Nutritional markers and proteome in patients undergoing treatment for pulmonary tuberculosis differ by geographic region

Contemporary phase 2 TB disease treatment clinical trials have found that microbiologic treatment responses differ between African versus non-African regions, the reasons for which remain unclear. Understanding host and disease phenotypes that may vary by region is important for optimizing curative...

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Vydáno v:PloS one Ročník 16; číslo 5; s. e0250586
Hlavní autoři: Jarsberg, Leah G., Kedia, Komal, Wendler, Jason, Wright, Aaron T., Piehowski, Paul D., Gritsenko, Marina A., Shi, Tujin, Lewinsohn, David M., Sigal, George B., Weiner, Marc H., Smith, Richard D., Keane, Joseph, Jacobs, Jon M., Nahid, Payam
Médium: Journal Article
Jazyk:angličtina
Vydáno: United States Public Library of Science 05.05.2021
Public Library of Science (PLoS)
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ISSN:1932-6203, 1932-6203
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Abstract Contemporary phase 2 TB disease treatment clinical trials have found that microbiologic treatment responses differ between African versus non-African regions, the reasons for which remain unclear. Understanding host and disease phenotypes that may vary by region is important for optimizing curative treatments. We characterized clinical features and the serum proteome of phase 2 TB clinical trial participants undergoing treatment for smear positive, culture-confirmed TB, comparing host serum protein expression in clinical trial participants enrolled in African and Non-African regions. Serum samples were collected from 289 participants enrolled in the Centers for Disease Control and Prevention TBTC Study 29 (NCT00694629) at time of enrollment and at the end of the intensive phase (after 40 doses of TB treatment). After a peptide level proteome analysis utilizing a unique liquid chromatography IM-MS platform (LC-IM-MS) and subsequent statistical analysis, a total of 183 core proteins demonstrated significant differences at both baseline and at week 8 timepoints between participants enrolled from African and non-African regions. The majority of the differentially expressed proteins were upregulated in participants from the African region, and included acute phase proteins, mediators of inflammation, as well as coagulation and complement pathways. Downregulated proteins in the African population were primarily linked to nutritional status and lipid metabolism pathways. We have identified differentially expressed nutrition and lipid pathway proteins by geographic region in TB patients undergoing treatment for pulmonary tuberculosis, which appear to be associated with differential treatment responses. Future TB clinical trials should collect expanded measures of nutritional status and further evaluate the relationship between nutrition and microbiologic treatment response.
AbstractList Introduction Contemporary phase 2 TB disease treatment clinical trials have found that microbiologic treatment responses differ between African versus non-African regions, the reasons for which remain unclear. Understanding host and disease phenotypes that may vary by region is important for optimizing curative treatments. Methods We characterized clinical features and the serum proteome of phase 2 TB clinical trial participants undergoing treatment for smear positive, culture-confirmed TB, comparing host serum protein expression in clinical trial participants enrolled in African and Non-African regions. Serum samples were collected from 289 participants enrolled in the Centers for Disease Control and Prevention TBTC Study 29 (NCT00694629) at time of enrollment and at the end of the intensive phase (after 40 doses of TB treatment). Results After a peptide level proteome analysis utilizing a unique liquid chromatography IM-MS platform (LC-IM-MS) and subsequent statistical analysis, a total of 183 core proteins demonstrated significant differences at both baseline and at week 8 timepoints between participants enrolled from African and non-African regions. The majority of the differentially expressed proteins were upregulated in participants from the African region, and included acute phase proteins, mediators of inflammation, as well as coagulation and complement pathways. Downregulated proteins in the African population were primarily linked to nutritional status and lipid metabolism pathways. Conclusions We have identified differentially expressed nutrition and lipid pathway proteins by geographic region in TB patients undergoing treatment for pulmonary tuberculosis, which appear to be associated with differential treatment responses. Future TB clinical trials should collect expanded measures of nutritional status and further evaluate the relationship between nutrition and microbiologic treatment response.
