• Rafik Karaman added an answer:
    Can BCG be used as a therapeutic vaccine ? Can booster shots be used ?

    Very rare studies are reported that have investigated role of BCG as therapeutic vaccine after TB infection. Can Single or booster dose of BCG be used as therapeutic vaccine alone with drug combination?

    Rafik Karaman

    Dear Aliabbas,

    The use of BCG to treat diseases:

    Leprosy: BCG has a protective effect against leprosy in the range of 26 to 41% based on controlled trials. The protective effect is somewhat larger based on case control and cohort studies—about 60%.[18][19] However BCG vaccine is not used specifically to control leprosy.
    Buruli ulcer: BCG may protect against or delay the onset of Buruli ulcer.[20]
    Cancer immunotherapy
    See also: Cancer immunotherapy, Cancer vaccine and Coley's toxins
    Micrograph showing granulomatousinflammation of bladder neck tissue due to Bacillus Calmette-Guérin used to treat bladder cancer, H&E stain
    A number of cancer vaccines use BCG as an adjuvant to provide an initial stimulation of the persons` immune systems.
    BCG is used in the treatment of superficial forms of bladder cancer. Since the late 1970s, evidence has become available that instillation of BCG into the bladder is an effective form of immunotherapy in this disease.[21] While the mechanism is unclear, it appears a local immune reaction is mounted against the tumor. Immunotherapy with BCG prevents recurrence in up to 67% of cases of superficial bladder cancer.
    Colorectal cancer[22]
    Lung cancer[23]
    Equine sarcoid (in horses)
    Type I diabetes[edit]
    Diabetes, type 1: Clinical trials based on the work of Denise Faustman use BCG to induce production of TNF-α, which can kill the T-cells responsible for type 1 diabetes. In a Phase I, double-blind, placebo-controlled trial, two doses of the BCG vaccine were administered to three adults with long-term type 1 diabetes, resulting in elimination of the pancreas-harming cells, induction of regulatory T cells (Tregs) and a transient rise in C-peptide levels, suggestive of temporarily restored insulin production.[26]

    [18] Setia MS, Steinmaus C, Ho CS, Rutherford GW. (2006). "The role of BCG in prevention of leprosy: a meta-analysis". Lancet Infect Dis 6 (3): 162–70. doi:10.1016/S1473-3099(06)70412-1. PMID 16500597.
    [19] Merle, Corinne SC; Cunha, Sergio S; Rodrigues, Laura C (2010). "BCG vaccination and leprosy protection: Review of current evidence and status of BCG in leprosy control". Expert Review of Vaccines 9 (2): 209–22. doi:10.1586/ERV.09.161. PMID 20109030.
    [20] Tanghe, A., J. Content, J. P. Van Vooren, F. Portaels, and K. Huygen (2001). "Protective efficacy of a DNA vaccine encoding antigen 85A from Mycobacterium bovis BCG against Buruli ulcer". Infection and Immunity 69 (9): 5403–11. doi:10.1128/IAI.69.9.5403-5411.2001. PMC 98650. PMID 11500410.
    [21] Lamm DL, Blumenstein BA, Crawford ED (1991). "A randomized trial of intravesical doxorubicin and immunotherapy with bacille Calmette-Guerin for transitional-cell carcinoma of the bladder". N Engl J Med 325 (2): 1205–9. doi:10.1056/NEJM199110243251703. PMC 1164610. PMID 1922207.
    [22] Mosolits S, Nilsson B, Mellstedt H. (2005). "Towards therapeutic vaccines for colorectal carcinoma: a review of clinical trials". Expert Rev Vaccines 4 (3): 329–50. doi:10.1586/14760584.4.3.329. PMID 16026248.
    [23] NAOTO MIYAZAWA; KEIICHI SUEMASU; TOSHIRO OGATA; TAKESHI YONEYAMA; TSUGUO NARUKE; RYOSUKE TSUCHIYA (1979). "BCG Immunotherapy as an Adjuvant to Surgery in Lung Cancer: A Randomized Prospective Clinical Trial". Jpn. J. Clin. Oncol. 9 (1): 19–26.
    [24] Lu, CY; Lin, GC; Gu, JZ; Zhou, GY; Cao, Y (Sep 1994). "[A preliminary study of BCG adjuvant therapy in oral and maxillofacial malignant melanoma.].". Shanghai kou qiang yi xue = Shanghai journal of stomatology 3 (3): 144–5. PMID 16538310.
    [25] Sari, Aysegul; Bal, Kaan; Tunakan, Mine; Ozturk, Cemil. "A case of a sporadic malignant peripheral nerve sheath tumor of the urinary bladder with concomitant in situ urothelial carcinoma treated by transuretheral resection". Indian Journal of Pathology and Microbiology 54 (1): 147. doi:10.4103/0377-4929.77376.
    [26]  Faustman, DL; Wang L; Okubo Y; Burger D; Ban L; Man G; Zheng H; Schoenfeld D; Pompei R; Avruch J; Nathan D (Aug 2012). Doherty, T. Mark, ed. "Proof-of-Concept, Randomized, Controlled Clinical Trial of Bacillus-Calmette-Guerin for Treatment of Long-Term Type 1 Diabetes". PLoS ONE 7 (8): e41756. doi:10.1371/journal.pone.0041756. PMC 3414482. PMID 22905105.

