ORIGINAL ARTICLE Year : 2021  |  Volume : 70  |  Issue : 1  |  Page : 38-39

Tuberculosis in patients with underlying thalassemia: a consideration of common antioxidative pathway − an expressional analysis

Won Sriwijitalai1, Viroj Wiwanitkit2
1 Medical Center, RVT Medical Center, Bangkok, Thailand
2 Department of Community Medicine, Dr DY Patil University, Pune, Maharashtra, India

Date of Submission05-Aug-2019Date of Decision14-Aug-2019Date of Acceptance28-Nov-2019Date of Web Publication27-Mar-2021

Correspondence Address:
PhD Won Sriwijitalai
Medical Center, RVT Medical Center, Bangkok
Thailand

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ejcdt.ejcdt_159_19

Background Tuberculosis is a common medical problem in the present day. The occurrence of this infection among the patients with congenital underlying disease is very interesting. Here, the authors study on the common pathways regarding the antioxidative process of tuberculosis and thalassemia, a congenic hemoglobin disorder.
Materials and methods This work is a bioinformatics expressional analysis. The authors performed common pathway analysis and interrelationship identification for expressional pathways regarding antioxidative process of tuberculosis and thalassemia.
Results The common pathway via glutathione can be shown and imply the increased risk for tuberculosis among the patients with underlying thalassemia.
Conclusion Based on identified common antioxidative pathway, patients with thalassemia might be prone to acquire tuberculosis infection.

Keywords: antioxidative, expression, pathway, thalassemia, tuberculosis

How to cite this article:
Sriwijitalai W, Wiwanitkit V. Tuberculosis in patients with underlying thalassemia: a consideration of common antioxidative pathway − an expressional analysis. Egypt J Chest Dis Tuberc 2021;70:38-9
How to cite this URL:
Sriwijitalai W, Wiwanitkit V. Tuberculosis in patients with underlying thalassemia: a consideration of common antioxidative pathway − an expressional analysis. Egypt J Chest Dis Tuberc [serial online] 2021 [cited 2021 Dec 5];70:38-9. Available from: http://www.ejcdt.eg.net/text.asp?2021/70/1/38/312133   Introduction 

Tuberculosis is a common infection, which is the important problem in clinical medicine. Worldwide, this infection still exists and has become an important global public health consideration [1]. The infection affects a wide range of patients. The patients with underlying diseases might be affected by tuberculosis infection. There are many reports on the increased risk of tuberculosis infection for the patients with underlying medical disorders [2].

Nevertheless, there are few reports on patients with underlying congenital disorders. Here, the authors focus on the interest in an important congenital disorder, thalassemia, which is the most common genetic disease of hemoglobin seen worldwide. In many areas where tuberculosis is endemic, there is also a high incidence of thalassemia. A good example is Southeast Asia, where tuberculosis infection is extremely common [3]. In the same area, the prevalence of thalassemia is also very high [4]. The occurrence of this infection among the patients with congenital underlying disease is very interesting. Here, the authors study on the common pathways regarding the antioxidative process of tuberculosis and thalassemia, a congenic hemoglobin disorder.

  Materials and methods 

The present study is a bioinformatics study. This work is a pure bioinformatics study and did not involve human or animal subject and it requires no ethical committee approval. The standard expressional pathway analysis is performed. The specific focus is on the antioxidative process in tuberculosis and thalassemia. The expressional analysis in the present study is based on the standard bioinformatics technique as used in the previous referencing publications [5],[6],[7]. In brief, a search in the international databases was firstly done to identify the biological pathways regarding antioxidative system in tuberculosis and thalassemia. The derived pathways were collected, and the common pathway seen in both tuberculosis and thalassemia was identified. Finally, the interrelationship analysis based on the identified common pathway between tuberculosis and thalassemia was done to derive the final common pathway regarding antioxidative system for both disorders.

