Biologic Basis Of Increased Susceptibility Of Smokers To Pulmonary Infection With Mycobacterium Tuberculosis
Biologic Basis Of Increased Susceptibility Of Smokers To Pulmonary Infection With Mycobacterium Tuberculosis
Identify a biologic (molecular) basis for the increased susceptibility of cigarette smokers
 to pulmonary TB (Mtb) by testing the hypothesis that smoking reprograms AM polarization
 towards a distinct phenotype associated with impaired host defense function against Mtb and
 that normalization of that phenotype via therapeutic modulation of the Alveolar Macrophage
 (AM) polarization or smoking cessation can restore the anti-Mtb host defense function of AM.
Samples from Non-Smokers with TB, Smokers with TB and Smokers with COPD and TB will be
 collected in Qatar under JIRB 14-00055. All subjects will be undergoing a clinical
 bronchoscopy as part of their disease evaluation and will be asked to give additional samples
 for research. All "in vivo" processing of specimens from subjects with TB will be performed
 in Qatar. Mycobacterium tuberculosis infection (Mtb) continues to have a detrimental impact
 of public health worldwide. Based on the epidemiological evidence linking smoking, COPD and
 Mtb, and our preliminary data we hypothesize that smoking reprograms Alveolar Macrophages
 (AM) polarization towards a distinct phenotype associated with impaired host defense function
 against Myobacterium tuberculosis (Mtb) and that normalization of that phenotype via
 therapeutic modulation of the Alveolar Macrophages (AM) polarization or smoking cessation can
 restore the anti-Mtb host defense function of AM.
Smokers and Non-smokers with TB

 Inclusion Criteria:

 -  Must provide informed consent

 -  Current smokers and non-smokers

 -  Undergoing clinical bronchoscopy as required by their doctor for evaluation of their
 disease

 -  Diagnosis of pulmonary tuberculosis without extra-pulmonary TB, confirmed by at least
 one of the following:

 -  Symptoms consistent with TB

 -  Chest xray and or chest CT with TB

 -  Positive PPD test

 -  Positive sputum test

 Exclusion Criteria:

 -  Females who are pregnant or nursing

 -  History of allergies to xylocaine, lidocaine, versed, valium, atropine, isoproterenol,
 terbutaline, aminophylline, or any local anesthetic

 Smokers with TB and COPD

 Inclusion Criteria:

 -  Must provide informed consent

 -  Current smokers with COPD

 -  Undergoing clinical bronchoscopy as required by their doctor for evaluation of their
 disease

 -  Diagnosis of pulmonary tuberculosis without extra-pulmonary TB, confirmed bu at least
 one of the following:

 -  Symptoms consistent with TB

 -  Chest xray and or chest CT consistent with TB

 -  Positive PPD test

 -  Positive sputum test

 Exclusion Criteria:

 -  Non-smokers

 -  Females who are pregnant or nursing

 -  History of allergies to xylocaine, lidocaine, versed, valium, atropine, isoproterenol,
 terbutaline, aminophylline, or any local anesthetic