    Hoping this will be helpful,


  • Hafid Soualhine added an answer:
    How do i determine if two similar proteins share similar expression patterns in two species.

    I want to determine whether SRM assays based on the peptide sequences from
    Mycobacterium tuberculosis can be applied directly to Mycobacterium africanum

    Hafid Soualhine

    I guess you are targeting specific isoform or proteotypic peptids ?

    Little is known about proteome in M africanum. My advice is to use the two lineages of M. africanum 1 and 2 (west africain and east african( that are quiet different relative to M. tuberculosis.

    you can also focus your analysis on some RD régions that are present / absent in each one like RD9 region, RD 701 and RD702. And use some hypothetical protein from those Rd regions as negative control.

    Here a publication from my colleagues

  • Yuri Kalambet added an answer:
    Where can I find a paper which shows that zoonotic tuberculosis (M bovis) is not transmissible among immunocompetent humans?

    Recently I read a paper which authors state that zoonotic tuberculosis (M. bovis) is not transmitted among immunocompetent humans.
    Now, when I search, I can't locate it. Can anyone help me?

    Yuri Kalambet

    Really people in the past did a very good job concerning TB, many of works are well-forgotten or just ignored. Medicine is very conservative. We just should not expect reliable differential diagnostics between M.Bovis and M.Tuberculosis in the past, as e.g. in the case of isolation of micobacteria from cattle it is very natural to identify it as M.Bovis:) just because it's a cow. I would not rely on differentiation of TB in past studies, but would easily accept most of other aspects of the studies.

  • Noemi Kaoru Yokobori added an answer:
    It is found that drug resistance TB occurs who Have spent time with someone known to have drug-resistant TB disease is there any specific study?

    It is found that drug resistance TB occurs who Have spent time with someone known to have drug-resistant TB disease is there any specific study?

  • Hafid Soualhine added an answer:
    Why is the development of TB vaccine delayed?

    The world is badly in need of a TB vaccine-which is effective pre exposure and/or post exposure-in order to End TB by the year 2035.

    From molecular point of view, what aspect of the tubercle bacillus makes it difficult to develop an effective vaccine?

    Hafid Soualhine

    I worked on BCG recombinant vaccine in previous postDoc,

    I remeber the STOP TB strategy annouced in 2005-2006 that at least 30 vaccines candidates will be availaible in 2015. But the real world is different, there is not much funding on this field. We are in 2015 and few are Under experimental phases.

    CD4 T cell play a central role in protection against TB infection. but the CD4 T cells are poorly stimulated by BCG vaccines.

