Tobacco Smoking and Second-Hand Smoke Exposure Impact on Tuberculosis in Children

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Altet, Neus
Latorre, Irene
Jiménez-Fuentes, María Ángeles
Soriano Arandes, Antoni
Villar-Hernández, Raquel
Milà, Celia
Rodríguez Fernández, Pablo
Muriel Moreno, Beatriz
Comella-Del-Barrio, Patricia
Godoy i García, PereGodoy i García, Pere - ORCID ID
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cc-by (c) Authors, 2022
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Little is known about whether second-hand smoke (SHS) exposure affects tuberculosis (TB). Here, we investigate the association of cigarette smoke exposure with active TB and latent TB infection (LTBI) in children, analyzing Interferon-Gamma Release Assays' (IGRAs) performance and cytokine immune responses. A total of 616 children from contact-tracing studies were included and classified regarding their smoking habits [unexposed, SHS, or smokers]. Risk factors for positive IGRAs, LTBI, and active TB were defined. GM-CSF, IFN-γ, IL-2, IL-5, IL-10, IL-13, IL-22, IL-17, TNF-α, IL-1RA and IP-10 cytokines were detected in a subgroup of patients. Being SHS exposed was associated with a positive IGRA [aOR (95% CI): 8.7 (5.9-12.8)] and was a main factor related with LTBI [aOR (95% CI): 7.57 (4.79-11.94)] and active TB [aOR (95% CI): 3.40 (1.45-7.98)]. Moreover, IGRAs' sensitivity was reduced in active TB patients exposed to tobacco. IL-22, GM-CSF, IL-5, TNF-α, IP-10, and IL-13 were less secreted in LTBI children exposed to SHS. In conclusion, SHS is associated with LTBI and active TB in children. In addition, false-negative IGRAs obtained on active TB patients exposed to SHS, together with the decrease of specific cytokines released, suggest that tobacco may alter the immune response.
Journal or Serie
Journal of Clinical Medicine, 2022, vol. 11, núm. 7