Leboueny Marielle, Maloupazoa Siawaya Anicet Christel, Bouanga Loraine Daisy Josiane, Mvoundza Ndjindji Ofilia, Mveang Nzoghe Amandine, Djoba Siawaya Joel Fleury
Service Laboratoire, Centre Hospitalier Universitaire Mère-Enfant Fondation Jeanne EBORI BP. 212, Libreville, Gabon.
Unité de Recherches et de Diagnostics Spécialisés, Laboratoire National de Santé Publique, Avenue Felix Eboué, BP10 736 Libreville, Gabon.
J Clin Tuberc Other Mycobact Dis. 2023 Jan 18;31:100348. doi: 10.1016/j.jctube.2023.100348. eCollection 2023 May.
Tuberculosis (TB) remains a public health concern worldwide, affecting millions of people every year. Detailed characterization of disease pathophysiology is key to proper diagnosis, disease progression, or treatment follow-up and evaluation. The present study investigated C-reactive protein and Procalcitonin (PCT) as candidate markers of early treatment response and disease activity.
September to December 2019 21 HIV-negative TB patients were recruited, within the setting of the Gabonese TB specialized hospital and the National Laboratory of Public Health, in a prospective study. CRP and PCT levels were measured by chemiluminescence at diagnosis and 4 weeks following the initiation of anti-TB treatment.
The mean concentration of CRP in TB patients was 114.7 mg/L (95 % CI: [83.8-145.6]) at diagnosis and 20.2 mg/L (95 % CI: [14.1-26.4]) 4 weeks following anti-TB treatment. The drop in CRP concentrations between diagnosis, and week 4 following anti-TB treatment showed was significant (p < 0.0001). The average concentration of PCT at the time of diagnosis was 0.3 ng/mL (95 % CI: [0.19-0.41]). PCT Concentration dropped below 0.05 ng/mL 4 weeks following the start of anti-TB treatment (p < 0.01).
CRP and PCT are potential TB biomarkers, each, carrying important keys. If the drop in both proteins may indicate a significant reduction of the burden, the maintenance of CRP above the inflammation threshold could indicate the presence of residual bacilli. However, the clinical translation of the present finding will require more investigation.
结核病仍是全球公共卫生关注的问题，每年影响数百万人。详细描述疾病病理生理学是正确诊断、疾病进展或治疗随访及评估的关键。本研究调查了C反应蛋白和降钙素原（PCT）作为早期治疗反应和疾病活动的候选标志物。
2019年9月至12月，在加蓬结核病专科医院和国家公共卫生实验室的背景下，招募了21名HIV阴性的结核病患者，进行一项前瞻性研究。在诊断时以及开始抗结核治疗4周后，通过化学发光法测量CRP和PCT水平。
结核病患者诊断时CRP的平均浓度为114.7mg/L（95%CI：[83.8 - 145.6]），抗结核治疗4周后为20.2mg/L（95%CI：[14.1 - 26.4]）。诊断时与抗结核治疗后第4周CRP浓度的下降具有显著性（p < 0.0001）。诊断时PCT的平均浓度为0.3ng/mL（95%CI：[0.19 - 0.41]）。抗结核治疗开始4周后PCT浓度降至0.05ng/mL以下（p < 0.01）。
CRP和PCT是潜在的结核病生物标志物，各有重要意义。如果两种蛋白的下降可能表明负担显著减轻，CRP维持在炎症阈值以上可能表明存在残留杆菌。然而，本研究结果的临床转化还需要更多的研究。