    A major problem is that M. tuberculosis can live in the intracellular compartments and escapes several immunologic pathways (Phagolysosome maturation), The BCG vaccines appears to mimic virulent Mtb strains in their capacity to block phagosome maturation and to inhibit Agprocessing and presentation to Th cells. Indeed, earlier studies showed that BCG organisms growing in human macrophages were sequestered from recognition by immune CD4 cells although in-fected cells continued to express MHC class II molecules .

    You can read more in our publication:

    Mycobacterium bovis Bacillus Calmette-Guerin Secreting Active Cathepsin S Stimulates Expression of Mature MHC Class II Molecules and Antigen Presentation in Human Macrophages. Available from: [accessed Nov 11, 2015].

    • Source
      [Show abstract] [Hide abstract]
      ABSTRACT: A successful Th cell response to bacterial infections is induced by mature MHC class II molecules presenting specific Ag peptides on the surface of macrophages. In recent studies, we demonstrated that infection with the conventional vaccine Mycobacterium bovis bacillus Calmette-Guérin (BCG) specifically blocks the surface export of mature class II molecules in human macrophages by a mechanism dependent on inhibition of cathepsin S (Cat S) expression. The present study examined class II expression in macrophages infected with a rBCG strain engineered to express and secrete biologically active human Cat S (rBCG-hcs). Cat S activity was completely restored in cells ingesting rBCG-hcs, which secreted substantial levels of Cat S intracellularly. Thus, infection with rBCG-hcs, but not parental BCG, restored surface expression of mature MHC class II molecules in response to IFN-gamma, presumably as result of MHC class II invariant chain degradation dependent on active Cat S secreted by the bacterium. These events correlated with increased class II-directed presentation of mycobacterial Ag85B to a specific CD4(+) T cell hybridoma by rBCG-hcs-infected macrophages. Consistent with these findings, rBCG-hcs was found to accelerate the fusion of its phagosome with lysosomes, a process that optimizes Ag processing in infected macrophages. These data demonstrated that intracellular restoration of Cat S activity improves the capacity of BCG-infected macrophages to stimulate CD4(+) Th cells. Given that Th cells play a major role in protection against tuberculosis, rBCG-hcs would be a valuable tuberculosis vaccine candidate.
      The Journal of Immunology 11/2007; 179(8):5137-45. DOI:10.4049/jimmunol.179.8.5137
  • Beatriz Garcillan added an answer:
    Replacement for Difco M. tuberculosis?

    Hi, I need to order M. tuberculosis for my EAE experiments. Apparently Difco (BD) has discontinued it. 

    Has anybody tried a different supplier?


    Beatriz Garcillan

    Hi Marc,

    Thank you very much for your response, I will check that as well. 

  • Jann-Yuan Wang added an answer:
    Can anyone recommend studies onto the diagnosis and management of tuberculosis related pleural effusions?

    I want to work out the best way of managing a slowly resolving tb effusions.

    Jann-Yuan Wang

    What would be the definition of slow-resolving tuberculous pleural effusion?

  • Paul H Mason added an answer:
    What ethical dimensions should be considered in isolating an immigrant with multidrug resistant tuberculosis?

    Submit a response (500-800 words) to the Journal of Bioethical Inquiry (JBI) for inclusion in the 13(1) issue to be published in March 2016:

    Paul H Mason

    Thank you for these wonderful responses. Just to let you know, that the Journal of Bioethical Inquiry is accepting responses of 500-800 words for possible inclusion in a special issue on TB and ethics next year. If you would like to write a response to this case study, you might like to copy and paste this link for further information on how to submit:

    Responses need to be received by mid November to fit with the peer-review and publication schedule.

  • Mohammad Siddiqur Rahman Khan added an answer:
    If i want to ship TB positive isolates from one country to other, what kind of shipment it should be?

    if i want to ship TB positive isolates from one country to other, what kind of shipment it should be? dry-ice shipment or ambient shipment by FedEx or shipment using ice pack?

    Please help me. I already have the permit. 

    Mohammad Siddiqur Rahman Khan


  • Chockalingam Chandrasekar added an answer:
    When do Tubercular Cervical Lymphadenopathy need excision?

