Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran; Systematic Review and Meta-analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran.
Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran; Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran.
Int Immunopharmacol. 2022 Oct;111:109147. doi: 10.1016/j.intimp.2022.109147. Epub 2022 Aug 13.
Neopterin (NEO) is a marker of immune stimulation. Increased NEO levels have been associated with autoimmune diseases, infections, and malignancies. Studies of NEO alterations in tuberculosis (TB) with or without HIV co-infection show inconsistent results. Moreover, challenges exist regarding TB diagnosis in people with HIV.
We did a systematic review and meta-analysis of studies comparing urinary, pleural, and blood NEO levels between patients with TB or HIV-TB co-infection as the case group and subjects without TB and HIV or subjects with HIV without TB as the control group, respectively.
Blood NEO levels in patients with active TB were higher than healthy controls, with a large effect size of 1.99. Patients with TB had higher blood NEO levels before anti-tuberculosis therapy (ATT) than after ATT for months or when treatment ended with moderate effect sizes (1.13-1.46). meta-analysis of studies of patients with HIV-TB co-infection yielded similar results, with higher blood NEO levels in patients than controls that remained significant in subgroups of studies on pulmonary TB (PTB) patients and serum NEO and higher blood NEO levels in patients before than after ATT.
Meta-analyses reveal alteration in NEO levels in different specimens, e.g., blood, urine, and pleural fluid, in patients with TB with or HIV-TB co-infection compared to the control groups. Future studies need to investigate the utility of NEO as a diagnostic/prognostic biomarker for TB. Also, cellular and molecular mechanisms linking NEO and TB remain to be addressed.
Neopterin（NEO）是一种免疫刺激标志物。NEO 水平升高与自身免疫性疾病、感染和恶性肿瘤有关。研究表明，在结核（TB）合并或不合并 HIV 感染的情况下，NEO 水平的改变不一致。此外，在 HIV 感染者中进行 TB 诊断存在挑战。
我们对比较 TB 或 HIV-TB 合并感染患者（病例组）与无 TB 和 HIV 或无 TB 但有 HIV 感染者（对照组）尿液、胸腔积液和血液 NEO 水平的研究进行了系统评价和荟萃分析。
活动性 TB 患者的血液 NEO 水平高于健康对照者，效应量较大（1.99）。TB 患者在接受抗结核治疗（ATT）前的血液 NEO 水平高于 ATT 后数月或 ATT 结束时（效应量为 1.13-1.46）。对 HIV-TB 合并感染患者的研究进行荟萃分析得到了类似的结果，与对照组相比，患者的血液 NEO 水平更高，在亚组研究中，肺结核（PTB）患者的血清 NEO 和血液 NEO 水平以及 ATT 前患者的血液 NEO 水平较高。
荟萃分析显示，与对照组相比，TB 合并或不合并 HIV 感染患者的不同标本（如血液、尿液和胸腔积液）中 NEO 水平发生了改变。未来的研究需要调查 NEO 作为 TB 诊断/预后生物标志物的效用。此外，NEO 与 TB 之间的细胞和分子机制仍有待解决。
