Department of Microbiology, Gulab Devi Hospital, Lahore, Pakistan; Institute of Molecular Biology and Biotechnology (IMBB), The University of Lahore, Defence Road Campus, Lahore, Pakistan.
School of Biological Sciences, University of the Punjab, Lahore, Pakistan.
Cytokine. 2021 Jun;142:155499. doi: 10.1016/j.cyto.2021.155499. Epub 2021 Mar 30.
The aim of this study was to explore the utility of inflammatory biomarkers in the peripheral blood to predict response to treatment in extrapulmonary tuberculosis (EPTB).
A Luminex xMAP-based multiplex immunoassay was used to measure 40 inflammatory biomarkers in un-stimulated plasma of 91 EPTB patients (48 lymphadenitis, and 43 pleuritis) before and at 2 and 6 months of treatment.
Overall a significant change was observed in 28 inflammatory biomarkers with treatment in EPTB patients. However, MIG/CXCL9, IP-10/CXCL10, and CCL23 decreased in all patients' groups with successful treatment at both time points. At 2 months, 29/64 (45%) patients responded partially while 35/64 (55%) showed complete regress. Among good responders, a higher number of biomarkers (16/40) reduced significantly as compared to partial responders (1/40). Almost half (14/29) of partial responders required longer treatment than 6 months to achieve satisfactory response. The levels of MIG, IP-10, MIF, CCL22 and CCL23 reduced significantly among 80, 74, 60, 71, 51% good responders, as compared to 52, 52, 52, 59, 52% partial responders, respectively. A biosignature, defined by a significant decrease in any one of these five biomarkers, corresponded with satisfactory response to treatment in 97% patients at 2 month and 99% patients at 6 months of treatment.
Change in inflammatory biomarkers correlates with treatment success. A five biomarker biosignature (MIG, IP-10, MIF, CCL22 and CCL23) could be used as an indicator of treatment success.
本研究旨在探讨外周性结核病（EPTB）患者外周血中炎症生物标志物在预测治疗反应中的作用。
采用 Luminex xMAP 基于多重免疫测定法，在治疗前及治疗 2 个月和 6 个月时，测量 91 例 EPTB 患者（48 例淋巴结炎，43 例胸膜炎）未刺激血浆中的 40 种炎症生物标志物。
EPTB 患者治疗后，总体上有 28 种炎症生物标志物发生显著变化。然而，在两个时间点成功治疗的所有患者中，MIG/CXCL9、IP-10/CXCL10 和 CCL23 均降低。在 2 个月时，29/64（45%）患者部分缓解，35/64（55%）患者完全缓解。在完全缓解者中，与部分缓解者（1/40）相比，有更多的生物标志物（16/40）显著减少。近一半（14/29）的部分缓解者需要延长治疗时间至 6 个月以上才能达到满意的缓解。与部分缓解者（52%）相比，80%、74%、60%、71%和 51%的完全缓解者中 MIG、IP-10、MIF、CCL22 和 CCL23 的水平显著降低。在 2 个月和 6 个月时，任何一种生物标志物显著降低的生物标志物谱对应于 97%和 99%患者的治疗反应满意。
炎症生物标志物的变化与治疗成功相关。五个生物标志物（MIG、IP-10、MIF、CCL22 和 CCL23）的生物标志物谱可作为治疗成功的指标。
