Department of Paediatrics, The University of Melbourne and Murdoch Children's Research Institute, Royal Children's Hospital Melbourne, Parkville, VIC, Australia.
Victorian Infectious Diseases Unit, The Royal Melbourne Hospital, Parkville, VIC, Australia.
Tuberculosis (Edinb). 2015 May;95(3):217-28. doi: 10.1016/j.tube.2015.01.003. Epub 2015 Jan 30.
The ability to monitor response to therapy for tuberculosis (TB) and confirm adequate treatment would be a major advance. The low reversion rate of interferon-gamma based assays means that they are unlikely to be useful for monitoring therapy. Several exploratory studies have evaluated the diagnostic potential of cytokine biomarkers other than interferon-gamma for monitoring anti-tuberculous therapy. A systematic review of these studies was performed to identify the most promising candidate biomarkers. TNF-α, IL-2, IL-6, IL-10 and IL-12 were the most extensively investigated cytokines. There was significant heterogeneity between studies in relation to study design and laboratory methodology, complicating direct comparisons. There was marked variation between studies in the observed changes during treatment for many of the biomarkers. Further longitudinal studies in sufficiently large patient cohorts with rigorous methodology are needed to determine the true potential of individual cytokine biomarkers, or combinations, for monitoring TB treatment.
监测结核病（TB）治疗反应并确认治疗是否充分的能力将是一项重大进展。基于干扰素-γ的检测方法的低逆转率意味着它们不太可能用于监测治疗。几项探索性研究评估了除干扰素-γ以外的细胞因子生物标志物在监测抗结核治疗方面的潜在诊断价值。对这些研究进行了系统评价，以确定最有前途的候选生物标志物。TNF-α、IL-2、IL-6、IL-10 和 IL-12 是研究最多的细胞因子。由于研究设计和实验室方法的不同，各研究之间存在显著的异质性，使得直接比较变得复杂。对于许多生物标志物，在治疗过程中观察到的变化在研究之间存在明显差异。需要在具有严格方法学的足够大的患者队列中进行进一步的纵向研究，以确定单个细胞因子生物标志物或其组合在监测 TB 治疗方面的真正潜力。