  Results 

Based on the present analysis, the identified common pathway is derived. The linkage node is via ‘glutathione’ [8],[9]. From interrelationship analysis, the final common pathway regarding antioxidative system for both tuberculosis and thalassemia is successfully done, as shown in [Figure 1].

Figure 1 The final common pathway regarding antioxidative system for both tuberculosis and thalassemia.

Click here to view

  Discussion 

Antioxidative pathway system is an important biological process in humans that helps in defense against several medical problems. The importance of antioxidative pathway in tuberculosis is reported in the literature. Cao et al. [8] found that antimycobacterial and immune-enhancing effects could be induced via glutathione pathway. In fact, this is the main pathophysiological pathway identified in several kinds of infections [10].Regarding thalassemia, the clinical importance of the antioxidative pathway system can also be seen. Kalpravidh et al. [9] showed that decreased glutathione level was observable in the patients with thalassemia. Kalpravidh et al. [9] noted that this alteration in antioxidative pathway system might affect the susceptibility of thalassemia patients to medical problems, including to infections.

As there are evidences on the interrelationship between antioxidative system and either tuberculosis or thalassemia, there might be a linkage via antioxidative system between both tuberculosis and thalassemia. To identify the possible relationship, the standard bioinformatics analysis might be applicable. In the present study, the authors use a standard technique for identification of common pathway as used in the previous studies.

In the present report, the authors perform a bioinformatics expressional analysis to identify the specific common pathway regarding antioxidative process of both tuberculosis and thalassemia. Of interest, herein, the study showed that there is an important common pathway via glutathione.

  Conclusion 

Base on the present study, the common pathway via glutathione can be identified. This might imply the increased risk for tuberculosis among the thalassemia patients.

Financial support and sponsorship

Nil.

Conflict of interest

There are no conflicts of interest.

 

  References 
1.Pai M, Behr MA, Dowdy D, Dheda K, Divangahi M, Boehme CC et al. Tuberculosis. Nat Rev Dis Primers 2016; 2:16076.  
    2.Ugarte-Gil C, Carrillo-Larco RM, Kirwan DE. Latent tuberculosis infection and non-infectious co-morbidities: diabetes mellitus type 2, chronic kidney disease and rheumatoid arthritis. Int J Infect Dis 2019; 80S:S29–S31.  
    3.Wise J. WHO identifies 16 countries struggling to control tuberculosis. BMJ 1998; 316:957.  
    4.Fucharoen S, Winichagoon P. Haemoglobinopathies in southeast Asia. Indian J Med Res 2011; 134:498–506.  
[PUBMED]  [Full text]  5.Wiwanitkit V. Endothelin-1 and protein kinase C co-expression in the pathogenesis of diabetic retinopathy. J Diabetes Complication 2007; 21:359–362.  
    6.Sriwijitalai W, Wiwanitkit V. Coinfection between human immunodeficiency virus and tuberculosis: a consideration on ritonavir-related heme Oxygenase-1 pathway. Biomed Biotechnol Res J 2019; 3:95–100.  
    7.Sriwijitalai W, Wiwanitkit V. Chikungunya virus infection and cholangiocarcinoma; a common pathway network analysis. Acta Persica Pathophysiol 2019; 4:e01.  
    8.Cao R, Teskey G, Islamoglu H, Abrahem R, Munjal S, Gyurjian K et al. Characterizing the Effects of Glutathione as an Immunoadjuvant in the Treatment of Tuberculosis. Antimicrob Agents Chemother 2018; 62:e01132–e01218.  
    9.Kalpravidh RW, Tangjaidee T, Hatairaktham S, Charoensakdi R, Panichkul N, Siritanaratkul N, Fucharoen S. Glutathione redox system in β −thalassemia/Hb E patients. Sci World J 2013; 2013:543973.  
    10.Morris D, Khurasany M, Nguyen T, Kim J, Guilford F, Mehta R et al. Glutathione and infection. Biochim Biophys Acta 2013; 1830:3329–3349.  
    
  [Figure 1]