Department of Respiratory Medicine and Infectious Diseases, Niigata University Graduate School of Medical and Dental Sciences, 757 Ichibancho, Asahimachi-dori, Chuo Ward, Niigata City, 951-8510, Japan.
BMC Infect Dis. 2019 Mar 18;19(1):263. doi: 10.1186/s12879-019-3888-4.
Mycobacterium avium complex lung disease (MAC-LD) can deteriorate rapidly to become fatal. Reported poor prognostic factors include radiographic findings, undernutrition, anemia and high inflammation test values. However, the association of these prognostic factors with the pathophysiology of the disease remains unknown. We aimed to clarify the pathophysiology of MAC-LD and develop a new biomarker that reflects the immune response to the disease.
We performed the cytokine panel analyses of serum from patients with MAC-LD and compared each cytokine level with clinically negative prognostic factors (radiographic disease type, body mass index, albumin, C-reactive protein and hemoglobin) and high-resolution CT scores.
We analyzed 27 patients with MAC-LD, 6 with the fibrocavitary form and 21 with the nodular bronchiectatic form on high-resolution CT. Serum CXC motif ligand 10 (CXCL10) concentration was significantly elevated in patients with the fibrocavitary form (p = 0.008). CXCL10 levels correlated with body mass index (r = - 0.60, p = 0.0008), serum albumin concentration (r = - 0.45, p = 0.016) and high-resolution CT scores (r = 0.61, p = 0.0006). Among 14 patients initially untreated, antibiotic therapy was initiated for five during the study period. CXCL10 concentration was significantly higher in these patients (p = 0.046), and receiver operating characteristic analysis for CXCL10 concentration on treatment initiation produced an area under the curve of 0.844, with a sensitivity of 100%, specificity of 66.7%, and cut-off value of 366.5 pg/mL.
We revealed cytokine profiles in patients with MAC-LD. Serum CXCL10 levels probably reflect the severity of MAC-LD. Our findings suggest that CXCL10 concentration may be a promising biomarker for managing treatment for patients with MAC disease of the lung.
鸟分枝杆菌复合群肺病（MAC-LD）可迅速恶化并导致死亡。据报道，不良预后因素包括影像学表现、营养不良、贫血和高炎症检测值。然而，这些预后因素与疾病的病理生理学之间的关系尚不清楚。我们旨在阐明 MAC-LD 的病理生理学，并开发一种反映对疾病免疫反应的新型生物标志物。
我们对 MAC-LD 患者的血清进行了细胞因子谱分析，并将每种细胞因子水平与临床阴性预后因素（影像学疾病类型、体重指数、白蛋白、C 反应蛋白和血红蛋白）和高分辨率 CT 评分进行了比较。
我们分析了 27 例 MAC-LD 患者，其中 6 例为纤维空洞型，21 例为结节性支气管扩张型。纤维空洞型患者血清趋化因子配体 10（CXCL10）浓度明显升高（p=0.008）。CXCL10 水平与体重指数（r=-0.60，p=0.0008）、血清白蛋白浓度（r=-0.45，p=0.016）和高分辨率 CT 评分（r=-0.61，p=0.0006）呈负相关。在 14 例初始未接受治疗的患者中，有 5 例在研究期间开始接受抗生素治疗。这些患者的 CXCL10 浓度明显较高（p=0.046），CXCL10 浓度用于启动治疗的受试者工作特征分析产生曲线下面积为 0.844，灵敏度为 100%，特异性为 66.7%，截断值为 366.5pg/mL。
我们揭示了 MAC-LD 患者的细胞因子谱。血清 CXCL10 水平可能反映 MAC-LD 的严重程度。我们的研究结果表明，CXCL10 浓度可能是管理 MAC 肺部疾病患者治疗的有前途的生物标志物。
