Mycobacterium tuberculosis genetic features associated with pulmonary tuberculosis severity

Autor: Charlotte Genestet, Guislaine Refrégier, Elisabeth Hodille, Rima Zein-Eddine, Adrien Le Meur, Fiona Hak, Alexia Barbry, Emilie Westeel, Jean-Luc Berland, Astrid Engelmann, Isabelle Verdier, Gérard Lina, Florence Ader, Stéphane Dray, Laurent Jacob, François Massol, Samuel Venner, Oana Dumitrescu
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: International Journal of Infectious Diseases, Vol 125, Iss , Pp 74-83 (2022)
Druh dokumentu: article
ISSN: 1201-9712
DOI: 10.1016/j.ijid.2022.10.026
Popis: ABSTRACT: Objectives: Mycobacterium tuberculosis (Mtb) infections result in a wide spectrum of clinical presentations but without proven Mtb genetic determinants. Herein, we hypothesized that the genetic features of Mtb clinical isolates, such as specific polymorphisms or microdiversity, may be linked to tuberculosis (TB) severity. Methods: A total of 234 patients with pulmonary TB (including 193 drug-susceptible and 14 monoresistant cases diagnosed between 2017 and 2020 and 27 multidrug-resistant cases diagnosed between 2010 and 2020) were stratified according to TB disease severity, and Mtb genetic features were explored using whole genome sequencing, including heterologous single-nucleotide polymorphism (SNP), calling to explore microdiversity. Finally, we performed a structural equation modeling analysis to relate TB severity to Mtb genetic features. Results: The clinical isolates from patients with mild TB carried mutations in genes associated with host-pathogen interaction, whereas those from patients with moderate/severe TB carried mutations associated with regulatory mechanisms. Genome-wide association study identified an SNP in the promoter of the gene coding for the virulence regulator espR, statistically associated with moderate/severe disease. Structural equation modeling and model comparisons indicated that TB severity was associated with the detection of Mtb microdiversity within clinical isolates and to the espR SNP. Conclusion: Taken together, these results provide a new insight to better understand TB pathophysiology and could provide a new prognosis tool for pulmonary TB severity.
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