Background:
Active pulmonary tuberculosis (PTB) is known to cause qualitative and quantitative changes in the systemic immune profile, resulting in a chronic inflammatory imbalance. However, less is understood about these profiles in extrapulmonary tuberculosis (EPTB). Identifying meaningful biomarkers is essential for improving diagnosis, disease staging, and predicting treatment outcomes.
Abstract:
Methods: We measured a panel of 27 inflammatory cytokines, soluble receptors, and lipid mediators in the peripheral blood of PTB ($n=94$) and EPTB ($n=50$) patients from a prospective cohort in China. Samples were collected before treatment and at weeks 2, 8, and 24 of antitubercular therapy (ATT).
Results: M. tuberculosis infection induced distinct expression and correlation profiles in PTB compared to EPTB. High mycobacterial loads in sputum were linked to increased IL-1$\beta$, IFN-$\alpha$, IL-10, and PGF2$\alpha$. While ATT triggered early changes in plasma markers for PTB patients (as early as 2 weeks), these responses were delayed in EPTB patients. Exploratory analyses showed a persistent “inflammatory imprinting,” with 89.7% of PTB and 94.7% of EPTB patients still molecularly perturbed after 24 weeks of treatment.
Conclusion: These findings highlight systemic and durable changes in inflammatory profiles that persist despite successful treatment, emphasized by the role of bacterial burden and disease site in modulating immune biomarkers.
Keywords: Cytokines; Lipid mediator; Inflammation; Mycobacterium tuberculosis; Acid-fast bacilli; Extrapulmonary tuberculosis.
Clique aqui
- Data de Publicação: 10/06/2019
- Autores: Caian L. Vinhaesa,b,c,1 , Deivide Oliveira-de-Souzaa,b,c,1 , Paulo S. Silveira-Mattosa,b,c , Betania Nogueirab , Ruiru Shid , Wang Weid , Xing Yuand , Guolong Zhange , Ying Caif , Clifton E. Barry IIIf , Laura E. Viaf , Kiyoshi F. Fukutania,b,c , Bruno B. Andradea,b,c,g,h,i,j,⁎,2 , Katrin D. Mayer-Barberk,⁎,2