Contemporary phase 2 TB disease treatment clinical trials have found that microbiologic treatment responses differ between African versus non-African regions, the reasons for which remain unclear. Understanding host and disease phenotypes that may vary by region is important for optimizing curative treatments. We characterized clinical features and the serum proteome of phase 2 TB clinical trial participants undergoing treatment for smear positive, culture-confirmed TB, comparing host serum protein expression in clinical trial participants enrolled in African and Non-African regions. Serum samples were collected from 289 participants enrolled in the Centers for Disease Control and Prevention TBTC Study 29 (NCT00694629) at time of enrollment and at the end of the intensive phase (after 40 doses of TB treatment). After a peptide level proteome analysis utilizing a unique liquid chromatography IM-MS platform (LC-IM-MS) and subsequent statistical analysis, a total of 183 core proteins demonstrated significant differences at both baseline and at week 8 timepoints between participants enrolled from African and non-African regions. The majority of the differentially expressed proteins were upregulated in participants from the African region, and included acute phase proteins, mediators of inflammation, as well as coagulation and complement pathways. Downregulated proteins in the African population were primarily linked to nutritional status and lipid metabolism pathways. We have identified differentially expressed nutrition and lipid pathway proteins by geographic region in TB patients undergoing treatment for pulmonary tuberculosis, which appear to be associated with differential treatment responses. Future TB clinical trials should collect expanded measures of nutritional status and further evaluate the relationship between nutrition and microbiologic treatment response.
About the Authors: Leah G. Jarsberg Roles Data curation, Formal analysis, Writing – original draft, Writing – review & editing Affiliation: Division of Pulmonary and Critical Care Medicine and UCSF Center for Tuberculosis, University of California San Francisco, San Francisco, California, United States of America ORCID logo https://orcid.org/0000-0001-6548-6337 Komal Kedia Roles Investigation, Methodology Affiliation: Department of Pharmacokinetics, Pharmacodynamics & Drug Metabolism (PPDM) Merck & Co., Inc., West Point, Pennsylvania, United States of America Jason Wendler Roles Data curation, Formal analysis Affiliation: Seattle Children’s Hospital, Seattle, Washington, United States of America ORCID logo https://orcid.org/0000-0003-4195-8138 Aaron T. Wright Roles Methodology Affiliations Biological Sciences Division and Environmental Molecular Sciences Laboratory, Pacific Northwest National Laboratory, Richland, Washington, United States of America, Voiland School of Chemical Engineering and Bioengineering, Washington State University, Pullman, Washington, United States of America Paul D. Piehowski Roles Investigation, Methodology Affiliation: Biological Sciences Division and Environmental Molecular Sciences Laboratory, Pacific Northwest National Laboratory, Richland, Washington, United States of America Marina A. Gritsenko Roles Formal analysis, Investigation, Methodology, Writing – original draft Affiliation: Biological Sciences Division and Environmental Molecular Sciences Laboratory, Pacific Northwest National Laboratory, Richland, Washington, United States of America Tujin Shi Roles Investigation, Methodology Affiliation: Biological Sciences Division and Environmental Molecular Sciences Laboratory, Pacific Northwest National Laboratory, Richland, Washington, United States of America David M. Lewinsohn Roles Conceptualization Affiliation: Pulmonary and Critical Care Medicine, Oregon Health & Science University, Portland, Oregon, United States of America George B. Sigal Roles Conceptualization, Resources Affiliation: Meso Scale Diagnostics, Rockville, Maryland, United States of America ORCID logo https://orcid.org/0000-0001-7149-6400 Marc H. Weiner Roles Conceptualization Affiliation: University of Texas Health Science Center at San Antonio and the South Texas VAMC, San Antonio, Texas, United States of America Richard D. Smith Roles