    We know Tubercular Cervical Lymphadenopathies resolve with anti-TB drugs. When do Tubercular Cervical Lymphadenopathy need excision?

    Chockalingam Chandrasekar

    When there is suspicion/ confirmation of diagnosis   and in MDR tuberculosis the rate of regression of the node is not in  expected line during treatment ( reserve regimen)

  • Adam Lai Hung Wei added an answer:
    Which drugs (beside isoniazid & metronidazole) can show significant activity against either acute or latent mycobacterium tuberculosis only in vitro?

    Mycobacterium tuberculosis. Which drugs (beside isoniazid & metronidazole) can show significant activity against either acute or latent mycobacterium tuberculosis only in vitro?

    Adam Lai Hung Wei

    Thank you very much for your help!

  • Utpal Sengupta added an answer:
    Is decontamination mandatory for all samples (blood, sputum, endometrial tissue, csf) in the case of DNA extraction for TB diagnosis by RT-PCR?
    We are not getting reproducible results.
    Utpal Sengupta

    Yes, I agree with Nkiru. As sputum and endometrial tissue will contain other mycobacteria these specimens should be decontaminated before mycobacterial culture.

  • Lynn Ogden added an answer:
    What is the progression risk of Latent TB Infection?

    One of the issue which we do not clearly know about tuberculosis biology is the risk or rate of progression from latent infection to active TB diseases. However, ones  life time risk of progression from latent TB to active TB is reported  to be between 5 to 10% in the absence of other risk factors such as HIV in many  documents. Sadly, these reports  are not citing the original  studies (if they ever have existed).

    So can I find the relevant original references? Opinions on the risk of progression?


    University of Melbourne 

    Lynn Ogden

    What is the risk of those previously treated with BCG?

  • Wladimir Queiroz added an answer:
    How is malnutrition related with the prevalence of TB?

    Tsedeke Wolde and Eyasu Ejeta, Jimma University

    Wladimir Queiroz

    The association between poor nutrition and inability in developing an appropriate immune response to M tuberculosis seems very clear.

  • Nikola Ilankovic added an answer:
    Does TB (Tuberculosis) spread through housefly like Muska-Domestica?
    TB is transmitted through the air. The droplet nuclei generated when a sputum positive pulmonary TB patients coughs, mixes in the air and are carried to a susceptible person in the vicinity or by air currents to longer distances. Sputum Negative TB patients may also contribute in transmission of infection to a smaller extent. Now my concern is that, "Can housefly provides an additional epidemiological link to spread TB infection in the community?"
    Nikola Ilankovic

    I agree Anthony. And then all dependence from  imunological status of body, too.

    But the bacteriological investigation of tissue must be primary, or in the same time with pathohystology.

  • Utpal Sengupta added an answer:
    Does anyone experience that TB strain loses its virulence after passing in culture several times?

    My TB strain (H37Rv) seems losing virulence after passing in liquid culture several times. Looks like that the growth rate in liquid culture (7H9+10%OADC) or on plates (7H11+10% OADC) slows down when stock is 1) stored at -20 degree for long period of time, 2-3 years; 2) in higher passage. We use 7H9+10% glycerol to stock down TB. Does anyone have similar experiences? What are the solutions for these issues? Thanks!

    Utpal Sengupta

    Most of the bacterial isolates lose their virulence in continuous culture. To get back  its virulence it has to be passaged through its host.

  • Tugumisirize Didas added an answer:
    What is the current trend of drug resistant Tuberculosis in Uganda?

    Hello researchers am trying to find out the current trend of drug resistant TB in Uganda based on your observations and experiences.

    Tugumisirize Didas

    According to WHO Global Tuberculosis Control Report (2014), 3.5% of new TB cases and 20.5% of previously treated TB cases are estimated to have multidrug resistant (MDR) form of TB worldwide, of which 9.0% have extensively drug resistant (XDR) form of TB.  In Uganda, the exact figures for MDR/XDR-TB are yet to be determined following an ongoing National TB Prevalence Survey which kicked off in August,2014. However, a  cross sectional survey conducted in Kampala's TB diagnostics and treatment health care facilities by Lukoye et al (2011) in 2008 showed an MDR prevalence of 1.1% among new cases and 11.7% in previously treated cases. In 2011, the prevalence of MDR-TB among retreatment cases and new cases confirmed with TB in Uganda was 12.1% and 1.4% respectively (National drug resistance survey, 2011).

