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炎症生物标志物和淋巴细胞亚群分析对预测结核病治疗结果有用吗?

Is analysis of inflammatory biomarkers and lymphocyte subpopulations useful in prediction of tuberculosis treatment outcomes?

作者信息

Musteikienė Greta, Miliauskas Skaidrius, Zaveckienė Jurgita, Urbonienė Daiva, Vitkauskienė Astra, Žemaitis Marius, Naudžiūnas Albinas

机构信息

Department of Pulmonology, Medical Academy, Lithuanian University of Health Sciences, Eiveniu 2, LT-50161 Kaunas, Lithuania.

Department of Radiology, Medical Academy, Lithuanian University of Health Sciences, Eiveniu 2, LT-50161 Kaunas, Lithuania.

出版信息

J Clin Tuberc Other Mycobact Dis. 2021 Sep 8;25:100275. doi: 10.1016/j.jctube.2021.100275. eCollection 2021 Dec.

Abstract

Analysis of inflammatory biomarkers and lymphocytes during the treatment of tuberculosis (TB) could yield findings that influence the routine clinical practice and use of new anti-TB drugs. This study aimed to evaluate whether the selected biomarkers-soluble intercellular adhesion molecule type 1, soluble urokinase-type plasminogen activator receptor (suPAR), and C-reactive protein (CRP)-and T-cell subpopulations are useful for predicting culture conversion, treatment outcomes, and the extent of radiological lesions (calculated using X-ray score) in patients with drug-sensitive pulmonary TB. This study included 62 patients with drug-sensitive pulmonary TB. CRP and suPAR levels significantly decreased after 1 month of treatment. Before treatment initiation, CRP and suPAR levels were significantly higher in patients without culture conversion; however, none of the selected host biomarkers appeared to significantly influence the conversion status or treatment outcomes. Some lymphocyte subpopulations were correlated with X-ray scores before TB treatment initiation, but lung destruction, as determined using X-ray scores, showed the highest correlation with the baseline CRP value. We conclude that selected host biomarkers have a very limited role in predicting TB treatment outcomes and culture conversion and do not appear to be superior to CRP in monitoring TB treatment.

摘要

对结核病(TB)治疗期间炎症生物标志物和淋巴细胞的分析可能会得出影响常规临床实践和新型抗结核药物使用的结果。本研究旨在评估所选生物标志物——可溶性细胞间粘附分子1、可溶性尿激酶型纤溶酶原激活剂受体(suPAR)和C反应蛋白(CRP)——以及T细胞亚群是否有助于预测药敏性肺结核患者的培养转化、治疗结果和放射学病变程度(使用X线评分计算)。本研究纳入了62例药敏性肺结核患者。治疗1个月后,CRP和suPAR水平显著下降。在开始治疗前,未实现培养转化的患者CRP和suPAR水平显著更高;然而,所选的宿主生物标志物似乎均未对转化状态或治疗结果产生显著影响。一些淋巴细胞亚群与结核病治疗开始前的X线评分相关,但使用X线评分确定的肺破坏与基线CRP值的相关性最高。我们得出结论,所选的宿主生物标志物在预测结核病治疗结果和培养转化方面作用非常有限,并且在监测结核病治疗方面似乎并不优于CRP。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/000a/8436121/3837d1aa56c5/gr1.jpg

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