Resources Affiliation: Biological Sciences Division and Environmental Molecular Sciences Laboratory, Pacific Northwest National Laboratory, Richland, Washington, United States of America Joseph Keane Roles Methodology, Writing – review & editing Affiliation: Department of Clinical Medicine, Trinity Translational Medicine Institute, St. James’s Hospital, Dublin, Ireland Jon M. Jacobs Roles Conceptualization, Data curation, Formal analysis, Funding acquisition, Investigation, Methodology, Project administration, Resources, Supervision, Validation, Writing – original draft, Writing – review & editing * E-mail: jon.jacobs@pnnl.gov Affiliation: Biological Sciences Division and Environmental Molecular Sciences Laboratory, Pacific Northwest National Laboratory, Richland, Washington, United States of America ORCID logo https://orcid.org/0000-0003-0557-7338 Payam Nahid Roles Conceptualization, Funding acquisition, Investigation, Methodology, Resources, Writing – original draft, Writing – review & editing Affiliation: Division of Pulmonary and Critical Care Medicine and UCSF Center for Tuberculosis, University of California San Francisco, San Francisco, California, United States of America ORCID logo https://orcid.org/0000-0003-2811-1311 Introduction Africa is home to 11% of the world’s population but carries 29% of the global burden of tuberculosis (TB) [1]. According to the World Health Organization (WHO), 84% of TB-related deaths worldwide occur in Africa [2]. Materials and methods Ethics statement Study 29 was approved by both CDC and local institutional review boards, and written informed consent was obtained from all study participants for collection of serum for TB-related research. Study population TBTC Study 29 (ClinicalTrials.gov Identifier NCT00694629) is a prospective, multicenter, open-label Phase 2 clinical trial comparing the antimicrobial activity and safety of a standard daily regimen containing rifampin, to that of an experimental regimen with daily rifapentine (10 mg/kg/dose), both given with isoniazid, pyrazinamide and ethambutol to adults with smear positive, culture-confirmed pulmonary TB.
About the Authors: Leah G. Jarsberg Roles Data curation, Formal analysis, Writing – original draft, Writing – review & editing Affiliation: Division of Pulmonary and Critical Care Medicine and UCSF Center for Tuberculosis, University of California San Francisco, San Francisco, California, United States of America ORCID logo https://orcid.org/0000-0001-6548-6337 Komal Kedia Roles Investigation, Methodology Affiliation: Department of Pharmacokinetics, Pharmacodynamics & Drug Metabolism (PPDM) Merck & Co., Inc., West Point, Pennsylvania, United States of America Jason Wendler Roles Data curation, Formal analysis Affiliation: Seattle Children’s Hospital, Seattle, Washington, United States of America ORCID logo https://orcid.org/0000-0003-4195-8138 Aaron T. Wright Roles Methodology Affiliations Biological Sciences Division and Environmental Molecular Sciences Laboratory, Pacific Northwest National Laboratory, Richland, Washington, United States of America, Voiland School of Chemical Engineering and Bioengineering, Washington State University, Pullman, Washington, United States of America Paul D. Piehowski Roles Investigation, Methodology Affiliation: Biological Sciences Division and Environmental Molecular Sciences Laboratory, Pacific Northwest National Laboratory, Richland, Washington, United States of America Marina A. Gritsenko Roles Formal analysis, Investigation, Methodology, Writing – original draft Affiliation: Biological Sciences Division and Environmental Molecular Sciences Laboratory, Pacific Northwest National Laboratory, Richland, Washington, United States of America Tujin Shi Roles Investigation, Methodology Affiliation: Biological Sciences Division and Environmental Molecular Sciences Laboratory, Pacific Northwest National Laboratory, Richland, Washington, United States of America David M. Lewinsohn Roles Conceptualization Affiliation: Pulmonary and Critical Care Medicine, Oregon Health & Science University, Portland, Oregon, United States of America George B. Sigal Roles Conceptualization, Resources Affiliation: Meso Scale Diagnostics, Rockville, Maryland, United States of America ORCID logo