1
|
Kulkarni S, Arunachala S, Chaya SK, ShankaraSetty RV, Karnik M, Bansal N, Ravindran S, Lokesh KS, Mohan M, Kaleem Ullah M, Siddaiah JB, Mahesh PA. The Assessment of Serum Fibronectin Levels as a Potential Biomarker for the Severity of Drug-Sensitive Pulmonary Tuberculosis: A Pilot Study. Diagnostics (Basel) 2023; 14:50. [PMID: 38201359 PMCID: PMC10804257 DOI: 10.3390/diagnostics14010050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 12/18/2023] [Accepted: 12/22/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Tuberculosis (TB) is a global health burden caused by Mycobacterium tuberculosis (Mtb) infection. Fibronectin (Fn) facilitates Mtb attachment to host cells. We studied the Fn levels in smear-positive TB patients to assess its correlation with disease severity based on sputum smears and chest X-rays. METHODS Newly detected consecutive sputum AFB-positive pulmonary TB patients (n = 78) and healthy control subjects (n = 11) were included. The mycobacterial load in the sputum smear was assessed by IUATLD classification, ranging from 0 to 3. The severity of pulmonary involvement was assessed radiologically in terms of both the number of zones involved (0-6) and as localized (up to 2 zones), moderate (3-4 zones), or extensive (5-6 zones). The serum human fibronectin levels were measured by using a commercially available enzyme-linked immunosorbent assay (ELISA) kit (Catalogue No: CK-bio-11486, Shanghai Coon Koon Biotech Co., Ltd., Shanghai, China). RESULTS The PTB patients showed lower Fn levels (102.4 ± 26.7) compared with the controls (108.8 ± 6.8), but they were not statistically significant. Higher AFB smear grades had lower Fn levels. The chest X-ray zones involved were inversely correlated with Fn levels. The Fn levels, adjusted for age and gender, decreased with increased mycobacterial load and the number of chest radiograph zones affected. A Fn level <109.39 g/mL predicted greater TB severity (sensitivity of 67.57% and specificity of 90.38%), while a level <99.32 pg/mL predicted severity based on the chest radiology (sensitivity of 84.21% and specificity of 100%). CONCLUSIONS The Fn levels are lower in tuberculosis patients and are negatively correlated with severity based on sputum mycobacterial load and chest radiographs. The Fn levels may serve as a potential biomarker for assessing TB severity, which could have implications for early diagnosis and treatment monitoring.
Collapse
Affiliation(s)
- Shreedhar Kulkarni
- Department of Respiratory Medicine, JSS Medical College, JSS Academy of Higher Education and Research, Mysore 570015, India (S.A.); (R.V.S.); (S.R.)
| | - Sumalatha Arunachala
- Department of Respiratory Medicine, JSS Medical College, JSS Academy of Higher Education and Research, Mysore 570015, India (S.A.); (R.V.S.); (S.R.)
- Public Health Research Institute of India, Mysore 570020, India
- Department of Critical Care Medicine, Adichunchanagiri Institute of Medical Sciences, Bellur 571448, India
| | - Sindaghatta Krishnarao Chaya
- Department of Respiratory Medicine, JSS Medical College, JSS Academy of Higher Education and Research, Mysore 570015, India (S.A.); (R.V.S.); (S.R.)
| | - Rekha Vaddarahalli ShankaraSetty
- Department of Respiratory Medicine, JSS Medical College, JSS Academy of Higher Education and Research, Mysore 570015, India (S.A.); (R.V.S.); (S.R.)
| | - Medha Karnik
- Centre for Excellence in Molecular Biology and Regenerative Medicine (A DST-FIST Supported Center), Department of Biochemistry (A DST-FIST Supported Department), JSS Medical College, JSS Academy of Higher Education and Research, Mysore 570015, India; (M.K.)
| | - Nidhi Bansal
- Department of Respiratory Medicine, JSS Medical College, JSS Academy of Higher Education and Research, Mysore 570015, India (S.A.); (R.V.S.); (S.R.)
| | - Sukanya Ravindran
- Department of Respiratory Medicine, JSS Medical College, JSS Academy of Higher Education and Research, Mysore 570015, India (S.A.); (R.V.S.); (S.R.)
| | - Komarla Sundararaja Lokesh
- Department of Respiratory Medicine, JSS Medical College, JSS Academy of Higher Education and Research, Mysore 570015, India (S.A.); (R.V.S.); (S.R.)
| | - Mikash Mohan
- Department of Respiratory Medicine, JSS Medical College, JSS Academy of Higher Education and Research, Mysore 570015, India (S.A.); (R.V.S.); (S.R.)
| | - Mohammed Kaleem Ullah
- Centre for Excellence in Molecular Biology and Regenerative Medicine (A DST-FIST Supported Center), Department of Biochemistry (A DST-FIST Supported Department), JSS Medical College, JSS Academy of Higher Education and Research, Mysore 570015, India; (M.K.)
