Sustained elevated levels of C-reactive protein and ferritin in pulmonary tuberculosis patients remaining culture positive upon treatment initiation

Clinical trials that evaluate new anti-tubercular drugs and treatment regimens take years to complete due to the slow clearance of Mycobacterium tuberculosis infection and the lack of early biomarkers that predict treatment outcomes. Host Inflammation markers have been associated with tuberculosis (...

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Veröffentlicht in:PloS one Jg. 12; H. 4; S. e0175278
Hauptverfasser: Miranda, Pryscila, Gil-Santana, Leonardo, Oliveira, Marina G., Mesquita, Eliene D. D., Silva, Elisangela, Rauwerdink, Anneloek, Cobelens, Frank, Oliveira, Martha M., Andrade, Bruno B., Kritski, Afrânio
Format: Journal Article
Sprache:Englisch
Veröffentlicht: United States Public Library of Science 06.04.2017
Public Library of Science (PLoS)
Schlagworte:
Acute phase proteins
Acute phase substances
Adult
Alcoholism
Anemia
Animal models
Antibodies
Antiinfectives and antibacterials
Antitubercular Agents - therapeutic use
Ascorbic acid
Attenuation
Autoimmune diseases
Bacilli
Bacteria
Biochemistry
Biology and Life Sciences
Biomarkers
Biotechnology
Bone marrow
Bone marrow transplantation
C-reactive protein
C-Reactive Protein - metabolism
Cages
Care and treatment
Carotene
Cell culture
Cell survival
Chemotherapy
Clinical outcomes
Clinical trials
Decontamination
Diagnosis
Digestion
Drug abuse
Drug resistance
Female
Ferritin
Ferritins - metabolism
Genetic aspects
Health aspects
Health risk assessment
HIV
Homeostasis
Human immunodeficiency virus
Humans
Infections
Inflammation
Interferon
Interleukin 1
Loads (forces)
Lung diseases
Male
Malignancy
Medicine and Health Sciences
Middle Aged
Mortality
Patients
Proteins
Psychiatry
Tuberculosis
Tuberculosis, Pulmonary - drug therapy
Tuberculosis, Pulmonary - metabolism
Vitamin E
Brazil
Rio de Janeiro Brazil
ISSN:1932-6203, 1932-6203
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Zusammenfassung:Clinical trials that evaluate new anti-tubercular drugs and treatment regimens take years to complete due to the slow clearance of Mycobacterium tuberculosis infection and the lack of early biomarkers that predict treatment outcomes. Host Inflammation markers have been associated with tuberculosis (TB) pathogenesis. In the present study, we tested if circulating levels of C-reactive protein (CRP) and ferritin reflect mycobacterial loads and inflammation in pulmonary TB (PTB) patients undergoing anti-tuberculous therapy (ATT). Prospective measurements of CRP and ferritin, used as readouts of systemic inflammation, were performed in cryopreserved serum samples from 165 Brazilian patients with active PTB initiating ATT. Associations between levels of these laboratory parameters with mycobacterial loads in sputum as well as with sputum conversion at day 60 of ATT were tested. Circulating levels of both ferritin and CRP gradually decreased over time on ATT. At pre-treatment, concentrations of these parameters were unable to distinguish patients with positive from those with negative acid-fast bacilli (AFB) in sputum cultures. However, patients who remained with positive cultures at day 60 of ATT exhibited heightened levels of these inflammatory markers compared to those with negative cultures at that time point. CRP and Ferritin levels in serum may be useful to identify patients with positive cultures at day 60 of ATT.
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Competing Interests: The authors have declared that no competing interests exist.
Conceptualization: LG-S BBA AK.Data curation: PM LG-S MGO EDDM ES AR.Formal analysis: LG-S BBA.Funding acquisition: AK FC MMO.Investigation: PM MGO EDDM ES AR FC MMO AK.Methodology: LG-S BBA.Project administration: MMO AK.Resources: PM LG-S MGO EDDM FC MMO AK BBA.Software: LG-S BBA.Supervision: AK BBA.Validation: BBA.Visualization: LG-S BBA.Writing – original draft: LG-S BBA.Writing – review & editing: PM LG-S ES FC BBA AK.
These authors also contributed equally to this work
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0175278