https://orcid.org/0000-0001-7149-6400 Marc H. Weiner Roles Conceptualization Affiliation: University of Texas Health Science Center at San Antonio and the South Texas VAMC, San Antonio, Texas, United States of America Richard D. Smith Roles Resources Affiliation: Biological Sciences Division and Environmental Molecular Sciences Laboratory, Pacific Northwest National Laboratory, Richland, Washington, United States of America Joseph Keane Roles Methodology, Writing – review & editing Affiliation: Department of Clinical Medicine, Trinity Translational Medicine Institute, St. James’s Hospital, Dublin, Ireland Jon M. Jacobs Roles Conceptualization, Data curation, Formal analysis, Funding acquisition, Investigation, Methodology, Project administration, Resources, Supervision, Validation, Writing – original draft, Writing – review & editing * E-mail: jon.jacobs@pnnl.gov Affiliation: Biological Sciences Division and Environmental Molecular Sciences Laboratory, Pacific Northwest National Laboratory, Richland, Washington, United States of America ORCID logo https://orcid.org/0000-0003-0557-7338 Payam Nahid Roles Conceptualization, Funding acquisition, Investigation, Methodology, Resources, Writing – original draft, Writing – review & editing Affiliation: Division of Pulmonary and Critical Care Medicine and UCSF Center for Tuberculosis, University of California San Francisco, San Francisco, California, United States of America ORCID logo https://orcid.org/0000-0003-2811-1311 Introduction Africa is home to 11% of the world’s population but carries 29% of the global burden of tuberculosis (TB) [1]. According to the World Health Organization (WHO), 84% of TB-related deaths worldwide occur in Africa [2]. Materials and methods Ethics statement Study 29 was approved by both CDC and local institutional review boards, and written informed consent was obtained from all study participants for collection of serum for TB-related research. Study population TBTC Study 29 (ClinicalTrials.gov Identifier NCT00694629) is a prospective, multicenter, open-label Phase 2 clinical trial comparing the antimicrobial activity and safety of a standard daily regimen containing rifampin, to that of an experimental regimen with daily rifapentine (10 mg/kg/dose), both given with isoniazid, pyrazinamide and ethambutol to adults with smear positive, culture-confirmed pulmonary TB.
Contemporary phase 2 TB disease treatment clinical trials have found that microbiologic treatment responses differ between African versus non-African regions, the reasons for which remain unclear. Understanding host and disease phenotypes that may vary by region is important for optimizing curative treatments. We characterized clinical features and the serum proteome of phase 2 TB clinical trial participants undergoing treatment for smear positive, culture-confirmed TB, comparing host serum protein expression in clinical trial participants enrolled in African and Non-African regions. Serum samples were collected from 289 participants enrolled in the Centers for Disease Control and Prevention TBTC Study 29 (NCT00694629) at time of enrollment and at the end of the intensive phase (after 40 doses of TB treatment). After a peptide level proteome analysis utilizing a unique liquid chromatography IM-MS platform (LC-IM-MS) and subsequent statistical analysis, a total of 183 core proteins demonstrated significant differences at both baseline and at week 8 timepoints between participants enrolled from African and non-African regions. The majority of the differentially expressed proteins were upregulated in participants from the African region, and included acute phase proteins, mediators of inflammation, as well as coagulation and complement pathways. Downregulated proteins in the African population were primarily linked to nutritional status and lipid metabolism pathways. We have identified differentially expressed nutrition and lipid pathway proteins by geographic region in TB patients undergoing treatment for pulmonary tuberculosis, which appear to be associated with differential treatment responses. Future TB clinical trials should collect expanded measures of nutritional status and further evaluate the relationship between nutrition and microbiologic treatment response.