- Division of Infectious Disease and Vaccinology, School of Public Health, University of California, Berkeley, CA 94720, USA
| | - Jayaraj Biligere Siddaiah
- Department of Respiratory Medicine, JSS Medical College, JSS Academy of Higher Education and Research, Mysore 570015, India (S.A.); (R.V.S.); (S.R.)
| | - Padukudru Anand Mahesh
- Department of Respiratory Medicine, JSS Medical College, JSS Academy of Higher Education and Research, Mysore 570015, India (S.A.); (R.V.S.); (S.R.)
| |
Collapse
|
2
|
Scott LE, Shapiro AN, Da Silva MP, Tsoka J, Jacobson KR, Emch M, Moultrie H, Jenkins HE, Moore D, Van Rie A, Stevens WS. Integrating Molecular Diagnostics and GIS Mapping: A Multidisciplinary Approach to Understanding Tuberculosis Disease Dynamics in South Africa Using Xpert MTB/RIF. Diagnostics (Basel) 2023; 13:3163. [PMID: 37891984 PMCID: PMC10606157 DOI: 10.3390/diagnostics13203163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 08/30/2023] [Accepted: 09/14/2023] [Indexed: 10/29/2023] Open
Abstract
An investigation was carried out to examine the use of national Xpert MTB/RIF data (2013-2017) and GIS technology for MTB/RIF surveillance in South Africa. The aim was to exhibit the potential of using molecular diagnostics for TB surveillance across the country. The variables analysed include Mycobacterium tuberculosis (Mtb) positivity, the mycobacterial proportion of rifampicin-resistant Mtb (RIF), and probe frequency. The summary statistics of these variables were generated and aggregated at the facility and municipal level. The spatial distribution patterns of the indicators across municipalities were determined using the Moran's I and Getis Ord (Gi) statistics. A case-control study was conducted to investigate factors associated with a high mycobacterial load. Logistic regression was used to analyse this study's results. There was striking spatial heterogeneity in the distribution of Mtb and RIF across South Africa. The median patient age, urban setting classification, and number of health care workers were found to be associated with the mycobacterial load. This study illustrates the potential of using data generated from molecular diagnostics in combination with GIS technology for Mtb surveillance in South Africa. Spatially targeted interventions can be implemented in areas where high-burden Mtb persists.
Collapse
Affiliation(s)
- Lesley Erica Scott
- Wits Diagnostic Innovation Hub, Faculty of Health Science, University of the Witwatersrand, Johannesburg 2093, South Africa; (M.P.D.S.); (J.T.); (W.S.S.)
| | - Anne Nicole Shapiro
- Department of Biostatistics, Boston University School of Public Health, Boston, MA 02118, USA; (A.N.S.); (H.E.J.)
| | - Manuel Pedro Da Silva
- Wits Diagnostic Innovation Hub, Faculty of Health Science, University of the Witwatersrand, Johannesburg 2093, South Africa; (M.P.D.S.); (J.T.); (W.S.S.)
- National Priority Program of the National Health Laboratory Services (NHLS), Johannesburg 2131, South Africa
| | - Jonathan Tsoka
- Wits Diagnostic Innovation Hub, Faculty of Health Science, University of the Witwatersrand, Johannesburg 2093, South Africa; (M.P.D.S.); (J.T.); (W.S.S.)
| | - Karen Rita Jacobson
- Division of Infectious Diseases, Boston Medical Center, Boston, MA 02118, USA;
| | - Michael Emch
- Department of Epidemiology, University of North Carolina School, Chapel Hill, NC 27127, USA;
- Department of Geography and Environment, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Harry Moultrie
- National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg 2192, South Africa;
| | - Helen Elizabeth Jenkins
- Department of Biostatistics, Boston University School of Public Health, Boston, MA 02118, USA; (A.N.S.); (H.E.J.)
| | - David Moore
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK;
| | - Annelies Van Rie
- Faculty of Medicine and Health Sciences, University of Antwerp, 2000 Antwerpen, Belgium;
| | - Wendy Susan Stevens
- Wits Diagnostic Innovation Hub, Faculty of Health Science, University of the Witwatersrand, Johannesburg 2093, South Africa; (M.P.D.S.); (J.T.); (W.S.S.)