    Hope you will find this information  useful to you.(For more information, contact me at


    Didas Tugumisirize

    (National Tuberculosis and Leprosy Control Programme, Ministry of Health, Kampala, Uganda)

  • Donald Konts Ngants added an answer:
    What are the influences of potts disease in PNG?

    What causes Spinal TB, the age group that are affected, risk factors and its influence.

    Donald Konts Ngants

    Spinal TB is a secondary infection. Pulmonary TB is a primary infection. Once the pulmonary TB is left untreated, the mycobacterium bacilli travels along the vessels to the spinal column. That is when the initiation of spinal TB occurs.

  • Prosper Adogu added an answer:
    How common is pulmonary hydatid cyst with pulmonary tuberculosis in same patient?

    24 year young boy, admitted in CTVS department for lobectomy of left lung for hydatid cyst, biopsy report was showing e/o hydatid cyst alongwith granulomatous lesion s/o Tuberculosis. I am not getting any review article for the same in the literature except few case reports. 

    Prosper Adogu

    It is an extremely rare phenomenon.

    You might find the article in the link below, helpful;

  • Amera Osama added an answer:
    Which is the best method for decontamination of a sputum sample before culturing it for Mycobacterium tuberculosis?
    I would like to know which is the easiest and cheapest but at the same time sensitive and specific method.
    Amera Osama

    Hello colleagues,

    Thanks much for your valuable answers. I have a question about bleach method: Do you recommend bleach method for sputum liquefaction, prior to DNA extraction of M.Tuberculosis? considering that PCR will be subsequently performed...

    In another word, Does bleach inhibit PCR?

    Thanks much!.

  • Aliabbas A Husain added an answer:
    How can I measure the concentration of TB drugs in organs of mice after chemotherapy? what is the ideal time after therapy to study concentration?

    I am studying efficacy of TB drugs to disseminate in  various organs after drug administration either orally or via IV route. Main aim is to study how much concentration actually reaches the organs after administration for prevention of pulmonary and extra pulmonary TB. Can anyone suggest some good protocols??

    Aliabbas A Husain

    Thanks sir for your valuable information

  • Yogarabindranath Swarna Nantha added an answer:
    What do you conclude when you have prevalence of latent TB infection (LTBI) amongst diabetics that's close to the prevalence of LTBI in the community?

    If the methodology of the study is sound, can you just conclude by saying that being diabetic does not confer an extra risk of being predisposed to latent TB infection (in contrast to having tuberculosis)? Or does this mean that the levels of latent TB in the community is overwhelmingly large that it is almost similar to levels in diabetics?

    Yogarabindranath Swarna Nantha

    Hi Shawn,

     Thanks for your imput. Yes, each patients who tested positive for Mantoux were subjected to chest x-rays.


  • Umamaheshwari S added an answer:
    Can ESR predict TB?

    On infections ESR gets elevated, but correlating with clinical conditions in TB, can ESR serve to predict TB especially in HIV positive and sputum smears are negative/ sputum nonproductive?

    Umamaheshwari S

    Elevated ESR though not a specific test for TB, few TB studies show elevated ESR. obviously correlating with clinical symptoms and elevated ESR can serve as one of the tool to suspec and diagnose especially in smear negative TB cases

  • Umamaheshwari S added an answer:
    Wont Mycobacteria isolated from stool specimen confer TB infection?

    Does isolate from a stool sample prove a person is infected with TB?

    Umamaheshwari S

    I do agree with Mr Werner. Species diagnosis is must to decide treatment

  • Nkiru Nenye Nwokoye added an answer:
    Any advice on tuberculosis screening in HIV-infected patients?

