Prediction of Treatment Outcome with Inflammatory Biomarkers after 2 Months of Therapy in Pulmonary Tuberculosis Patients: Preliminary Results

Abstract

Pro-inflammatory mediators play an important role in the pathogenesis of pulmonary tuberculosis. Consecutively, 26 pulmonary tuberculosis patients were enrolled in our study based on the exclusion criteria. We have used Spearman’s correlation analysis, hierarchical clustering and regression modelling to evaluate the association of 11 biomarkers with culture status after antituberculosis treatment. The results of our study demonstrated that six inflammatory biomarkers of 11, C-reactive protein (CRP), white blood cells (WBC), neutrophils, interferon gamma inducible protein 10, C-reactive protein (CRP) to albumin ratio (CAR) and neutrophil to albumin ratio (NAR), were significantly associated with culture negativity. The predictive ability of a composite model of seven biomarkers was superior to that of any single biomarker based on area under the receiver operating characteristic curve (AUC) analysis, indicating an excellent prediction efficacy (AUC:0.892; 95% CI:0.732-1.0). We also found that the highest significant trends and lower levels of CRP and IP-10 were observed in the two-month treated tuberculosis (TB) patients. We believe that our study may be valuable in providing preliminary results for an additional strategy in monitoring and management of the clinical outcome of pulmonary tuberculosis. Using a panel of predictors added a superior value in predicting culture status after anti-TB therapy.

Evaluation of Systemic Inflammation Before and After Standard Anti-tuberculosis Treatment in Patients With Active Pulmonary Tuberculosis and Diabetes Mellitus

“…Given this, these three markers could be useful for monitoring subjects with APTB during standard TB treatment. Our findings align with previous studies, which emphasize the significance of monitoring circulating acute phase reactants and cytokines as parameters that aid in distinguishing individuals with TB both before and after standard TB treatment [ 22 , 62 , 86 , 87 ]. Thus, the importance of the study lies in the fact that systemic inflammation can be evaluated with the determination of these inflammatory mediators (IFN-γ, CRP, and total sialic acid), and this evaluation could be useful in conjunction with sputum smear microscopy to evaluate the response to anti-tuberculosis treatment in subjects with APTB and TBDM [ 7 , 17 , 29 , 82 ].…”

Screening performance of C-reactive protein for active pulmonary tuberculosis in HIV-positive patients: A systematic review with a meta-analysis

“…and the host, based on the interaction of bacterial strains and inflammatory biomarkers released by macrophages, monocytes, neutrophils, and lymphocytes ( 30 – 34 ). C-reactive protein (CRP) is also a non-specific biomarker in TB, with highly increased plasmatic concentrations, due to sputum bacillary load and severity of inflammation ( 30 , 35 ). Human liver CRP production usually forgoes clinical symptoms ( 30 , 31 ).…”

A clinical indicator-based prognostic model predicting treatment outcomes of pulmonary tuberculosis: a prospective cohort study

“…Luo et al established clinical indicators in routine blood tests to distinguish between active TB and latent tuberculosis infection (LTBI) [ 24 ]. Stefanescu et al supposed that inflammatory biomarkers, including CRP, WBC, neutrophils, interferon-gamma inducible protein 10, CRP to albumin ratio (CAR), neutrophil to albumin ratio (NAR) and serum LL37, had a good prediction ability for 2-months treatment outcomes of pulmonary TB patients [ 25 ]. Previous studies also suggested that the power of a single index to predict prognosis was limited, and the combination of clinical indicators can effectively improve the prediction effectiveness.…”