast, in this group of patients BALF LYS levels were not significantly higher than in the other groups of patients, but were in the group with interstitial lung diseases.. BALF ADA activity seems to be a useful tool in the differentiation of tuberculosis from other lung diseases. Its estimation can be restricted to the detection of cases with AFB negative smears.

Topics: Adenosine Deaminase; Bronchoalveolar Lavage Fluid; Carcinoma, Bronchogenic; Case-Control Studies; Clinical Enzyme Tests; Diagnosis, Differential; Female; Humans; Lung Diseases; Lung Diseases, Interstitial; Lung Neoplasms; Male; Middle Aged; Muramidase; Tuberculosis, Pulmonary

Tuberculosis Research Centre, Indian Council of Medical Research, Madras, India.. To elucidate the role of HLA-Class II genes/gene products on phagocyte enzymes such as lysozyme, beta-glucuronidase and acid phosphatase in the plasma of pulmonary tuberculosis patients.. Serological determination of HLA-DR and -DQ antigens was carried out in 54 active and 84 inactive pulmonary tuberculosis (quiescent) patients and 36 healthy control subjects. The levels of lysozyme, beta-glucuronidase and acid phosphatase were measured in the plasma of tuberculosis patients and control subjects.. Increased lysozyme levels were observed in active pulmonary tuberculosis patients. beta-glucuronidase activity was higher in inactive-TB than in active-TB patients and control subjects. HLA-DR2 positive patients showed a lower lysozyme level than -DR2 negative patients.. Increase in the plasma lysozyme level in active TB reveals the active stage of the disease. Further, increase in the activity of beta-glucuronidase in inactive-TB patients reveals the quiescent stage of the disease. The low level of lysozyme in HLA-DR2 positive patients may also be one of the possible factors involved in susceptibility to tuberculosis.

Topics: Acid Phosphatase; Adult; Female; Glucuronidase; Histocompatibility Testing; HLA-DR2 Antigen; Humans; Male; Middle Aged; Muramidase; Phenotype; Prognosis; Tuberculosis, Pulmonary

The defence factors against infection in sputum and bronchoalveolar lavage fluid (BALF) of patients with pulmonary tuberculosis were measured. As the defence factors, lactoferrin, lysozyme and secretory IgA (sIgA) in sputum or BALF of patients with bacilli (+) or (-) tuberculosis were measured and compared. Lactoferrin in sputum was significantly higher in patients with sputum smear positive tuberculosis compared with patients with smear and culture negative tuberculosis. SIgA in sputum was significantly higher in smear negative and culture positive cases compared with culture negative cases. As to the lysozyme in sputum, significant difference was not proved between each group. The level of these factors in BALF did not show significant difference between bacilli (+) and (-) cases. Neither significant correlation was observed among the level of three defence factors in sputum or BALF, nor between the number of leucocyte and tubercle bacilli in sputum. In tubercle bacilli positive group, however, significant positive correlation between the number of leucocyte and lactoferrin in sputum was found. In vitro experiments, high concentration of lactoferrin or lysozyme inhibited the growth of standard strain of tubercle bacilli (H37Rv) and BCG. The results suggest that the measurement of lactoferrin, lysozyme and sIgA in sputum or BALF is useful to determine the clinical activity of tuberculosis.

Topics: Bronchoalveolar Lavage Fluid; Humans; Immunoglobulin A, Secretory; Lactoferrin; Muramidase; Mycobacterium tuberculosis; Sputum; Tuberculosis, Pulmonary

The relationship between expression of lysozyme and tuberculosis lesions was studied in 132 patients. The positive rate of lysozyme expression in 132 tuberculosis cases was 83.3%. Lysozyme was mainly distributed intracellularly, and the positive rates in different types, i.e. in cases with lesions of caseous necrosis, cellular nodes, and fibroid nodes were 90.1%, 79.3% and 63.3% respectively (P < 0.05 between lesions of caseous necrosis and fibroid nodes). The positive rate of lysozyme in cases of infection associated with L-form tubercule bacillus was 64.4%, which was higher in cases with positive L-form antigen than that in antigen negative cases (P < 0.025). The results indicated that expression of lysozyme was rather active, and might be considered as a marker for the prognosis of tuberculosis treatment.

