4.6 Article

Development of prognostic scoring system for predicting 1-year mortality among pulmonary tuberculosis patients in South India

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Summary: Platelets play an important role in the pathogenesis of tuberculosis. Patients with active tuberculosis have higher platelet counts and lower lymphocyte counts, resulting in an elevated platelet to lymphocyte ratio. In addition, the concentration of platelet differentiation mediators and platelet activation-associated factors is increased in active tuberculosis. Immunohistochemistry analysis shows that platelets are located around lung granuloma lesions in close contact with T lymphocytes and macrophages. Transcriptomic analysis reveals that genes associated with platelet activation are highly expressed in caseous tissue of human pulmonary tuberculosis granulomas. In vitro studies demonstrate that activated platelets inhibit T lymphocyte proliferation and IFN-gamma production induced by BCG, as well as inhibit the growth of intracellular macrophages of Mycobacterium tuberculosis. The soluble factors released by activated platelets mediate both immunological and M. tuberculosis replication activities. TGF-beta and PF4 are identified as the factors responsible for inhibiting T-cell response and enhancing the mycobactericidal activity of macrophages, respectively. These findings highlight the importance of platelets in the pathogenesis of tuberculosis.

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