- National Priority Program of the National Health Laboratory Services (NHLS), Johannesburg 2131, South Africa
| |
Collapse
|
3
|
Zhang YM, Wang F, van Soolingen D, Anthony RM. The impact of diabetes mellitus on pulmonary TB. Public Health Action 2022; 12:64-67. [PMID: 35734008 PMCID: PMC9176187 DOI: 10.5588/pha.21.0070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 02/03/2022] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To compare the clinical characteristics and laboratory results of pulmonary TB (PTB) patients with and without diabetes mellitus (DM) and the relationship between haemoglobin A1C (HbA1c) concentration and mycobacterial load at county level area in Sichuan Province, China. METHODS A retrospective study was performed from January 2018 to July 2019 inJianyang People's Hospital, Sichuan Province. Clinical characteristics and laboratory results of newly diagnosed TB patients were collected. Univariable and multivariable logistic regression analyses were performed. The Kruskal-Wallis test was used to compare HbA1c level and mycobacterial load. RESULTS The final sample included 415 patients with TB, of whom 45 were diagnosed with DM (10.8%). Uni-variable logistic regression showed that PTB patients with concomitant DM were more likely to present with haemoptysis, positive acid-fast bacilli (AFB) smear, cavity, higher erythrocyte sedimentation rate (ESR), higher serum C-reactive protein (CRP), lower serum albumin (ALB), or higher fasting blood glucose (FBG). Multivariate logistic regression analyses showed that AFB smear positivity (OR 15.81, 95% CI 3.09-80.95) and FBG (OR 1.88, 95% CI 1.53-2.31) were independent risk factors of DMPTB. The mycobacterial load was heaviest when the HbA1c was 7.9 mmol/L (95% CI 7.35-11.1) and declined along with HbA1c rising up. But it has not been significantly associated with HbA1c. CONCLUSIONS Patients with PTB over 45 years old, with haemoptysis, positive AFB, cavity, higher ESR, higher CRP, lower ALB or higher FBG are more likely to present with concomitant DM. Patients with PTB with these factors need to be targeted for DM screening. The mycobacterial load has not been significantly associated with HbA1c.
Collapse
Affiliation(s)
- Y. M. Zhang
- People’s Hospital of Jianyang City, Hospital Road 180#, Jianyang City, Chengdu, Sichuan Province, China
| | - F. Wang
- People’s Hospital of Jianyang City, Hospital Road 180#, Jianyang City, Chengdu, Sichuan Province, China
| | - D. van Soolingen
- Tuberculosis Reference Laboratory, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - R. M. Anthony
- Tuberculosis Reference Laboratory, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| |
Collapse
|
4
|
Bisognin F, Amodio F, Lombardi G, Bacchi Reggiani ML, Vanino E, Attard L, Tadolini M, Re MC, Dal Monte P. Predictors of time to sputum smear conversion in patients with pulmonary tuberculosis under treatment. New Microbiol 2019; 42:171-175. [PMID: 31157399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 09/10/2019] [Indexed: 06/09/2023]
Abstract
Sputum acid-fast bacilli smear conversion is a fundamental index of treatment response and reduced infectivity in patients with pulmonary tuberculosis (P-TB). To date, there are no models to predict the time to sputum conversion based on patient characteristics. This study aims to ascertain the time to sputum conversion in patients with smear-positive P-TB under treatment, and the variables associated with time to smear conversion. We retrospectively evaluated the time to sputum smear conversion of 89 patients with smear-positive P-TB undergoing treatment at the S. Orsola-Malpighi University Hospital, Bologna (Italy), a referral centre for the diagnosis of TB. Multivariate Cox regression analysis was performed to document variables independently associated with time to conversion. Median time to sputum smear conversion was 24 days (IQR 12-54); the sputum smear converted within the first 2 months of treatment in 78.7% patients. Multivariate Cox regression analysis showed that older age, high baseline mycobacterial load detected by Xpert MTB/RIF, and severity of lung involvement are predictors of persistent smear positivity. The identification of risk factors delaying smear conversion allowed us to develop predictive models that may greatly facilitate the management of smear-positive patients in terms of the duration of respiratory isolation and treatment.
Collapse
Affiliation(s)
- Francesco Bisognin
- Department of Experimental, Diagnostic and Specialty Medicine - Unit of Microbiology, S. Orsola-Malpighi University Hospital, Bologna, Italy
| | - Francesco Amodio
- Department of Medical and Surgical Sciences - Unit of Infectious Diseases, S. Orsola- Malpighi University Hospital, Bologna, Italy
| | - Giulia Lombardi
- Department of Experimental, Diagnostic and Specialty Medicine - Unit of Microbiology, S. Orsola-Malpighi University Hospital, Bologna, Italy
| | - Maria Letizia Bacchi Reggiani
- Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola-Malpighi University Hospital, Bologna, Italy
| | - Elisa Vanino
- Department of Medical and Surgical Sciences - Unit of Infectious Diseases, S. Orsola- Malpighi University Hospital, Bologna, Italy
| | - Luciano Attard
- Department of Medical and Surgical Sciences - Unit of Infectious Diseases, S. Orsola- Malpighi University Hospital, Bologna, Italy
| | - Marina Tadolini
- Department of Medical and Surgical Sciences - Unit of Infectious Diseases, S. Orsola- Malpighi University Hospital, Bologna, Italy
| | - Maria Carla Re
- Department of Experimental, Diagnostic and Specialty Medicine - Unit of Microbiology, S. Orsola-Malpighi University Hospital, Bologna, Italy
| | - Paola Dal Monte
- Department of Experimental, Diagnostic and Specialty Medicine - Unit of Microbiology, S. Orsola-Malpighi University Hospital, Bologna, Italy
| |
Collapse
|