Topics: Biomarkers; Biopsy; Humans; L Forms; Muramidase; Mycobacterium tuberculosis; Tuberculosis, Pulmonary

To evaluate the local immune response in lung and activity of pulmonary tuberculosis. Broncho-alveolar lavage (BAL) was performed on 15 patients with pulmonary tuberculosis. Patients consisted of nine in the active stage and six in the inactive stage. Acid-fast bacilli (AFB) in BAL fluid (BALF) were found in six out of nine active stage patients (BAL-AFB positive group). The results obtained were as follows; 1) The number of total cells in BALF increased significantly in BAL-AFB positive group. BALF from two patients of this group, who were in the very early stage, revealed that the lymphocytes increased predominantly whereas neutrophils were dominant in BALF from the other four patients. 2) No case showed increase of B cells in BALF. Lymphocytes surface markers were compared between BAL-AFB positive and negative groups. No difference was found in the numbers of OKT3, OKT4 and OKT8. The positive rates of OKIal, and OKT4/8 ratio were both increased in BALF compared to the BAL-AFB positive group. 3) The numbers of OKT4 and OKT4/8 ratio in peripheral blood, which were taken simultaneously with BAL, were decreased in patients in the active stage. 4) Protein, albumin, IgG, IgA, lysozyme and alpha 1-antitrypsin levels in BALF were all increased in tuberculous patients. No correlation between the activity of tuberculosis and levels of protein, albumin, IgG and IgA was observed. Lysozyme level increased in the inactive stage of patients. On the other hand alpha 1-antitrypsin level increased in the active stage. Fibronectin level in BALF from patients was lower than that from normal controls. 5) Smoking habit had no influence on the above results. 6) Only one case showed the appearance of new lesions after BAL procedure as a complication.

Topics: Adult; Aged; Aged, 80 and over; Bronchoalveolar Lavage Fluid; Fibronectins; Humans; Middle Aged; Muramidase; T-Lymphocyte Subsets; Tuberculosis, Pulmonary

Local protection in patients with complicated tuberculosis was investigated. The bronchoalveolar lavage fluid (BALF) was tested for the levels of IgA, sIgA, IgM, IgG, lysozyme, activity of granulocyte proteinases (elastase and trypsin-like proteinases) and their acid-fast inhibitors, ability to produce interferons by the BALF cells, the BALF cell composition and functional activity of alveolar macrophages. The local protection was shown to be decreased in the patients with nonspecific inflammatory processes in the bronchi. The decrease was especially pronounced in the patients with purulent endobronchitis. The data indicated the necessity of using immunocorrectors in combined therapy of such patients.

Topics: Adjuvants, Immunologic; Bronchitis; Bronchoalveolar Lavage Fluid; Humans; Immunoglobulins; Interferons; Muramidase; Tuberculosis, Pulmonary

Own experiences in practical application of immunohistochemistry are demonstrated in cases of lung fibrosis, sarcoidosis, tuberculosis and allergic vasculitis. Methods for demonstration of immunoglobulins (IgG, IgE) are useful in diagnosis of allergic vasculitis (IgG) and allergic alveolitis (IgE). Lysozyme is an important morphological parameter for the estimation of the activity of sarcoidosis. First results of application of antisera against mycobacteria and Kveim antigen are discussed in respect to more precise differential diagnosis of granulomatous lung diseases (sarcoidosis, tuberculosis).

Topics: Alveolitis, Extrinsic Allergic; Antigens, Bacterial; Humans; Immunoglobulins; Immunohistochemistry; Lung; Lung Diseases; Muramidase; Mycobacterium; Pulmonary Fibrosis; Sarcoidosis; Tuberculosis, Pulmonary; Vasculitis

We have determined simultaneously the ADAp and Lp/Ls ratio in 138 pleural effusions: 61 tuberculous; 42 malignant; 14 transudates; five parapneumonic uncomplicated; six empyematous; and ten cases belonging to a miscellaneous group which included two disseminated lupus erythematosus; two posttraumatic; one pancreatitis; one pleuropericarditis by Mycoplasma; one viral pleuropericarditis; and three pulmonary embolisms. This has allowed us to clear the overlapping for the ADAp activity among tuberculous patients (two cases of lupus and three cases of malignant effusions) in our series. The overlap in the Lp/Ls ratio among tuberculous patients, two malignant, and two parapneumonic uncomplicated cases was also cleared. Fixing the ADAp values at 33 U and the Lp/Ls ratio at 1.2, the tuberculous pleural effusion cases were differentiated from the nontuberculous with a sensibility, positive predictive value, negative predictive value, and safety diagnosis of 100 percent. It has been proven that there is a good correlation between ADAp and Lp/Ls ratio (r = 0.717) and the ADAp and Lp (r = 0.660).