Contemporary phase 2 TB disease treatment clinical trials have found that microbiologic treatment responses differ between African versus non-African regions, the reasons for which remain unclear. Understanding host and disease phenotypes that may vary by region is important for optimizing curative treatments.INTRODUCTIONContemporary phase 2 TB disease treatment clinical trials have found that microbiologic treatment responses differ between African versus non-African regions, the reasons for which remain unclear. Understanding host and disease phenotypes that may vary by region is important for optimizing curative treatments.We characterized clinical features and the serum proteome of phase 2 TB clinical trial participants undergoing treatment for smear positive, culture-confirmed TB, comparing host serum protein expression in clinical trial participants enrolled in African and Non-African regions. Serum samples were collected from 289 participants enrolled in the Centers for Disease Control and Prevention TBTC Study 29 (NCT00694629) at time of enrollment and at the end of the intensive phase (after 40 doses of TB treatment).METHODSWe characterized clinical features and the serum proteome of phase 2 TB clinical trial participants undergoing treatment for smear positive, culture-confirmed TB, comparing host serum protein expression in clinical trial participants enrolled in African and Non-African regions. Serum samples were collected from 289 participants enrolled in the Centers for Disease Control and Prevention TBTC Study 29 (NCT00694629) at time of enrollment and at the end of the intensive phase (after 40 doses of TB treatment).After a peptide level proteome analysis utilizing a unique liquid chromatography IM-MS platform (LC-IM-MS) and subsequent statistical analysis, a total of 183 core proteins demonstrated significant differences at both baseline and at week 8 timepoints between participants enrolled from African and non-African regions. The majority of the differentially expressed proteins were upregulated in participants from the African region, and included acute phase proteins, mediators of inflammation, as well as coagulation and complement pathways. Downregulated proteins in the African population were primarily linked to nutritional status and lipid metabolism pathways.RESULTSAfter a peptide level proteome analysis utilizing a unique liquid chromatography IM-MS platform (LC-IM-MS) and subsequent statistical analysis, a total of 183 core proteins demonstrated significant differences at both baseline and at week 8 timepoints between participants enrolled from African and non-African regions. The majority of the differentially expressed proteins were upregulated in participants from the African region, and included acute phase proteins, mediators of inflammation, as well as coagulation and complement pathways. Downregulated proteins in the African population were primarily linked to nutritional status and lipid metabolism pathways.We have identified differentially expressed nutrition and lipid pathway proteins by geographic region in TB patients undergoing treatment for pulmonary tuberculosis, which appear to be associated with differential treatment responses. Future TB clinical trials should collect expanded measures of nutritional status and further evaluate the relationship between nutrition and microbiologic treatment response.CONCLUSIONSWe have identified differentially expressed nutrition and lipid pathway proteins by geographic region in TB patients undergoing treatment for pulmonary tuberculosis, which appear to be associated with differential treatment responses. Future TB clinical trials should collect expanded measures of nutritional status and further evaluate the relationship between nutrition and microbiologic treatment response.
IntroductionContemporary phase 2 TB disease treatment clinical trials have found that microbiologic treatment responses differ between African versus non-African regions, the reasons for which remain unclear. Understanding host and disease phenotypes that may vary by region is important for optimizing curative treatments.MethodsWe characterized clinical features and the serum proteome of phase 2 TB clinical trial participants undergoing treatment for smear positive, culture-confirmed TB, comparing host serum protein expression in clinical trial participants enrolled in African and Non-African regions. Serum samples were collected from 289 participants enrolled in the Centers for Disease Control and Prevention TBTC Study 29 (NCT00694629) at time of enrollment and at the end of the intensive phase (after 40 doses of TB treatment).ResultsAfter a peptide level proteome analysis utilizing a unique liquid chromatography IM-MS platform (LC-IM-MS) and subsequent statistical analysis, a total of 183 core proteins demonstrated significant differences at both baseline and at week 8 timepoints between participants enrolled from African and non-African regions. The majority of the differentially expressed proteins were upregulated in participants from the African region, and included acute phase proteins, mediators of inflammation, as well as coagulation and complement pathways. Downregulated proteins in the African population were primarily linked to nutritional status and lipid metabolism pathways.ConclusionsWe have identified differentially expressed nutrition and lipid pathway proteins by geographic region in TB patients undergoing treatment for pulmonary tuberculosis, which appear to be associated with differential treatment responses. Future TB clinical trials should collect expanded measures of nutritional status and further evaluate the relationship between nutrition and microbiologic treatment response.
