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接受抗布鲁里溃疡治疗的患者的炎症标志物变化及其预测矛盾反应的能力。

Changes in Inflammatory Markers in Patients Treated for Buruli Ulcer and Their Ability to Predict Paradoxical Reactions.

机构信息

Service des Maladies Infectieuses et Tropicales, University Hospital Angers.

Université Angers, Nantes Université, Inserm, Immunology and New Concepts in ImmunoTherapy, Immunology and New Concepts in Immunotherapy (INCIT), Angers, France.

出版信息

J Infect Dis. 2023 Nov 28;228(11):1630-1639. doi: 10.1093/infdis/jiad176.

DOI:10.1093/infdis/jiad176
PMID:37221015
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10681857/
Abstract

Mycobacterium ulcerans causes Buruli ulcer, the third most frequent mycobacterial disease after tuberculosis and leprosy. Transient clinical deteriorations, known as paradoxical reactions (PRs), occur in some patients during or after antibiotic treatment. We investigated the clinical and biological features of PRs in a prospective cohort of 41 patients with Buruli ulcer from Benin. Neutrophil counts decreased from baseline to day 90, and interleukin 6 (IL-6), granulocyte colony-stimulating factor, and vascular endothelial growth factor were the cytokines displaying a significant monthly decrease relative to baseline. PRs occurred in 10 (24%) patients. The baseline biological and clinical characteristics of the patients presenting with PRs did not differ significantly from those of the other patients. However, the patients with PRs had significantly higher IL-6 and tumor necrosis factor alpha (TNF-α) concentrations on days 30, 60, and 90 after the start of antibiotic treatment. The absence of a decrease in IL-6 and TNF-α levels during treatment should alert clinicians to the possibility of PR onset.

摘要

溃疡分枝杆菌可引起溃疡分枝杆菌病，这是继肺结核和麻风病之后的第三大常见分枝杆菌病。在抗生素治疗期间或之后，一些患者会出现暂时的临床恶化，称为矛盾反应（PRs）。我们在一项来自贝宁的 41 例溃疡分枝杆菌病患者的前瞻性队列研究中，调查了 PRs 的临床和生物学特征。中性粒细胞计数从基线下降到 90 天，白细胞介素 6（IL-6）、粒细胞集落刺激因子和血管内皮生长因子是与基线相比每月显著下降的细胞因子。10 例（24%）患者出现 PRs。出现 PRs 的患者的基线生物学和临床特征与其他患者无显著差异。然而，在抗生素治疗开始后 30、60 和 90 天，出现 PRs 的患者的 IL-6 和肿瘤坏死因子-α（TNF-α）浓度显著升高。在治疗过程中，IL-6 和 TNF-α 水平没有下降，这应该引起临床医生对 PR 发病的警惕。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c237/10681857/c5069bc7ef95/jiad176f6.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c237/10681857/e271e5bc2055/jiad176f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c237/10681857/6b228cb04773/jiad176f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c237/10681857/deaea460d1c4/jiad176f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c237/10681857/c5069bc7ef95/jiad176f6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c237/10681857/8b4a05bebdef/jiad176f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c237/10681857/d05691708464/jiad176f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c237/10681857/e271e5bc2055/jiad176f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c237/10681857/6b228cb04773/jiad176f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c237/10681857/deaea460d1c4/jiad176f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c237/10681857/c5069bc7ef95/jiad176f6.jpg

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