Topics: Adenosine Deaminase; Adolescent; Adult; Child; Empyema; Female; Humans; Lung Diseases; Lung Neoplasms; Male; Middle Aged; Muramidase; Nucleoside Deaminases; Pleural Effusion; Tuberculosis, Pulmonary

Topics: False Positive Reactions; Female; Humans; Middle Aged; Muramidase; Pleural Effusion; Tuberculosis, Pulmonary

Topics: Adenosine Deaminase; alpha-2-HS-Glycoprotein; Blood Proteins; Carcinoembryonic Antigen; Diagnosis, Differential; Ferritins; Humans; Hydrothorax; Lung Neoplasms; Muramidase; Neoplasm Proteins; Peptides; Tissue Polypeptide Antigen; Tuberculosis, Pulmonary

Topics: Adolescent; Adult; Aged; Female; Humans; Male; Middle Aged; Muramidase; Tuberculosis, Pulmonary

The importance of immunologic factors in the local defense against myobacterial disease derives from different mechanisms of action. These may be characterized as follows: mycobacteria act as antigens or antigenic fragments to cause local sensitization, activation, and proliferation of T-lymphocytes leading to the formation of giant cells of Langhans' type. Antibodies play a role only as opsonines and are not directly responsible for the destruction of the invading organisms. Lymphokines on the other hand activate connective tissue cells and thereby contribute to the walling of infection and the development of scar tissue.

Topics: Antibody Formation; Antigens, Bacterial; Humans; Immunity, Cellular; Immunoglobulins; Lung; Lymphokines; Macrophage Activation; Muramidase; Mycobacterium tuberculosis; Phagocytosis; Tuberculoma; Tuberculosis, Pulmonary

Topics: Adult; Chronic Disease; Clinical Enzyme Tests; Diagnosis, Differential; Female; Humans; Lung Diseases; Male; Middle Aged; Muramidase; Tuberculosis, Pulmonary

After a summary of the aspecific defensive host mechanisms against bacteria, Author examines the granulocytes structure containing A and B granules, and he observes that phagocytosis is different in extension and in significance into granulocytes or into macrophages. Particularly, M. tuberculosis can survive and multiply into macrophages. This fact can explain the further pathologic tubercular manifestations, that morphologically are dominated by granulomas forming. Activated macrophages are important in granulomas forming, but also the rôle of a specific response needs be considered. From an attentive investigation of recent literature, we can demonstrate that T lymphocytes are the main defending agents against M. tuberculosis, through interaction with macrophages. This picture is a step forward to understand the antitubercular defensive mechanisms and it is a useful acquisition also in clinical practice.

Topics: Cell Communication; Cytoplasmic Granules; Granuloma; Humans; Macrophage Activation; Macrophages; Muramidase; Phagocytosis; T-Lymphocytes; Tuberculosis, Pulmonary; Virulence

Topics: Adult; Aged; Humans; Middle Aged; Muramidase; Sarcoidosis; Tuberculosis, Pulmonary

Topics: Adolescent; Adult; Aged; Diagnosis, Differential; Female; Humans; Lung Neoplasms; Male; Middle Aged; Muramidase; Pleural Effusion; Pleurisy; Pneumonia; Tuberculosis, Pulmonary

We studied the value of serum lysozyme as a helpful test in distinguising tuberculous involvement of intrathoracic glands from lymphoma. Nineteen of the 28 patients (all Asian immigrants) with intrathoracic glandular tuberculosis had raised serum lysozyme level as compared with 2 of the 29 patients with lymphoma. While a normal serum lysozyme level is unhelpful, a raised level in an Asian immigrant with hilar or mediastinal lymphadenopathy makes tuberculosis a highly probable diagnosis.

Topics: Africa, Eastern; Bronchial Neoplasms; Clinical Enzyme Tests; Diagnosis, Differential; Female; Humans; India; Lymphatic Diseases; Lymphoma; Male; Muramidase; Sarcoidosis; Thoracic Neoplasms; Tuberculosis, Lymph Node; Tuberculosis, Pulmonary; Wales

Topics: Adolescent; Adult; Aged; Female; Humans; Immunity, Innate; Leukocytes; Male; Middle Aged; Muramidase; Phagocytosis; Recurrence; Tuberculosis, Pulmonary

Serum angiotensin-converting enzyme (ACE) activity was studied in healthy controls, in 57 untreated sarcoidosis patients, and in 164 patients with other chest or lymph node diseases. The serum ACE activity of healthy persons was independent of sex, intake of meals, and smoking habits. There were no diurnal variations. Healthy children had a significantly higher ACE mean value than adults, whose ACE activity was not affected by age. The sarcoidosis patients had the highest ACE mean values, but those of patients with silicosis and asbestosis were also significantly elevated. Pulmonary cancer patients had decreased serum ACE activity, which was probably due to antimitotic treatment. Serum lysozyme (LZM) concentrations did not correlate with normal ACE activity, but the correlation between elevated ACE and LZM was significant in sarcoidosis and silicosis, and the trend was clearly the same for asbestosis. This indicates separate sources for these enzymes when ACE activity is normal, and a common source, i.e. macrophages, when ACE activity is increased. ACE production in certain diseases involving macrophages may be due to the bradykinin inhibiting effect of this enzyme.

