OBJECTIVE: To identify patients at high risk of relapse after anti-tuberculosis (TB) therapy or with poor long-term outcomes. METHODS: Fifty-one patients with pulmonary TB: 7 were classified as high association with both cavitations on initial chest radiography and positive sputum smear/cultures after two months of anti-TB treatment (HA group); 19 medium association (MA, one risk alone); and 25 low association (LA, neither risk). Serum interferon (IFN)-γ-inducible protein 10 (IP-10), interleukin-17 (IL-17), and C-reactive protein levels were investigated. RESULTS: There was a trend towards higher serum IP-10 levels (p=0.042) for HA patients throughout the 6-month treatment period. Month-2 IP-10 levels were higher in the HA than in the MA/LA group (656.2 ± 234.4 vs. 307.6 ± 258.5 pg/ml, adjusted p =0.005). Receiver operating characteristic curves showed that the risk of relapse was well-captured by month-2 IP-10 levels at a cut-off value of 431 pg/ml (AUC=0.857, 95% CI 0.75-0.97, p =0.003). Month-2 serum IL-17 levels were lower in non-survivors than survivors (15.7 ± 2.9 pg/ml vs. 24.6 ± 8.2 pg/ml, p=0.001). Multivariate analysis demonstrated that a month-2 serum IL-17 level of ⩽ 17 pg/ml (p =0.026) was independently associated with all-cause mortality. CONCLUSIONS: Serum IP-10 and IL-17 levels after 2 months of anti-TB treatment may be biomarkers for estimating risk of both cavitation and delayed sputum conversion, and for predicting long-term mortality, respectively.
OBJECTIVE: To identify patients at high risk of relapse after anti-tuberculosis (TB) therapy or with poor long-term outcomes. METHODS: Fifty-one patients with pulmonary TB: 7 were classified as high association with both cavitations on initial chest radiography and positive sputum smear/cultures after two months of anti-TB treatment (HA group); 19 medium association (MA, one risk alone); and 25 low association (LA, neither risk). Serum interferon (IFN)-γ-inducible protein 10 (IP-10), interleukin-17 (IL-17), and C-reactive protein levels were investigated. RESULTS: There was a trend towards higher serum IP-10 levels (p=0.042) for HA patients throughout the 6-month treatment period. Month-2 IP-10 levels were higher in the HA than in the MA/LA group (656.2 ± 234.4 vs. 307.6 ± 258.5 pg/ml, adjusted p =0.005). Receiver operating characteristic curves showed that the risk of relapse was well-captured by month-2 IP-10 levels at a cut-off value of 431 pg/ml (AUC=0.857, 95% CI 0.75-0.97, p =0.003). Month-2 serum IL-17 levels were lower in non-survivors than survivors (15.7 ± 2.9 pg/ml vs. 24.6 ± 8.2 pg/ml, p=0.001). Multivariate analysis demonstrated that a month-2 serum IL-17 level of ⩽ 17 pg/ml (p =0.026) was independently associated with all-cause mortality. CONCLUSIONS: Serum IP-10 and IL-17 levels after 2 months of anti-TB treatment may be biomarkers for estimating risk of both cavitation and delayed sputum conversion, and for predicting long-term mortality, respectively.
Authors: Uma Shanmugasundaram; Allison N Bucsan; Shashank R Ganatra; Chris Ibegbu; Melanie Quezada; Robert V Blair; Xavier Alvarez; Vijayakumar Velu; Deepak Kaushal; Jyothi Rengarajan Journal: JCI Insight Date: 2020-07-23
Authors: Kaori Sakamoto; Mi Jeong Kim; Elizabeth R Rhoades; Rachel E Allavena; Sabine Ehrt; Helen C Wainwright; David G Russell; Kyle H Rohde Journal: Infect Immun Date: 2012-12-21 Impact factor: 3.441
Authors: Frédéric F Little; Diana M Delgado; Philip J Wexler; Frank G Oppenheim; Patricia Mitchell; James A Feldman; David R Walt; Roger D Peng; Elizabeth C Matsui Journal: PLoS One Date: 2014-01-07 Impact factor: 3.240
Authors: Irene Andia Biraro; Simon Kimuda; Moses Egesa; Stephen Cose; Emily L Webb; Moses Joloba; Steven G Smith; Alison M Elliott; Hazel M Dockrell; Achilles Katamba Journal: PLoS One Date: 2016-01-15 Impact factor: 3.240