    From a public health standpoint , what  current or future alternatives would you recommend for better tuberculosis screening in HIV-infected patients?

    Nkiru Nenye Nwokoye

    Tuberculosis (TB) is difficult to diagnose in HIV-positive patients because they form poor granulomas resulting in lower concentrations of Mycobacterium tuberculosis (MTB) in lesions.Culture which has higher sensitivity is time consuming and not readily available. In line with the recent WHO recommendation on the use of GeneXpert, Nigeria reviewed its diagnostic algorithm to reflect the use of GeneXpert as first screening test for HIV-infected persons showing symptoms of TB. 

    i must say that with the new algorithm, increased number of HIV-infected persons are being screened for TB and appreciable number are coming out positive for not only susceptible TB but also the drug resistant strains. 

  • María Teresa Herrera added an answer:
    Why I can not find sufficient and well macrophage after PBMCS culture?

    I have a research about phagocytosis activity of macrophage from cell culture of PBMCS from children contact with adult tuberculosis, but I cannot found good macrophage from my culture. I don't know waht happen. Any suggest from other researcher that have more experiend with this procedure?

    María Teresa Herrera

    Hi Finny

    You have to isolate PBMC fron whole blood and then purify monocytes from adherente but I recommend  by positive or negative selection using Miltenyi kit. I have very good experience with Miltenyi kit using an anti-CD14 conjugarte to magnetice beads. The MN population has more than 94% of purity. Just you have to followe the manual instrucción.

    Then you have to resuspend the MN in RPMI+L-glutamine-10% human pool serum not heat inactivated. Count and add in a chamber slide and incubaste 1hr, 37 grade 5% CO2. It let the MN adherent at the plastic. Here you have two alternativas for your experiment: 1) Phagocytosis by MN or 2) Let the MN differentiation tomacrophages by 5-7 days and then study the phagocitosis.

    When we compared the MN rpurification between adherence to plastic and by Miltenyi column, the MN obtained after column there are less lynphocytes contamination.


  • Gehendra Mahara added an answer:
    Can anyone explain to me how to do a study about PM 2.5 and tuberculosis infection?

    Can anyone explain me that how to do a study about PM 2.5 and tuberculosis infection?

    Gehendra Mahara

    Thank you Saileela Kondapaneni madam.

  • Tefera B Agizew added an answer:
    What is a suitable way we can eliminate tuberculosis?

    Do you have suggestions/ideas which can change the statistics of TB in the world?

    Tefera B Agizew

    In my opinion resource and political commitment seem to be the two major key points from the European experience and even from the USA. In the USA we have seen TB resurgence after control and again when resource boosted the TB situation went down hill again. These are clear indications to the road to elimination o TB. All other things, education, awareness, living conditions, application of available best drugs and diagnostics are also key factors. However, controlling or improving these factors depends where you are - low, middle or high income countries. With all these the journey is long but possible.  

  • Jamunanantha Sivanathan added an answer:
    Mycobacteria DNA extraction directly from blood?
    Currently there are some kits allow the extraction of Mycobacteria DNA directly from sputum samples and tissue biopies. Does anyone know any similar fast and simple method for extraction from blood samples?
    Jamunanantha Sivanathan

    Mycobacteria  is an intracellular pathogen and not in the blood circulation.So it is not the correct question.

  • Nagendra Babu Mennuru added an answer:
    Does anyone know Research centers in India that carry out assays for tuberculosis for screening of new compounds?

    Does anyone know any commercial or non-commercial research facilities within India (preferably in Chennai, Hyderabad, Bangalore and rest of India) to perform screening assays for Tuberculosis on new compounds? Added to this I require the results within 15-20 days?

    Nagendra Babu Mennuru

    Dr. Sonali Dalwadi:

    Thank you for the information, I will check these sources....

    Dr. Mayur:

    Thanks for the details, yes, I had contacted through mail regarding the possibility, reply need to be expected....

    Thanks & Regards,

    Nagendra Babu M.

About Tuberculosis

Any of the infectious diseases of man and other animals caused by species of MYCOBACTERIUM.

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