Topics: Adolescent; Adult; Alveolitis, Extrinsic Allergic; Asbestosis; Bronchitis; Female; Hodgkin Disease; Humans; Lung Diseases; Lung Neoplasms; Lymphatic Diseases; Lymphoma; Male; Middle Aged; Muramidase; Peptidyl-Dipeptidase A; Pneumonia; Pulmonary Fibrosis; Sarcoidosis; Silicosis; Thoracic Neoplasms; Tuberculosis, Lymph Node; Tuberculosis, Pulmonary

Topics: Carcinoembryonic Antigen; Humans; Lung Neoplasms; Muramidase; Neoplasm Metastasis; Pleural Effusion; Tuberculosis, Pleural; Tuberculosis, Pulmonary

Topics: Adolescent; Adult; Child; Female; Humans; Male; Middle Aged; Muramidase; Tuberculosis, Pulmonary

Topics: Adult; Aged; Female; Humans; Male; Middle Aged; Muramidase; Tuberculosis, Pulmonary

Serum lysozyme (muramidase) concentrations were determined in 55 patients with inflammatory bowel disease, 6 with miscellaneous bowel disease, 40 with pulmonary tuberculosis, and in 20 normal subjects. The mean (+/- SE) lysozyme concentration for each group was as follows: controls 6,95 +/- 0,36 microgram/ml; ulcerative colitis 9,61 +/- 1,02 microgram/ml; inactive Crohn's disease 7,61 +/- 0,53 microgram/ml; active Crohn's disease 20,77 +/- 2,17 microgram/ml; sputum-negative tuberculosis 13,05 +/- 1,06 microgram/ml; and sputum-positive tuberculosis 20,35 +/- 2,08 microgram/ml. The mean enzyme levels were significantly higher in patients with Crohn's disease than in those with ulcerative colitis (P less than 0,05) or in normal controls (P less than 0,01). Our findings suggest that serum lysozyme levels may be useful in differentiating active Crohn's disease from ulcerative colitis, but the results overlap somewhat. However, the enzyme level may be a useful index of disease activity in following up patients with Crohn's disease. As tuberculosis is endemic in this country it must first be excluded, because patients with pulmonary tuberculosis have similarly high levels of serum lysozyme.

Topics: Adolescent; Adult; Aged; Colitis, Ulcerative; Crohn Disease; Female; Humans; Intestinal Diseases; Male; Middle Aged; Muramidase; Tuberculosis, Pulmonary

Topics: Adolescent; Adult; Aged; Antibodies; Blood Bactericidal Activity; Complement System Proteins; Humans; Middle Aged; Muramidase; Phagocytosis; Tuberculosis, Pulmonary

Topics: Aged; Female; Hepatomegaly; Humans; Leukemia; Leukemia, Myeloid; Leukocyte Count; Male; Middle Aged; Monocytes; Muramidase; Sarcoidosis; Splenomegaly; Tuberculosis, Miliary; Tuberculosis, Pulmonary

Topics: Adolescent; Adult; Age Factors; Aged; Blood Urea Nitrogen; Female; Humans; Leukocyte Count; Male; Middle Aged; Muramidase; Mycobacterium tuberculosis; Prognosis; Sex Factors; Sputum; Tuberculosis, Pulmonary

Topics: Humans; Microbial Sensitivity Tests; Muramidase; Staphylococcus; Tuberculosis, Pulmonary

Topics: Adolescent; Child; Female; Humans; Male; Muramidase; Phagocytosis; Time Factors; Tuberculosis, Pulmonary

Topics: Acid Phosphatase; Animals; Cell Count; Deoxyribonucleases; Esterases; Female; Glucuronidase; Lipase; Macrophages; Male; Muramidase; Pulmonary Alveoli; Rabbits; Radiation Injuries, Experimental; Ribonucleases; Tuberculosis; Tuberculosis, Pulmonary

Topics: Animals; Anti-Infective Agents, Local; Antitubercular Agents; Lung; Muramidase; Rabbits; Tuberculosis; Tuberculosis, Pulmonary

Topics: Humans; Muramidase; Saliva; Tuberculosis; Tuberculosis, Pulmonary

Topics: Humans; Lung; Muramidase; Neoplasms; Tuberculoma; Tuberculosis; Tuberculosis, Pulmonary