Audience Academic
Author Gritsenko, Marina A.
Keane, Joseph
Kedia, Komal
Lewinsohn, David M.
Jacobs, Jon M.
Piehowski, Paul D.
Wright, Aaron T.
Nahid, Payam
Jarsberg, Leah G.
Weiner, Marc H.
Wendler, Jason
Sigal, George B.
Shi, Tujin
Smith, Richard D.
AuthorAffiliation 7 Meso Scale Diagnostics, Rockville, Maryland, United States of America
8 University of Texas Health Science Center at San Antonio and the South Texas VAMC, San Antonio, Texas, United States of America
1 Division of Pulmonary and Critical Care Medicine and UCSF Center for Tuberculosis, University of California San Francisco, San Francisco, California, United States of America
3 Seattle Children’s Hospital, Seattle, Washington, United States of America
4 Biological Sciences Division and Environmental Molecular Sciences Laboratory, Pacific Northwest National Laboratory, Richland, Washington, United States of America
2 Department of Pharmacokinetics, Pharmacodynamics & Drug Metabolism (PPDM) Merck & Co., Inc., West Point, Pennsylvania, United States of America
5 Voiland School of Chemical Engineering and Bioengineering, Washington State University, Pullman, Washington, United States of America
Rutgers Biomedical and Health Sciences, UNITED STATES
6 Pulmonary and Critical Care Medicine, Oregon Hea
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– notice: 2021 Jarsberg et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.
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CorporateAuthor Pacific Northwest National Lab. (PNNL), Richland, WA (United States). Environmental Molecular Sciences Lab. (EMSL)
CorporateAuthor_xml – name: Pacific Northwest National Lab. (PNNL), Richland, WA (United States). Environmental Molecular Sciences Lab. (EMSL)
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Snippet Contemporary phase 2 TB disease treatment clinical trials have found that microbiologic treatment responses differ between African versus non-African regions,...
Introduction Contemporary phase 2 TB disease treatment clinical trials have found that microbiologic treatment responses differ between African versus...
About the Authors: Leah G. Jarsberg Roles Data curation, Formal analysis, Writing – original draft, Writing – review & editing Affiliation: Division of...
IntroductionContemporary phase 2 TB disease treatment clinical trials have found that microbiologic treatment responses differ between African versus...
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SubjectTerms Adult
Analysis
Antiinfectives and antibacterials
Antimicrobial activity
BASIC BIOLOGICAL SCIENCES
Bioengineering
Biology and Life Sciences
Biomarkers
Biomarkers - metabolism
Blood proteins
Care and treatment
Chemical engineering
Clinical medicine
Clinical trials
Critical care
Data analysis
Dosage
Drug metabolism
Editing
Ethambutol
Female
Funding
Humans
Informed consent
Isoniazid
Laboratories
Lipid Metabolism
Male
Medicine
Medicine and Health Sciences
Metabolism
Methodology
Middle Aged
Mycobacterium tuberculosis - drug effects
Mycobacterium tuberculosis - isolation & purification
Mycobacterium tuberculosis - metabolism
North America
Nutrition
Nutritional Physiological Phenomena
People and Places
Pharmacodynamics
Pharmacokinetics
Pharmacology
Physical sciences
Population studies
Product/Service Evaluations
Proteome - metabolism
Proteomes
Proteomics - methods
Pulmonary tuberculosis
Pyrazinamide
Review boards
Rifampin
South Africa
Spain
Treatment Outcome
Tuberculosis
Tuberculosis, Pulmonary - drug therapy
Tuberculosis, Pulmonary - metabolism
Tuberculosis, Pulmonary - microbiology
Uganda
Young Adult
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Title Nutritional markers and proteome in patients undergoing treatment for pulmonary tuberculosis differ by geographic region
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