血浆可溶性髓系细胞触发受体-1浓度作为每周使用利福喷汀和异烟肼治疗潜伏性结核感染患者全身不良反应标志物的研究

Plasma Concentrations of sTREM-1 as Markers for Systemic Adverse Reactions in Subjects Treated With Weekly Rifapentine and Isoniazid for Latent Tuberculosis Infection.

作者信息

Wang Tsai-Yu, Feng Jia-Yih, Shu Chin-Chung, Lee Susan Shin-Jung, Chen Chung-Yu, Wei Yu-Feng, Lin Chih-Bin, Huang Wei-Chang, Su Wei-Juin, Lin Shu-Min

机构信息

Department of Thoracic Medicine, Chang Gung Memorial Hospital Linkou Main Branch, Taoyuan, Taiwan.

School of Medicine, Chang Gung University, Taoyuan, Taiwan.

出版信息

Front Microbiol. 2022 Mar 3;13:821066. doi: 10.3389/fmicb.2022.821066. eCollection 2022.

DOI:10.3389/fmicb.2022.821066

PMID:35308376

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8927064/

Abstract

BACKGROUND

A regimen of once-weekly rifapentine plus isoniazid for 3 months (3HP) is an effective treatment for subjects with latent tuberculosis infection; however, no reliable biomarker exists for predicting systemic adverse reactions (SARs) to 3HP treatment.

METHODS

This prospective, multi-center study evaluated the plasma concentrations of soluble triggering receptors expressed on myeloid cells (sTREM)-1 and sTREM-2 in subjects undergoing 3HP treatment and examined the associations between these biomarkers and SARs.

RESULTS

This study enrolled 80 consecutive subjects receiving 3HP treatment, 25 of whom had SARs and 55 of whom did not. Subjects with SARs presented higher concentrations of sTREM-1 at baseline than those without SARs (240.1 ± 19.1 vs. 176.7 ± 9.4 pg/mL, = 0.001). The area under the receiver operating characteristic curves revealed that day 1 plasma levels of sTREM-1 (0.708, 95% CI, 0.584-0.833, = 0.003) and sTREM-2 (0.343, 95% CI, 0.227-0.459, = 0.025) as well as the sTREM-1/sTREM-2 ratio (0.748, 95% CI, 0.638-0.858, = 0.001) had modest discriminative power pertaining to the development of SARs. An sTREM-1 level exceeding the cut-off value (>187.4 pg/mL) (hazard ratio [HR], 6.15; 95% CI 1.67-22.70, = 0.006) and a sTREM-2 below the cut-off value (<237.2 pg/mL) (HR, 4.46; 95% CI 1.41-14.1, = 0.011) were independent predictors of SARs after controlling for other variables.

CONCLUSIONS

Plasma sTREM-1 and sTREM-2 levels are useful biomarkers for predicting SARs during 3HP treatment.

CLINICAL TRIAL GOVERNMENT

NCT04655794.

摘要

背景

每周一次利福喷丁联合异烟肼治疗3个月（3HP）的方案是潜伏性结核感染患者的有效治疗方法；然而，目前尚无可靠的生物标志物可用于预测3HP治疗的全身不良反应（SARs）。

方法

这项前瞻性、多中心研究评估了接受3HP治疗的受试者骨髓细胞上表达的可溶性触发受体（sTREM）-1和sTREM-2的血浆浓度，并研究了这些生物标志物与SARs之间的关联。

结果

本研究连续纳入80例接受3HP治疗的受试者，其中25例出现SARs，55例未出现。出现SARs的受试者在基线时的sTREM-1浓度高于未出现SARs的受试者（240.1±19.1 vs. 176.7±9.4 pg/mL，P = 0.001）。受试者工作特征曲线下面积显示，第1天血浆sTREM-1水平（0.708，95%CI，0.584 - 0.833，P = 0.003）、sTREM-2水平（0.343，95%CI，0.227 - 0.459，P = 0.025）以及sTREM-1/sTREM-2比值（0.748，95%CI，0.638 - 0.858，P = 0.001）对SARs的发生具有一定的判别能力。sTREM-1水平超过临界值（>187.4 pg/mL）（风险比[HR]，6.15；95%CI 1.67 - 22.70，P = 0.006）和sTREM-2低于临界值（<237.2 pg/mL）（HR，4.46；95%CI 1.41 - 14.1，P = 0.011）是在控制其他变量后SARs的独立预测因素。